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Handling TMJ (Temporo-Mandibular Joint) problems






Dear Choralist,

Wow! My request for information about jaw problems in singers
clearly touched a nerve! Not literally.

We have a singer who has been diagnosed with TMJ, and I asked:
>(1) Has anyone seen something like this and seen it improve -- if
>so, what happened?, and (2) What sort of doctor deals with this sort
>of question -- physical therapist?

Our singer had also wondered if a volleyball injury had anything to do with it.

Here are the replies I got. I'm too swamped to annotate or organize
them, but I encourage anyone interested to read them all. There are
valuable differences of opinion, experience, perspective and
expertise.


From Guy Durward :
>I have TMJ also and this has resulted in one side of my jaw being
>shaped differently from the other. It was not, however, a result of
>an injury....it resulted from grinding and clenching my teeth while
>I sleep. I suspect this may be the case with your girl also, as it
>can be a mark of tension and may also be genetic. (My mom, an opera
>singer, does this also.)
>
>The solution was to see an orthodontist, who made a night guard (in
>my case, a particular type called an Essex) for the lower and upper
>jaws. This has made a great deal of difference, in that it both
>prevents the grinding and breaks the habit. I would suggest that
>she get an orthodontic consultation. This can be fairly expensive,
>but is covered by some insurances and, in any case, is well worth
>it, because TMJ can cause all sorts of problems later on, including
>substantial dental repair which I have had to have.


From Carol Clary :
>This condition is not uncommon. I see variations of TMJ very often in my
>college voice students and in my private studio. And, I am a TMJ survivor
>and finishing my doctorate in voice at the University of Southern California.
>
>I believe that there was an article in the NATS (National Association of
>Teachers of Singing) Journal in the last 3 years on this topic.
>
>Your singer should seek out a dentist whose specialty is in treating TMJ.
>Younger dentists in So. California routinely get this training so I am sure
>there must be someone in your area who has the extra knowledge. This dentist
>should give your student some exercises to stretch and release the muscles of
>jaw joints. Sometimes, bio feedback is necessary to change habitual
>offending bite or movement patterns. Often, a casting is made of the teeth,
>and the patient is fitted with a bite plate to wear at night. Additionally,
>planing (grinding off, uneven biting surfaces) to make a better bite pattern
>is usually done. Sometimes braces are necessary to move teeth into better
>alignment. In any case, this student should immediately stop chewing gum,
>ice and hard candy and take care of the problem. Untreated, TMJ causes
>headaches, deterioration of chewing surfaces, loss of high and low notes, not
>to mention a free functioning voice, clear articulation and resonating space.
> Vocal tone will usually be tight, limited and strident. And vocal progress
>will be very slow or actually worsen.
>Poor body balance (posture) with a forward neck and/or collapsed chest also
>aggravate the problem.
>
>Good luck with your student.
>
>Carol Clary
>Instructor at East Los Angeles Community College
>Formerly Adjunct Assistant Professor at California State University, Los
>Angeles
>Member of NATS


From Charles Rusizca :
>Nina: I feel that the "three fingers" concept is really not an accurate
>bench-mark as to the space needed to sing properly. Some folks have large
>hands/fingers and cannot place three-fingers in their mouth. I strongly
>believe that if the jaw is unhinged--you can do this by placing your index
>fingers in front of the ear holes and dropping the jaw. You will feel your
>fingers go in behind the jaw joint/hinge. Thus, the jaw is unhinged. I
>have found much success with this technique. If the jaw is dropped too
>far, the back of the throat tends to close and thus, tension results.
>
>Only my thought. It might be worth experimentation.
>
>Best regards,
>
>CR


From Frank Albinder :
>Tell her not to open her mouth so wide! When I was in elementary school
>choir, we had the "three finger rule." It's ridiculous. Stick three
>fingers in your mouth and try and sing! It's painful, even if everything's
>normal. This reminds me of the guy who goes to the doctor and tells him
>that it hurts when he sticks his arm over his head. The doctor tells him
>not to stick his arm over his head.
>
>Of course, if she has TMJ, forcing the jaw open so wide to sing will
>exacerbate the problem. I say go with common sense and when it hurts, don't
>do it!



From Peter Koster :
>RECOMMENDATIONS FROM PRESCRIPTION FOR NUTRITIONAL HEALING BOOK - TMJ
>IS NOT THE
>ONLY DISORDER THAT CAUSES JOINT PAIN. ANOTHER POSSIBLE CAUSE IS RHEUMATOID
>ARTHRITIS. IF SYMPTOMS ARE MORE SEVERE IN THE MORNING AND TEND TO
>EASE SOMEWHAT
>AS THE DAY GOES ON THEN R.A. COULD BE THE PROBLEM. IF TMJ IS CONFIRMED, 90
>PERCENT OF ALL CASES RESPOND TO SIMPLE INEXPENSIVE TREATMENT AND
>SURGERY SHOULD
>BE LAST RESORT SOLUTION. IF PERSON TENDS TO CLENCH AND GRIND TEETH
>THEN A SPECIAL
>BITE PLATE THAT IS WORN AT NIGHT MIGHT HELP. PHYSICAL THERAPY IS BECOMING THE
>MOST WIDELY RECOGNIZED VIABLE TREATMENT FOR TMJ. THIS MAY INVOLVE
>JAW AND TONGUE
>EXERCISES TO RETRAIN STRESSED MUSCLES, USE OF A TENS MACHINE, ULTRASOUND AND
>BIOFEEDBACK TREATMENT. 2,000 MG OF CALCIUM AND MAGNESIUM DAILY WITH VITAMIN
>B COMPLEX (100 MG) 3 TIMES DAILY. AVOID ALL SUGAR AND WHITE FLOUR PRODUCTS,
>ALL CAFFEINE ITEMS AND FAST FOOD AND JUNK FOOD. DO NOT CHEW GUM AND
>AVOID OVERLY
>CHEWY FOODS SUCH AS RED MEAT AND BAGELS. EXPERIMENT WITH HOT AND COLD THERAPY
>WHICHEVER WORKS BEST. IF POSSIBLE SEEK HELP FROM PRACTIONERS WITH A
>UNIVERSITY
>DENTAL OR MEDICAL SCHOOL.


From Joellen Patterson :
>Having worked for a physical therapist that worked with the TMJ
>problems, either a PT or even a massage therapist could help with
>the muscular problems related to it.
>
>I have had friends who are both teachers and singers who ended up
>with nodes on their vocal chords that had to go to speech therapists
>with specialties in working with singers. I think it might be worth
>a try to seek out such a specialist in your area and see if they
>have any ideas. Maybe positioning when she speaks and sings could be
>adjusted....
>
>I bet a good oral surgeon, or perhaps better, a good orthopedist
>could help come up with a non-surgical treatment plan.
>
>I don't know if perhaps even a rheumatologist might be a good idea.....


From Gillian Brinston :
>I too suffer from TMJ. I was diagnosed at the age of 12 and have been
>wearing a night splint for ten years. The splint is made out of a hard
>plastic and was constructed by an orthodontic surgeon. The Doctor gave me a
>series of exercises to do to relieve the muscle tension. When I was first
>diagnosed I could open my jaw to 22 millimeters measuring from the bottom of
>my top teeth to the top of my bottom. I now can open up 28-30mm depending
>if I have been wearing my splint all the time. The splint cost approx. $400
>Canadian and I had to replace it after six years. Some guidelines Megan can
>follow are:
>1. do not chew gum at all cost
>2. avoid hard candy and toffee
>3. make sure food is cooked to an easily chewable state
>4. Don't stop singing. By giving in we are not exercising our jaws, just
>letting them seize up.
>4. Try Ibuprofen for the pain verses acetaminophen or aspirin because it is
>an anti-inflammatory. If it gets worse a Doctor can prescribe Voltarine.
>
>TMJ is caused by clenching our teeth or grinding them when we sleep.
>Depending which way you grind will depend on which side of your jaw will be
>more affecting. It is probably safe to say the Megan did not injure her jaw
>playing volleyball, the ball very soft and your bones are fairly strong.
>The TMJ, I am sure, has come from years and years of grinding and clenching.
>
>I hope this helps. If you have any more question, please do not hesitate to
>ask.


From larsonsean(a)aol.com:
> We have a son that is, now, a opera singer - he suffered with TMJ
>(in high school) until he started wearing a guard at night. He felt
>so much better & could open his mouth much wider during the day,
>when he wore the brace that fit over his teeth at night.
>
>Also this jaw problem would show up big time when he was under a lot
>of stress. It's funny how things like that happen. Stress is an
>underlying cause of alot of ailments.
>
>I must tell you that most insurances do not cover TMJ. The
>insurance Co. thinks it's a dumping ground for jaw related things
>that are unexplainable.
>
>Good luck with this problem.
>
>larsonsean(a)aol.com


From Hakan Lindberg :
>My name is Hakan, from sweden who joins the chorallist.
>I read your mail about the jaw problem on one of your singers.
>I also sing in a choir and I have found out that my jaw wants to
>move just a little to the side, also resulting in a small "klick",
>(just hearable in my head) , I asked a dentist and he told me it was
>beacuse of one of my wisdomtoth growing sideways in my upper jaw.
>I dont now if you can have any help out of my letter but i hope your
>choralsinger get better.
>Hope you understand my english.
>Yours sincerely.
>Hakan Lindberg.


From Sharyn Baker :
>I have a similar problem with a hole in the disc in my jaw. I had dye
>injected into the joint to see all this. It probably arose because someone
>hit me in the jaw with a frying pan as a kid, and I too was hit by a
>softball on the jaw when I was older. I sang in the Occidental Glee Club and
>elsewhere and still sing.
>
>The condition also limits my ability to drop my jaw so far. But I believe
>that with good training and an understanding of the problem, that she can
>continue to sing and sing well. Sometimes people overly drop the jaw anyway.
>So some of the suggestions I have are that she learn to stifle her yawns a
>little, that she eats a little less food that is tough to chew and that she
>massage her jaw while practicing. I would also suggest ice alternated with
>heat for the jaw and perhaps even some sort of anti-inflammatory. Is she has
>a broken bone that needs to be fixed. But otherwise, I would caution her to
>get lots of opinions before she opts for any kind of surgery. Usually, these
>kinds of surgery then require that the teeth be realigned and all of a
>sudden, one is into thousands and thousands of dollars in bills and years of
>braces etc. In my situation, I decided I would live with the problem. Often,
>such surgeries are not successful and one is trading one kind of discomfort
>for another.
>
>I hope this helps. If she can get two fingers in her mouth, that should
>still enable her to sing well.
>Sharyn Baker
>Colorado


From David Schildkret :

>My daughter, who is now 11, was discovered to have what sounds
>marginally like a
>similar condition when she was about 8. In her case, the condiles
>of the lower
>jaw (the curved part of the bone at the top) did not develop properly. The
>result is that her jaw is slung back, giving her a tremendous overbite. She
>wears an orthodontic appliance at night to try to correct the
>problem; she will
>eventually need surgery (which is horrifying: it involves breaking the jaw).
>
>My suggestion is to get her to a good orthodontist. He or she may
>have more to
>suggest. Speech/voice therapists may have some experience as well. But I'd
>certainly start with an orthodontist. I'm surprised the dentist
>didn't suggest
>that....
>....
>Best of luck to her. It was a real trauma for us when we learned of our
>daughter's difficulty (we thought we were going for braces, and this guy
>starts talking about degenerative diseases...thank goodness it has
>turned out NOT to be that!). The advice to stop singing when it hurts
>is outrageous.
>
>Here in Winston-Salem, there is a very fine otolaryngology team that
>specializes in the singing voice. I wonder if somewhere near you--like
>at University of Pennsylvania, or even in New York, there would be a
>person who specializes in singers' problems who might have some
>insight? Worth asking around.


From Judith Higbee :
> I have had TMJ and when the dentist x-rayed he found that the painful
>side was flattened (no point however.) It is from wear and tear. A BIG
>factor is teeth-grinding at night. My dentist said that at first people
>deny it (as i did) but as then become more aware, they realize they are
>doing it. They may also wake up with headaches. After a round of
>prescription anti-inflammatories it improved and I also made a conscious
>effort to relax my jaw as I went to sleep. I haven't had a problem in over
>a year.
>Once before when I had it, I was eating hurriedly and chomping on a hot dog
>rather vigorously (because of a tense conversation.) This and eating hard
>rolls also kicked it off.
>I don't think that surgery would be my first choice, either.
>Hope this helps.


From Tina Thielen-Gaffey :
>I can give a little advice, as I have TMJ myself. I had huge issues
>with it as an undergrad and went through all of the pre-surgery
>things.....mouth splints, therapy, medication. However, my situation
>sounds a little like your sopranos......screwed up joint, not just a
>misalignment. Even though you say she was hit on the non troubled side,
>it could have knocked her out of alignment and that is the side that was
>affected. One of the first things they ask when you are having clicking
>and jaw issue is have you been in an accident or been hit in the face.
>I think there is much to be said for the fact that she was hit in the
>face, although I am no doctor! I ended up having "exploratory" surgery
>and they ended up putting in an artificial disc, as I didn't have one
>when they opened me up. They did surgery on the other side a few months
>later.
>
>I know the rule is avoid surgery as much as possible, but for me,
>surgery was a Godsend. I don't know how I could have functioned without
>it. I felt tremendously better, even as early as the recovery room. My
>face hurt, but my joints felt soooooooooooooooooooooooo much better, so
>I don't know that I would worry so much if surgery should happen. Of
>course, doctors know best. I did end up having a few more surgeries,
>mostly due to implant issues and bone splints, but I still feel a whole
>lot better. I have limited movement from side to side due to scar
>tissue, but I am able to open as wide as I need to function well as a
>singer. I do get headaches from it, but a good dose of Ibuprofen always
>does the trick. I have perscription doses in 800 mg and it always
>works.
>
>I hope this helps you understand a little better. I am happy to help in
>anyway.


From Brian Russell :
>I, too, have suffered from TMJ and might have some
>helpful information.
>
>In college, my jaw was locked (no more than one
>finger-wide opening) for about three months. All this
>was preceeded by years of popping and pain.
>
>Finally, I went to a specialist at Vanderbilty
>University Hospital (Nashville, TN) where I was to
>undergo surgery. My jaw bone, too, had been tapered
>just as you described about your student's. The
>surgery was to be as follows:
>
>The doctor was goin to make a vertical incision in my
>jawbone, then lower the upper portion of the bone,
>therby increasing the amount of space betweeen the
>"ball" and "socket." I was then going to have to have
>my mouth wired shut for six months.
>
>When he put me under for the procedure, he needed a
>few measurements of how far the opening was before and
>after. After he took the "before" measurement, he
>began applying pressure to see if he could force it
>open anymore. As he did, the cartilage between the
>ball and the socket, which was getting caught and
>making my jaw lock, ripped into three pieces! With
>the now smaller pieces, he was able to open my jaw
>back to its original size. He did not go ahead with
>the procedure but decided to see how it played out. I
>wake up every morning with my jaw locked, but it is
>easily unlocked. I enjoy a healthy career in singing
>and am pain free. The surgery was four years ago.
>
>Sorry for the long email, but I hope you can find some
>usefullness in here somewhere. Go to a specialist and
>ask about options - you might get lucky like me!
>
>Sorry for all the misspelled words and grammatical
>errors - I write this in haste, as such I end it also.


From Linda Tedford :
>Last spring I was in rehearsal, opened my mouth a little too far and felt a
>def. crack in my right jaw. Over the summer it got worse, though I could
>still sing.
>Went to my dentist who diagnosed TMJ and made a device for me to wear almost
>constantly. It got much worse...I could not sing, had a hard time speaking
>to large groups..ie my choirs, and teaching voice lessons. It did improve
>immensely with my wearing the device, and over Christmas when I didn't do
>any rehearsals or lessons...had a month off...It feels a lot better, though
>still not back to normal. I have noticed that my jaw is "wierd...ie one
>side is higher than the other..whether that will resolve, I don't know.: do
>you want info from my dentist?
>Linda TEdford
>It's very aggravating, frustrating, depressing.


From Brenda Kayne :
>My niece has had TMJ for years and did recently have surgery. She is now in
>the mending process. She lives far from me and I was not aware that she was
>going to have the surgery - it seems so drastic. I think, however, that she
>is going to recuperate well IF and only if, she learns how not to carry
>tension in that part of the body. I truly believe that things like,
>massage, accupressure, yoga, and meditation - and a less stressful
>lifestyle - will help her. Even more important, (and if she were a singer
>I'd love to help her), is how she uses her breath and I mean every day
>breath. I think the phrase, "breathe into the area of pain" can be helpful
>to releasing that stiffness.
>
>It's amazing how badly singers can breathe - especially the dedicated ones
>who want to do well. I myself used to sing with a forward jaw in efforts to
>produce a good tone (there again, it was a matter of not relying upon the
>breath and lower support). I would get a very sore jaw.
>
>Another constant image that should be in the minds of someone with TMJ is
>that the jaw is a hinge - it falls back and does not just "opens wide". I
>think this is very important.
>
>In the case of your singer, it seems that if her jaw was hurt by injury,
>that she really should check out surgery or some kind of specific therapy to
>get back on track. This sounds like one for the specialists! I know that
>my niece will be having physical therapy soon. Don't know what she will be
>asked to do - but I'll be seeing her in February if you are interested in
>knowing about it.
>
>Brenda C. Kayne


From Emily McDuffee :
>I am a music ed student/singer in college, and I have TMJ, but not
>too the point that your student does. My jaw clicks to its most
>open and then clicks back to close, so I cannot open it all the way
>while singing, and I have just learned to compensate - and that is
>why I tend to put too much control in my jaw. So, my dentist has
>fitted me for a splint that looks like a football mouthgard that I
>will wear to bed and it will hopefully remove some of the tension in
>my jaw and relieve that pressure. He also told me that orthodontics
>can help, but I already went through my three years of that in
>junior and senior high. So, have her ask her dentist about a night
>splint and maybe a retainer.


From Tim Hendrickson :

>I don't know if I have an answer for you or not, but perhaps this
>information will help.
>
>My wife, who is also a singer - was diagnosed with TMJ a little over a year
>ago. She has almost the exact same problem - she used to be able to place
>three fingers in the space of her open mouth - and then it gradually became
>less.
>
>Singing has been extremely difficult for her. She has been to several
>different specialists and all but one said the same thing - surgery. A
>process in which they actually go in and break the jaw, re-set it, and then
>wire it shut. (Hence - realigning the jaw bones)
>
>Since this was not an option we were very enthused about, we sought the help
>of a different specialist. As it turns out, this new specialist offered a
>completely different approach - physical therapy!
>
>I scoffed at the idea at first - thinking that some type of oral surgery
>would ultimately be necessary. This doctor said the problem wasn't with the
>"jaw" but with my wife's spine. She began stretching my wife's back, arms,
>legs and had her sleeping with a special orthopedic pillow - ONLY on her
>BACK not on her SIDE. This method did in fact begin to correct her
>misaligned jaw bones - and her teeth began to meet properly.
>
>Within a month we noticed a marked improvement. The "click" that she would
>feel when opening her mouth wide to sing, or to eat was gone - and she has
>gained much of her unrestricted movement back.
>
>I don't know if this helps you or your student - but I strongly advise
>AGAINST any type of oral surgery if this physical therapy process will work
>in her case. I would seek the advice of a muscular/bone specialist BEFORE
>going to an oral surgeon.
>
>Hope this helps. I will be glad to give you the name of the physician my
>wife was seeing here in Michigan, if it will be of help.


From Michelle Feiszli :
>Your e-mail was forwarded to me by Jim. Your question is an
>interesting one and I believe I can give you some information that may
>be helpful.
>
>I am 30 years old and a singer. I have dealt with jaw problems most
>of my adult life. Originally it was thought that I just had a severe
>over-bite and an open-bite. (Open-bite is when the front incisors do
>not touch when biting into something, like a piece of lettuce.)
>
>While I was working for one of the top orthodontists in this country
>(Dr. James Evans, Rapid City, South Dakota), I had him look at my jaw
>for possible orthodontics to correct my bite. (side note: he treated
>me when I was a child and was interested in the fact that I had
>significant relapse - even with his excellent treatment.)
>
>After several series of x-rays, tomograms, and a visit to a
>maxillofacial surgeon, I was diagnosed with Idiopathic Condylar
>Resorption. It is a condition which causes TMJ-like symptoms (pain,
>clicking, & locking of the jaw joint) and affects women at precisely
>Megan's age, 18-24 years old.
>
>By definition, Idiopathic Condylar Resorption is "a progressive
>alteration of the condylar shape and decreased mass bilaterally, in
>temporomandibular joints that previously exhibited normal growth
>patterns with no identifiable precipitating event."
>
>The condyles of my temporomandibular joint are shaped like a spike and
>are nearly non-functional. I experience severe jaw pain and headaches
>which I've learned to control with medication and by wearing a
>jaw-splint called a "twin-block appliance" at night. It helps prevent
>clenching and grinding and works to move my jaw forward, relieving
>much of the pain. I've had quite a bit of success with this
>management.
>
>Having discovered that I am not a surgical candidate due to my age and
>the advancement of the condition, I have learned to "sing around" the
>problem. I have discovered internal resonance, the importance of
>relaxation of the vocal cords and jaw (I let my lower body do all the
>work!:)), tongue placement, and soft palate flexibility.
>
>You mentioned "three fingers vs. two" for space in the mouth. I have
>found
>that to be a great source of jaw tension and creates a "swallowed"
>sound. I've tried thinking of "lifting the upper back molars" like
>there is something pushing up in the back, rather than opening the
>mouth more in the front. This may help Megan with some of the pain
>she is experiencing.
>
>I would recommend she continue to seek answers to her problem at this
>early age. You wrote:
>
> > I guess our questions are: (1) Has anyone seen something like this
> > and seen it improve -- if so, what happened?,
>
>The situation *can* improve depending on the form of therapy chosen.
>There are surgical solutions that may not be the "last resort", based
>on the latest research. There is also *management* of the symptoms -
>which is what I do.
>
> >and (2) What sort of
> > doctor deals with this sort of question -- physical therapist?
>
>I've not seen a physical therapist (not that I don't recommend it) but
>I would suggest she see an orthodontist and an oral surgeon to
>evaluate several things. 1) the current condition of her TMJ 2)a
>"base-line" set of x-rays etc. 2) is it progressing and how fast 3)
>treatment vs. management.
>
>Go to www.uic.edu and take a look at the information there. At their
>home page type 'Idiopathic Condylar Resorption' into the search
>engine. It will bring up a very thorough research article on the
>subject.
>
>I hope this is helpful to you. I'd love to know what happens with
>Megan, as I am always looking for new ways to manage this problem!


From Joan Yakkey :
>I had a Aunt with this problem and she had to wear a dental corrrection
>apparatus all night as she slept to reset the jaw and the teeth to coincide.
>Your student needs to take care of this urgently because it will lead to
>terrible headaches as time goes on.


From Wendy Catlin :
>She might try a chiropractor(sp?) I had jaw problems after being hit on the
>one side-trouble started on the other, there is a muscle on the inside of
>the mouth in the back that she could learn to massage- and also try
>thinking of tension going to the other end of her body (like a big toe or
>something)


From Pat Lacey :
> May I add a note from my dentist that was news to me (she gave me a
>printout on things to avoid, etc., but this was her personal addition to the
>traditional warnings). Students (and all of us) often sit with our hand
>under our jaw, sort of like Rodain's (sp?) "Thinker". My dentist pointed out
>how this puts great pressure on the jaw, so should be avoided. You may pass
>that hint along to those fighting this battle.


From Laura Ann Horwitz :
>I recommend your student find a dentist who specializes in TMJ. What
>you describe are classic symptoms. I am a (professional) singer who
>has been treated for TMJ : treatment included being fitted for splints
>and eventually I wore braces (as a 35 year old!). It helped but never
>completed went away. (I did not have exactly the same symptoms you
>describe...but when I saw your subject 'jaw problems' I knew
>immediately it was a TMJ problem). Surgery was also a last resort
>option, which thankfully I never had to undergo.
>
>There is a TMJ clinic at UCLA~~ if you are unable to find a local
>specialist, maybe they can recommend someone in your area. Or check
>with local universities where there is a dental school.


From Stephanie Charbonneau :
>I am both a singer and choir director - and I have TMJ. It is irritating,
>however my doctors/dentists have all said that I just need to deal with it.
>I take ibuprofen when it gets really irritated - but they are mostly
>right...you just stop singing or eating when it gets really bad. Eating
>anything crunchy just makes it worse - so avoid those sorts of foods if it's
>already feeling bad. Currently, my jaw pops EVERY time I open it
>widely...singing or not. Most of the time when I'm singing I do not open it
>all the way - thus avoiding the 'pop'! It all started when, at the age of
>four, I hit my jaw on a hard surface. Then at age 12, following toe surgery
>(when they had my mouth propped open for the breathing tube) it's started
>getting irritate again. It's been a problem ever since.
>
>Wish her good luck - and let me know if you find any solutions!


I hope others find these replies as informative as we do!


With many thanks,

Nina Gilbert

--

-------------------------------------------------------------
| Nina Gilbert
| gilbertn(a)lafayette.edu
| Director of Choral Activities, Lafayette College
| Easton, Pennsylvania 18042-1768
| phone 610-330-5677
| fax 610-330-5058
| http://ww2.lafayette.edu/~gilbertn

on August 5, 2002 10:00pm
I would suggest that all persons with "TMJ"
or related problems (facial pain, tooth grinding,
headache, misalignment, etc.) should investigate
and consider trying CranioSacral Therapy (also
look into Myofascial Release therapy).

My own experience resulted from problems
in the lower back, hip, and leg. Eventually
this will pull the entire body out of line,
affecting and vocal production, including
your BREATHING.

There is a website (www.upledger.com),
put up by the Upledger Institute, that discusses
craniosacral therapy and other related
modalities; the site lists, by state,
the names and contact info on health-care
professionals who have studied at the
Upledger Institute, including the specific
courses of study that each has completed.

Practitioners who do craniosacral therapy
are usually osteopathic physicians (D.O.'s);
physical therapists; massage therapists;
chiropractors; dentists, or other licensed
health care practitioners.

In my opinion this vey simple, gentle,
non-invasive, and reasonably priced therapy
has great potential for singers with musculo-
skeletal and breathing problems.

I am not in any way qualified to deliver an
endorsement of the Institute, nor have I any
connection with them, but I have done a
considerable amount of reading on the
aubject of craniosacral therapy and since
many people have not yet heard of it, I
wanted to bring it to your attention.

-H.B. Andreasen







on March 20, 2004 10:00pm
I suffered with TMJ as a result of arthritis in my joint for years, having had the equilibration (grinding down of tooth surfaces) several times and finally wearing an orthodontic splint 24/7 for about 8 years. I was symptom-controlled, but could not go more than 1/2 hour without the splint without experiencing pain. It affected my singing a lot. The arthritis finally stabilized to the point where surgery was recommended. By this time, my face had become quite crooked. I was very uncertain about the surgery, and wondered if it would do any good. Thank God I had two wonderful doctors who were specially trained in this field. They cut completely through my upper jaw, took out about 3/8" of bone on one side and tapered it off to straighten it out. It was a tough recovery time, but boy was it worth it! Since that time I was able to go to college and major in music, spending sometimes as much as 2-3 hours/day singing. I never could have done that before! I now teach elementary music, sing all the time, and have no discomfort. I still wear a splint at night to keep things stable, NO CHEWING GUM, and I always cut up apples. Long story short--make sure you see a doctor who specializes in this. Too many family dentists like to play around with it and that only makes things worse.
on January 5, 2007 10:00pm


I am a musician who has spent a good deal of my life investigating the problems I've had with my head neck and spine which became intollerable after a neck manipultion 5 years ago. I trained as a teacher in the Alexander technique and tracked down
much of the dysfunction to my jaw and palate. an MRI did then show that my discs were anteriorly displaced.

As a child ,I had my 'adult' premolars extracted and later my wisdom teeth taken out. this causes the upper palate and jaw to be much narrower than they otherwise would be. I realise that this is a common orthodontic technique and people resist criticism of it, but even a basic understanding of the head neck relationship leads you to the inescapable conclusion that restricting growth of the palate must surely affect that relationship and cause compensation patterns in the musculature. And , as every Alexander teacher knows, the functioning of the head/neck governs the functioning of the whole spine and indirectly the whole body and all its systems.

Unfortunately, there are no short-cuts. I recommend finding a dental orthodontist who can reposition the jaw and possibly also the teeth as gently as possible using splints and braces. Make sure you get proper scans so the practitioner has a really accurate picture of what is going on before attempting treatment. Then you must address the functioning of the whole spine. I would, of course, suggest Alexander technique! Actually, because of my own problems, I do ask pupils and colleagues about orthodontic treatment and jaw function. You would be surprised at just how common these problems are and I fear that treating orthodontic problems without thinking of the possible consequences may have caused many people to be wandering around with 'unexplained' symptoms. If you have an example you think might be of interest to me, feel free to e-mail me: rachelerdos@hotmail.com

good luck!



on February 11, 2007 10:00pm
I am in a very similar situation as LZ above. Wear a splint that is higher on one side to compensate for the imbalance in my jaw. I go through severe severe pain if I remove the splint. Even with the splint I have some pain. LZ if you read this post could you please post the name of your doctors or email me at nour.saran@gmail.com. I am so amazed to hear that you are now pain free and how much the surgery has helped you.

This condition has completely debilitated my life. I agree with rachel (above) the there is a strong relationship between the head, neck and jaw. My problems started when I had jaw surgery and they removed bone from one side of the upper jaw which created an imbalance and 'premolars' were also extracted pre-surgery. These two things combined, completely de-stablized the cranio-cervical balance. I started experiencing extreme exhaustion from doing the simplest of activities. The muscles (esp. the core stabilizing ones) ached and were tired all the time with lactic acid buildup. My head, neck and jaw were in severe pain. The splint has helped somewhat but I believe that I need a surgeon who understands this relationship and can re-balance my jaw and head like LZ above.