Alexandria TMJ

Dr. Kenneth M. Van Stralen is a dentist and has answered some of the common questions Bizymoms visitors have about TMJ.


Q. What is TMJ?  

A. TMJ is an acronym for Temporal Mandibular Joint.  The TMJ is the joint that is comprised of your temporal bone (slightly above your ear), your mandible (your lower jaw), a donut shaped piece of cartilage between the two and the ligaments that hold it all together.  Most everybody has two TMJ's just as mostly everybody has two knees.  

Q. How do I know if I have TMJ?  

A. As mentioned above, most people have two TMJ's.  A disease associated with the TMJ is called temporal mandibular joint dysfunction or TMD.  TMD is often painless.  However, when the disease progresses, it can cause migraine headaches, muscle spasms, and a host of other symptoms.  Often there is a clicking of the jaw joint and sometimes a jaw with a damaged joint can lock open or closed.  Grinding your teeth or bruxism can be a sign of TMD.  

Q. Can painkillers help in treating TMD?   

A. It depends upon what type of pain killer is used.  Pain killers treat the symptoms of TMD.  Certain pain killers can be a very useful diagnostic tool.  For example, ibuprofen is useful in relieving muscle pain.  If a patient with TMD takes ibuprofen and the pain is less then there is a good chance that the patient would respond favorable to occlusal splint therapy (mouthguard).   On the other hand, pain killer with a narcotic component mask pain.  A pain taking a narcotic might feel better but continue an activity that exacerbates the problem.  With pain masked by a narcotic, such a patient might do considerable damage to their TMJ's without being aware of it.  

Q. Who should treat TMD?  

A. Much like dental implant treatment, the treatment of TMD is not a recognized specialty.   Anyone who learned to treat TMD patients did so by attending continuing education courses after formal training.  Adding to the difficulty in assessing training is the fact that there are widely divergent approaches to treatment.  It is probably best to go with a conservative treatment which is likely to resolve the problem and if the treatment recommendation seems overly aggressive, get a second opinion.  

Q. What should you expect from a TMD doctor?  

A. A joint and muscle diagnosis, a clear explanation of the problem and how and why the proposed treatment might help.  

Q. What result can I expect from surgery?  

A. I believe the research is clear on this.  Surgery rarely helps.  TMD can have an incredibly painful stage, but often, if the pain can be endured, the joint heals and the symptoms subside.  Joint surgery usually is recommended only if the pain cannot be endured.  

Q. Is TMD covered by insurance?  

A. It depends on how much the purchaser of the insurance (usually your employer) paid for the insurance.  There are many types and grades of insurance.  In some respects, dental insurances are like cars.  There are Mercedes and there are Chevy's.  If someone bought you a Chevy, you are not driving away in a Mercedes.  

Q. How do I contact Dr. Van Stralen with questions?  

A. Dr. Van Stralen can be reached at 3111 Telegraph Corner Lane, Suite 201, Alexandria, VA 22310.  The office telephone number is 703 317 3900.  He may also be reached by email at drvanstralen@drvanstralen.com.