About Dr. Parker, DMD:
Pioneer in Craniofacial Pain Management
Dr. Art Parker devotes his practice in Portland, Oregon to patients with some form of head, jaw and/or facial pain. He has treated over 10,000 patients and has become recognized in the community for effective diagnosis, treatment and management of this complex area.
The Great Imposter Disease
The signs and symptoms associated with TMJ/TMD can be confusing to patients and physicians alike; it has been known for many years as the “Great Imposter Disease.”
It is true that some patients present with Temporomandibular Joint dysfunction as their sole and only problem. However the great majority of patients will bring a “laundry list” of symptoms that can include, but not be limited to, headache, facial pain and ear complaints. These patients present a more complex diagnostic challenge, as they could be considered to have a TMD or temporomandibular dysfunction, which can be difficult to diagnosis correctly. It is truly astounding the journey that many patients have been on prior to finding our practice; they often present a long and detailed medical history that involves many physicians, diagnostic tests and unsuccessful procedures.
I-Cat cone beam tomography/ct scanning
Assessing the temporomandibular joints is an important part of the diagnosis. The first sign of problems in those joints is some type of joint noise: clicking/ popping, cracking. This usually represents an internal derangement of the articular disk.
Conventional wisdom has held that unless there is pain involved, these sounds can be considered to be benign.
More recently we have come to understand that these joint sounds will usually lead to degeneration of the condyle. In addition, due to the mechanoreceptors in the joint capsule, this usually leads to muscle bracing or muscle recruitment to help stabilize the displaced disk.
Muscles, Headaches, Bad Bites
The role of muscles in TMJ/TMD pain is often misunderstood, underappreciated or outright ignored.
For example, headache is one of the most common reasons patients visit a doctor. The medical community has been slow to recognize the value and importance of dentistry’s contribution to this area. Dentists and especially those who have been trained in neuromuscular concepts, recognize that malocclusions (bad bites) are a tremendous source of muscle tension which often cause face and head pain. A well-trained dentist who can provide the proper diagnosis and treatment can often reduce or eliminate these types of headaches.
Determining an accurate prescription for correcting these malocclusions is crucial and will often make the difference between success and failure.
We find that many of our patients have previously been fitted for a “night guard” that has proven to be of little value in treating their pain. This is primarily due to not establishing the right treatment position before sending the prescription to the laboratory. A good analogy is to that of eye glasses, you can wear an off-the-shelf pair or you go to the optometrist and have a prescription made for your individual vision correction. The right dental appliance with the correct prescription can produce tremendous effects. A correct diagnosis and following the appropriate treatment protocol is all important for achieving success in these complex cases.
The relationship between your teeth, muscles of the jaw and neck, and the temporomandibular joints is complex and critical to your overall health; if these three important elements are not working in harmony you can experience significant head, neck and facial pain.
One study tracked 953 headache patients for five years. They made nearly 4,000 visits to doctors in seeking relief from headache.
These patients went to every conceivable medical specialty but only 8% of those visits were to dentists!
Modern Headache Research has determined that very little difference exists between the classifications of headaches, recognizing that all headaches are ultimately mediated by and involve the Vth cranial nerve, more commonly called the Trigeminal. This is the nerve that that serves the dental system: teeth, tongue, gums, muscles of mastication and the TMJ and importantly, each of the three main branches send a twig back to the somatosensorary pain receptors of the brain’s cortex.