Craniomandibular dysfunction (CMD) is a complex condition that affects multiple factors that influence the jaw and associated structures. With over 20 years of experience in treating CMD patients, I have gained insights into why CMD affects patients across the disciplines of orthopedics, physiotherapy, and Osteopathy While interprofessional collaboration can certainly lead to rapid symptom relief, it is crucial to understand that TMD is primarily associated with inflammatory processes. Therefore, Traditional Chinese Medicine methods, particularly herbal medicine and dietary adjustments, have proven to be far more effective and ultimately curative.

Anatomy of the masticatory system

The temporomandibular joint consists of two components: the mandibular and the temporal parts. Similar to the spine, an articular disc (discus articularis) lies between these components and divides the joint into an upper and a lower joint chamber.

Stability and mobility are maintained by various muscles, fascia, tendons, and cartilage. These structures place the temporomandibular joint in direct contact with other skull bones, as well as with more distant structures such as the paranasal sinuses, ears, and teeth. The lower jaw (mandible) is connected to the skull base via the temporal bones, while the upper jaw (maxilla) is connected via the palatine bones.

The masticatory apparatus receives sensory and motor innervation from the three branches of the trigeminal nerve, which arise directly from the brain and partially from the second cervical vertebra. The joint capsules are innervated by the articular branches of the auriculotemporal nerve, the deep temporal nerve, and the masseteric nerve.

CMD in Osteopathy

TMD is often mistakenly attributed to orthopedics, dentistry, or osteopathy. The term itself refers to a dysfunctional arrangement or position of the skull and jawbones. However, as Dr. Still, the founder of osteopathy, once said: "Structure follows function." In fact, asymmetries and functional deviations of the jawbones are widespread, but do not correlate with patient complaints.

Therefore, osteopathy cannot provide lasting help to CMD patients and is only useful if the functionality of the masticatory system is severely limited.

Holistic causes of CMD

Dental causes

Inflammation of the jawbone, such as that which occurs after root canal treatments or tooth extractions, can cause lateral displacement of the skull base due to impaired lymphatic drainage, resulting in bite disorders. Poorly fitted crowns and ill-fitting dentures are also often the cause, which can lead to massive blockages of the second cervical vertebra.

Inflammatory causes

In my practice, I frequently diagnose inflammation of the masticatory muscles and salivary glands in patients with TMD. Neuritis caused by biomechanical problems or toxic stress can disrupt the control of the masticatory muscles, leading to occlusion disorders and pain. This condition may also be associated with a diagnosis of trigeminal neuralgia.

In addition, organic disorders caused by infections or toxic exposure can affect the cranial system and the masticatory system via fascial tension. In principle, any stress on the organism affects our statics and thus the craniosacral system and the masticatory system.

Patients with jaw problems are often in poor general health and frequently present with a variety of complaints that they do not associate with the masticatory system. Therefore, a systemic approach is always necessary. Since the causes are diverse, the Diagnostics first and foremost. I mainly use methods of osteopathy and Kinesiology.

Holistic therapy of CMD

Depending on the diagnostic results, it may be necessary to consult a dentist or radiologist. To stop inflammatory processes, traditional Chinese medicine Herbal therapy is the best choice. For severe pain, Acupuncture provide significant relief. Osteopathy serves to uncover structural problems and is primarily helpful in diagnostics.

Conclusion

TMD is a complex challenge that requires a comprehensive understanding of its pathology, diverse diagnostic approaches, and effective treatment strategies. By integrating insights from traditional Chinese medicine and osteopathy, we can offer holistic treatment plans that not only address symptoms but also aim to heal underlying issues.