Temporomandibular Joint Disorders (TMD) & the TMD Institute
The Origin of the TMD Institute
Most TMD patients are treated by dentists with mouthguards. However, many patients do not respond. To help these patients, and recognizing that TMD is a joint disorder, Dr Hatz decided to join forces with internationally renowned Orthopaedic Surgeon Chadwick Prodromos MD to form the ideal combination of expertise to tackle this problem. They formed the TMD institute (TMDI) to study new cutting edge treatments which are described below. Dr Hatz, a highly trained dental surgeon, now limits her dental practice entirely to the study and treatment of disorders of the TMJ.
What is TMD?
TMD refers to all disorders related to the temporomandibular joint.
What is the TMJ and is it Unique?
Yes, it is the only joint in the body to be composed of fibrocartilage instead of hyaline cartilage. It also has a unique disk that sits within the joint and is mobile. Because it is such a complicated joint it is subject to complicated abnormalities.
How Many People are Affected by TMD?
The National Institute of Dental and Craniofacial Research estimates that about ten million Americans suffer from TMD.
Where Does the Pain Come From in TMD?
The TMJ can produce pain from degeneration of the joint or from the unique disk that exists within the joint and can become damaged.
What Other Problems are Associated with TMD?
Many patients have pain in the jaw muscle or masseter. This can result in Trismus, or grinding of the teeth. Others have frontal headache in the temporalis muscle or in the neck muscles.
How is TMD Diagnosed?
It is diagnosed by a combination of the history, physical exam and, in some cases, imaging studies such as MRI.
All patients are seen initially for a consultation by Dr. Marilyn Hatz, DDS who will initiate a customized treatment program. Patients who are candidates for stem cell injection will also be evaluated by noted Orthopaedic surgeon, Chadwick Prodromos, MD; an international leader in platelet rich plasma (PRP) and stem cell treatment.
Low level light laser therapy is one of the most exciting advances of the 21st century. The intensity of the laser is low enough that there is no heat produced, no pain and no side effects. The laser works by two mechanisms. First it increases blood flow to the area to enhance healing and increases nitric oxide production which is a natural anti-inflammatory. Second, it is used to stimulate acupuncture meridians, parasympathetic nerves, which have a direct immunomodulatory anti-inflammatory effect. The treatments last for twenty minutes.
Platelet Rich Plasma Injections
Platelet Rich Plasma, or PRP, is produced in our office by drawing a small amount of blood and processing it to concentrate the platelets within it for injection into the TMJ. These platelets contain powerful growth factors that help heal injured tissue naturally, and also anti-inflammatory cytokines to decrease inflammation. No drugs are used. Because it is your own tissue you cannot have a reaction to it.
Stem Cell Treatment
We utilize a newly discovered pluri-potential stem cell that is filtered from a small blood draw from your arm. These stem cells help healing, decrease inflammation, and may help to rebuild injured tissue. As with PRP, no drugs are used, only your own natural tissue. Dr Prodromos is a world leader in the use of PRP and stem cells to enhance joint healing and now brings this expertise to the treatment of TMD.
Specialized Physical Therapy
We have two licensed physical therapists each with advanced training in the treatment of TMD. They work to relax and stretch tight muscles and also to release scar tissue.
PRP and Stem Cell Microneedling
Some patients are candidates for micro needling of the facial area. This is a tremendously effective cosmetic procedure that also has the potential to decrease muscle spasm and pain. By increasing blood flow to the area and providing growth factors it can decrease pain from the underlying muscles and also enhance healing.
Is the Treatment Covered by Insurance?
Physical therapy is covered by traditional health insurance. The laser, PRP and stem cell injections are not, but the cost is modest. Visits with Dr Prodromos are covered by insurance.