Acupuncture & TMJ

By David Trevino, L.Ac.

Temporo Mandibular Joint syndrome (TMJ) is a condition that is related to the muscles and tendons connecting the jaw to the skull. People who suffer from TMJ often experience jaw pain that may radiate to the neck and shoulders, difficulty opening and closing the mouth, popping and clicking of the jaw, facial pain, headaches, ear pain and ringing in the ears.

There are several causes of TMJ, including overstretching the jaw during dental procedures/surgery, injury, repetitive movements, movement and misalignment of teeth and jaw, and clenching and grinding of the teeth.

According to the National Institute of Health (NIH), about 25 million Americans may experience some or all of these symptoms during their lifetime. Women are more likely to experience TMJ than men.

Western medical treatment options include anti-inflammatory medications, mouth guard or oral splints, even surgery.

In 1997 the NIH created a panel of pain specialists, who concluded that, "Acupuncture may be an acceptable alternative to treat TMJ." Today TMJ is treated successfully with acupuncture.

Acupuncture meridian theory provides a good explanation for the treatment of TMJ. For example, the meridians that cross along the jaw area are related to the energy of the Stomach, Gallbladder and Small Intestine. When the energy of these pathways is blocked, pain results.

The pain can be relieved by inserting needles into specific points on the body, which facilitates the flow of energy in the blocked pathways. The trick is to determine which pathways are blocked, so that the acupuncturist can then attempt to open them up to relive the pain. Utilizing pulse diagnosis can help the acupuncturist determine which channels are most likely to be involved in creating the condition.

The approach for the treatment of TMJ with acupuncture varies. Some practitioners prefer to place needles locally in the affected area of pain and focus on placing needles around the ear and along the jaw. Other methods include using points distally along the ankles, big toe, elbows and knees.

Specific points along the body may be included to treat the underlying cause of the problem. In some cases, electrical stimulation of the acupuncture points is used in order to help the jaw relax. Herbal medicines may also be prescribed. If the TMJ has been chronic, several treatments are usually necessary.

Acupuncture for Post Surgical Dental Pain

By David Treviño, L.Ac.

One of my colleagues recently needed gum surgery and was in a lot of pain after the procedure. Her dentist prescribed painkillers, but my colleague said that she did not like to take medications. I offered her an acupuncture treatment and during the treatment she said that she felt significantly more comfortable, relaxed and had less pain. I spoke to her a couple days later, and she said that the day after acupuncture, she had minimal dental pain and was able to avoid taking pain medication altogether. I was glad that the acupuncture treatment had been so helpful, and I decided to take this opportunity to do some research regarding this subject since it appears that most Americans are unaware of acupuncture’s effectiveness for dental pain.

Research regarding acupuncture for the treatment of dental pain appears to have started in the West in the early to mid 1970’s, but has been a part of Chinese Medicine for centuries. Most research in the West found acupuncture to be effective for dental pain, as well as for temperomandibular joint pain (TMJ) and post surgical dental pain.

Two important review articles that are still referenced today concerning dental pain and acupuncture were published in 1998 by Ernst & Pittler and in 2002 by Ted Kaptchuk. The investigators from these two review articles found that out of sixteen acupuncture trials for the treatment of dental pain, twelve of these trials had adequate methodology and concluded that “good evidence exists that acupuncture is effective for relieving dental pain.”

In my practice, I have found acupuncture to be helpful in managing dental pain. Many patients have described acupuncture to be effective in minimizing acute dental pain, and others have acquired pain relief while waiting for their dentist to perform a root canal. You may wish to consider acupuncture for post surgical dental pain, especially if you are sensitive or allergic to analgesics, or like my colleague, prefer to avoid pain medications altogether. Try using plain clove oil for tooth pain, or the Chinese Acupuncture Clinic’s mouthwash formula made from Chinese herbs that are helpful for gingivitis.

References:
1. Ernst E, Pittler MH: "The effectiveness of acupuncture in treating acute dental pain: a systematic review." Br Dent J 1998, 184:443-447
2. Ernst E, White AR: "Acupuncture as a treatment for temporomandibular joint dysfunction. A systematic review of randomized trials." Arch Otolaryngol Head Neck Surg 1999, 125:269-272
3. Kaptchuk, T: "Acupuncture: Theory, Efficacy, and Practice." Ann Intern Med. 2002; 136:374-383.
4. Lao, L., Bergman, S., Hamilton, G., Langenberg., Berman, B., "Evaluation of acupuncture for pain control after oral surgery, a placebo controlled trial." Arch Otolaryngol Head and Neck Surg. 1999; 125:567-572.
5. Rosted P. "The use of acupuncture in dentistry: a review of the scientific validity of published papers." Oral Dis. 1998;4:100-4.

Teething

By M. Cissy Majebe, L.Ac., & Karen Litton, L.Ac.

Cutting teeth is a rite of passage for all babies. The reaction to this experience varies from child to child. It can be an uncomfortable process for the child and the entire family.

Most cases of teething cause mild discomfort to the child, and some sleepless nights for the child and/or parents. In rare cases, a fever can develop that would require attention.

The channels that pass through the gums are related to the Stomach and Large Intestine Meridians in Chinese Medicine. Interestingly, many babies stop eating when they are getting close to teething -- a natural reaction to clear out the digestive system.

If a child has food stagnation in his stomach when teething starts, there will be more distress for the child when the teeth push through. The extra heat associated with the food stagnation in the stomach combines with the heat in the gums to create discomfort for the child during teething.

With teething, there can be an increase in the following symptoms: sore gums, drooling, wakefulness, irritability, mild temperature, diarrhea with foul-smelling stools, and sometimes a poor appetite just before and during teething.

In treatment, if there is heat, then the practitioner will bring down the heat and help clear the accumulation in the stomach. Acupuncture can also effectively reduce the heat and inflammation in the gums.

There are actions you as a parent can take at home to diminish your child’s discomfort. One of these is the stimulation of certain acupressure points, such as the following:

• Large Intestine 4: located between the thumb and the first finger, on the mound created when you squeeze the thumb to the hand.
• Stomach 40: located half way down the outer leg between the knee and ankle, about an inch off the shin bone.
• Stomach 44: in the webbing between the second third toes.

These points can help take the heat out of the gums, Stomach, and Intestines, thus relieving the child’s discomfort.

There are also herbal formulas and essential oils that can ease the child’s teeth discomfort. One of these is lavender oil. For those sleepless nights, rubbing lavender oil on the child’s stomach can be soothing. In addition, the lavender oil can be rubbed on the above mentioned points or chest. Just this oil’s essence can bring relaxation.

There are also herbal pills, one of which is Suan Zao Ren, which can help with those children, or parents, having difficulty sleeping. Suan Zao Ren also comes as a powder or a tincture.