First off, I want to note this, or anything I say for that matter, is not medical advice or me telling you what to do. I'd like to discuss this, however, because today I woke up to someone posting a picture of their palate in my comment section asking if they should do expansion. While I found that hilarious, it also brought up a lot of thoughts that I want to share. So, as always, let me explain this from my own experience and why I plan to get one. The symptoms I struggled with kept directing me toward ENTs. Post-nasal drip, ear congestion and ringing, hearing loss, constantly feeling like I had to clear my throat, sinusitis, and not breathing well through my nose, just to name a few. With a symptom list like that, who wouldn't think the best specialist to see would be an ENT? Unfortunately, after meeting with seven of them, none had any answers to my problems. The only new thing discovered was a mild case of acid reflux. After ear pressure tests, hearing tests, and seven nasal endoscopies, one doctor did offer to do surgery on my septum. I was too nervous to sign up for the surgery initially, but after a year or so of persistent symptoms and no answers, I went back to the surgeon. I thought maybe he saw something the others missed when, in reality, I should have viewed it as a major red flag. In general, if six out of seven doctors don't bring up the idea of surgery, it's probably not needed. But hey, I was desperate for symptom relief. After the septum surgery that I'm still coming to terms with, I was left with a weaker-looking nose, a more crooked septum than I started with (because I personally don't even know if there was a deviated septum in the first place—my nose was straight as an arrow), turbinates reduced to the point of almost being invisible, dryness, bleeding, and a hard time clearing my nose. This isn't meant to scare anyone away from septum surgery if it's actually needed, but in my case, it wasn't. After putting my body through an unnecessary four-hour surgery that, on average, takes 30–90 minutes, and still not being able to breathe well through my nose to this day, I found out the hard way that what I truly needed was a palate expander.

In this post, I'll break down what I believe to be the four root causes of TMJ symptoms. Before diving in, I want to clarify what "main causes" means in the title. I am referring to the most common root causes, not an exhaustive list. There are always outliers, and my heart goes out to those dealing with TMJ stemming from cancer, autoimmune disease, or other conditions where even less information exists, in the already limited TMJ conversation. The Core Four: 1. Structural Issues 2. Nervous System & Stress 3. Myofascial Issues 4. Lifestyle Let me do a brief dive into each of these, we can always discuss them at greater length in a later post. One very important thing to note is the order in which these need to be addressed. I find that getting the order right is just AS essential as figuring out which one(s) you're dealing with. So when you read 1–4, by no means are they ranked by how common they are. Ironically, I believe number two, a dysregulated nervous system, is likely the biggest and most common culprit. 1. Structural Issues Many issues fall under this umbrella. Some tend to be more rare, like a benign tumor requiring surgical intervention. Others are more commonly seen, like underdeveloped jaws. If someone's jaw didn't grow forward and wide enough, it brings on a chain of complications — an obstructed airway, compression in the TMJ joint from the mandible being "stuck" back by a recessed maxilla, narrow palates causing poor nasal breathing, sleep apnea, tongue/lip/cheek ties, and bad occlusion, to name a few. From my own research and experience, these need to be addressed before any muscle or fascia work, because muscles follow structure and will always compensate until the structure is corrected. Now, this doesn't mean going to a chiropractor to be "put into alignment" (I don't fully agree with that in a general sense anyway). I'm talking about getting unstuck from forward head posture. If your jaws are recessed and cutting off your airway, your body will have no choice but to extend your head forward to prioritize breathing. The downstream effects, tight muscles, neck pain, poor posture, are minor inconveniences compared to insufficient oxygen.

Ron offered a free 30 minute follow-up call for anyone willing to let him post the results on youtube. While I wish I had more to bring to him, I knew I couldn't' pass up this opportunity. Main Points: How recessed my jaw ACTUALLY is The possibility of me needing total joint replacement (TJR) The aesthetics of a good surgery Can I get enough protraction through a palate expander and skip surgery? Youtube Link: https://www.youtube.com/watch?v=acHCxC9K6B4&t=259s Hope there is something useful to take away, With love, John

A lot of health professionals will tell you there’s no real link between wisdom tooth extraction and TMJ problems. But here’s the thing, since I started talking about my own journey, one of the single most common comments I get is from people who noticed TMJ symptoms after having their wisdom teeth out. I try to stay open-minded, but honestly, even if the link turns out to be weaker than people think, I keep coming back to a more fundamental question: "why are we extracting in the first place? If our jaws are too small to house all 32 teeth, shouldn’t we be asking why, and looking at expansion rather than removal?" I also noticed through my research on Reddit, you’ll find hundreds of people reporting the same correlation. No, Reddit is not a clinical trial, and I saw how messy self-reported data could be throughout my nutrition schooling. However, at some point, the volume of reports stops being something you can just wave away. What seems hard to deny: There’s a real pattern of TMJ symptoms showing up after wisdom tooth extraction: clicking, popping, discomfort, the whole thing. And it seems like the harder and longer the surgery, the worse the outcome. Impaction angle, surgical difficulty, how much force and leverage was needed, all appear to be risk factors modulating how severe symptoms can be. When the joint is held open for such an extended period of time in an unnatural position, this can cause strain, damage, and/or inflammation on the joint capsule along with surrounding ligaments. Some literature even notes that a jaw injury of any kind, including wisdom tooth extraction, can increase the odds of developing TMD three to seven fold. However, the main TMJ symptoms from this procedure do seem to resolve themselves in conjunction with the surgical healing process. Overall, what we can take way is that uncontrolled or excessive force on the joint during extraction is the main contributor. Individuals that have cases resulting in lasting problems tend to be those with pre-existing joint laxity, those who had a very difficult/prolonged surgery and/or general anesthesia with aggressive jaw manipulation during intubation, or those who develop guarding/clenching habits during recovery that outlast the actual tissue healing. On this note, it is important to emphasize that this is where hypermobility may come into play. Sadly, I am not sure if currently there is enough awareness or testing in general about hypermobility, but my gut feeling is no based on the available information I've seen. That said, even if there was a pre-surgical screening for tooth extraction, hypermobility would most likely be missed, as many people are undiagnosed and there is currently no biochemical measurement to diagnose hypermobility anyway.