Neuromuscular Dentistry or TMJ

TMJ (Tempro Mandibular Joint) also referred to as TMD (Temporal Mandibular Dysfunction)

This is a cycle of pain and muscle spasms when your teeth, jaw joints and muscles do not work together in harmony. Temporal Mandibular Dysfunction is problems with muscles and jaw joints that form the mandibular part of the jaw and the temporal bone at the base of the skull. When balance to the teeth, muscles and bones is lost, the result can be:

• Headaches
• Worn Teeth
• Pain Behind the Eyes
• Sensitive Teeth
• Earaches,
• Popping or Clicking in the Jaw Joint
• Difficulty Opening and Closing the Mouth
• Jaw Pain
• Stiffness in the neck and shoulders
• Painful muscles in the face, neck and shoulders

Diagnosis requires an exam, x-rays, diagnostic models of your teeth and bite registration. Some patients require a more extensive exam involving Neuromuscular Dentistry: requiring Tomography, Sonography and Electromyography.

Causes of TMD (temporal mandibular dysfunction)

• Clenching or Grinding of your teeth
• Bad Bite or Bad Occlusion
• Joint Injury
• Arthritis
• Stress – physical or mental
• Tooth Wear in the middle aged patient is a major contributor

Treatment of TMD

Treatment can be moist heat for muscle spasms, inflammation reducing drugs or muscle relaxants, muscle massage or physical therapy and a soft diet. To restore balance to the joint and teeth, We may construct an Orthotic or Bite Splint as initial therapy. Millions of people suffer from TMD but treatment and life style changes can restore health and harmony to the joint.

Everyone has a different combination of problems. Each of us needs to have a complete assessment to fully diagnose and treat.

Neuromuscular Dentistry

Neuromuscular Dentistry focuses on the relationship of the teeth, jaw muscles and jaw joints functioning in a harmonious bite. The muscles on both sides of the face are relaxed when you are not chewing. When you chew or swallow (you swallow thousands of times per day), your muscles should contract evenly and when you bring your teeth together, they touch evenly. When your bite is uneven, the muscles have to shift to bring the teeth together and that means the muscles have to work harder. Even though the muscles feel normal to you, the muscles are still working much harder and that makes them become tired quickly, leads to headaches and damage to your teeth and jaw joint or TMJ. (Tempro Mandibular Joint)

Diagnosis of Neuromuscular Dentistry

Diagnosis of Neuromuscular Dentistry is to identify problems of the muscles, joints and bite (or occlusion) and to look for problems we can treat to stabilize the bite or occlusion . Many people do not have major symptoms that they can see but their teeth can be worn down which impacts their face. They look older because there is so much wear. Their jaw has to shift to make the teeth contact which makes the muscles work much harder trying to get the bite in a harmonious position. This causes constant muscle tension which leads to muscle fatigue, spasm and pain. Sometimes the muscle tension is so constant that the jaw joint is permanently damaged from bone rubbing against bone.

Your bite is analyzed, usually an orthotic is made to relax the muscles and stabilize the bite.

Complex Motion Tomography

Complex Motion Tomography Unit is a CAT SCAN image that exposes patients to 728 times less radiation than a normal CAT SCAN. We can get a detailed view of the jaw joint and the relationship between the upper and lower jaws. We can check the health of the joint and amount of damage done, as well as the position of your jaw in the socket. We will take an image with the patient biting down hard which can show if the jaw is in the best position in the socket. If the patient has a bad bite , the jaw may not be in the optimal jaw joint position. Treatment is greatly facilitated because we now has information that directs the construction of the orthotic or bite splint or occlusal splint . After construction of the orthotic, we can take another image to verify that the patient’s jaw position is improved. Tomography is very helpful information. Tomography gives information that is not possible to obtain using only Sonography or Electromyography. Headaches and jaw pain can be treated with the information from Complex Motion Tomography.

Sonography or Joint Vibration Analysis

This is equipment that measures the sounds in the jaw joint as you open and close your mouth. These measurements can be helpful in identifying joint problems.

Electromyography

Electromyography is the measurement of muscle tension in the chewing muscles when the muscles are tense or strained. Strained or tense muscles give off electrical currents that can be measured. After the patient’s muscles are relaxed there is a different electrical current. If the doctor can determine the differences, he or she can conclude that you have a bad bite.

Jaw Tracking Equipment

This can help locate the best path for jaw movement when chewing, talking and swallowing. The dentist can devise a treatment plan to help the patient stay in a stable comfortable position. We think that Tomography offers more reliable and reproducible information. Sometimes this equipment is so cumbersome that the patient postures differently when the equipment is on. This could create information that may not be reliable.

Tens Units

Tens Units sends electrical pulses into the muscles to relax the jaw muscles and relieve muscle pain. Then you can repeat the electromyography to compare relaxed and tense muscles.

NEUROMUSCULAR DENTISTRY, TMD OR TMJ TREATMENT

Once it is determined that a bad bite is responsible or partly responsible for your problems, we can use a number of procedures to restore your mouth to health.

1. Relieve Pain and Stabilize the Bite using an orthotic or bite splint or occlusal splint It can help reposition the jaw to provide comfort. Sometimes the patient will wear the appliance for months. We have found that headaches and neck aches can be relieved without drugs within a week in most cases. The jaw needs to be optimally positioned for each person.

2. Adjust the bite or equilibrate the bite, braces or orthodontics, replace missing teeth with implants or bridges and crowns or veneers or a complete bite reconstruction combined with the Dental Face Lift or Face Lift Dentistry. This level of care is started after the patient is comfortable and their bite balanced.

The goal is to establish a better position for the lower jaw in the joint socket for the relationship between the upper and lower teeth to function in harmony. Pain is relieved when the jaw position is in harmony with the bite.

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