Neuromuscular dentistry
From Wikipedia, the free encyclopedia
Neuromuscular dentistry is a form of dentistry that focuses on correcting misalignment of the jaw at the temporomandibular joint (TMJ). While conventional dentistry primarily concentrates on the teeth, gums, and bones, neuromuscular dentistry acknowledges the multi-facted musculoskeletal occlusal signs and symptoms that relates to postural problems involving the lower jaw and cervical region. Neuromuscular dentistry recognizes the need to solve the root of the misalignment problem(s) by understanding the relationships of the tissues which include the muscles, teeth, temporomandibular joints, and nerves. Symptoms of temporomandibular joint disorder (TMD) include:
- Headaches / migraines
- Facial pain
- Neck and shoulder pain
- Tinnitus (Ringing in the ears)
- Vertigo (dizziness)
- Trigeminal neuralgia (Tic douloureux), a neuropathic pain disorder unrelated to TMD
- Bell's Palsy, a nerve disorder unrelated to TMD
- Unexplained loose teeth
- Sensitive and sore teeth
- Jaw pain
- Limited jaw movement or locking jaw
- Numbness in the fingers and arms (related to the cervical musculature and nerves, not to TMD)
- Worn or cracked teeth
- Clicking or popping in the jaw joints
- Depression[citation needed]
Neuromuscular dentistry uses computerized instrumentation to objectively measure the patient's jaw movements via computerized mandibular scanning (CMS), muscle activity via electromyography (EMG) and temporomandibular joint sounds via electro-sonography (ESG) to assist in identifying joint derangements. Surface EMG's are used to verify pre-, mid- and post-treatment conditions before and after low frequency TENS (transcutaneous electrical neural stimulation). Combining both computerized mandibular scanning (CMS) with low frequency TENS the dentist is able to locate a "physiological rest" position as a starting reference position to find jaw relationship between the upper to lower jaw along an isotonic path of closure up from physiologic rest position to establish a bite position. Electromyography can be used to confirm rested/homeostatic muscle activity of the jaw prior to taking a bite recording.[citation needed]
Once a physiologic rest position is found, the doctor can determine the optimal positioning of the lower jaw to the upper jaw. An orthotic is commonly worn for 3-6 months (24 hours per day) to realign the jaw, at which point orthodontic treatment, use of the orthotic as a "orthopedical realigning appliance", overlay partial, or orthodontic treatment and/or rehabilitation of the teeth is recommended to correct teeth and jaw position.
Because of the additional training needed and because of the complex computer systems, hardware, and hand-crafted orthotics, neuromuscular dentistry is more expensive yet more effective at eliminating head and neck pain[citation needed]. The costs can range from $1,500 to $10,000 for usually four to six months and/or up to one year or more of treatment depending on the complexity of the case. (This does not include any additional orthodontics or restorative treatment). TMJ symptoms are generally eliminated within 6 weeks to 6 months[citation needed].
Neuromuscular dentistry has been very successful in reducing the symptoms of TMD. The success is well documented and has shown to be an effective means to treat TMJ/TMD as opposed to other treatment modalities that are merely supportative treatments addressing symptoms of an underlying problem[citation needed].
