What is Neuromuscular Dentistry?

The way that your upper and lower teeth come together (your bite or “occlusion”) is a part of a system of teeth, muscles and joints.  If your teeth do not fit together properly, the muscles and joints accommodate by working to get them together.

Because of this, a misaligned or malaligned bite often leads to muscles that are overworked when they should be relaxed, leading to various painful conditions.  Neuromuscular dentistry considers the entire system that controls the positioning and function of your jaw.  The neuromuscular dentist seeks to establish a physiologic jaw position based on a harmonious relationship of the three main factors affecting occlusion - the teeth, muscles and jaw joints.  The resulting jaw position is called the neuromuscular bite.

This may be considered during various types of treatment such as to improve aesthetics of your smile, to correct a misaligned bite, or to relieve pain.

What is TMD/TMJ?

Most people don’t think to mention the pain in their facial muscles or jaw joints to their dentist.  Yet such pain is a common symptom of TMD or temporomandibular disorders.  Your TMJ refers to your temporomandibular joints.  This condition causes pain on one or both sides of the forehead, temple, jaw, base of skull and sometimes in the neck, shoulders and back as well.  Other symptoms of TMD may include jaw pain, biting or chewing difficulty or discomfort, reduced ability to open or close the mouth and popping/clicking of the jaw joints during opening and closing.  TMD can be caused by tension in the muscles that move the jaw, the way your upper and lower teeth fit together (bite) or in some cases the jaw joints.  Any problem that prevents this complex system of muscles, teeth and joints from working properly may result in TMD.
There are many possible causes of TMD.  The neuromuscular dentist is trained and equipped to diagnose and treat you TMD condition.  Non-invasive tests can aid your dentist to determine whether or not muscle tension, your bite or your jaw joints may be the cause of your TMD and whether treatment by a dentist might resolve your condition.  If you suffer more than an occasional pain in the facial, jaw or neck area, it is well worthwhile to talk to a neuromuscular dentist about it.

TMD/TMJ Symptoms Self Quiz

The following are a few of the more common symptoms that may possibly be associated with your TMD.
1. Pain in the muscles that control jaw function
2. Jaw pain or tenderness of the jaw
3. Pain in the face, neck or shoulder
4. Difficulty chewing
5. TMJ noise during opening or locking of the jaw
6. A change in the way the upper and lower teeth fit together
7. Sensitive teeth when no dental problem can be found
8. Facial swelling without infection
9. Muscle spasms of neck or jaw
10. Insomnia, snoring or sleep apnea
11. Clenching or grinding the teeth
12. Tingling in the hands and/or fingers
13. Crowded teeth
14. Worn or chipped teeth
15. Damage to the roots of the teeth
16. Loss of molars
17. Loose teeth

Are You Saying Yes to a Number of the Signs/Symptoms Noted?

If so, there’s a very good chance that your problem is related to your bite and that a muscle, joint or occlusal instability exists.  If you would like, we can try to help via orthotic therapy. As any muscle in your body works, it produces lactic acid.  As this builds up in muscles it can be quite painful.  There can be pain in or around muscles associated with the TMJ, headaches, facial pain, head, neck or shoulder pain, numbness and tingling hands and fingers, etc.

Imagine if we put a pebble in your shoe and asked you to walk across the room.  It may not be comfortable, but you could do it.  Imagine if we took the same pebble and told you to put it in your shoe and walk a hundred miles.  By the time you finish, you have a very sore foot BUT more than likely, you will also have a sore ankle, a sore knee and maybe a sore hip because of the way you compensated for the pebble hurting your foot.  As the foot starts to hurt you try to walk more on the side of the foot instead of right on the pebble, this made your ankle start to hurt.  A little while later you try to shift up onto the front of your foot, after a while your knees start to bother you because of the abnormal way you’re walking, and so on and so on.....  This is the same thing that happens to you when your upper and lower jaws are unstable and are being held in an abnormal position all the time, it starts to affect the face, then the neck, shoulders, etc..

How Did They Get This Way?

There are lots of contributing factors as you grew and the muscles and joints found a position to be in.  It could be chronically enlarged tonsils as a child, allergies that caused you to breathe through your mouth and drop your lower jaw, habits such as thumb sucking, accidents that caused damage to the supporting structures of the teeth, tooth decay that has led to premature tooth loss, etc.

Achieving Truly Relaxed Muscles

Someone who is clenching and grinding their teeth (bruxism) is a person with unhappy muscles; these muscles are trying to find a better place to the detriment of the teeth and the joints.  NMD begins by relaxing muscles associated with the jaw.  To help your muscles reach a truly relaxed state, a device called the myomonitor or TENS is used to deliver gentle electrical stimulation to your muscles.  The myomonitor is a battery operated electrical muscle stimulator.  Mild electrical stimulation is delivered through adhesive patch electrodes attached over nerves that control specific muscle groups.  The virtually painless stimulus delivered by the myomonitor will cause your facial and jaw muscles to twitch or pulse once every one and a half seconds.  After about 40-60 minutes this electrical induced exercise will allow your muscles to overcome their programming and go to a relaxed state.

From this, the relaxed position is recorded and is compared to the original bite.  If discrepancies exist, a clear plastic appliance called an orthotic is made for you to wear.  This helps to keep your bite in its new position.  You may wear this orthotic as a long-term appliance or as an interim step to a more permanent treatment.