TMJ Dysfunction Treatment

Neuromuscular harmony is the goal


Have you ever considered that symptoms such as headaches, dizziness, ear pain, neck, shoulder, or back pain could be related to your bite? Most people haven’t, however as many as 44 million Americans suffer from a condition known as “TMJ Dysfunction”. In addition to the symptoms mentioned above, people who suffer from this condition might also experience: clicking or popping in the jaw, jaw pain, locking or limited opening of your mouth, difficulty swallowing and sleep disruption. TMJ Dysfunction is a medical disorder treatable by dentists with proper training and education.

What is neuromuscular dentistry?

Neuromuscular dentistry is dental treatment approach centered on the premise that the position that your teeth adopt when they come together in their "bite" should be a position that requires the least amount of strain to your TMJ joint and muscles, while maintaining a good whole body posture and open upper airway. There are various “bite” problems which may lead to malfunction of the musculature responsible for the movement of the jaw, and supporting muscles of the head and neck. These malfunctions often lead to pain of the head and neck or other symptoms which may seem unrelated. If the jaw muscles are compensating because of an improper bite relationship, the result is malfunction of the trigeminal nerve and associated cranial nerves which in part make up the autonomic nervous system. As well, if the bad bite is causing the lower jaw to fit in a posterior position, which is almost always the case, the upper airway is then diminished. The body's number one concern is oxygen, therefore it compensates for the retruded jaw and closed airway by adopting posture that opens the airway--a forward head posture. This posture allows oxygen to pass more easily into the lungs, but this is at the expense of the muscles of the posterior neck and leads to neck pain and headaches. These malfunctions and compensations are called craniomandibular dysfunction or CMD (also TMD or TMJ for Temporomandibular Joint Disorder). CMD commonly causes chronic head, neck and/or facial pain. There are many causes of headaches. However, conservatively, 50% of those that suffer from headaches, including migraines, are really suffering from trigeminal nerve dysfunction due to masticatory (chewing) muscle over compensation resulting from jaw alignment problems, CMD.

CMD is treated using neuromuscular concepts.

Treatment begins with thorough diagnostic evaluation including computerized jaw movement analysis, jaw muscle electromyography studies, and posture analysis. Then the jaw muscles are relaxed using ultra -low frequency TENS or gentle, soothing electrical impulses. The jaw’s new, relaxed posture is then stabilized with an intraoral orthotic, a retainer like appliance. Just as the ankle or knee is stabilized with foot orthotics, the jaw is stabilized through the use of an intraoral orthotic. The orthotic allows the doctor to test and confirm the therapeutic effects of the new jaw posture. The goal of the bite realignment is to allow the muscles to remain relaxed while poper body posture is more easily maintained, and thus not painful or referring pain. This holistic approach is used to optimize complex or extensive dental treatment, and can be applied to all aspects of dentistry including orthodontics and reconstructive therapy. The neuromuscular approach treats chronic and acute pain in a comprehensive and lasting way, thus protecting the patient from future problems.

Chronic Pain Treatment

Chronic pain affects millions of Americans. It is commonly associated with structures of the head & neck or facial region (upper quarter). Upper quarter chronic pain is very commonly misunderstood by the medical community. Failed diagnostics and treatment frequently lead patients on the medical “merry go round”. General physicians often refer patients to neurologists or Ear, Nose and Throat specialists. Usually after extensive diagnostic workups with MRIs, cat scans, and blood workup patients are finally told: “it’s all in your head”. Victims are instructed to “learn to live with it”, the only options being to suffer or keep experimenting with the latest prescription pain medication. Often these people experience debilitating pain and associated psychological, social and physical pathologies. Treatment is available to many of these people that may not expect to find it at a dental office.

At Saratoga Dental we successfully treat chronic pain patients. While some have suffered for decades, others are as young as 10 years old. In addition to utilizing the latest techniques and technologies, our approach also involves other health care modalities like physical therapy, massage therapy, chiropractic, and acupuncture, creating a holistic and comprehensive pain treatment. At Saratoga Dental we begin with a no cost screening exam which determines the source of pain to be craniomandibular, skeletal neurologic, or a combination of the three. If the screening shows a craniomandibular component we initiate the diagnostic examination. This includes specific radiographs (x-rays), casts of the jaws, a physical exam, and computerized diagnostics. With this completed we establish an appropriate treatment plan— the focus of a comprehensive consultation with Dr. Giswold.

Treatment typically includes two phases. After consultation and financial arrangements have been made, treatment begins. Phase I is the treatment phase, requiring treatment for about 3 months. Depending on the complexity of the problem— treatment is “evolutionary”. Levels of dysfunction unfold like layers of an onion and need various treatment modalities. This phase of pain treatment often entails the use of an intraoral orthotic (or splint) to reposition the lower jaw relative to the skull. These orthopedic changes allow reduction of muscle and nervous system strain. It may also require the assistance of other therapeutic modalities to relax splinted muscles of the head, neck and face.

Phase II includes treatment intended to stabilize the craniomandibular or jaw and muscle relationship established in Phase I treatment . This phase usually begins after at least three months of a pain free (or maximum medical improvement) state has been achieved. Orthodontics, reconstruction, prosthetics, or a combination of the three may be required to achieve stabilization. The team’s thorough understanding of the musculoskeletal and autonomic nervous systems become the most valuable tool, for every treatment is different and every case is unique. Our up to date technology as well as years of experience have allowed us to give many people relief from decades of chronic pain.

Saratoga Dental provides brochures for you to read as well as a questionnaire that helps determine if this treatment may be right for you or someone you know. So if you or someone close to you suffers with headache or facial pain, especially if the jaw joints pop, snap or grind when opening or closing, please call Saratoga Dental for a no-fee consultation.