“TMJ”, although it has become almost a household word, is a non specific, catch-all term for a variety of pain/dysfunction conditions of the head and neck. It was originally derived from “Temporomandibular Joint”, your jaw joints — once thought to be the source of most of these ailments.

Today we know that there are many causes of head and neck problems that may or may not be related to the temporomandibutar joint. For this reason, although not as widely familiar, most dentists use “TMD” (for ternpporomandibular disorders) to more accurately describe the condition.

You may normally think of a number of the symptoms of TMD as being medical conditions, not related to dentistry. We will explain what they are, why they may involve your dentist, and how we would diagnose and treat them.

SIGNS & SYMPTOMS OF TMD
Pain or dysfunction of the head and neck is a very common condition and one that might be resolved very simply or might be very complex and frustrating to treat, depending upon the circumstances.

The bite can be a factor in many types of pain or functional problems because of the inter-relationship of the overall muscu loskeletal system. Since there is a relationship between the teeth, jaw joints, head and neck muscles, and head posture, a problem in any one of these areas may affect others. These can include
painful clicking or popping of the jaw joint, various types of head and neck pain, swallow ing problems, postural problems, and excessive snoring or sleep apnea, to mention a few.

If it is suspected that you suffer from this type of problem, the neuromuscular dentist may ask you if you have any of the symptoms shown below.

MUSCULOSKELETAL SIGNS AND SYMPTONS Do you suffer from any of these?   Headaches Clenching or grinding   Jaw joint pain Facial pain   Jaw joint noise or clicking Sensitive teeth   Limited mouth opening Chewing difficulties   Ear congestion Neck pain   Dizziness Postural problems   Ringing in the ears Tingling of the fingert   Difficulty swallowing Hot & cold sensitivity of teeth   Loose teeth Nervousness or insomnia

What is Neuromuscular Dentistry?
To understand Neuromuscular Dentistry (NMD), it helps to first know a few things about your occlusion or “bite’ Your occlusion is the way that your upper and lower teeth fit together. The muscles of your head and neck posture your jaw and hold the lower teeth dose to the upper ones. You don’t consciously hold your jaw in this position — it is “programmed” in your brain. Even though the present position “programmed” by your brain seems like it would be the optimal position, it is not always the best one for you. Neuromuscular Dentistry (NMD) is a term applied to techniques that expand upon the more traditional approach to dentistry that is more mechanically oriented. NMD places the occlusion where the muscles that control jaw position are at their best for optimal function and comfort.

Is Neuromuscular Dentistry for You?
There are always options to consider when you are choosing dental treatment. After initially evaluating your situation, your dentist or treatment counselor will discuss those options with you. NMD becomes one of your options when/if you are contemplating aesthetic or cosmetic, reconstructive, or orthodontic dental procedures.
Additionally, NMD techniques are used to treat patients that suffer from TMJ-like symptoms and to aid in establishing the occlusion for dentures. It is in these cases that establishing the optimal occlusion becomes so important. This is when choosing neuromuscular techniques may have a substantial and positive impact on the outcome of treatment. The relaxed jaw position gives your dentist an added insight that may allow for a faster completion and improve final treatment results.

The Dentist's Diagnosis
The neuromuscular dentist will consider all of the information gathered by taking your history and doing a physical examination of your teeth, head and neck. When indicated, they may conduct a series of tests using non-invasive electronic instruments. Data from these tests will indicate to your dentist whether your bite is a major contributing factor to your problem and will help rule in or rule out your bite as the cause of, or major component of, your condition.

If these tests show that your habitual bite is a probable cause of your condition or pain, the neuromuscular dentist then identifies a jaw position determined by the relaxed state of the muscles. This jaw position and the corresponding new bite is called neuromuscular occlusion.

Treatment
An orthosis is a custom made appliance fabricated of plastic that can be worn over the teeth to maintain the neuromuscularly derived bite position.

At this point nothing is done to permanently alter your teeth or your bite. You typically wear this plastic appliance for a prescribed period of time to verify that this new jaw position solves or reduces the problem.

If it does, it has proven that the imperfect bite was the cause of the problem and you may elect to go on and have your natural teeth treated to permanently maintain that new bite position.
If symptoms are not substantially alleviated, the bite position is most likely not the cause of the problem. Your natural bite has not been altered and other causes may then be further explored. (Although this latter circumstance is possible, it is not likely since the dentist will only proceed with an orthosis if there are strong indications that the bite is a major factor in your problem.)