TMJ & NEUROMUSCULAR DENTISTRY

• TMJ & Neuromuscular Dentistry
• Neuromuscular Dentistry
• Your Bite: What's The Big Deal?
• Full-Mouth Reconstruction
• Braces : Neuromuscular Functional Orthodontics
• Sports Dentistry
• Sleep Apnea

TMJ / TMD TREATMENT

What is TMJ ?

TMJ incorrectly refers to pain resulting from acute or chronic inflammation of the joint tissue and muscles connecting the lower jaw to the skull. The Temporomandibular joint is actually the joint located on each side of the head in front of the ears, where the lower jawbone meets the skull.

The Temporomandibular Joint allows us to chew, yawn, and even talk!

Pain associated with the relationship between the jaw, mandibular joints, muscles and teeth is actually Temporomandibular Disease.

What is TMD ?

For many people, TMD, is constant pain that manifests itself in so many ways, that it is often difficult to diagnose outright. The best way to define TMD is to list its many manifestations:

• Clicking or Popping noises in the Jaw Joints
• Jaws that get "stuck" or "lock" in the open- or closed-mouth position
• Pain when chewing and a feeling "that my bite is off" (sensation that top teeth aren't meeting the bottom teeth correctly)
• Facial pain, jaw joint area, neck and shoulders, and in or around the ear when you chew, speak, or open your mouth wide
• Headaches
• Pain in the back of the neck
• Grinding or clenching of teeth
• Limited ability to open mouth wide
• Ringing of the ears
• Toothaches and unexplained loose, chipped, cracked teeth
• Congestion in the ears
• Vertigo
• Presence of osteoarthritis or rheumatoid arthritis in the TMJ

How We Treat TMJ / TMD:

Often patients come to us with huge medical files including CT-Scans, X-rays, and MRI images,having consulted neurologists, chiropractors, orthopedists, and other medical doctors, bewildered that they are still in pain and have no diagnosis regarding the cause and treatment of their symptoms.

Our approach and treatment protocol for TMD involves the use of advanced tools charting a person's posture, neck position, and the position of the jaw. Instrumentation tracks the movement of the jaw to determine the ideal "relaxed" position of the jaw so that the patient's occlusion (or bite) is no longer misaligned. The science behind Neuromuscular Dentistry is based on the idea that the muscles of the face, jaw and mouth, must work together with the joints and the teeth, in a correct, and aligned manner. Thus, we look at whether or not a person's bite is a major contributing factor to their condition and pain.

We use Myotronic's K-7 Evaluation and Tracking system to do our charting of the jaw movement which shows us how the jaw is moving and how a person's bite is coming together, range of motion studies ( how much you can open your mouth and how far you can slide it side to side, and forward), and electromyography. Electromyography will measure muscle activity at rest and after relaxation, to help determine the most ideal position for the lower jaw.

This shows muscle activity before and after relaxation with TENS. We often get charts that look like a person's jaw is moving all over the place!

This bottom picture helps us to determine the final bite position.

This scan, below, helps us check first tooth contact

Using the above information, most patients will benefit from tensing to relax the muscles and begin the process of adjusting the way the teeth come together. This will improve the patient's dental health as well as begin to address neuromuscular issues such as headaches, facial and neck pain, and other symptoms described above.

Here a patient is tensing and relaxing the muscles of the jaw and neck.

At the end of the K-7 study, we have captured your ideal bite with a bite registration. This is used to fabricate an occlusal orthotic appliance which is similar to a nightguard. This is what is considered phase one treatment. The appliance is worn until all symptoms go away.

Photo of the Orthotic Appliance

See the difference between these two pictures, above?  At left, Patient is not wearing the orthotic, whereas in the picture on the right, the patient is wearing the orthotic and her bite is in the optimal position, her muscles relaxed!  Here's the secret:  That's Dr. Marisol Lopez-Belio in both pictures!

Some patients will continue to Phase Two, which may include orthodontics and restorative work.  Each case is designed based on the specific and individual needs of the patient.

Call Us, We Can Help You with Your TMD!  (561) 791-8184

Call Us, We Can Help You with Your TMD!  (561) 791-8184