TMD and Neuromuscular Dentistry

What Is Neuromuscular Dentistry?

Neuromuscular dentistry is a branch of dentistry that considers the physiologic aspects of head and neck symptoms. This type of dentistry seeks to cure TMD by retraining the muscles, tissues, and nerves to properly align the jaw at rest. If left untreated, the jaw must work harder to perform basic functions, such as chewing or speaking and in turn may repeatedly injure the surrounding muscles.

What Is Temporomandibular Disorder (TMD)?

Any type of pain or condition that is associated with the jawline is referred to as Temporpmandibular Disorder, or TMD.  These are the joints that make it possible for us to move our jaw sideways and forward, which is why it is so painful when there are problems. Located in front of your ears, having this condition can make it difficult to eat. Meaning it affects your daily life, and should be taken care of. Some patients suffer from this condition for many years when they don’t have to. Have a consultation with Dr. Hiebert or Dr. Smith to live a life without TMD pain.

The Symptoms of TMD

According to the American Dental Association, 10.8 million Americans suffer from temporomandibular disorder syndrome (TMD). The condition is caused by an improperly aligned jaw. If you hear a clicking or cracking noise when you move your jaw, you may have TMD. This condition contributes to a myriad of problems including:

• Migraines
• Headaches
• Sore neck muscles
• Tinnitus (Ringing in the ears)
• Vertigo
• Worn, chipped teeth
• Facial pain
• Sore jaw joints
• Numbness of the fingertips

Can TMD Be Cured?

This condition should be treated as you would treat any muscular injury. You can find relief with lifestyle changes like applying heat, muscle relaxers and having a softer diet. In severe cases, the problem may only be solved by surgical treatments. While a certain degree of pain is manageable, intense pain can really impact a persons day-to-day life and overall happiness.

What Causes TMD?

It can be challenging for dentists to get at the root cause of a patient’s TMD symptoms, but that’s where our specialized neuromuscular training helps our patients. The causes can be a direct result of an improperly aligned bite, but they can also be the result of less obvious factors, such as nightly bruxism (teeth grinding), teeth clenching, or overall stress. There might even be a genetic predisposition to TMD. These are the typical causes of TMD:

• Misalignment of the teeth and/or the jaw
• Teeth clenching
• Long-term teeth grinding
• Trauma to the teeth and/or jaw
• Stress or anxiety
• Poor posture in the neck and upper back
• Arthritis

How Is TMD Diagnosed?

At Hiebert Smith Dental Group we use state of the art diagnostic instruments, including a specially tuned TENS unit and EMG. With sophisticated computer analysis, we are able to quantify your optimal jaw and bite position and thus find balance between facial muscles and joints. Bite evaluation and analysis is comfortable and pain-free, resulting in precise diagnoses.

The first point of examination is a muscle and joint palpation. As you open and close your mouth, and clench your teeth, we feel for function in the different facial muscles and the temporomandibular joints. Pain or tenderness is an indicator of misalignment or the overworking of muscles. Catches, locks, clicks, and pops when moving the jaw are also typical signs of alignment problems.

After examination and analysis of the pain patterns, we will usually recommend making a neuromuscular oral orthotic, fabricated to your “relaxed muscle position bite”. A majority of headache patients experience a decrease in headache frequency and intensity within several weeks of first wearing the orthotic. The entire process is 100% non-invasive and very relaxing.

Other more involved tests include:

• Full-face x-rays, MRIs, or CT scans — These may be used to view the position of the jaw and temporomandibular joints.
• Sonography – Sound waves are used to determine whether there are any problems with jaw alignment. We also listen for any abnormal sounds emanating from the jaw.
• Electromyography (EMG) – This method uses the electricity generated by jaw muscles to measure both muscle and nerve function. It can help us see when there is a reaction (such as pain) to movement.
• Computerized test equipment — This is used to measure the correct resting position of the jaw, identifying misalignment problems.

TMD Treatment

When treating TMD, Dr. Hiebert and Dr. Smith use a variety of methods. Sometimes one option may not be effective, so we’ll move on to another. Our treatments usually involve a combination of lifestyle changes, cosmetic and general dentistry, and possible nerve stimulation. These are some of the methods that we use to help our patients:

• Splints or night guards — Night grinding and clenching is a main factor in TMD. To combat this, it’s important to put the jaw in the correct position at night. To do this, we fabricate plastic mouthpieces that fit over the upper and lower teeth. Patients usually wear these at night.
• Exercises — Tightening the jaw muscles and clenching the teeth is a common cause of TMD problems. We have various jaw exercises that stimulate and relax the jaw muscles.
• Cosmetic dentistry — To correct alignment, we can replace missing teeth with dental implants or bridges, crown overly worn teeth, or move the teeth with orthodontics. This can involve widening constricted arches.
• Lifestyle changes — Stress and anxiety are often root causes of TMD; stress reduction techniques are important.
• Transcutaneous electrical nerve stimulation (TENS) — Small electrical pulses are delivered to the jaw muscles through a small wand. These pulses stimulate the nerves, encouraging the muscles to relax and the jaw to fall into alignment.

Schedule A Consultation

If you are experiencing TMJ symptoms, call (503) 397-6144 to schedule a consultation at Hiebert Smith Dental Group in St. Helens, OR.