Neuromuscular and TMJ
Neuromuscular Dentistry and Tempromandibular Disorders TMD also known as TMJ
Dr. Spoor is one of the area's leading dental practices for the treatment of TMD. Many suffer from pain in the jaw, head or neck areas and are not sure of the nature of their condition or how to solve it. You may have heard other terms that describe this condition such as TMJ (Tempromandibular Joint) syndrome, Craniomandibular Dysfunction (CMD) or Tempromandibular Joint Disorder (TMD). It is usually a combination of factors involving the muscles of mastication (jaw muscles) and neck, the tempromandibular joints (TMJ) and the teeth. Both the joints and the muscles have the ability to accommodate, sometimes pathologically, to the position of the teeth.
A muscular imbalance can lead to a variety of signs and symptoms that can be acute or chronic such as:
- Unexplained loose teeth
- Worn, chipping or cracked teeth
- Cracking, chipping or breaking dental restorations
- Pain or soreness around the jaw joints
- Pain in the teeth that seems to move around
- Neck, shoulder or back pain
- Facial pain
- Clicking or grating sounds in the jaw joints
- Limited movement or locking jaw
- Numbness in your fingers and arms
- Congestion or stuffiness of the ears
- Ringing in the ears
The underlying conditions that cause these signs and symptoms are structural, biochemical and emotional. The structural problem is almost always present and leads to over activation of the jaw, head and neck muscles. Over a period of time it can lead to pain, tension and spasms.
Tempromandibular joint disorder (TMD), Myofascial Pain Dysfunction (MPD) or tempromandibular joint syndrome (TMJ), is a chronic illness that affects 40 million people at any one time. There are many people who have no pain but still have occlusal disease (misaligned bite). Worn, chipped or broken teeth, broken fillings, changing bite position or shape of the smile are all indications that can benefit from treatment.
To correct TMD or misaligned bite, the jaw is brought back into a muscularly balanced position, through sophisticated computer analysis. We use low frequency Transcutaneous Electrical Neural Stimulation (TENS) to relax the muscles of the head and neck and determine a muscularly-oriented jaw-to-skull relationship. TENS is also used to relieve pain caused by spasm and tension by releasing endorphins, the body's own natural pain killers. We also use TENS to close the jaw in combination with jaw tracking to find a position that is compatible with the relaxed muscles. Electromyography (EMG) is used to objectively look at the electrical activity in the muscles and sonography (ESG) to evaluate joint noises.
These sophisticated instruments have been used in medical specialties for years and are being used in dentistry to measure muscle dysfunction of the jaw, a major component in many headaches. This objective collection of data is then analyzed and combined with computer aided tomography (CAT scan) to diagnose the problem. An individualized and precise treatment plan is developed that most often leads to improvement and or elimination of pain.
Once a bite position has been determined, we typically have a patient wear a removablwe or fixed bite repositioning appliance until we can verify that the new bite position is correct (reduction and ideally elimination of pain). After we are certain, then we can either continue the appliance therapy indefinitely or go on to an orthodontic or restorative final solution. As a chronic degenerative disease, it often takes years to develop TMD. With these techniques and the objective computerized data, we have been able to help many that have been previously unable to find relief.