Dr Parthasarathi Reddy, Founder Chairman, FMS Dental Clinics explains about neuromuscular denistry and highlights that this approach aims to provide a more comprehensive solution for conditions such as temporomandibular joint disorders (TMD), chronic headaches and jaw misalignment, ensuring not only dental health but also overall well-being
Neuro muscular dentistry is an evolving field that focuses on temporomandibular joint (TMJ) disorders and jaw movement issues and also includes orofacial pain (OFP) disorders like neuropathic and neurovascular pain disorders, headaches and sleep disorders. Symptoms of OFP can vary widely, encompassing headaches, neck pain, ear pain, dental discomfort, facial burning or stabbing sensations and jaw pain. Additionally, atypical symptoms such as tinnitus (ringing in the ears), dizziness, muscle incoordination or unusual itching and tingling in the head and neck may also occur. Traditional dentistry has long addressed issues related to teeth and gums, but neuromuscular dentistry goes beyond these to explore the relationship between the jaw, the surrounding musculature and the nervous system. This approach aims to provide a more comprehensive solution for conditions such as temporomandibular joint disorders (TMD), chronic headaches and jaw misalignment, ensuring not only dental health but also overall well-being.
The foundations of neuromuscular dentistry
At the core of neuromuscular dentistry is the belief that optimal jaw health is achieved by aligning the teeth, muscles and joints in their most natural, relaxed positions. This differs from traditional methods that often emphasise a purely occlusal approach, focusing only on how the upper and lower teeth come together. Neuromuscular dentistry instead takes into account how the jaw’s position affects surrounding structures, including the head and neck muscles, nerves and even posture.
Many of the symptoms that people experience, such as jaw pain, chronic headaches, neck pain, earaches and difficulty chewing are often linked to neuromuscular imbalances. By addressing these issues at their source, namely, improper jaw alignment and dysfunctional muscle activity – neuromuscular dentists aim to provide lasting relief.
Key techniques in neuromuscular dentistry
Neuromuscular dentistry employs several advanced techniques to diagnose and treat issues with the jaw’s alignment and function. Here are some of the most common procedures:
Electromyography (EMG)
Electromyography is a diagnostic tool used to measure the electrical activity of muscles in the jaw and surrounding areas. By analysing muscle tension and contractions, EMG helps dentists understand how the muscles are working in real time. If muscle activity is elevated, it can indicate stress or overcompensation caused by poor jaw alignment. This tool enables the dentist to target the specific muscles that may be contributing to a patient’s discomfort.
Jaw tracking
Jaw tracking is another diagnostic technique that uses computer technology to measure the movement of the jaw as it opens, closes and moves side to side. It provides an accurate, three-dimensional representation of the jaw’s movement patterns, helping the dentist identify any irregularities. By pinpointing areas of misalignment, the dentist can develop a treatment plan to reposition the jaw in a more natural and functional way.
Sonography
This diagnostic tool measures sounds produced by the temporomandibular joint (TMJ) as it moves. Clicking, popping or grinding sounds often indicate TMJ dysfunction or damage to the joint’s internal structures. Sonography helps to detect these problems early on, allowing for a more targeted treatment approach that addresses the root causes of joint disorders.
TENS (Transcutaneous Electrical Nerve Stimulation)
TENS therapy is one of the most effective tools in neuromuscular dentistry for relieving muscle pain and tension. By delivering low-level electrical impulses to the facial and jaw muscles, TENS helps to relax these muscles, which can become hyperactive or tense due to misalignment. Relaxation of the muscles allows the jaw to settle into a more natural position, reducing discomfort and promoting healing. This technique is often used in conjunction with other treatments to restore the jaw’s ideal function.
Procedures in neuromuscular dentistry
Neuromuscular dentistry aims to correct improper jaw alignment, teeth occlusion problems and relieve associated symptoms. Below are some of the primary procedures used to achieve optimal jaw health:
Bite repositioning orthotics
One of the most common interventions in neuromuscular dentistry is the use of bite repositioning orthotics (also called splints or appliances). These devices are custom-made to fit a patient’s mouth and are designed to realign the jaw by guiding it into a more optimal position. Over time, the orthotic helps the muscles and jaw joints adapt to this new alignment, providing relief from tension and discomfort.
In some cases, these orthotics are used temporarily to retrain the muscles, while in other cases, they may be worn long-term. The goal is to find the most balanced position for the jaw that minimizes strain on muscles and nerves, reducing the risk of TMD and other jaw-related problems.
Orthodontic adjustments
For patients with misaligned teeth contributing to jaw imbalance, orthodontic treatments like braces or clear aligners can be part of the neuromuscular dentistry approach. Correcting the bite and ensuring proper occlusion are vital to long-term jaw health. When the teeth align correctly, it allows the jaw to function more efficiently and comfortably, preventing excessive wear on the teeth and reducing muscle strain.
Coronoplasty (Selective reshaping of teeth)
Coronoplasty is a procedure that involves reshaping the biting surfaces of the teeth to improve how they come together when the jaw is closed. This can relieve pressure points or premature contacts that contribute to TMJ disorders and jaw misalignment. By modifying the structure of specific teeth, the dentist can create a more even distribution of force across the bite, reducing strain on the TMJ and muscles. T-Scan Novus is a great computerized device which helps in identifying these premature occlusal contacts and facilitate adjustments.
Restorative dentistry
For patients whose jaw problems stem from missing, damaged or misaligned teeth, restorative dental treatments such as crowns, bridges or implants may be necessary. These procedures not only restore the function and appearance of the teeth but also help to realign the bite and support proper jaw positioning.
Advanced technologies and techniques are utilised to diagnose and treat neuromuscular disorders of the face. EMG sensors, jaw tracker, BioJVA (Joint Vibrational Analysis), Ultra Low-Frequency TENS unit, ultrasound therapy and low-level laser therapy are used to detect and treat neuromuscular disorders. The T-Scan Novus system provides detailed dynamic occlusal measurements, assessing force distribution on individual teeth and overall bite stability.
The benefits of neuromuscular dentistry
Neuromuscular dentistry offers several benefits for patients, especially those suffering from chronic pain or dysfunction related to the jaw. By focusing on the alignment of the jaw and its relationship to the muscles and nerves, this approach can provide lasting relief from symptoms that traditional dentistry may not address. Patients often report a significant reduction in pain, improved range of motion in the jaw, better posture and enhanced overall quality of life.
Additionally, neuromuscular dentistry provides a more holistic approach to treatment, considering not just the teeth and gums but also the muscles, joints and nerves that control jaw function. This comprehensive view allows for more effective and long-lasting treatment outcomes.