Neuromuscular and TMJ Dentistry Explained
What exactly is “neuromuscular” dentistry? Neuromuscular dentistry is a category of dental treatment aimed at aligning the jaw properly to provide optimal functioning and comfort.
The relationship of your jaw bone to your skull is more important than many people realize. When your jaw is properly aligned, all is well—you are able to chew normally, to swallow your food, to breathe freely and to express yourself with a range of facial expressions and unimpeded speech. When a structural problem exists, however, even these basic functions may be compromised.
In order for your jaw to function properly, it needs to be correctly positioned and adequately supported—the bones, muscles, connective tissue and nerves must work together in harmony. Any structural imbalance will prevent the jaw from opening and closing correctly. This type of structural imbalance is called temporomandibular joint disorder (TMJ or TMD).
According to The TMJ Association, TMJ disorder is extremely common, particularly among women in their childbearing years. Sometimes TMJ occurs as the result of an injury to the face or head, but often it is the result of nighttime bruxism, teethgrinding or jaw-clenching during sleep. The very doctors and dentists that will ultimately treat your TMJ may also have contributed to it—stretching and holding the jaw open during dental procedures and surgeries is also thought to have an adverse effect on a developing TMJ condition. Certain autoimmune disorders and low-level infections can also cause inflammation or degeneration of the jaw joint, worsening TMJ-related symptoms.
Do I Have TMJ?
A report published by the National Institute of Dental and Craniofacial Research explains that the first sign of TMJ is usually craniofacial (head and face) discomfort or a dull, throbbing pain in the jaw. A clicking or popping sound in the joint when you open and close your mouth is also a sure sign that you should be evaluated for TMJ. However, other, less obvious symptoms can also point to a problem with your jaw’s alignment.
Because of the joint’s proximity to the ears, TMJ can cause ear pain and other ear-related discomforts such as vertigo (dizziness), tinnitus (a “ringing” in the ears) or the sensation that the ears are clogged. Some patients also report tooth sensitivity or general aches and pains, most often involving the head, eyes, neck, throat and shoulders. Chronic “tension” type headaches are one of the most prevalent symptoms of TMJ disorder. Because of the variety of symptoms associated with TMJ, misdiagnosis is common.
What Are the Benefits of Treatment?
The primary benefit to treating your TMJ is the relief of the pain and discomfort associated with your condition. When the joint is repositioned properly, your ability to move your jaw freely is restored and TMJ-related symptoms are lessened or eliminated.
There are other preventive benefits to treatment as well. Leaving your TMJ untreated may set you up for more serious problems over time, including sleep apnea, migraine headaches, back or neck pain, and muscle spasms. If the condition is aggravated by ongoing grinding, clenching or repeated injury, you could ultimately face challenges with speech, chewing and swallowing, facial expressions and even breathing.
What Are the Risks?
There are many ways to treat TMJ. The most common and least invasive is the use of a special appliance to prevent grinding your teeth and clenching your jaw during sleep. Your dentist will likely also prescribe rest for your jaw and may suggest stretches and relaxation techniques to help you avoid putting excess pressure on the joint. These non-invasive treatment techniques are not associated with any major risks although some discomfort may be associated with wearing an appliance.
Another treatment option involves irrigating the joint using a local anesthetic and the injection of fluids. This procedure is generally effective at relieving the pain associated with TMJ and, if not successful, can perform a valuable role in diagnosing the root cause of your discomfort. This minimally-invasive procedure is associated with few risks.
As a last resort, surgery may be considered. As with all surgeries, certain risks are involved. You may experience bleeding, swelling, pain or infection. Although rare, nerve damage or injury to the adjacent ear may also occur.
The Bottom Line
While TMJ can certainly be debilitating condition, it is also treatable. With the help of a qualified dentist, your jaw can be coaxed back into its proper alignment, eliminating the pain and discomfort associated with TMJ and restoring the joint to its full function.
The information in the article is not intended to substitute for the medical expertise and advice of your healthcare provider. We encourage you to discuss any decisions about treatment or care with an appropriate healthcare provider.
According to the National Institutes of Health TMJ brochure “Research disputes the popular belief that a bad bite can trigger a TMJ disorders”. As with many other TMJ dental treatment groups that have their own standards, those who practice neuromuscular dentistry have their own standards for what are normal and abnormal readings so that patients may be told they have a TMJ problem when they really don't, leading to unnecessary treatments.
There is no specialty in TMJ diseases and disorders because this area lacks the science necessary for the American Dental Association and American Medical Association to establish a specialty. Although a variety of healthcare providers advertise themselves as TMJ specialists, treatments available today are based largely on beliefs, not on scientific evidence.
The TMJ Association – September 17, 2009 , 3:46 PM