TMJ or as the dental profession refers
to as
TMD, patients occupy a unique niche in our health care system. They often shuttle from doctor to doctor in search of a solution to their discomforts that are not easily remedied, or even diagnosed by the medical and dental establishment. TMJ patients often face an indifferent attitude from insurance companies who, at best, limit their benefits to cover needed treatment. Sometimes they are told they are in need of psychological counseling to treat very real physical symptoms. This is usually a very frustrating journey.
There can be much confusion of people who suffer from TMD and that confusion has come from a lack of a cohesive definition by the dental and medical professions. Today with new knowledge, and the application of modern bioelectronic technology, TMD and other complex dental problems can be successfully diagnosed and treated. The technology used for this diagnosis and treatment is commonplace in our computerized world, and is utilized as an extension of the doctor's senses to measure and quantify muscle and jaw physiology that we cannot see with our eyes, feel with our hands, and hear with our ears. This specialized diagnostic equipment is non-invasive and painless.
The benefit for patients with complicated dental conditions such as TMD or patients needing extensive restorative dentistry, is that treatment decisions are based upon measured physiologic parameters. Dr.
Bernard Jankelson, the founder of neuromuscular dentistry, was fond of stating "If it as been measured it is a fact, if not it is an opinion." Unfortunately, many TMD, or extensive dental restorative patients, are diagnosed and treated with a good deal of opinion, and not upon measured physiologic facts that neuromuscular dental treatment facilitates. Every person is unique and must be treated as such for successful outcomes. Objective measurement of jaw and muscle physiology can help give the dentist a blueprint (road map) for successful and predictable treatment by facilitating the identification of specific dysfunctions present in the TMD patient. As stated earlier, every person has a unique jaw and muscle physiology. This is of prime importance and must be respected. Although no two people are alike, this is an outline of neuromuscular dental diagnosis and treatment: The patient is evaluated thoroughly with a complete examination. Reviewing the medical and dental histories may reveal critical information pertinent to the dysfunction. Bioelectronic measurement of muscle physiology and jaw movement can pinpoint specific problems in the TMD/complex restoration case that we may not detect conventionally. The doctor's senses alone are not sensitive enough. A thorough examination utilizing bioelectronic instrumentation can detect these important findings: acute and chronic muscle spasm in the jaw and head musculature, presence or absence of displaced articular disks, jaw muscle status during function, presence of arthritis in the temporomandibular joints, and identify the true physiologic rest position of the mandible (jaw), the location from which ideally all dental restorative procedures should commence.
The identification of the true neuromuscular (physiologic) rest position is the critical step in neuromuscular dental treatment. This is the position where muscles relax and function most efficiently. Since most pain in the TMD patient arises from injured or unhealthy muscle, muscle function normalization can greatly reduce pain. A precision oral appliance is fabricated and worn by the patient. When the rest position is correctly identified, appliance therapy can rapidly reduce TMD symptoms including headaches, clicking and popping joints, ringing ears (tinnitus), jaw pain, and a locking jaw. When symptoms become reduced or disappeared, the appliance becomes a guide for permanent stabilization procedures that can include orthodontics or prosthetic and reconstructive dentistry.
