What is Neuromuscular Dentistry? (PART TWO)

Neuromuscular dentistry is a medical paradigm in which TM Joints, masticatory muscles and central nervous system mechanisms follow generic physiologic and anatomic laws applicable to all musculoskeletal systems. It is a treatment modality of dentistry that objectively focuses on correcting misalignment of the jaw at the temporomandibular joint (TMJ).

In previous post, we discussed that Neuromuscular dentistry acknowledges the multi-faceted musculoskeletal occlusal signs and symptoms that relates to postural problems involving the lower jaw and cervical region. Neuromuscular dentistry recognizes the need to solve the root of the misalignment problem(s) by understanding the relationships of the tissues which include the muscles, teeth, temporomandibular joints, and nerves.

The importance of a correct bite

As you have now learned, neuromuscular dentists evaluate the muscles and joints in addition to the teeth to establish a neuromuscular occlusion that they believe is crucial to achieving optimal results in virtually every type of major dental procedure and in treating many types of pain and dysfunction. No matter what type of treatment you are considering, it is important that you understand the significance of getting your bite right.

In short, neuromuscular dentistry and technology add objective data and understanding to previous mechanical models of occlusion.

How do we get the bite right?

Now that you know how important your occlusion is, let's discuss how the neuromuscular dentist evaluates your bite and establishes your neuromuscular occlusion.

Muscle relaxation

Earlier we discussed the important role that muscles play in your bite and temporomandibular joint health. We learned that muscles will accommodate to overcome an otherwise bad bite and to allow the teeth to come close to occlusion. And, that as a result, the muscles are sometimes subconsciously held in abnormal continual contraction through the process of proprioception. So, if this is done subconsciously, how do we get those muscles to relax?

It is extremely difficult, if not impossible, to achieve true muscle relaxation by just asking someone to relax those muscles. Proprioception may be overcome through a process called biofeedback training, but that generally takes a long time and is not practical for clinical use during dental appointments. Further, the muscles will again assume their tense state as soon as the biofeedback session ends or you start biting.

The way that the neuromuscular dentist achieves relaxed muscles is through the use of electrical muscle stimulation, sometimes referred to and TENS (Transcutaneous Electrical Neural Stimulation). A device called the Myomonitor is used to deliver gentle electrical stimulation to your muscles to help them get to that relaxed state. The Myomonitor is a battery operated electrical muscle stimulator. Mild electrical stimulation is delivered through adhesive electrodes attached to the skin over muscle sites and nerves that control specific muscle groups. The stimulus delivered by the Myomonitor will cause your facial and jaw muscles to twitch or “pulse” once every one and one half seconds (40 times per minute).

Tense muscles suffer from restricted blood flow. As the muscles are “exercised” with the electrical stimulation and the muscles being to relax, blood flow in the muscles increases. This not only brings more oxygen and nutrients to the muscles, but flushes away accumulated waste products of metabolism. Usually after 30-60 minutes, this electrically induced “exercise” will allow your muscles to overcome their programming and go to a state of physiologic rest.
We learned that tense muscles in the neck or upper back (cervical muscles) can affect head posture and therefore have an affect on occlusion. If the dentist determines that to be the case, they may also want to use electrical stimulation to help relax those muscles.

Muscle relaxation can also be an effective means of pain relief. If pain (such as the temporal headaches referred to earlier) is originating from muscle tension, relaxation of the muscle with electrical stimulation may result in pain relief as the muscle is restored to a more normal physiology. This can be an effective means of drug-free pain relief for some patients. However, this pain relief is temporary. It does not get at the underlying cause of the pain so it more than likely will return unless the underlying problem is treated.

Once your muscles are relaxed, the neuromuscular dentist will confirm and record the position of your jaw through a process called bite registration.

- Cloverdale Dentist