Neuromuscular Dentistry

Phone 425.466.0100

Motion, movement, action to breath, eat and talk are the physiologic functions of the mouth.  Dentistry is more than fixing holes and cleaning teeth.  When working with "ease" the mouth should have full range of motion without muscle, joint or teeth pain. As Neuromuscular Dentists, Drs. Osmunson and Bowden measure the Range of Motion of the mandible to ensure smooth comfortable movement.   Neuromuscular      dentistry can help achieve the best comfort, health, and aesthetics for your smile.

Zebris Jaw Tracking, anterior and condylar

WHAT IS NEUROMUSCULAR DENTISTRY?

Neuromuscular Dentistry places the teeth, fillings and restorations where the nerves and muscles are at their best to prevent problems of TMJ/TMD (Temporomandibular dysfunction), or in the case of damage from whiplash or injury to provide the most ergonomic and comfortable mandibular position. Neuromuscular dentistry includes the evaluation of the causes for TMD.  Frequently injury or a reduced or restricted airway can cause poor tongue and muscle posture resulting in an incorrect position of teeth and development of the jaws, joints, and nose.

Recent advancements in technology have allowed Neuromuscular Dentists to more accurately measure the most comfortable (least muscle tense) position of the jaw for rest and function.   

WHO NEEDS NEUROMUSCULAR DENTISTRY?

            A thorough dental diagnosis should include teeth, periodontium (gums), bones, ligaments, joints, nerves, muscles, speaking, eating and airway.  Anyone considering braces, fillings, restorations or periodontal treatment should include an evaluation of the forces and function of muscles so the position of the teeth do not cause symptoms.  It is not unusual for symptoms of TMJ, clicking popping of the joint, muscle pain, tension behind the eyes, headaches, etc. to surface months or years after the treatment.  Chronic muscle tension does not always have a rapid onset of pain.  In some surveys women rate headaches as their number one health care concern.  Neuromuscular dentistry can treat about 90% of headache pain.

TREATMENT

The first step in treatment is a thorough diagnosis which includes temporarily positioning the jaw in the neuromuscular position for healing.  During this diagnostic phase the patient can feel the difference, see the difference and know what it will be like to have a correct jaw position. This is a reversible diagnostic phase.            The second step is to review the options in making this position permanent.  If the benefits are not worth treatment, the patient is returned to their original jaw position.

Treatment can vary from simple adjustments, braces, or restorations of some or all teeth.  In the course of a thorough evaluation other problems of airway and posture may result in further treatment. 

BENEFITS

            Benefits range from the prevention of symptoms, pain and damage to the treatment of pain, joints, teeth, bones, muscles, improved airway and quality of life. The relief of muscle spasm and pain is frequently a life altering experience. 

 “HAPPY MUSCLES”  

Happy muscles work together in harmony and when finished working, rest comfortably.  When muscles rest comfortably, they do not cause symptoms such as grinding, wearing, and pushing of the teeth.  Only by measuring the muscles with simultaneous jaw tracking can the doctor determine how the muscles are reacting in each jaw position. To the left are EMG recordings of muscle hyperactivity before and rested muscle activity after.  To maintain rested muscles, the clinician must start out with rested muscles.

The muscles which power our jaw can become tense, sore, and spastic due to improper jaw and teeth position.  These unhappy muscles can contribute to a significant amount of pain, tension and lower the quality of comfort in and around our mouths.          

Unhappy muscles can contribute or cause a wide assortment of problems including painful teeth; gum disease; painful, clicking. or popping jaw joints (TMJ or TMD, temporomandibular dysfunction); hearing and ear problems (dizziness, chronic ear infections, ringing); headaches; face, neck and back pain; tingling in the fingers; sleep problems; chipped and warn teeth.  Painful muscles inside our heads are sometimes behind the bones and hard to reach and touch.

NEUROMUSCULAR DENTISTRY CAN RESOLVE SYMPTOMS

Estimates range from 20% to 80% of Americans suffer from symptoms of  tense, tight, spastic and tired muscles in the head, neck and shoulders,  TMJ or TMD.  A bad bite position can cause or increase many painful and damaging symptoms by  requiring  the jaw to posture for swallowing and biting so the muscles and forces maintain a high level of tension and never truly rest.  Neuromusuclar dentistry determines the optimal bite position of the teeth so the muscles work in harmony rather than in conflict with each other.  This ergonomic posturing is like lifting loads with your arm in front of you rather than lifting loads behind your back.  The position of the teeth must be extremely accurate for comfortable relaxed muscles.

Symptoms include:

• Headaches / Migraines
• Postural Problems
• Facial pain
• Neck and shoulder pain
• Tinnitus (Ringing in the ears)
• Unexplained loose teeth
• Sensitive and sore teeth
• Jaw pain
• Limited jaw movement or locking jaw
• Numbness in the fingers and arms
• Worn or cracked teeth
• Clicking or popping in the jaw joints

·     Depression

DIAGNOSTIC AND TREATMENT CONSIDERATIONS:

PHYSIOLOGIC REST

            Jaw positioning begins with “rest”.   To sustain relaxed musculature, a relaxed position of the jaw must be found and maintained between episodes of work.  Physiologic rest should be evaluated with surface electromyography, evaluating for rest without fatigue.  Just like blood pressure, the patient and dentist cannot determine whether the muscles are fully relaxed without measuring the muscle activity on each person.

ERGONOMIC PATH OF CLOSING

            When the jaw closes without food, muscles should not work any harder than to counteract the effect of gravity.  The muscles should not have to torque, twist, or move the jaw into any strained or tense position because of malocclusion of the teeth.  The ergonomic path or trajectory of closing should be measured to make sure the teeth are lined up with a NON postured position.  Just like an arm has a “most comfortable swing of movement” so the jaw should have a most comfortable, relaxed, ergonomic path or swing of closure.

SIMULTANEOUS TOOTH CONTACT

            When the teeth contact in closing, the patient should feel comfortable even contacts on both sides.   Based on the sequence of muscle contraction, the bite can be precisely adjusted to ensure relaxed posturing of the muscles.  

Myotronics Jaw tracking and EMG

AESTHETIC DENTISTRY, COSMETIC DENTISTRY

            “Form follows function”.  Optimal beauty will only happen in the absence of pain, stress, and tension.  Both Aesthetics and Neuromuscular Dentistry combine to provide the best health.  Beautiful teeth causing painful muscles do not create a dazzling beautiful smile. Aesthetic neuromuscular dentistry ensures teeth, gums, and muscles are beautiful.

PHOTOGRAPHS, RADIOGRAPHS AND STUDY MODELS

            Dental records are essential for a complete dental diagnosis and vary depending on the problems and symptoms of each patient.  Each patient's specific needs and problems will determine necessary dental records. 

SONOGRAPHY

Sonography enables Drs. Osmunson, Bowden and Lawson to accurately measure joint sounds and degeneration of the jaw joints.  These measurements help diagnose the quality, quantity and location of sound during movement indicating the amount of clicking, popping, grinding, scraping and screeching taking place in the joint.  During and again after treatment, these sounds can be compared and the improvement in healing monitored.  Unhappy muscles can cause joint disease.

ULF-TENS

            Traditional dental treatment is built to fit your existing dental conditions and problems.  In order to end with comfortable muscles the doctor needs to start with comfortable muscles. ULF-TENS massages the muscles, works out lactic acid and works in fresh blood and nourishment for the muscles to relax.  Relaxed comfortable muscles and nerves must be the foundation for jaw positioning and then dental treatment. The finest Myotronics ULF-TENS is incorporated into diagnostics and treatment.

ELECTROMYOGRAPHY

            Electromyography is technologically monitoring the electrical activity and tension in a muscle.  Not unlike a physician taking an EKG of the heart, Drs. Osmunson, Bowden and Lawson can monitor and record the muscles of chewing.  One of the most exciting aspects of the EMG is the ability to measure the accurate fit of the teeth when biting.  Precise adjustments of crowns, fillings and teeth not only help teeth last longer but reduce disease and improve the comfort of muscles and teeth.  

JAW TRACKING