Neuromuscular Dentistry (Head Pain, Jaw Problems, Neck Pain)

Dentistry is about more than just your teeth

Neuro - Head, Mandible, Hyoid, Cervical, Shoulder Girdle Most patients do not realize that muscles play an important role in dentistry. In an improper bite, your jaw posturing muscles can be overworked in an attempt to maintain your present “programmed” bite position, even when you think they are relaxed. Head posture can also affect your occlusion and muscles that control head pos-ture are primarily in the neck and upper back. Taken together, these conditions can lead to a variety of problems including a less than ideal bite, muscle contraction headaches, pain in the neck or shoulder region and/or jaw joint problems (TMJ). The science of Neuromuscular Dentistry (NMD) evaluates and treats your overall oral health by considering how your muscles, teeth and joints all work together. As a neuromuscular dentist, my goal is to determine the jaw position that is associated with re-laxed posturing muscles and adjust or alter your occlusion (bite) to that position.

Is Neuromuscular Dentistry For You? There are often op-tions to consider when you are choosing dental treatment. After initially evaluating your situation, your dentist should always be willing to discuss those options with you. In many cases, NMD becomes one of your options especially when considering aesthetic, cosmetic, reconstructive or orthodontic dental procedures. Additionally, NMD tech-niques are used to treat pa-tients that suffer from TMJ-like symptoms and aid in establishing the occlusion (bite) for den-tures. It is in these cases that establishing the optimal bite be-comes so important and adds years of longevity and comfort to the treatment.

Understanding TMD (TMJ)

Temporomandibular Disorder

Temporomandibular Joint (TMJ) TMD refers to a disorder as opposed to a disease and does not have a single cause or a single symptom. As a matter of fact, TMD sufferers commonly have several symptoms and there may be more than one underlying cause. Common signs and symptoms include headaches, jaw joint pain, jaw joint noise or clicking, ear con-gestion, facial pain, sensitive teeth, neck pain, postural problems, ringing in the ears, dizziness, difficulty swallowing, and loose teeth. Both signs and symptoms are an important part of TMD diagnosis. As your dentist, we will carefully note any signs that you exhibit- forward head posture, crowding or excessive wear of front teeth, loose teeth, and gumline erosion to name a few.

Your Bite and TMD. Most people don’t realize that their bite can be a primary cause of pain and dysfunction of the head and neck. Until re-cently, dentistry has largely been based on the assumption that wherever your bite naturally occurred (habitual occlusion), was the correct position. In fact, most dental treatments are still planned from the patient’s existing or habitual occlusion. Although this bite can be a reasonably good position some of the time and because our body systems are often adaptable to less than ideal circumstances, many of these procedures have an acceptable re-sult.

However, if the patient’s habitual bite shows signs and symptoms of exces-sive wear, gumline recession, joint pain or noise and/or muscle pain and headaches, then many times treatment procedures carried out using this bite will not produce a result that is fully functional or comfortable.

Neuromuscular Dentistry & TMD. Neuromuscular dentistry (NMD) en-hances traditional dentistry and is used to describe the additional consideration of muscle and joint status when evaluating your bite (occlusion). While dentistry has always focused on the teeth, the effects of muscle forces on occlusion and, likewise, the effects of the bite on the muscles and the jaw joints are now widely recognized.

If you have been diagnosed with TMD (TMJ) or have some of the aforementioned signs and symptoms, please give our office a call. As a NM dentist, our office is one of only a few in the entire area to have the latest diagnostic equipment to properly evaluate, test and treat your condition.

Cosmetic Dentistry (Laser Tissue Treatments)

Things You Should Know

Cosmetic Dentistry - Laser Tissue Treatment) Most of us have seen the spectacular smile makeovers on TV. There is no doubt that modern techniques and materials permit spectacular results in what has come to be known as cosmetic dentistry. What is less known is that frequently the cause of a poor smile is related to a bad bite (malocclusion). Further, if that malocclusion is not cor-rected as part of the cosmetic treatment plan, there is a good probability that the cos-metic work will not last nearly as long as it should.

My staff and I have undergone post-graduate training in what is known as neuromus-cular (NM) dentistry. NM dentistry goes beyond simply considering the teeth. It takes into consideration not only the teeth, but the jaw joint and the muscles that control your lower jaw. If there is an imbalance in this system (teeth, joints, muscles), it not only can lead to various types of head and neck pain, but also can be the cause of your need for cosmetic dentistry. With our advanced training and instrumentation, we are careful to restore not only the appearance of your smile, but the function of your bite as necessary.

If you have any questions, please feel free to give us a call. Or, if you were thinking about having cosmetic dental procedures done, mention this letter when you call and we will provide you with a free initial examination.

Headaches (Muscle Tension Headache, Muscle Contraction Headache)


Headaches - Muscle Tension Headache, Muscle Contraction Headache Headaches are generally classified into several basic types: Sinus, Cluster, Tension and Mi-graine. You can determine which type you have by discuss-ing it with your physician or dentist. While headaches are typically treated by your physician, improper occlusion (your bite) may play a significant role in certain types of headaches as well as other head and neck pain.

The muscles of the temple area of the forehead are muscles that play an important part in the posturing and closing of the jaw. If your occlusion (bite) is not right, it can lead to abnormal tension in these muscles- one of the several possi-ble causes of tension type headaches. If the bite is not corrected, the muscles may remain tense for long periods of time. The contracted muscle does not get a chance to rest and soon suffers from poor circulation- thus a lack of needed oxygen and the accumulation of waste prod-ucts of metabolism. The result can be pain (headache). New technology allows us to objectively evaluate the state of these muscles and various other factors affecting your bite. Based on this and other information obtained from a thorough physical examination, we can rule in or rule out your bite as a possible cause of headache pain.

Headaches are just one symptom that may be attributed to a poor bite. Other symptoms such as pain or noise in the jaw joint, facial pain, sensitive teeth, difficulty chewing, and neck pain may also be related to your occlusion.

Your Teeth & Your Airway

What have my teeth got to do with my airway?

Your Teeth & Your Airway Do you or someone you know breathe with your mouth open most of the time or snore loudly? This condition, generally known as mouth-breathing, is a result of partial blockage of the nasal airway. It can have a number of causes and can be the source of significant medical or dental problems. People who snore very loudly and/or seem to stop breathing for what seems like a long time, should be medically evaluated for a condition known as sleep disordered breathing or sleep apnea. Once diagnosed with sleep apnea, a custom-made dental appliance is one of the most com-mon means of correcting this problem.

In addition, as a dentist I am interested in these signs or symptoms since they can be related to your bite. The mus-cles of the cheeks and the tongue are powerful muscles. During the main growth stages (pre-adolescence) the upper and lower dental arches mainly get their shape and characteristics from these strong muscles forces working on either side of the teeth. If this system is “in bal-ance” the dental arches are wide, the roof of the mouth quite flat, and there is plenty of room for the tongue inside the teeth while your mouth is closed and you breathe through your nose. If you are unable to breathe freely through your nose and hold your mouth open to breathe more easily, the strong mus-cles forces of the tongue can play havoc with your bite.

I wanted to call this to your attention for two reasons. First, if you have, or know, a young child that is mouth breathing, they should be evaluated as early as possible. In young children, treating the condition early will allow normal development of the dental arches and avoid more complex problems in adulthood. Secondly, if you or a family member are considering major dental work (orthodontics, cosmetic, or reconstruction) failure to include correction of the breathing problem in your treatment may very well have a negative impact on your new dental work.

If you have any questions or would like a complimentary brochure, please give us a call. Or, if you think you may have an airway problem, mention this newsletter when you call and we will pro-vide you with a free initial examination.

Dental Implants: Done the Right Way

Dental implants are a proven and predictable means of replacing missing teeth or stabilizing a removable prosthesis like a denture. Done and cared for properly, dental implants can provide a lifetime of service and, unlike natural teeth, are resistant to decay and periodontal disease. However, in order to have long lasting success with dental implants, abnormal and destructive occlusal forces from a bad bite must be eliminated. Neuromuscular dentistry in combination with implant restoration is taking the guesswork out of traditional dental implant technology, which is good news for dentists and patients alike. Now, the advanced technology of neuromuscular dental implants allows the assessment and planning necessary for placing a patient’s implant- supported restorations to be done with a computerized evaluation prior to implant placement. “In short, we are able to determine the most optimal position for the implant-supported restoration prior to implant placement insuring the greatest potential for a long-lasting result.”

In addition, the utilization of the latest three-dimensional x-ray technology allows us to pinpoint the exact location for a patient’s implants with much greater ease and precision allowing for more conservative and comfortable surgical procedures.

Finally, by incorporating all-tissue laser dentistry as part of the implant restoration process, we can often replace an unsaveable natural tooth immediately with a dental implant thus eliminating multiple surgeries and shortening your overall treatment time.

A Perfect Bite Is More Than Straight Teeth

In dental school, we were taught that teeth are attached to the jaws, yet there are also muscles, joints, nerves, and blood vessels that make up the whole head and neck complex. Somewhere along the line, some of us have forgotten that basic knowledge. When closing the jaw teeth, we guide the muscles to a position — but that’s not always where the muscles want to be. If the bite is off, the muscles will fight to stabilize the jaw. If a person’s bite is out of line with where the muscles naturally want to go, the muscles become strained and tired resulting in jaw pain, neck pain, headaches and recrowding of the teeth. Teeth act like gears in a machine. When a machine is balanced and works properly, the gears will mesh allowing the machine to run smoothly and efficiently without having to put in a lot of energy. However, when something is out of whack, the machine begins to break down. Establishing an occlusion (bite) based upon the most stable position and function of the temporomandibular joints and the most relaxed posture and function of the chewing muscles is a key component of neuromuscular dentistry and neuromuscular orthodontics. It is commonly assumed that the teeth, active muscles, and jaw joints will accommodate to the treated occlusion however, this is often not the case. With bioinstrumentation, it is possible to determine a proper resting jaw position that positively affects the facial, head, and neck muscles, as well as the teeth and joints.

Neuromuscular orthodontics emphasizes how the muscles, jaw joints, and teeth affect one another. Proper meshing of the teeth so that they function in harmony with the jaw joints and muscles will allow teeth to wear and function evenly, be stable, and decrease trauma to the surrounding supporting bone. By using bioinstrumentation with a neuromuscular approach, the fundamental and structural components of the face (which includes the jaw), the jaw joints and muscles are taken into consideration in assessing optimal function. The use of this state-of-the-art jaw recording instrumentation identifies a proper tongue and jaw position to help eliminate negative forces on teeth. Rather than guessing subjectively and assuming the jaw trajectory is correct, the instrumentation assists in identifying a correct jaw position before and after orthodontic treatment.

By positioning teeth and jaws on a stable neuromuscular trajectory, any unidentified occlusal forces and muscular imbalances that would encourage further relapse are eliminated.