Neuromuscular dentistry is the science of studying the muscles and nerves of the head and neck to determine an optimal orthopedic relationship between the upper and lower jaw. This will allow the rest of the body to align properly, and may help eliminate nagging symptoms due to a misaligned bite position. When the jaw is not properly aligned, damage can be done to the teeth as well as their supporting tissues. This approach to neuromuscular dentistry presents an effective, efficient and timely solution to those that suffer.
The dental professionals at Dr Ueckert’s practice focus on finding a harmonious relationship between the temperomandibular joint and its surrounding tissues. With the understanding that each person’s condition is unique, Dr Ueckert uses neuromuscular dentistry to provide proper occlusion to all patients. While not everyone can be cured by this process, he performs all treatments in a slow, thorough and meticulous manner; offering the best neuromuscular dentistry treatments available.
Finding the Right Bite
In neuromuscular dentistry, the initial visit is about gathering data to paint a picture of how the muscles routinely perform. Electromyography (EMG) data is gathered to quantify how each group of muscles must work to make the jaw open, close and chew. This data allows for assessment of whether the muscles are working within an optimal functional range while at rest and during use.
Three dimensional jaw tracking data is taken to accurately envision the exact jaw movements. Deviations in jaw movement in the lateral and frontal directions can be measured down to 1/10 of a millimeter. This type of accuracy is a main tenant of neuromuscular dentistry.
Electrosonography is used to listen to the TMJ opening and closing to ascertain whether there is any pathology within the joint space. If pathology is heard within the joint, then there may be a problem with the way the teeth fit together. This will place the joint in a poor position, which causes the pop and click that maybe felt and even heard. Once all the data is gathered and analyzed, the new optimal bite position can be identified.
Stabilizing the Bite
The next neuromuscular dentistry technique is reprogramming the muscles of mastication to allow them to assume their optimal functional range. The concept of muscle memory applies to all the muscles of the body. It allows muscles to quickly perform routine tasks with little neurological stimulation. Think about activities that improve with practice such as typing, riding a bike, or playing a musical instrument. All these activities train your muscle memory to create maximum motor system performance.
Just like the fingers know exactly where to go to type a letter “T”, the muscles of your head and neck know exactly how to contract to bring your teeth together. Neuromuscular dentistry will make your muscles forget poor position, and create function in the most optimal contractile zone. This is done using the TENS unit also known as a J5 Myomonitor
The TENS (Transcutaneous Electrical Neural Stimulation) unit sends signals to the muscles that are responsible for opening, closing and chewing; causing them contract involuntarily. This machine eliminates any learned patterns of chewing along with acting as a therapeutic massage. Additionally, it will help to expel any toxins, such as lactic acid, that have built up over time in the muscles due to overuse.
The restful position of the lower jaw is identified after 45-60 minutes of therapy. This allows an optimal range of motion to be discovered, which is driven by the muscles and nerves, not the teeth. Once the ideal position of rest has been found, an optimal bite position can then be captured. This neuromuscular approach is the cornerstone of our practice for successfully dealing with TMJ disorders.
Once the muscles have unlearned their “memory” path of contraction, the next neuromuscular dentistry process is to determine where the teeth should come together. This orthopedic bite position will allow the muscles and bones of the head and neck to be aligned in an optimal position. It is the optimal alignment of the head and neck system, supported by a stable bite position, which allows for treating the symptoms of TMJ disorder.
The new bite position is referred to as the “Neuromuscular bite”. With this information, an anatomic, functional, orthotic appliance is created that will replicate the neuromuscular bite position and stabilize this correct positioning. The orthotic fits over the natural lower teeth, and is worn at all times, except during brushing and flossing. It is recommended to eat with it in, as the muscles are retraining to function at a different, more optimal position. This is the “test drive” period of the new bite position.
Finalizing the Bite
Once the bite is stabilized and symptoms are significantly decreased or eliminated, it is time to make permanent adjustments. The new neuromuscular bite is used to develop a restorative plan that will permanently stabilize the bite at this new position. This may require placement of porcelain crowns, changing the shape of some teeth or possibly moving teeth with orthodontics.
This is a meticulous neuromuscular dentistry process that takes time and should not be rushed. The body does not heal overnight, and time must be invested to ensure positive results. If you believe you could benefit from neuromuscular dentistry, contact our office to schedule your consultation. We will be happy to determine your needs, guide you through the neuromuscular dentistry process and answer any questions you might have. Dr Ueckert is one of the country’s top neuromuscular dentistry specialists, and through this approach seeks to improve quality of life for all his patients.
A Neuromuscular Conversation
A Neuromuscular Conversation – Part 2
Neuromuscular Dentistry: Questionnaire