TMJ Disorders or TMD hare often an Enigma to most dentists.
Neuromuscular Dentists utilize modern technology to offer a personalized medicine approach to these issues. All Neuromuscular Dentists are not alike and I strongly suggest looking for a Neuromuscular Dentist who is a member of ICCMO, the International College of Craniomandibular Orthopedics.
They utilize the concepts that approach TMD disorders from a primary functional direction and are experts at evaluating orthopedic problems that cause TMD issues. The OroFacial Pain dentists take a medical approach to TMD and tend to ignore the occlusal concepts and do not consider correction of occlusal and joint issues as a primary portion of diagnosis or treatment.
What is the approach of the top Neuromuscular dentists?
First, they realize the importance of complete diagnosis including complete medical history review., neurological evaluation, full body posture analysis and more. They also tend to look at full body posture and pay attention not just to jaw and joint position but also evaluate head position, Upper Cervical Alignment and many work with Atlas/ Orthoganol or NUCCA Chiropractors as well as with Physical Therapists.
Most important, is that use medical instruments that measure the physiologic function of the jaw joints, the jaw muscles and the interactions with posture. They utilize Ultra-low frequency TENS to relax the muscles naturally by causing repetitive contraction and relaxation which pumps out waste products from the cells and brings in nutrition. This is very similar to warm up and cool down exercise as part of a fitness program. Most TMD issues include muscles and connective tissues known as Fascia. TMD problems are a type of Repetitive Strain Injury similar to Carpal Tunnel issues, Tennis Elbow and other disorders that occur secondary to abnormal function. In medicine, an important concept is "Form Follows Function".
The gathering of information was described by Dr Barney Jankelson the Father of Neuromuscular Dentistry as "If it is measured it is a fact, otherwise it is merely and opinion!" Carpenters describe this concept as "Measure twice, cut once!" This is where the DNO™ or Diagnostic Neuromuscular Orthotic comes into paly. After differential Diagnosis there is a hiearchy of possible diagnosis and often there are multiple related diagnosis that apply. The DNO™ Appliance or the Diagnostic Neuromuscular Orthotic is utilized to check the validity of that diagnosis. It is a reversible procedure designed to confirm diagnosis and be an initial approach to treatment.
The DNO@ is a "test drive" for the patient a allows for a period of time for structural issues to correct. A problem that has grown for years or even decades has had a multitude of compensations throughout the body. These are best understood by studying the work of Sir Charles Sherrington who received a Nobel Prize for his work on the Righting Reflex. Sherrington showed that these compensations occur almost instantly to maintain homeostasis. Much like the Patella Tendon reflex elicits a kick when tapped, so does the righting reflex elicits full body compensation and both of these are peripheral reflexes that do not include the Central Nervous System.
The changes can take place very rapidly, this link is to a small pilot study on evaluating Descending Sherrington issues in patients who had uneven hip heights at initial physical therapy exam. 78% of patients (n=27) with uneven hip heights had 100% correction in 3 minutes of walking on a treadmill. It is important that patients be aware of the full body effects of a pathologic and/or unbalanced bite. In my practice when utilizing the DNO™Appliance correction of descending disorders is an important part of the first treatment visit. The Diagnostic Neuromuscular Orthotic should maintain this correction for the patient! This is just one of many diagnostic aspects of the DNO™. Orofacial Pain doctors and orthodontists rarely look or try to correct these issues. https://www.tandfonline.com/doi/full/10.1080/08869634.2022.2031169
The next article is mine and was published in the same issue of CRANIO Journal when I was Editor in Chief of Cranio Journal. https://www.tandfonline.com/doi/full/10.1080/08869634.2022.2031167
This article was written in 2007 for CRANIO Journal, I was asked to write it by Dr Riley Lunn the Founder of CRANIO Journal because I was one of the few dentists in the world with 25 years experience in treating Sleep Apnea, and as a Visiting Assistant Professor at Rush Medical School from 1985-1991 and as an Assistant Professor from 1998-2001. I was the first dentist to be a professor at a medical school sleep disorder center. More important was the Sleep Lab Chair of the Department was Dr Rosalind Cartwright, generally acknowledged as the mother of Dental Sleep Medicine.
While Dr Shapira is very interested in science the Best Patient Outcomes is his primary concern. His YouTube Channel has over 250 Patient Testimonial Visits. https://www.youtube.com/@thinkbetterlife-orofacialp9625/videos
This link is to a FREE prepublication version of Dr Shapira's Article on Neuromuscular Dentistry and the Autonomic Nervous System. https://www.sphenopalatineganglionblocks.com/spg-blocks-and-neuromodulation/
This link is to pubmed abstract of the article. https://pubmed.ncbi.nlm.nih.gov/30973097/
