TMJ treatment outline

Every person has unique jaw and muscle physiology.  This is of prime importance and must be respected.  Although no two people are alike, this is an outline of neuromuscular diagnosis and treatment.  The patient is evaluated thoroughly with a complete examination.  Medical history is very important especially any history of allergies, breathing problems, or upper airway obstruction.  Dental history is critical and particular attention must be paid to the analysis of casts of the patient's teeth to evaluate the extent of the problem.  Bioelectronic measurement of muscle physiology and jaw movement is very sensitive and illuminating.  Electrical activity of muscle is measured to one ten-millionth of a volt, and sonography of the temporomandibular joints records sounds that can indicate disease processes that cannot be heard with or without a stethoscope.  A thorough examination utilizing bioelectronic instrumentation can detect these important findings:  acute and chronic muscle spasm in jaw musculature, presence or absence of displaced articular disks, jaw muscle status during function, presence of arthritis in the temporomandibular joints, and identify the true physiologic rest position of the mandible (jaw), the location from which ideally all dental procedures should commence.
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    The identification of the true neuromuscular rest position is the critical step in neuromuscular dental treatment.  This is the position where muscles are relaxed and function most efficiently.  Since most pain comes from injured or unhealthy muscle, muscle function normalization greatly reduces pain.  A precision oral appliance is fabricated and worn by the patient.  When the rest position is correctly identified, appliance therapy can rapidly reduce TMD symptoms including headaches, clicking and popping joints, tinnitus, jaw pain, and a locking jaw.  When symptoms become greatly reduced or disappeared, the appliance becomes a guide for  permanent stabilization procedures that can include orthodontics or prosthetic dentistry.