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Saturday, June 12, 2010

Neuromuscular Dentistry, Neuromuscular orthotics, Neuromuscular Reconstruction all work by removing impediments to healing.

To understand Neuromuscular Dentistry you need to recognize the difference between ideal health,absence of overt disease and the presence of TMD symptoms including Migraines, Tension Type Headaches, Chronic Daily Headaches, Facial Pain, Sinus Pain and/or sinus headaches, temporal headaches, morning heaaches and hundreds of other symptoms of TMD (temporomandibular disorders).

We all recognize when we do not fel well but often we are subject to sub-clinical disease where there are neuromuscular adaptations that allow us to cover-up most symptoms but are still far from ideal health.

Is health the absence of Illness or is it optimum health a state where our physiological and anotomical processes function at their best.

The real beauty of Neuromuscular Dentistry (http://www.sleepandhealth.com/neuromuscular-dentistry) is that it produces idealized physiology of the trigeminal nervous sytem and idealization of the posture of the patient. Posturology is the science of ideal posture, Neuromuscular Dentistry combines idealized posture, physiology and neural function.

What is a diagnostic Neuromuscular Orthotic? A diagnostic orthotic allows the application of Neuromuscular Dentistry to idealize a three dimensional relation of the cranium to the mandible. Idealizing this relation starts a process of healing and postural corrections. The diagnostic orthotic is adjuste to match healing throughout the body. This is not magic though many patients report pain relief that seems magical.

In reality as we remove impediments to healing, the body heals itself. This is what holistic medicine and/or anti-aging medicine is about. Creation of a internal environment that idealies internal physiological processes. A Neuromuscular Reconstruction is a long term solution to long term stabilizing of the most important joints and systems in the body.

The trigeminal nerve is responsible for maintaining nutrition and respiration both necessary for life. The trigeminal nerve also is key to communication and central to romance and interpersonal relations. The trigeminal nervous system is key to almost all measures of health due to its autonomic functions and control of blood flow to the brain.

Wikipedia defines Neuromuscular Dentistry based on symptoms rather than underlying science. The current Wikpedia definitions are reproduced below. In future blogs I will point out shortcomings to these definitions.

"Neuromuscular dentistry is a dental treatment philosophy in which temporomandibular joints, masticatory muscles and central nervous system mechanisms are claimed to follow generic physiologic and anatomic laws applicable to all musculoskeletal systems. It is a treatment modality of dentistry that focuses on correcting "misalignment" of the jaw at the temporomandibular joint (TMJ). Neuromuscular dentistry acknowledges the multi-facted musculoskeletal occlusal signs and symptoms as they relate to postural problems involving the lower jaw and cervical region. Neuromuscular dentistry claims that "misalignment problem(s)" can be corrected by understanding the relationships of the tissues involved, which include muscles, teeth, temporomandibular joints, and nerves. In short, proponents of neuromuscular dentistry claim that it adds objective data and understanding to previous mechanical models of occlusion.
Symptoms of temporomandibular joint disorder (TMD) are claimed to include:
Headaches / migraines
Facial pain
Back, neck and shoulder pain
Tinnitus (ringing in the ears)
Vertigo (dizziness)
Trigeminal neuralgia (tic douloureux), a neuropathic pain disorder unrelated to TMD
Bell's Palsy, a nerve disorder unrelated to TMD
Sensitive and sore teeth
Jaw pain
Limited jaw movement or locking jaw
Numbness in the fingers and arms (related to the cervical musculature and nerves, not to TMD)
Worn or cracked teeth
Clicking or popping in the jaw joints
Jaw joint pain
Tender sensitive teeth
Trigeminal sensitization of the brain and related Fibromyalgia
A limited opening or inability to open the mouth comfortably
Deviation of the jaw to one side
The jaw locking open or closed
Postural problems (forward head posture) Forward head posture is actually forward neck posture with rotation of the occiput an the atlas.
Pain in the joint(s) or face when opening or closing the mouth, yawning, or chewing
Pain in the muscles surrounding the temporomandibular joints
Pain in the occipital (back), temporal (side), frontal (front), or infra-orbital (below the eyes) portions of the head
Pain behind the eyes
Swelling on the side of the face and/or mouth
A bite that feels uncomfortable, "off," or as if it is continually changing
Older Bells palsy
The basic premise of Neuromuscular Dentistry is to find a rest position that when the patient closes their mouth to swallow the muscle will return to a healthy rest position. There should be no muscle accomadation necessary to go from rest to Myocentric position. The Trigeminal Nerve is paramount in attaining this position. Swallowing is a neuromuscular resetting mechanism. A more complete explanation of the science behind Neuromuscular Dentistry is found in Sleep and Health Journal, and was originally published by the American Equilibration society. http://www.sleepandhealth.com/neuromuscular-dentistry
Neuromuscular dentistry uses computerized instrumentation to measure the patient's jaw movements via Computerized Mandibular Scanning (CMS) or Jaw Motion Analysis (JMA), muscle activity via electromyography (EMG) and temporomandibular joint sounds via Electro-Sonography (ESG) or Joint Vibration Analysis (JVA) to assist in identifying joint derangements. Surface EMG's are used to verify pre-, mid- and post-treatment conditions before and after ultra-low frequency Transcutaneous Electrical Nerve Stimulator (TENS). By combining both computerized mandibular scanning (CMS) or jaw motion analysis (JMA) with ultra-low frequency TENS, the dentist is able to locate a "physiological rest" position as a starting reference position to find a relationship between the upper and lower jaw along an isotonic path of closure up from the physiologic rest position in order to establish a bite position. Electromyography can be used to confirm rested/homeostatic muscle activity of the jaw prior to taking a bite recording. [citation needed]
Once a physiologic rest position is found, the doctor can determine the optimal positioning of the lower jaw to the upper jaw. An orthotic is commonly worn for 3-6 months (24 hours per day) to realign the jaw, at which point orthodontic treatment, use of the orthotic as a "orthopedical realigning appliance", overlay partial, or orthodontic treatment and/or rehabilitation of the teeth is recommended to correct teeth and jaw position.
Because of the additional training needed and the complex computer systems and hardware required, neuromuscular dentistry is more expensive than conventional dentistry. The costs can range from $3,500 to $25,000 for usually four to six months, and up to one year or more of treatment for complex cases. (This does not include any additional orthodontics or restorative treatment)."

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posted by Dr Shapira at 3:32 PM

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