Neuromuscular occlusion is the common denominator
Historically, TMD’s were referred to as TMJ or TMJD when the disorder was considered only to involve the temporomandibular joints. Currently, the name TMD is used to describe a group of diseases that can involve the jaw joints, the muscles that control jaw movement and the dental occlusion. They are physical/functional disorders arising from an imbalance in the delicate working relationship of the jaw and skull with the muscles that move the jaw and the nervous system associated with them. This imbalance results in muscle fatigue, spasm and/or joint dysfunction, and even changes in the form and position of the teeth, which in turn cause a variety of symptoms. In order to understand what appears in some patients to be global manifestations of TMD, we must understand that the complex stomatognathic system is comprised of the central nervous system in conjunction with the dentition, masticatory muscles and temporomandibular jaw joints all functioning in harmony with one another and its interconnections with the entire musculoskeletal system. Everything is connected and dysfunction in one part can affect dysfunction in other parts. In contradistinction, healthy function in all parts of the stomatognathic system along with proper cranio-cervical posture and healthy airway contribute to homeostasis. Various concepts of dental occlusion are used in dentistry today. Neuromuscular Dentists adopted in dentistry the neuromuscular occlusion philosophy. This physiological approach is based on the creation of dental occlusion position synchronized with relaxed balanced masticatory muscle function. How this is achieved and how neuromuscular occlusion is applied in various fields of dental practice including complex restorative dentistry and orthodontics that will be described in this website.
For patients suffering from various manifestations of TMD, neuromuscular dentistry has allowed clinicians the opportunity to help a growing number of patients that were unable to obtain alleviation of their clinical problems previously by dentists and other health care providers. The study of neuromuscular dentistry allows the clinician to understand orthopedic principles and dynamic physiologic occlusion concepts more comprehensively than traditional static dental paradigms. Computerized measurement devices record and permit analysis of mandibular movements, dental occlusion, masticatory muscle function and TMJ joint sounds provide objective information to help dentists treat patients successfully, rather than only relying on subjective symptoms reports from patients and clinical observations throughout treatment. The recognition of musculoskeletal clinical signs including occlusal flags and subjective patient symptoms aid in the establishment of an accurate diagnosis of acute and chronic pain patients as well as patients requiring the establishment of a new dental occlusion. In the initial stabilization phase of TMD therapy through the creation of a physiological therapeutic neuromuscular occlusion, it is necessary to identify an optimal starting point of physiologic rest and then select a therapeutic stable occlusal position. This phase of treatment utilizes a fixed or removable oral orthotic appliance. Removing all afferent and efferent noxious proprioceptive stimuli of occlusion and objectively measuring all muscle and postural responses of the mandible will allow the dentist to remove harmful muscle torques and strains that relate to the health or dysfunction of the trigeminal system.
In summary, the importance of a physiologic occlusion cannot be over-emphasized in treating TMD patients.