What is neuromuscular dentistry?

Neuromuscular Dentistry is the science of dentistry that embodies accepted scientific principles of patho-physiology, anatomy, form and function. NMD objectively evaluates the complex relationship between teeth, temporomandibular joints and the masticatory muscles in order to achieve an occlusion that is based on the optimal relationship between the mandible and the skull - Neuromuscular Occlusion. The goal of the Neuromuscular Dentist is to relax the muscles controlling jaw position to establish a true physiological rest position upon which treatment considerations are based.


What is tens (transcutaneous electrical neural stimulation)?

Neuromuscular Dentistry begins with the true relaxation of the muscles through the use of TENS. TENS is a widely used term, but as used in Neuromuscular Dentistry it is more properly called ultra-low frequency electrical muscle stimulation.

Why use tens?

Muscles of the face and neck are often "programmed" (propriocepted) to control head and mandibular posture in a way that accommodates occlusion, even though that particular occlusion may be less than ideal. The Neuromuscular Dentist wants to relax these often tense muscles to find their true resting state and establish the occlusion at that position. It is extremely difficult to voluntarily overcome this proprioception, so "TENS" is used. A secondary use of low frequency stimulation is to achieve drug-free pain relief of pain of muscular origin.

Muscles activity before TENS Muscles activity after TENS

Why is evaluation of physiologic function important?

The state of the teeth and the joints very often cause the muscles to accommodate. Evaluation of the hard tissue alone does not provide insight to the true status of the occlusal system. This is why the Neuromuscular Dentist uses objective, scientific documentation methods in the comprehensive evaluation of occlusion. Through the use of jaw tracking, electromyography and joint sound recording, a complete analysis of the function (or dysfunction) of the masticatory system is accomplished. 

What is jaw tracking?

"Jaw tracking" is one of the modalities used by Neuromuscular Dentists. It is used to precisely identify the relationship of the mandible to the skull and to study mandibular movement dynamically. Sensors track the path of the mandible in three dimensions by sensing magnetic field changes - a science developed by Myotronics.

Why is jaw tracking data so valuable?

The data produced through jaw tracking has three important roles. First, is to permit the dentist to study mandibular action dynamically by recording and replaying traces representative of the mandibular path of opening and closing. This can reveal, in a highly precise fashion, a number of anomalies otherwise difficult to discern.

One example is a sudden slowdown of mandibular velocity, invisible to the eye but often an alert to a clicking joint.

Second, the jaw tracking device records the relationship of the mandible to the skull with great precision, information useful in the diagnostic process, and in taking a neuromuscular bite registration.

The third application of jaw tracking is to record and verify that patient's closure to centric occlusion is on a neuromuscular (physiologic) trajectory.

© 2014 - Dr. Yves Delessert, DDS - DMD - MS, Your jaw pain and TMJ expert.
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