Neuromuscular dentistry is dedicated to realigning the jaw to relieve temporomandibular disorders (TMD) and fix malocclusion, also known as a bad bite. This branch of dentistry is not recognized by the American Dental Association, making the practice controversial, according to the TMJ Association. Correcting jaw position to either treat or prevent temporomandibular disorders has not been proven with randomized controlled clinical trials, which is the gold standard in evidence-based dentistry. Read on to learn more about this specialty and when (or if) this treatment is necessary.
The actual position of the jaw is very complex. The function of the oral cavity is determined by the facial muscles, the teeth, and the dynamic and static occlusion, or how the teeth come together in function and at rest. A person's bite changes over time as he or she grows and develops, and then during the aging process. It is true that certain dental procedures require obtaining a new jaw position, but there is not necessarily an "ideal" position for that individual, notes a study published in the journal Journal of Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology (JOOOO). The bite that is deemed as ideal may allow for a reasonable outcome to the dental work.
The Journal of Craniomandibular & Sleep Practice reports a poll of professionals belonging to the American Alliance of TMD reveals that the majority of clinicians believe in the following statement: "Dental occlusion may have a significant role in TMD; as a cause, precipitant and/or perpetuating factor."
Technology and Cost
Computerized analyses may be administered to diagnose the source of jaw pain. Here are a few tests a dentist may perform to find the root of jaw pain, per the TMJ Association:
- Sonography. A sonography measures vibrations in the jaw when it opens and closes to identify where the joint is not functioning.
- Electromyography. Electrical impulses track jaw muscle movements.
- Jaw tracking. Magnets draw a 3-D model of the jaw to identify abnormalities.
- Transcutaneous electrical nerve stimulation. Also known as TENS, electrical stimulations are administered to the muscles to relieve muscle spasms.
The JOOOO concludes that sonography, vibratography, thermography, jaw tracking, electromyography and electrical stimulation have not been proven to identify the exact etiology of a patient's temporomandibular disorder. Additionally, the tests can't predict the jaw position that will correct the problem.
The cost of a neuromuscular procedure varies greatly. The TMJ Association estimates it can cost from $3,500 to more than $25,000 for four to six months to one year or longer of treatment. Insurance may not cover the cost, because there is little scientific evidence backing the effectiveness of neuromuscular dentistry.
Research in the Journal of Oral Biology and Craniofacial Research notes jaw realignment may be irreversible and orthodontic and prosthodontic measures should be carefully considered. TMD can lead to severe conditions, such as headaches, poor posture, shoulder and neck pain, and a general detriment to the well-being of the patient. JOOOO argues that realignment is rarely a "medical necessity."
Jaw pain, in many situations, can be managed with noninvasive treatments. Tests and imaging may be performed to rule out any potential pathology, but tests do not determine if the jaw position is the problem. Inflammation is usually present if there is acute pain. The acute pain can be managed by a dentist and may involve taking anti-inflammatory medications. According to the National Institutes of Health, a splint may be used to stabilize the joint, but again, it is not advised to permanently change the bite alignment.
Very few dentists have received formal university training in neuromuscular dentistry. If you have developed what you believe to be a chronic temporomandibular disorder, you should first consult with your dentist and dental hygienist to get the appropriate referral. Before permanently repositioning the jaw, it is advised to seek several opinions and treatment options from dental specialists.
Despite the debate over the neuromuscular dental field, there is one constant: if you are experiencing pain, schedule a visit to your dentist. He or she will prescribe the best course of action to obtain relief. If you have a bad bite, it may be more difficult to reach all the teeth and gums with a toothbrush and floss. A mouthwash like Colgate Total Mouthwash for Gum Health fights plaque between teeth and along the gumline, and will help keep your mouth healthy.