Craniomandibular
Disorder (CMD)
Treating head,
neck and facial pain
Have you ever considered that symptoms such as headaches, dizziness, ear
pain, neck, shoulder, or back pain could be related to your bite? Most people
haven’t, however as many as 44 million Americans suffer from a condition
known as “TMJ Dysfunction”. In addition to the symptoms mentioned
above, people who suffer from this condition might also experience: clicking
or popping in the jaw, jaw pain, locking or limited opening of your mouth,
difficulty swallowing and sleep disruption. TMJ Dysfunction is a medical
disorder treatable by dentists with proper training and education.
What is neuromuscular dentistry?
Neuromuscular dentistry is dental treatment approach centered around
the premise that various “bite” problems may lead to
malfunction of the musculature responsible for the movement of the
jaw. These malfunctions
often lead to pain of the head and neck or other symptoms which may seem
unrelated. If the jaw muscles are compensating because of an improper bite
relationship, the result is malfunction of the trigeminal nerve and associated
cranial nerves which in part make up the autonomic nervous system. This
malfunction and compensation is called craniomandibular dysfunction
or CMD (also TMD).
CMD commonly causes chronic head, neck and/or facial pain. There are many
causes of headaches, however conservatively 50% of those that suffer from
headaches, including migraines, are really suffering from trigeminal nerve
dysfunction due to masticatory (chewing) muscle over compensation resulting
from jaw alignment problems, CMD.
CMD is treated using neuromuscular concepts.
Treatment begins with thorough diagnostic evaluation including computerized
jaw movement analysis and jaw muscle electromyography studies. Then the
jaw muscles are relaxed using ultra -low frequency TENS or gentle, soothing
electrical
impulses. The jaw’s new, relaxed posture is then stabilized with
an intraoral orthotic, a retainer like appliance. Just as the ankle or
knee
is stabilized with foot orthotics, the jaw is stabilized through the use
of an intraoral orthotic. The orthotic allows the doctor to test and confirm
the therapeutic effects of the new jaw posture. The goal of the bite realignment
is to allow the muscles to remain relaxed and thus not painful or referring
pain. This holistic approach is used to optimize complex or extensive dental
treatment, and can be applied to all aspects of dentistry including orthodontics
and reconstructive therapy. The neuromuscular approach treats chronic and
acute pain in a comprehensive and lasting way, thus protecting the patient
from future problems.
“For years I suffered from face pain resulting from head trauma. Even with surgery, medication was my only relief. Dr. Bob changed all that. One bite plate later, I am pain free!” Ann
“ I
am deeply grateful for the care and consideration shown me by Dr.
Giswold and his staff throughout my treatment for TMJ. Over the
course of two years, my jaw that wouldn’t open more that
about an inch and headaches that wouldn’t quit have resolved
to where I am pain free and have the full range of motion in my
jaw. Through it all Dr. Giswold and his staff did far more than
treat my condition; they educated me as to how to maintain better
health all around.” |
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Chronic
Pain Treatment
Chronic pain affects millions of Americans. It is commonly associated
with structures of the head & neck or facial region (upper quarter).
Upper quarter chronic pain is very commonly misunderstood by the medical
community. Failed diagnostics and treatment frequently lead patients on
the medical “merry go round”. General physicians often refer
patients to neurologists or Ear, Nose and Throat specialists. Usually after
extensive diagnostic workups with MRIs, cat scans, and blood workup patients
are finally told: “it’s all in your head”. Victims are
instructed to “learn to live with it”, the only options being
to suffer or keep experimenting with the latest prescription pain medication.
Often these people experience debilitating pain and associated psychological,
social and physical pathologies. Treatment is available to many of
these people that may not expect to find it at a dental office.
At Saratoga Dental we successfully treat chronic pain patients. While
some have suffered for decades, others are as young as 10 years old.
In addition to utilizing the latest techniques and technologies, our
approach also involves other health care modalities like physical therapy,
massage
therapy chiropractic, and acupuncture, creating a holistic and comprehensive
pain treatment. At Saratoga Dental we begin with a no cost screening
exam
which determines the source of pain to be craniomandibular, skeletal
neurologic, or a combination of the three. If the screening shows a
craniomandibular component we initiate the diagnostic examination. This
includes specific
radiographs (x-rays), casts of the jaws, a physical exam, and computerized
diagnostics. With this completed we establish an appropriate treatment
plan— the
focus of a comprehensive consultation with Dr. Giswold.
Treatment typically includes two phases. After consultation and financial
arrangements have been made, treatment begins. Phase I is the treatment
phase, requiring treatment for anywhere from three months to two years.
Depending on the complexity of the problem— treatment is “evolutionary”.
Levels of dysfunction unfold like layers of an onion and need various
treatment modalities. This phase of pain treatment often entails the use
of an intraoral
orthotic (or splint) to reposition the lower jaw relative to the skull.
These orthopedic changes allow reduction of muscle and nervous system
strain. It may also require the assistance of other therapeutic modalities
to relax
splinted muscles of the head, neck and face.
Phase II includes treatment intended to stabilize the crainiomandibular
or jaw and muscle relationship established in Phase I treatment . This
phase usually begins after at least three months of a pain free (or
maximum medical
improvement) state has been achieved. Orthodontics, reconstruction,
prosthetics, or a combination of the three may be required to achieve
stabilization.
The team’s thorough understanding of the musculoskeletal and autonomic
nervous systems become the most valuable tool, for every treatment
is different and every case is unique. Our up to date technology as well
as years of
experience have allowed us to give many people relief from decades
of chronic pain.
Saratoga Dental provides brochures for you to read as well as a questionnaire
that helps determine if this treatment may be right for you or someone
you know. So if you or someone close to you suffers with headache or facial
pain, especially if the jaw joints pop, snap or grind when opening
or closing,
please call Saratoga Dental for a no-fee consultation.
“Caring
quality among friends since 1976”
For questions or to
schedule an appointment, please call 360.221.6373.
Camano Center- 742 Camano Avenue, Langley, Washington 98260