Gneuromuscular Dentistry

Gneuromuscular dentistry (GNM) combines the clinical application of occlusal therapies (gnathology) with the science of neuromuscular dentistry. It focuses on the healthy relationship of the teeth, jaw joints (TMJs), and muscles. It is the science of letting the relaxed muscles of the head and neck determine the optimal physiologic position of the jaw. As opposed to “traditional” dentistry in which your jaw position is determined by your “bite” or forced manipulation. If your bite is not in a harmonious relationship with your neuromuscular network, problems can arise.
A problematic bite often exists when teeth are missing, misaligned or worn down. This creates tense, strained muscles and an unhealthy jaw joint position. Over time this can lead to temporomandibular dysfunction (TMD). This is a chronic degenerative disease that often takes years to develop. Symptoms that one may suffer from are of the following:

• Headaches/ Migraines
• Clicking, popping or grating sounds in the jaw joints
• Jaw pain
• Neck, shoulder or back pain
• Limited movement or locking jaw
• Numbness or tingling of the fingers and/or arms
• Intermittent tooth sensitivity to hot or cold
• Intermittent pain of teeth
• Worn or cracked teeth
• Vertigo (dizziness or loss of balance)
• Congestion, stuffiness or ringing of the ears
• Insomnia
• Depression
• Implants

Advancements in technology allow us to use a specialized computer utilizing electromyography (EMG), sonography, transcutaneous electrical neuromuscular stimulation (TENS) and jaw tracking to identify problems.

Sonography allows us to record joint sounds which we can analyze on the computer to determine if there are any abnormalities in the jaw joint. During and after treatment, these sounds can be compared and the improvement in healing monitored.

Electromyography (EMG) tells us the physiological state of muscle-whether it is relaxed, strained or stretched. It is the same technology used by cardiologist when doing an EKG of the heart.

TENS rhythmically pulses muscle to increase blood flow (increased oxygen and nutrients) and pump out waste products. It also stimulates the body’s production of endorphins (the body’s natural anesthetic to reduce pain). The end results are relaxed physiologic muscles.

Jaw tracking records jaw movement, resting position, and path of closure. This allows us to target the optimal position your jaw should be in when the teeth, muscle, and joints are in harmony.

Once the optimal position of your jaw has been determined, a temporary appliance, known as an orthotic, is constructed and worn over the lower teeth to help maintain this position. When the symptoms have been relieved and the bite stabilized, we now know where the correct bite should be. A more permanent way to maintain this position is then done by one or a combination of the following procedures:

Coronoplasty/Equilibration
This is the smoothing and reshaping the enamel of teeth to correct the bite. It is a simple procedure that does not require anesthesia and can be used when the bite is only slightly misaligned.

Removable Overlay Partials
This is a permanent orthotic that usually fits over the back teeth and designed to maintain an optimal bite position.

Reconstruction
This approach involves making the teeth higher by using crowns. This permanently realigns the bite and provides structural support for the jaw.

Orthodontics
The teeth are moved to the optimal position by use of braces.

We invite you to talk with us about how neuromuscular approach to your dentistry can enhance your life by decreased or eliminated pain and discomfort to better overall health and longer-lasting dental restorations.