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What Is Physiologic Dentistry?

Close up image of someone's smiling mouth after TMJ treatment

Physiologic dentistry is a specialized area of dentistry focused on the alignment of the jaw. A neuromuscular dentist is concerned with the health of the teeth and gums, but also with how the teeth, jaw joints, and facial muscles work together to open and close your mouth. By considering the position of the teeth and how they relate to the function of the joints and muscles, the neuromuscular dentist seeks to balance the relationship for patients who are experiencing chronic pain or reduced function.

Our doctors are trained and have significant experience in physiologic dentistry.

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What Does Physiologic Dentistry Treat?

There are three components to a balanced bite: the teeth, the muscles, and the temporomandibular joints (TMJ). In a balanced bite, all three components work together effectively and efficiently. When one or more of the three causes the jaw to become misaligned, the corresponding problems with the patient’s bite can lead to jaw pain that also radiates down the neck and into the shoulders.

Physiologic dentistry looks beyond individual teeth, instead of viewing the teeth, jaw, head, and neck together as a unit. By looking beyond solely the jaw, our physiologic dentists can customize a treatment plan that corrects overbites, unusual tooth wear, painful jaw symptoms, or disorders such as temporomandibular joint disorder (TMD).

How is TMD Diagnosed?

When examining patients for jaw alignment problems, our doctors begin with a muscle and joint palpation. As you open and close your mouth, and clench your teeth, they feel for function in the different facial muscles and the TMJs. Pain or tenderness is an indicator of misalignment or of muscles being overworked. Catches, locks, clicks, and pops when moving the jaw are also typical signs of alignment problems.

Other more involved tests can be used:patient suffering TMJ at the dentist's office, talking to a dentist

  • Full-face x-rays, MRIs, or CT scans

    These may be used to view the position of the jaw and temporomandibular joints.

  • Sonography

    Sound waves are used to determine whether there are any problems with jaw alignment. We also listen for any abnormal sounds emanating from the jaw.

  • Electromyography (EMG)

    This method uses the electricity generated by jaw muscles to measure both muscle and nerve function. It can help us see when there is a reaction (such as pain) to movement.

  • Computerized test equipment

    This is used to measure the correct resting position of the jaw, identifying misalignment problems.

What Causes TMJ Disorder?

Pinpointing the exact causes of a patient’s TMJ disorder can be challenging. Causes can be related to problems with the bite, but also from subtle issues such as stress or even posture. Injury to the jaw, joints, or related muscles can also lead to TMJ. There may also be a possible genetic predisposition. Here are some causes:

  • Grinding or clenching the teeth
  • Movement of the soft cushion or disc between the ball and socket of the joint
  • Arthritis in the joint
  • Stress, which can cause a person to tighten facial and jaws muscles or clench the teeth

What are the Symptoms of TMJ Disorder?

TMJ Symptoms include:
image of woman with face pain or cheek pain from bruxisum or TMJ during sleep

  • Pain or tenderness in your face, jaw joint area, neck, and shoulders.
  • Pain in and around the ears when you chew or otherwise open your mouth
  • Jaws that get “stuck” or “lock” either open or closed
  • Clicking, popping, or grating sounds in the jaw joint when you chew or simply open or close your mouth
  • Consistent headaches
  • Regular jaw stiffness
  • Ear ringing
  • Unintentional teeth grinding
  • Tori or exostoses, which are excessive deposits of bone in the mouth
  • Tingling fingertips
  • A feeling that your teeth do not fit together properly

What is the difference between TMD and TMJ?

TMJ is the acronym used to describe the temporomandibular joints. This is the pair of joints that sit one on each side of the face, just in front of the ears. The TMJs are involved in jaw movements like opening and closing the mouth and the side-to-side movements that occur when we chew. TMD is the acronym for the temporomandibular joint disorder. This condition involves persistent, chronic, or recurrent inflammation in the TMJs that causes uncomfortable symptoms. TMJ is the structure, TMD is the condition.

TMD Treatment

Below are some methods of TMD Treatment: 

  • Cosmetic Dentistry – We replace missing teeth with dental implants or dental bridges, the crown worn teeth, move the teeth with Invisalign, whatever is necessary to get your bite into proper alignment. 
  • Splints, night guards, or orthotics — We fabricate plastic mouthpieces that fit over your upper and lower teeth so they can’t touch. This serves two purposes: mouthpieces lessen the effects of clenching and grinding, and they put the teeth in a more correct position.
  • Exercises – Jaw problems can often be attributed to stress, which causes people to tighten their jaw muscles. Jaw exercises are assigned that will stimulate and relax the jaw muscles.
  • Lifestyle – Lifestyle changes such as stress reduction techniques or personal care solutions can reduce jaw pressure and pain.
  • Transcutaneous Electrical Nerve Stimulation – Small electrical pulses are delivered to the jaw muscles through a small wand. These pulses stimulate the nerves, encouraging muscles to relax and the jaw to align.

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What if TMJ goes untreated?

Temporomandibular joint disorder needs to be treated appropriately in order to reduce or stop symptoms. Without care, these may worsen over time and cause additional problems, such as:

  • Deterioration of healthy tooth structure.
  • Joint inflammation and degradation over time.
  • Chronic headaches or migraines due to consistent muscle contraction in the head, neck, and face.
  • Ringing in the ears.
  • Increased risk of an airway sleep disorder such as obstructive sleep apnea.

Living with TMJ can be unpleasant. The persistent symptoms associated with this condition can affect eating habits, mood, sleep, and even posture.

How long does it take for TMJ to go away?

Depending on what is causing TMD, the condition may not go away without professional treatment. In some mild cases caused by overuse of the jaw, such as gum-chewing, a TMJ flare-up may resolve with a few weeks of rest. Persistent symptoms can flare-up periodically and last for a few days to several weeks. Each case is unique based on the underlying cause and the person’s pain tolerance.

Common causes of a TMD flare-up include:

medical illustration of a injured jaw bone that can cause TMD.

  • Injury to the face or jaw
  • Joint deterioration due to arthritis
  • Erosion of the disc within the TMJ
  • Smaller factors that can contribute to a TMD flare-up include:
  • Posture
  • Stress
  • Dehydration
  • Chewing on hard food or objects
  • Clenching and grinding teeth

How to prevent TMJ from Recurring

There is no way to control all of the factors that can lead to a TMJ flare-up. However, there are things you can do to decrease your risk of TMD becoming a recurrent or chronic problem. These include:

  • Unless you are chewing, keep the in a relaxed position with the teeth slightly apart. The tongue should rest on the roof of the mouth, not between the teeth.
  • Try to avoid opening the mouth to its full extension, including when yawning.
  • Do not chew on hard objects.
  • If you think you clench your jaw or grind your teeth, talk to your dentist about wearing a custom-fit nightguard.
  • Cut food into small, bite-sized pieces.
  • Do not chew gum for more than a few minutes at a time.
  • Eat a well-balanced diet that includes anti-inflammatory and joint-healthy foods, such as berries, oranges, nuts, fatty fish, and healthy oils like olive or coconut oil.

Is TMD permanent?

TMD can be a permanent condition. It is important to consult with a dentist who has received training in neuromuscular dentistry. Doing so helps identify what is causing flare-ups of inflammation in the temporomandibular joints and surrounding muscles and tendons. It isn’t enough to perform x-rays and a general dental exam. To understand TMD, we perform a variety of tests that gauge the alignment of the jaw, electrical activity within the jaw, and more. With a proper diagnosis and customized treatment plan, it is possible to get a handle on TMD so flare-ups decrease or are completely resolved.

Schedule a Consultation

To schedule a consultation with one of our dentists to see if Physiologic Dentistry is right for you, call (303) 277-9600 today! Our practice serves Golden, Denver, and surrounding areas in Colorado.

Dr. Nancy Gill & Dr. Dallas Kenson

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