TMJ/TMD Diagnosis

TMJ / TMD Diagnosis
Dr. Widen, a Neuromuscular dentist, uses state-of-the-art technology to determine if your symptoms are caused by malocclusion and if so, what your optimal jaw position is. Dr. Widen uses computerized jaw tracking instruments to record jaw movement, resting position, and path of closure. Electromyography is used to measure your jaw's muscle function in both its stressed and relaxed positions, and will also measure the jaw-to-skull relationship to see if there is a structural imbalance. Sonography is used to record jaw joint sounds to detect any abnormalities. Additionally, x-rays of the jaw may be taken to help evaluate the condition and positioning of the joint.

TMJ / TMD Treatment
Once Dr. Widen has diagnosed you with TMJ, he can determine the best course of treatment for your specific needs. Typically treatment will follow three steps:

1. Relieve muscle spasm and pain.
   The immediate concern for neuromuscular dentists is to provide relief of your symptoms. The best way to do this is by using a technology called ULF-TENS. ULF-TENS stands for Ultra Low Frequency Transcutaneous Electrical Neural Stimulation, but don't let this term intimidate you. Basically, ULF-TENS is a way to relax muscles with a gentle massage of the muscles. The rhythmic pulsing relaxes the muscles by increasing blood flow and pumping out waste products. ULF-TENS also helps with pain relief by stimulating the body's production of endorphins, the body's natural anesthetic.
   
   
2. Stabilize the bite.
   Often for this step a temporary device, known as an orthotic is worn over the teeth. The orthotic allows your neuromuscular dentist to make easy adjustments to the plastic without adjusting the teeth until the bite is stabilized. Once symptoms are relieved and the bite has been stabilized, your dentist will move on to the next step and permanently adjust your bite to the correct position.
   
   
3. Long-term management.
   There are a variety of ways to correct your bite in a more permanent way. Four of the most common of these approaches are outlined below:
   

• Coronoplasty/Equilibration
  Coronoplasty is smoothing and reshaping the enamel of the teeth to correct your 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
  These are permanent orthotics that usually fit over the back teeth and are designed to maintain an aligned bite.
  
  
• Reconstruction
  This approach involves making the teeth higher by using crowns. This permanently realigns the bite and provides structural support for the jaw.
  
  
• Orthodontics (Braces)
  When the teeth are healthy they may be moved to the optimal position using braces.

 

Some of the equipment we use are featured below.

 J-5 Myomonitor

J-5 Myomonitor is a muscle stimulating device to help relax muscles of the jaw and neck simultaneously using transcutaneous electrical muscle stimulation. It is a battery powered device that the guest controls and it is used to treat the following:

Temporomandibular joint (TMJ) dysfunction and associated pain

To relieve symptoms associated with muscle spasm

To relax muscles and establish a physiologic biting position

To take bite registrations and impressions for dentures

To increase blood circulation

To maintain or increase mandibular range of motion

This gives us accurate reproducible physiologic rest position or the position in which measurements of muscle activity is calmest. The ultimate goal is relaxed muscles and relaxed muscles are free from tension and pain and will function properly when chewing and speaking and smiling. Tense muscles can cause head,neck and back pain and this new technology may help relieve some of these symptoms. An orthotic or splint is constructed to fit over the teeth to help the muscles relax at the position as determined by the J5.

    K-7 Computerized Jaw Tracking and Surface Electromyography       We have invested in technology that will precisely and quantitatively measure the activity in your jaw and neck muscles.  We have found that calm muscles are "happy" muscles and are free from pain.  We can determine by watching the muscle activity the most comfortable position for your jaw. We can track your jaw to that position and capture that physiologic rest position.  This will allow us to make an orthotic in that position to allow your muscles to relax and heal. Which allows you to be comfortable with your new jaw position.