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Neuromuscular Treatment of TMD
Once the diagnosis of malocclusion and temporomandibular dysfunction is made, the course of treatment is planned. The
muscles are relaxed using TENS and a determination of the jaw position that corresponds to neuromuscular occlusion is made and this bite is registered.
This bite will allow the dentist to align models of the patient's teeth in this relationship in order to study them and determine the course of treatment.
Coronoplasty
If evaluation of the bite shows that only minor adjustments are needed to relieve the symptoms, coronoplasty may be
recommended. This is a process where the teeth are selectively and judiciously adjusted, every so slightly, until the upper and lower teeth contact each other in proper occlusion and without interferences.
Orthosis
If a coronoplasty is insufficient to alleviate the symptoms, an orthosis is usually made. An orthosis (or orthotic) is
a removable plastic dental appliance custom fitted to the lower teeth that will maintain the bite in the precise relationship determined to be the proper neuromuscular occlusion.
It is worn for a period of time as prescribed by the dentist in order to relieve the TMD symptoms.
Once the doctor and the patient are satisfied that the new bite is comfortable, they must evaluate all the options for
treatment that will be appropriate for the patient and prevent recurrence of the symptoms. Following are several options that may be considered:
Restorative and Cosmetic Options
The restoration of several teeth using crowns, onlays or veneers is often a viable option.
These restorations can be constructed into the proper neuromuscular relationship so that the new bite is comfortable. The smile can be reconstructed, also, into a beautiful one that will be long-lasting because the forces that may have chipped or adversely worn the natural teeth have been neutralized and balanced.
Full-mouth Rehabilitation
This is major reconstruction of virtually all the teeth in the patient's mouth. Crowns, onlays and/or veneers are
placed on all the teeth in just a few appointments. They are precisely prepared and constructed to the jaw relationship that was determined through the neuromuscular diagnostic procedures and verified by
continued wearing of the orthosis. The result is a bright, beautiful smile and a comfortable occlusion.
Orthodontics
Sometimes orthodontics can be the recommended course of treatment to establish the correct bite. Braces and/or other
orthodontic appliances are often used to move teeth out of malocclusion and into the proper neuromuscular relationship in both children and adults.
Modern neuromuscular orthodontic procedures allow the dentist to create comfortable occlusions because he knows where the bite needs to be, he just has to move them there.
Combination Therapy
Sometimes a combination of the above options is used, such as orthodontically corrected the bite and then cosmetically
restoring the front teeth with veneers.
Every patient is an individual and every treatment plan must be customized for each patient. A neuromuscularly-trained dentist has studied the diagnosis and treatment of TMD. They are dedicated to providing patients with the highest level of care available.
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