Neuromuscular Solutions

Headaches and migraines can affect many peoples lives. At the Dental Sedation Center, Dr. Cohen offers many treatments for headaches and migraines.

Treating TMJ Symptoms

A "bad bite"" or malocclusion will eventually lead to an imbalance in the relationship of the upper jaw to the lower jaw. This will result in an unnatural, strained position for the muscles of the jaw. The muscles do not like this strained position. They will compensate by constantly contracting. This will cause muscle spasm, pain and soreness. As they fatigue, there is a build up of lactic acid and other waste metabolites. These waste products are what cause the spasms and discomfort. At some point, the body tries to flush out the muscles with increased blood flow, which results in the pounding headache. Muscles work together as a team. This is known as muscle recruitment. When the jaw muscles, which are involved with chewing, biting ,talking, breathing and head posture are overused, they recruit muscles of the neck, shoulder and back. The tight, painful, contracted muscles of the jaw result in pain in the muscles of the neck ,shoulder and back. Not all of our patients experience these symptoms, nor do we claim to be treating them. However, many patients are happy when these symptoms are relieved with neuromuscular treatment.

Finding the Cause

Using state-of-the-art neuromuscular dentistry, we determine if the symptoms you are experiencing are the result of a bad bite. We then go thru a series of steps to not only relieve your symptoms, but to also correct the cause of your symptoms. Treatment usually begins with the relieve of muscle spasms and the associated pain. We use a unit called a Myo-monitor which helps relax the patient’s muscles. It is a low frequency T.E.N.S. (Transcutaneous Electrical Neural Stimulation)unit. The Myo-monitor stimulates the Trigeminal Nerve and The Facial nerve using a very mild electrical impulse. This TENSingaccomplishes 3 things. First, It pumps waste metabolites and lactic acid away from the stressed muscles. Second, it increases the blood flow to the muscle, which increases the oxygen, glucose, and energy to the muscle itself. Finally, it allows the jaw to relax into its ideal position. Tensing usually takes 45- 60 minutes depending on how bad a patients symptom are and how tight their muscles are. Sometimes we will use an EMG machine to measure the level of tightness in the different muscles. Before tensing ,the EMG will show the hyperactivity of the muscles. After TENSing there is much less activity and the muscle are much “happier”.

Bite Stabilization

After the muscles are relaxed we start the next phase of treatment which is bite stabilization. We fabricate a temporary appliance, known as as an orthotic, which is worn on the teeth. The orthotic keeps the muscles in the "happy" position which was established with the use of the Tens unit. Once you are stable, we can move on to the next step, which involves correcting the bite to keep the jaws in this comfortable position. There are essentially four ways to correct your bite to this comfortable position. First, if the bite is not badly misaligned, we can use a process known as coronoplasty or equilibration. This involves adjusting the enamel to correct your bite. It is a relatively easy procedure. Second, we can create a more permanent orthotic. This is a removable appliance that fits over the back teeth and is designed to maintain the comfortable biting position. The third option is to completely rebuild the bite using porcelain crowns and veneers. A full mouth reconstruction is a permanent solution that will maintain the muscles "happy" position. The fourth option depends on the health of the teeth. Sometimes it is possible to use orthodontic treatment to move the teeth into a position that is comfortable for the muscles.