Most people think dentistry begins and ends with teeth. But there is more to it than that. The mouth, jaw and tongue – even the neck – all contribute to and are affected by overall tooth health and function. The field that wraps in this more holistic view is neuromuscular dentistry. You might not have heard of it, but it’s more important than you think.
Advanced Dental Artistry principal dentist Dr Adrian Kat says neuromuscular dentistry is really trying to find balance and harmony among all the oral and supporting structures.
For example, one of the most common conditions in neuromuscular dentistry is TMJ disorder (we’ll give the full name later). It is a chronic pain condition that affects around 1 in 30 people, on one or both sides of the jaw, at some time in their life.
Often, they’re stuck with it as doctors and dentists confuse causes and chase symptoms. Their specialised training means they lack the holistic view of how teeth affect the body and the body affects teeth.
“It is important to remember that the mouth, teeth, the jaw, the jaw joint and the bite are all part of a bigger system,” Dr Adrian says.
“For example, the bite – how your teeth close together – affects the jaw joint. The set of the jaw joint, in turn affects the muscles that act allow the jaw to open and close the jaw.”
The muscles involved are very strong, especially the masseters, which close the jaw. As such, their function has effects through the entire biomechanical system of your neck, torso and spine.
“If we have a patient who has worn their teeth down, is missing teeth or has clenching symptoms, then TMJ disorder is often lurking in the background.”
The condition’s official name is temporomandibular joint disorder. Quite a mouthful, so we’re just going to call it TMJ disorder. On the basic level, it is pain that is caused by a misalignment between your upper jaw, lower jaw and the jaw muscles. Any physiotherapist or chiropractor will tell you how this is a very tight system overall.
“When there is an imbalance in the bite or the jaw joint or the muscles of the head or neck, it will have a detrimental effect on the rest of the spinal column, including pain in neck and upper back and sometimes all the way down through the postural chain.”
It’s often difficult to figure out why TMJ disorder appears. There is rarely a sole cause; however, arthritis, genetics, age and injury are common factors. Regardless of why it appears, the condition can cause a cascade of problems – not least jaw pain.
If your medical professional is unfamiliar with the condition, TMJ can be tricky for them to diagnose. For example, some of its effects – such as headaches – can easily be mistaken for causes. And if you’re always treating the symptom, you’ll never find a cure.
There is a spectrum of symptoms to look out for. If you have one or more of these, the cause might be TMJ disorder:
Dr Kat says that what this constellation of signs could really be saying is that your bite is out of balance. It takes sensitive equipment and advanced dental imaging to see exactly how the jaw structures are working together … or fighting each other.
If TMJ disorder is diagnosed, the treatment goal is to get teeth, jaw joint and muscles working in harmony. Do that and most of the symptoms simply go away.
To get your jaw working properly again, requires “tuning” of the jaw muscles. The simplest and most effective way to do this is, remarkably, Botulinum toxin. Far more than a miracle anti-wrinkle eraser, BTX injections are a way to precisely “switch off” tiny parts of muscles.
For treatment for TMJ disorder, a few precisely targeted injections alter how your jaw functions up, down and side to side. It is a non-surgical procedure requiring no anaesthetic. The only pain is a few small needle pricks (much smaller than the needles used to take blood).
Most of the process of resolving TMJ disorder is in the diagnosis and the imaging and testing to identify exactly where the best sites to make the injections are. Once these areas are found, the injections themselves may only take 10-20 minutes to administer depending on the quantity required. Some patients experienced dramatic improvement through just 2 or 3 carefully targeted injections on the outside of the jaw.
The good news is that the Botulinum toxin injections provide near-instant relief from the symptoms and can remain effective for up to 3 months. Further, speaking, chewing and swallowing are completely unaffected by this approach. Nope, there is no recovery downtime or limited function.
Generally, the only side-effect of treating TMJ disorder with Botulinum toxin is minor inflammation and swelling. This only occurs for around 1 in 100 people though.
If you are feeling chronic jaw pain – or any of the long list of symptoms above – it might well be TMJ disorder. There’s only one way to find out: ask the advice of an expert dentist and get the detailed dental imaging you require.
If you’re in Perth, that might just mean coming to see us at Advanced Dental Artistry – we’re one of Western Australia’s few TMJ disorder experts.
So, if you have been putting up with the pain of what might be TMJ disorder, know that answers and rapid, long-lasting relief can be available quickly and simply through the magic of BTX.
If you have any further questions or queries, don't hesitate to contact us.