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Neuromuscular Dentistry

A Definition

Neuromuscular dentistry is a specialized approach that considers the teeth, muscles, and joints as an interconnected system. This field focuses on achieving optimal jaw alignment to ensure the harmonious function of the masticatory system. By using advanced biomedical instrumentation, neuromuscular dentists can objectively measure and analyze the physiological aspects of mandibular function.

In essence, neuromuscular dentistry aims to relax the muscles around the jaw, alleviate tension on the joints, and improve jaw alignment. This approach is particularly beneficial for treating temporomandibular disorders (TMD) and malocclusion (misalignment of the teeth). Despite its potential benefits, it is important to note that the American Dental Association does not officially recognize neuromuscular dentistry, making it a somewhat controversial practice.

A Brief History

The roots of neuromuscular dentistry can be traced back to the work of Dr. Bernard Jankelson, who introduced the term to the dental profession in 1967. Dr. Jankelson’s journey began much earlier, in the 1940s when his wife Cherub developed symptoms of a neuromuscular disorder. This personal experience fueled his quest for understanding the complex interactions between muscles, nerves, and the temporomandibular joints (TMJs).

In collaboration with muscle physiologist Dr. H.H. Dixon, Dr. Jankelson pioneered the use of low-frequency Transcutaneous Electrical Nerve Stimulation (TENS) to alter muscle metabolism and resting states. This breakthrough marked a significant shift in the dental industry, moving from a static, two-dimensional focus on teeth and joints to a dynamic, three-dimensional approach encompassing teeth, joints, and muscles.

In 1979, surface electromyography (sEMG) became available to dental clinicians, allowing for the real-time monitoring of muscle activity. This technology was integrated into the computerized jaw tracking system in 1987, providing a comprehensive tool for correlating muscle activity with jaw position.

Dr. Jankelson’s work laid the foundation for modern neuromuscular dentistry, transforming it into a field where dentists can diagnose and treat temporomandibular disorders (TMDs) with scientific accuracy. His vision and perseverance have enabled clinicians to manage complex occlusal problems and improve patient outcomes through a holistic understanding of the masticatory system.

What are TMDs

Temporomandibular Disorders (TMDs) encompass a variety of conditions affecting the temporomandibular joints (TMJs), jaw muscles, and associated structures. These disorders can be broadly classified into two categories: intra-articular and extra-articular.

Intra-articular Disorders

Intra-articular disorders involve the internal structures of the temporomandibular joint itself. These can include:

  • Inflammation: Swelling within the joint due to injury or infection.
  • Internal Derangement: Structural changes such as displaced discs within the joint.
  • Degeneration: Wear and tear of the joint structures, often due to arthritis.

Extra-articular Disorders

Extra-articular disorders are primarily related to the muscles surrounding the jaw, known as the muscles of mastication, and the cervical muscles. These disorders are often a result of:

  • Muscle Imbalance: Over-activity or under-activity of the jaw muscles.
  • Postural Dysfunction: Poor posture, especially of the cervical spine, which can exacerbate TMD symptoms.

Symptoms and Diagnosis

Symptoms of TMD can vary widely and may include:

  • Jaw pain or tenderness
  • Headaches
  • Earaches
  • Difficulty in chewing or opening the mouth
  • Clicking or popping sounds in the jaw

Treatment options

Managing Temporomandibular Disorders (TMDs) involves a combination of diagnostic tests and various treatment approaches. The goal is to alleviate pain, restore jaw function, and improve overall quality of life. Here are some common diagnostic tools and treatment options used in neuromuscular dentistry:

Diagnostic Tools

TENS unit being applied to a patient's jaw by dentist
  1. Sonography: Measures vibrations in the jaw during movement to identify joint dysfunction.
  2. Electromyography (EMG): Tracks electrical impulses in jaw muscles to assess muscle activity.
  3. Jaw Tracking: Uses magnets to create a 3-D model of the jaw, highlighting abnormalities.
  4. Transcutaneous Electrical Nerve Stimulation (TENS): Applies electrical stimuli to relieve muscle spasms and improve muscle function.

Non-Invasive Treatments

Most TMD cases can be managed with non-invasive treatments aimed at reducing pain and inflammation and improving jaw alignment. Here are some effective options:

  1. Physiotherapy
    • Soft tissue release and joint mobilization techniques.
    • Exercises to improve jaw coordination, stability, and alignment.
    • Posture correction for the head, neck, shoulder, and tongue.
  2. Splints and Mouthguards
  3. Medications
    • Anti-inflammatory drugs: Reduce pain and swelling.
    • Muscle relaxants: Alleviate muscle tension and spasms.
  4. Lifestyle Modifications
    • Stress management techniques to reduce muscle tension.
    • Diet changes: Soft foods to minimize jaw strain during acute phases.
    • Avoiding habits that stress the jaw, such as chewing gum, nail-biting, and wide yawning.

Invasive Treatments

For severe or persistent TMD cases that do not respond to conservative treatments, more invasive options may be considered:

  1. Orthodontic Treatment
    • Braces or aligners to correct dental misalignment and improve bite function.
  2. Surgical Procedures
    • Arthrocentesis: A minimally invasive procedure to wash out the joint.
    • Arthroscopy: A surgical technique to diagnose and treat joint problems.
    • Open-joint surgery: For severe cases requiring direct access to the TMJ.
  3. Dental Restoration
    • Addressing dental issues like cavities, missing teeth, or uneven bite to improve overall jaw function.

Comprehensive Management

Dentist touching patients jaw

Effective TMD management often requires a multi-faceted approach, addressing all contributing factors. A tailored treatment plan may include a combination of the above methods, along with patient education on maintaining good oral habits and long-term self-care strategies.

It is always better to consult your dentist before trying to solve TMD problems yourself. At Florence Dentistry, we provide a comprehensive evaluation and recommend the most appropriate treatment plan for your specific condition.


  1. How Long Does TMD Treatment Last?

The duration of treatment for Temporomandibular Disorders (TMD) can vary significantly based on the severity of the condition and the specific treatment plan. Some patients may experience relief within a few weeks, while others may require several months of ongoing therapy. It is crucial to follow your dentist’s recommendations and attend all scheduled appointments to achieve the best results.

  1. What is the Cost of TMD Treatment?

The cost of neuromuscular dentistry procedures varies widely depending on several factors, including the complexity of the condition, the type of treatment required, and geographical location. It’s important to note that insurance may not always cover neuromuscular dentistry treatments, as the practice is still debated within the dental community and may lack comprehensive scientific backing. Consulting with your dental professional can provide a more accurate estimate based on your specific needs.

  1. When Should I See a Dentist?

If you experience persistent jaw pain, headaches, earaches, or difficulty in chewing or opening your mouth, it is essential to consult a dental professional. Early diagnosis and treatment can prevent further complications and improve your quality of life. Opting for neuromuscular dentistry at Florence Dental means putting your trust in a team of highly skilled professionals based in downtown Ottawa. Our dedicated staff is committed to delivering personalized care, ensuring each patient receives a treatment plan designed for their specific needs.