Have you tried neuromuscular dentistry?
July 29, 2010 6:32 AM   Subscribe

Anyone have any experience with "neuromuscular dentistry"? Did it help your TMJ? If not, what did?

I've got what appear to be many of the symptoms of TMJ and am not 100% certain how to go about it. I'm seeing a lot of information about something called neuromuscular dentistry, but I don't know anyone who's ever had it or if it was successful, or really even what it entails. Here's what I want to know: have you had TMJ, and if so, did this or anything else help you?
posted by vraxoin to Health & Fitness (8 answers total) 2 users marked this as a favorite
According to my dentist, TMJ can be exacerbated by jaw clenching and grinding. It overworks your jaw muscles and stresses them out, which is not conducive to your jaw working the way it's supposed to. Do you notice if you clench your teeth during the day? I think I've heard too that excessive gum-chewing can stress your jaw muscles out.

My dentist gave me a mouth guard to wear at night, and it's helped my TMJ so much that I never sleep without it now. If you don't have a regular dentist, you can often buy a mouthguard at the drugstore (in the dental section, specifically labeled for sleeping--don't buy a sports mouthguard).

If you do have a regular dentist, talk to them. They can probably tell you more certainly whether or not you've got TMJ, and they will probably have other possible solutions and/or palliatives for you before you go straight to major dental surgery.

If you have already tried these lesser options, I apologize for pointing out the obvious.
posted by colfax at 7:27 AM on July 29, 2010

I had TMJ bad until about 2 years ago. My symptoms started when I was around 14 due to some funky style of retainer my orthodontist gave me after my braces came off. He said it was normal and that it would get better over time. By the time my jaw started to click I decided I needed to be more proactive about it, but my orthodontist died suddenly and all of his patients got switched to an orthodontist several miles away, and I sort of forgot about it.

Over the next few years my symptoms got slowly and progressively worse. I was busy with school, life, etc, and didn't deal with it. My dentist is my uncle who lives in another state, so our "appointments" were usually pretty quick during holidays and stuff, so the jaw issue just got put on the back burner.

Then, two years ago, I was eating some Thanksgiving leftovers and my jaw got stuck. Stuck open, about 3/4 of an inch. I couldn't shut my mouth. It was horrifying. I called my uncle, sobbing, my roommate had to translate for me, and he called in an emergency prescription for a valium for me so I could relax my mouth to get it shut again. It was pretty insane.

Less than a month later, I went in to get some serious mouth work done to finally fix the problem. Apparently, I was way past the point where any mouth guard would help. With every successive mouth opening/closing and clenching my teeth at night, I was opening my tempromandibular joint a little further. This caused the cartilage in the joint to slowly, bit by bit, sneak forward until it was almost completely out of the joint. It caused my bite to become off-center, so that every time I closed my mouth I was doing more damage than the time before.

What he (uncle/dentist) did to fix this was shave down and re-shape all of my back teeth to create a whole new bite for me to work with my new, completely whack jaw alignment. After about a week with my new bite, my jaw was able to relax enough that the cartilage slipped back into place. It was SO AMAZING. My mouth felt right for the first time in years! Woo!

This ended up being way longer than I intended. Sorry. What you should do is ask your dentist about the mouth guard, because if your bite is still salvageable, that's absolutely your best option. But if you're past the mouth guard stage (i.e. does your mandible pop out of socket when you open and close your mouth?), you should ask your dentist about shaving down and reshaping your teeth to remodel your bite.

Good luck, and DEFINITELY take care of this as soon as possible. You really don't want to get to the point where your mouth gets locked into position. Trust me.
posted by phunniemee at 8:08 AM on July 29, 2010

I am also not familiar with neuromuscular dentistry, but I can tell you what helped me.

First, I got a small bite guard from my dentist, just a little nubbin that went between my front teeth that prevented my teeth from touching. Later, after my jaw loosened up a bit, I got a bigger guard, one that covered all my teeth and was designed to realign my jaw. My dentist says I have a "deep bite," which contributes to the issue.

Second, I used a TENS machine (borrowed from dentist) to loosen the muscles in that area.

I also tried out various methods that made it more difficult for me to close my mouth while sleeping. I know that open-mouthed sleeping isn't attractive, but it is helpful. For me, tucking a pillow under my neck in a way that forced my mouth open was helpful and not uncomfortable.

I stopped chewing gum, and for the time when my symptoms were bad, I chewed nothing chewy and nothing that required a serious biting down action. I also tried to be mindful of not clenching while I was awake.

I didn't seek help for my TMJ until my jaw clamped shut for a week. I had a similar experience to phunniemee's, except my jaw was stuck closed, not open, and every minute it stayed like that was damaging the muscle and tissues further. So, if your problems are not as severe, you may not need to do as much. I have been symptom-free for about three years now. Best of luck.
posted by TrarNoir at 8:12 AM on July 29, 2010

My story is similar to Trarnoir and phunniemee's, my mouth wouldn't open without pain until I had a cup of coffee in the morning.

My dentist in Indiana (a long bus trip away) made me what he called a splint that I wear 24 hours, all except for brushing teeth. My new dentist normally refers to it as an 'appliance'. I get it remade every couple years because I chew it down to nothing. It does amazing things, things you wouldn't think your jaw connected to.

As I've said before when people have ask-me'd about TMJ, my current dentist doesn't really believe in it, sure, he'll make me the appliance, but if I hadn't walked in with the old one and said 'I need another one of these,' he wouldn't have made me one.
posted by rakish_yet_centered at 8:33 AM on July 29, 2010

There are a lot of scam options for TMJ. Complaining of mild TMJ (clicking but not much pain or soreness), I had my old dentist suggest something that sounds somewhat similar to neuromuscular dentistry but involved using braces rather than a sprint after the expensive diagnostic procedures. My dentist assured me that if I didn't treat it, it would eventually get worse and worse until I was completely miserable, and mentioned that he'd had several people suffering from TMJ so bad that they killed themselves. More than a little freaked out, I called my uncle for a second opinion, and was told to pop a couple of anti-inflammatories and lay off big sandwiches and hamburgers for a week or so. I followed this advice, my symptoms improved and I switched to my uncle for dental care.

My advice is to try conservative options first; if aspirin and soft food seems to alleviate your symptoms, there's little reason to invest thousands of dollars into a technique that seems unproven at best.
posted by infinitywaltz at 8:58 AM on July 29, 2010

I was just at the dentist for this problem (although it is not as severe as some of the descriptions here.)and he's sending me to physiotherapy. He also told me that a night guard is usually the first thing to do for TMJ. I have been using one regularly for 10 years-- they are great.
posted by sadtomato at 9:09 AM on July 29, 2010

Because I was a night clencher, my TMJ went away almost completely once I escaped from major elements of stress (like parents), putting on a "Fuck you, world" attitude that required I take care of myself first before anyone else's desires.

And avoided the likes of bagels and whole apples, of course.

Otherwise, a minimal night guard approach is best. No need to ratchet up the "fixes" until you tried all the lower rungs first. They want to upsell.
posted by Ky at 9:21 AM on July 29, 2010

I have no experience with neuromuscular dentistry, but I did have TMJ issues. Muscle relaxants and a bite guard didn't help. Surgery (both sides) solved the problem completely, followed by braces to correct my bite. As long as I wear my retainer (also a bite guard) every night, I have no issues.
posted by bq at 12:23 PM on July 29, 2010

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