Dr. Sid Solomon Explains Neuromuscular Treatments
Article Written by Dr. Sid Solomon
When a patient visits me with TMJ issues, I have one main objective: to correct the bite and realign the jaw. First, I perform and extensive TMJ evaluation and consultation where I will spend quality time with the patient and figure out exactly what problem or problems they are dealing with. My patients fill out a neuromuscular questionnaire, which we go over in detail together, and I also perform certain diagnostic tests as needed. If I find the patient is suffering from a TMJ related symptom, I then explore different treatment options and steps, including:
• relieve muscle spasm and pain by bite adjustment
• relieve muscle spasm and pain by tensing
• relieve muscle spasm and pain by Botox® injections
• stabilize the bite with an orthotic
• seek long-term management by reconstruction
• seek long-term management by permanent orthotics
• seek long-term management by orthodontics
The first step is to relieve muscle spasm and pain. At my practice, I have designed a spa-like experience for patients who require TMJ care in order to assist with pain relief and the relaxation process. We offer massage chair, relaxing sounds, calming images, and other clinically-proven relaxation techniques. The most common methods I have mastered to relieve muscle spasm and pain are bite adjustment, TENS therapy, and Botox® injections.
The clinical workhorse that I employ to achieve complete relaxation of the facial and masticatory muscles is the low frequency TENS (Transcutaneous Electrical
Stimulation) unit. Basically, the TENS unit is a great way to relax the muscles by gently massaging them. The TENS unit is non-invasive and it simply delivers
rhythmic pulses that relax the muscles by increasing blood flow and pumping out waste products. The TENS unit also helps with pain relief by stimulating the body’s production of endorphins, our body’s natural anesthetic.
In certain cases, a simple bite adjustment will help drastically relieve muscle spasms and pain. A highly experienced neuromuscular dentist is able to detect the
slightest misalignment of the bite and is sometimes able to correct this with very small adjustments to the teeth. Furthermore, I have found that Botox® injections also help in certain cases. In an effort to provide my patients with all-encompassing care, I try to stay abreast of all the latest pain alleviation techniques and offer them to my patients at my practice.
The next step is to stabilize the bite. Most TMJ patients benefit greatly from a bite stabilization device known as an orthotic. The orthotic (also known as Orthosis) is customized for each patient after the jaw is properly aligned using K7 computerized technology. The K7 computer analysis system is advanced technology that measures and records mandibular function and masticatory muscle status. Once the Orthosis (custom- made splint worn on the lower teeth) is fabricated by the lab per our specifications, we adjust the device to make sure it delivers its desired effects. The Orthosis is a very thin, plastic mouthpiece which is worn on the lower teeth.
Patients are able to live and talk comfortably with the Orthosis in their mouth, as it is hardly visible when worn. Many of my patients swear their Orthosis has saved their lives and will absolutely not leave home without it!
The final step is to devise a plan for long-term management of TMJ related symptoms. Now that the pain has been relieved and the bite is stabilized, I determine the best long-term solution for each patient. Some of my patients like their Orthosis so much that they decide to stay with it as a long-term solution. Other more severe cases demand a permanent solution, such as full mouth reconstruction. This approach involves reconstructing the entire set of teeth to permanently realign the bite per the blueprint provided by the Orthosis. Another option is permanent orthotics that usually fit over the back teeth and are designed to maintain the aligned bite. Finally, when the teeth are healthy and in good condition, they may be moved to the optimal position using orthodontic braces.
Dr. Sid Solomon DDS founded the Center for Cosmetic, Implant and Neuromuscular Dentistry in the year 1989. His philosophy is to provide the highest quality of care with impeccable bedside manner and in a warm and friendly environment. His office looks and feels like a welcoming home and he treats all of his patients like family.