GNATHOLOGY AND TMD/TMJ TREATMENT
Gnathology has been rapidly developed only in the last two decades, although it has been known and practiced for over a century.
This is due to the fact that only recently, thanks also to neurophysiological research, it was demonstrated that the jaw and craniomandibular disorders play a role of primary importance in the genesis of postural problems and all the series of pathologies that can arise from any alteration of this complex system. A classical example is a muscle-tension headache that, even after the complicated diagnostic investigations and “traditional” farmacological treatment, is completely resolved only after a correct gnathological treatment.
Today, there are different schools of gnathology, but the pricipal aims are:
– The identification of the correct cranio-mandibular relationship ( the orthopedic physiological relationship between the mandible and maxilla),
– Maintaining the correct positioning after dental intervention (a classic example is a filling: even a slight change in occlusal contacts can disturb the position),
– Resetting the relationship cranio-mandibular in all those cases in which the efforts of the adaptive gnatological system consequently lead to a state of muscular tension and dysfunction. In order to return to a proper neuro-muscular function and to free patients from using drugs and painkillers which they are often forced to take because of the great discomfort and pain they experience.
BRUXISM – TMJ DISORDER
Bruxism is the grinding of the teeth and clenching of the inferior jaw against the superior one, which occurs mainly during sleep and followed by a noisy sound usually lasting for a few seconds.
Generally when the patient wakes up he doesn’t feel any trouble except in cases of intense bruxism when a painful sensation of the jaws could be felt.
The grinding, however, can create damage due to wear of the chewing surface of the teeth of the upper arch as well as of the lower arch, and in most of the cases it has been noticed by the dentist first. During the time bruxism can produce important changes of the teeth, pain in the temporomandibular joints, and if continued, may result in headaches or severe joint dysfunction. To prevent this outcome, an appropriate device called a splint, which can be produced in hard or soft plastic depending on the therapeutic indication, is used to protect the teeth from erosion at night. It is also used as a prosthodontic pretreatment to help us restore correct alignment of the dental arches.
BOTULINUM TOXIN USAGE IN DENTISTRY
The application of Botulinum Toxin (Botox® or Dentox® for Dentistry) is a simple, non-surgical procedure. The doctor will administer several tiny injections directly into the muscle to “paralyze” it. Therefore, the benefit of TMJ/TMD patients is the reduction in the number of clenching events and their intensity. This will reduce the destruction of teeth, gums and jaw joint, and reduce the discomfort and pain in the face and chewing muscles. Another possible benefit is that the botulinum toxin does not stay in the body indefinitely, so if there is an adverse effect it is only temporary. There is also the likely possibility that with frequent treatments, the injected muscles will atrophy allowing the patient to go longer and longer between treatments.