What is Neuromuscular Dentistry? - Priya Mistry, DDS (the TMJ doc)

[@adrianseditz4168]

Wow this makes sense thank you, is it possible that these treatments can cause recession of the jaw or mandible?

[@theTMJdoc]

No - I’ve never seen that happen :)

[@adrianseditz4168]

@@theTMJdoc Phew, that is a relief because i have anxiety about that! :) What happens if you have a MORA orthotic while eating food, does that lead to something bad? Also I cant find a place in Australia Sydney where i see someone say on website in neuromuscular dentistry say they offer orthotic (mora). Can i pay a consultation with you so you can help me see one or you can say one for free if you want?

[@theTMJdoc]

@@adrianseditz4168 hi! I’m sorry but I don’t know anyone in Australia!

[@lHARDlCaps]

One of the things I continue to ponder, is how can a neuromuscular approach find the 'optimal' position for the mandible when suboptimal facial growth is present? Suboptimal maxillary and mandibular development would seem to make it impossible for there to ever be an optimal position. As the optimal position of the jaws only occurs with optimal development of the jaws. Thus all positions with suboptimal development will be suboptimal, with approaches to reposition jaws merely finding positions in which the most function is possible within the suboptimal system. And that position may or may not allow adequate function for health and well-being. From the outside I observe neuromuscular dentistry doesn't seem to embrace this above concepts when it comes to orthotics, despite NM physicians acknowledging how faces are underdeveloped and cause airway and orthopedic problems. It's confusing to me to see this. Why would anyone believe finding a position in which the muscles are least active is an optimal position when there's nothing optimal about the underlying anatomy? To me it's like listening to people argue about how the optimal place to balance a weight on a four legged table with only three legs so that the table doesn't tip over and then upon finding that balance zone claim that the best treatment is to weight the table at that spot with 'crowns', when the simple truth is, just put that forth leg on the table and the problem is fixed for Full Function. I don't see NM physicians acknowledging the crutch of a NM orthotic to be a crutch which may or may not work because the optimal position cannot be acquired. Instead I see the narrative 'we find out where your bite and muscles and airway and nervous system want to be'. And I don't understand how that can be true. So I keep wondering what's going on and where people get help and why things work sometimes and not others. When is NM useful, when is it not? I think it might be more easy to answer that question if the way it was presented to patients and practiced clinically was less confusing/contradicted by other concepts.

[@theTMJdoc]

Great questions. As for optimal position when there is suboptimal facial growth - with suboptimal facial growth, the "optimal position" found with NM dentistry is the optimal position, given the situation at hand rather than the most optimal or ideal position if the facial growth was also ideal. Putting the muscles in their most relaxed position has helped so many of my patients in terms of pain and sleeping better that it's impossible for me to discount the positives of NM dentistry. Having said that, I don't have a 100% success rate; I don't know anyone who does.

[@philonavis792]

Doctor, will this treatmet help someone with disc displacement and doctor suggested arthroscopy? Will neuromuscular dentistry help in this situation ?

[@theTMJdoc]

It can!

[@yuppystick]

Would jaw surgery help? I have a slight overjet, weak underdeveloped chin from sucking my thumb as a kid, loud clicking jaw when yawning and a patulous eustachian tube. Will insurance cover jaw surgery to help this?

[@theTMJdoc]

I don't typically recommend surgery as a first line of therapy with clicking noises in the jaw.

[@satisfyingcooking44]

Mam will you suggest TMJ Arthroscopy for jaw popping, locking and clicking all the way??

[@theTMJdoc]

no, I don't recommend arthroscopy for this.

[@taytayb1231]

I was wondering if there is any link to post nasal drip and tmd? I’ve been suffering with tmd for at least 10 years and it’s horrible. I’ve tried muscle relaxers, mouth guards, chiro care and nothing helps. Since 2016 I’ve had post nasal drip and the need to clear my throat or sniff every few seconds it’s so annoying. Almost like a nervous tic but I can’t help it. Then I suffer with muscle soreness around my jaw and I’m clenching at night and throughout the jaw. I can’t stop. I’m from Dallas but travel to Washington every summer. Could I stop in? How long would I need to stay for treatment I’m miserable! No doctors in Texas are helping me.

[@theTMJdoc]

I’m sorry but I don’t have experience with nasal drip in relation to TMJD.

[@danieljvossvoiceover7812]

I clicked on this simply because I thought this was the girl from that 70's show!! lol

[@theTMJdoc]

Haha thanks! I wish I looked like Mila Kunis!! 😊

[@allisonwagstaff2470]

If a patient uses a removable orthotic for several months and is feeling better and is ready for phase 2, will the patient still be able to tolerate phase two with the muscles in a comfortable position since they would no longer be using the orthotic?

[@theTMJdoc]

Yes because the goal with phase 1 is to bring the muscles back to a healthy position.

[@jayapatil6079]

Dr. Priya, Great informational Video on Neuromuscular Dentistry!!

[@theTMJdoc]

Thank you!

[@LabMileyLab]

My chronic migraines frequency has been cut in half since getting my myoaligner orthotic!

[@theTMJdoc]

Wonderful!

[@LabMileyLab]

@@theTMJdoc and as time goes on it's only getting better!

[@soft_threads]

I just got new splint made day before yesterday as my old one broke through I still need some adjustments to be made with the new one but whenever I wear it I tend to chock on it and it feels really tight and is hard to remove once I wear it I just don't know what to do.

[@theTMJdoc]

I think you have the right idea about needing adjustments :)

[@soft_threads]

@@theTMJdoc I aslo been having chocking issues with wear the splint and I don't know what to do.

[@DragonBall-hv3rs]

Mam I need your suggestion, I was diagnosed with tmj dysfunction exactly 1yr ago... and doc performed DTR treatment to correct my bite position But yesterday he told me by bite issues are fixed and there is no requirement of further treatment But i am facing problems like stuffy ears, vertigo, dizziness, neck pain and stiff mouth opening....he referred me to an ENT specialist but i don't think an ENT specialist would do something as it is definitely related with muscle dysfunction I am feeling helpless mam....please suggest something and btw are u indian (from ur name) because i am an indian 😅 If it would be possible i would have come to ur place for treatment

[@theTMJdoc]

My office is in Vancouver, Washington (close to Portland, Oregon). We can generally help a lot with vertigo/dizziness, neck pain, and stiff mouth opening. The stuffy ears is a symptom that we have an 80% success rate with.

[@DragonBall-hv3rs]

@@theTMJdoc Mam i do not hv sufficient funds to come...but only want to ask u... Will orthotics help..and relieve my ear and joint disc problems forever?

[@theTMJdoc]

@@DragonBall-hv3rs Again I cannot answer that question over the internet. Each persons condition can vary a lot on severity and I cannot tell you if an orthotic will relieve your symptoms forever.

[@pk-wi4mg]

@@DragonBall-hv3rs kaha pr treatment karya bro

[@yuppystick]

I have patulous eustachian tube. My jaw clicks hard and loud when I yawn. Could these two be related?

[@theTMJdoc]

Yes they could be

[@liamcarr7889]

Hi Doctor, can I wear an tmj orthotic if I have 3 teeth removed on each side of my lowers jaw?. I have a partial plate. Thank you for all your work.

[@theTMJdoc]

you sure can! :)

[@liamcarr7889]

@@theTMJdoc would the orthotic sit on top of the partial denture?

[@theTMJdoc]

@@liamcarr7889 the daytime one can. The nighttime one would not.

[@liamcarr7889]

@@theTMJdoc Thankyou… would that mean I would need some implants on lower jaw?

[@theTMJdoc]

@@liamcarr7889 no the orthotic can sit on the empty spaces :)

[@drbillwilliams]

Excellent information for both patients and dental professionals. As an instructor, clinician and practicing dentist in Neuromuscular dentist since 1979, I am impressed with the level of educational offerings you share with the public. Dr. Bill Williams DMD, MICCMO, MAGD

[@theTMJdoc]

Thank you so much for your kind words Dr. Williams! These videos are actually quite a lot of work, so hearing praise and acknowledgement really means a lot to me. Thank you again :)

[@drbillwilliams]

@@theTMJdoc work is the word! I have about 50 videos in my KZbin channel from the last 6 years and about 38 years of teachings on VCR and DVD’s.

[@theTMJdoc]

@@drbillwilliams amazing!! Where do you practice?

[@chrisyoung8759]

A physical therapist, I've gone to recently, squeezed my left masseter. The next day I was moving my jaw around to get my left ear to pop, like it usually does for some reason, and I think my left TMJ popped really big and loud and it hurt. The ear popping stopped. I also have tinnitus that a doctor thinks could be caused by neck, masticating muscles and TMJ, which is why the physical therapist worked on the masseter. When I push my lower jaw forward, I can modulate the tinnitus and and make it louder for a quick second. The doctor also thinks my left TMJ is "problematic". I also have pressure on my top left molars that comes and goes all day. Wondering if this has ever made a difference in tinnitus and this pressure problem I'm having.

[@theTMJdoc]

Yes, jaw position can have an effect on tinnitus. However it's highly unpredictable as to which way it will go.

[@Ridhii19]

You're appreciated 💜✨

[@hbinfinity]

Thanks for this great info! I'm curious, do you know any exercises that align the lower jaw into the joint? I had an MRI that showed a bilateral anterior disc displacement on my left side. As far as I can tell, that means my jaw is misaligned? Looking for P.T. moves to help.

[@theTMJdoc]

No, I don't have exercises for this. We treat this condition with orthotics, myofascial release, and osteopathic manual jaw manipulation and it can take 4-6 months with weekly or biweekly appointments to get the discs back in proper alignment and stable in that position.

[@hbinfinity]

@@theTMJdoc thank you for the information. I'm so scared. I feel like my life will never return back to normal. I live in Sonoma CA, near the San Francisco Bay area, and I found a dentist to make the orthodic, but I don't know what to do about the osteo pathic manipulation. If you know anyone or have any ideas, it would be appreciated. Thanks for what you do!!

[@theTMJdoc]

@@hbinfinity I’m sorry I don’t know anyone there that does that. You could try to find a TMJ physical therapist.

[@hbinfinity]

@@theTMJdoc I'll try that!

[@theTMJdoc]

@@hbinfinity good luck to you!