• Muscles, joints & teeth

    Muscles, joints & teeth

    Where traditional dentistry focuses on the teeth, neuromuscular dentistry is concerned with the muscles and joints of the jaw, and how they work together to influence your bite. And your bite is central to every major dental procedure, your overall oral health and your general wellbeing.

    An imperfect bite can be the cause of—or severely aggravate—head and neck pain, and many associated complaints. These include:

    • headache/earache
    • jaw/neck/facial pain
    • jaw clenching/teeth grinding
    • jaw joint clicking/popping
    • limited jaw movement/mouth opening
    • difficulty chewing/swallowing
    • dizziness
    • ringing in the ears

    So… Muscles + joints + teeth = neuromuscular dentistry
    And… A better bite = a healthier, happier you

    Neuromuscular dentistry aims to establish your natural or ideal jaw “posture”, and adjust your bite to maintain that position.

    You may consider neuromuscular dental treatment in various cases:

    • as part of a cosmetic, orthodontic, restorative or reconstructive dental procedure
    • to establish the ideal bite for the preparation of a denture
    • to treat conditions that may be caused or aggravated by an imperfect bite (these conditions are known as temporomandibular disorders or TMD)

    There are several stages to neuromuscular dental diagnosis and treatment
    Your neuromuscular dentist will conduct a thorough physical examination of your teeth, head and neck. Certain non-invasive instruments may be used to further diagnose your bite and jaw function. The findings of these tests enable your dentist to determine if your habitual bite is causing you problems.

    If so, your natural jaw posture needs to be determined by relaxing your jaw posturing muscles. These muscles can become overworked in maintaining their “programmed” position. And, as mentioned, this can result in a less than ideal bite, pain and jaw joint problems.To relax these tense muscles and find their true resting state, a process known as TENS is used – transcutaneous electrical nerve stimulation. Using a battery-operated device, a gentle electrical stimulus is applied to the relevant muscles and nerves through adhesive patches. This causes the muscles to twitch or pulse. After 40 to 60 minutes, this electrically-induced exercise “de-programs” your jaw muscles, restoring their true resting state.

    While the process may initially feel a little strange, it is painless and harmless. TENS has been used for many years, in applications ranging from childbirth to the treatment of back pain. 

    When your jaw muscles are relaxed, an impression will be taken of your bite. Your dentist can then compare this with your usual bite, to determine if and how your bite should be adjusted.

    To start the process of adjusting your bite, a dental orthotic is prepared. This is a plastic appliance that is worn over your teeth to maintain your ideal jaw posture. You will wear the orthotic for a period of time to confirm that your new jaw posture resolves or alleviates your initial complaint.

    If so, you may then choose to have your teeth treated to permanently maintain this ideal bite position.

  • Smile symmetry

    We all know a great smile when we see one. But what exactly is it that makes a smile fantastic? A beautiful set of teeth? Then what makes teeth beautiful? The answer lies in the parameters set by nature.

    When you see someone’s smile as ‘beaming’ or their teeth as ‘beautiful’, you’re responding to a formula we see every day in nature from the ferns and flowers at Queen’s Park to the seashells on Maggie. It's known as ‘the golden proportion’ – the formula or ratio that marks the measure of beauty in nature. That ratio is 1:1.618.

    The spiral of a seashell, for instance, increases at the ratio of 1:1.618. The same can be observed in flowers, feathers and leaves. The golden proportion is evident throughout the human body, including the teeth.

    The relationship between the upper front teeth, the teeth next to them and those next to them reflect this proportion. A person’s facial height, that is the shape and position of the eyes, nose and mouth et cetera, reflects the golden proportion.

    When the smile is compromised by tooth crowding, grinding, loss or decay, it becomes obvious that something isn’t right. And it’s not just about appearances.

    The loss of facial height, or the malposition of the jaw, can lead to ailments such as migraines, ear ringing, dizziness, back pain and teeth clenching.

    This is where neuromuscular dentistry comes in – taking the head and neck into account. By considering the golden proportion, the ideal tooth length/width and jaw position can be determined. This is where all muscles in the jaw are at rest and the patient is subsequently symptom-free.

    That perfect smile or beautiful set of teeth isn’t as enigmatic as you may have thought. It's simply a matter of proportion.

  • Teeth grinding

    Teeth grinding is such a common condition, it even has a name: bruxism.

    Many people grind or clench their teeth while they’re asleep or during times of stress. And they’re often not aware of it. 

    Perhaps your partner has brought your grinding to your attention. Or maybe your children grind their teeth – the sound can often be heard beyond the bedroom. 

    Of course, the grinding and clenching of the teeth are part of the normal eating process. However, bruxism can lead to all sorts of problems – in addition to irritating partners and parents:

    • worn-down or loose teeth
    • sore or enlarged jaw muscles
    • damaged jaw joints
    • cracked teeth
    • broken fillings
    • ear and hearing problems
    • headaches.

    What causes it?
    In some cases, teeth grinding begins with an incorrect bite or jaw alignment. It’s often triggered by a stressful event, such as a new job, a new school, exams, money worries or relationship problems. Once established, the habit may come into play whenever you’re stressed or tired.

    How to treat it
    If the condition is stress-related, it may go away of its own accord as you adjust to the situation. 

    If, however, there is an established pattern of teeth grinding, it is advisable to have the problem investigated and treated.

    Evening out the bite
    Ideally, the upper and lower teeth should meet together evenly and comfortably. If the bite is uneven, the jaw and chewing muscles may try to grind the teeth into a comfortable position. 

    Simply smoothing down the protruding teeth or fillings may be all that’s required to rectify the problem.

    Wearing a bite splint
    The side effects of teeth grinding can be effectively avoided by wearing a bite splint. Generally worn at night, the appliance places a barrier between the upper and lower teeth. This protects against wear and relieves the soreness in the jaw and chewing muscles.

    The easy to wear device is generally made to fit the upper teeth. It is moulded to the precise shape and contours of your own teeth and mouth. The biting surface of the splint is smooth so that the opposing teeth can slide over it harmlessly, without gritting or grinding. 

    Taking it easy
    Of course, one of the best ways to address the problem of teeth grinding is to learn how to relax. 

    Regular exercise, such as walking, builds up your stress-resistance. Activities such as yoga, meditation, tai chi, or simply taking regular time out, may also be helpful.

  • Bite splints

    A splint is primarily designed to reduce wear on your teeth from grinding. At the same time, the appliance also reduces the risk of cracked teeth and problems associated with the loss of tooth enamel.

    It is a customised, precision-made device constructed specifically to the shape and contours of your own teeth and mouth.

    Care for it well so it continues to function correctly and retains its fit

    • An unclean splint is neither healthy nor comfortable. To clean, remove the appliance and brush with a toothbrush and toothpaste.
    • Be careful not to drop the splint on a hard surface, as it may break. It’s a good idea to fill the sink with water – so if you drop the appliance, it’s less likely to break.
    • Brush your teeth as well before reinserting the splint.
    • You may find wearing your new appliance a little strange at first. But you will soon get used to it.
    • Your saliva flow may increase during the first few days of use. This will soon taper back to normal.
    • During the first week or so, you may find that the appliance falls out in your sleep. This is normal, and will cease as you adapt to wearing it.
    • We will check on you and your appliance after a week, but we’ll be happy to see you earlier if necessary. 

    Be careful where you leave your bite splint

    • Do not expose the splint to direct sunlight or excessive heat, as it may lose its shape.
    • To a dog, your precision-made splint may look like a tasty chew toy.
    • If you leave it lying around in a tissue, it could easily go out with the rubbish.
    • For protection, store your bite splint in the plastic case provided. The appliance should be kept moist by adding a little water to the case.
  • Sleep Dentistry

    Sleep Dentistry

    Sleep dentistry concentrates on the diagnosis, treatment and prevention of obstructive sleep apnoea (OSA) – the most common sleep-related medical disorder.

    For those suffering OSA, breathing is interrupted by a physical blocking of airflow to the lungs – despite the body’s innate capacity and best efforts to continue breathing while we sleep. 

    The statistics are very revealing:

    • Estimates suggest that up to 20% of the population may suffer from some form of OSA. Most go undiagnosed.
    • OSA sufferers often remain unaware of the condition – until they’re told by an observant partner, or diagnosed due to associated symptoms.
    • Partners often complain about the OSA sufferer’s snoring, or express concern about their pauses in breathing during sleep.
    • OSA sufferers are often tired during the day, and rarely wake up feeling fully refreshed. They may fall asleep easily when relaxing, reading or watching television.
    • OSA significantly increases the risk of accidents on the road and in the workplace.
    • When OSA goes unchecked for extended periods, the incidence of conditions such as cardiovascular disease, high blood pressure, diabetes, weight gain, stroke and depression significantly increase.
    • It is estimated that untreated OSA can reduce life expectancy by up to 20%.

    So how does this relate to dentistry?
    Many people think that the typical OSA sufferer is a middle-aged, overweight male. This is not entirely true. While obesity is a contributing factor, more pertinent causes are jaw development and – subsequently – jaw position.

    Jaw development begins before we’re born. Our jaw position is largely determined by the end of adolescence. If we can promote the correct growth and position of our children’s jaws and airways, then we can protect them from this insidious condition.

    It is estimated that OSA is present in around 3% of pre-school children. Curiously, while adult sufferers tend to be tired and sluggish, children with OSA exhibit hyperactive behaviour. This affects concentration, learning and performance at school. Researchers believe this can lead to a 10 point drop in IQ.

    So what can be done?
    From a diagnosis and prevention point of view, if your child snores, you should get them checked out by your GP. 

    Removal of swollen tonsils and adenoids is coming back into favour, and can make a huge difference to an apnoeic child. Early interceptive orthodontics can make a big difference to the development of the upper and lower jaws. If there is more room in the mouth for the tongue and soft tissue, then there is more room for the airway.

    Treatment for adults often involves use of a continuous positive airway pressure (CPAP) machine for the more severe cases. Milder cases can be treated with a removable appliance – a little like a mouthguard – which is worn while sleeping to keep the airway open.