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Temporomandibular Joint Disorder (TMD / TMJ)

We are the premier physiologic neuromuscular dental practice in the Heidelberg / Mannheim area, that treats TMJ pain, TMD, CMD, Headaches, Migraines, Neck Pain, ear pain, Jaw pain … and many other symptoms resulting from poor jaw alignment. We are known for our expertise, experience and exceptional customer service. Our practice is devoted to helping chronic pain patients regain pain free lives. Treating mainly TMJ / TMD patients for over 15 years has resulted in experience and expertise.

What is Temporomandibular joint dysfunction?

Temporomandibular joint dysfunction (TMD, TMJD) is an umbrella term covering pain and dysfunction of the muscles of mastication (the muscles that move the jaw) and the temporomandibular joints (the joints which connect the mandible to the skull). The most important feature is pain, followed by restricted mandibular movement, and noises from the temporomandibular joints (TMJ) during jaw movement. Although TMD is not life-threatening, it can be detrimental to quality of life, because the symptoms can become chronic and difficult to manage.

The prevalence of TMD is very high. 75 % of the general population present at least one sign of dysfunction (joint noise or deviation on opening) and 33 % have at least one symptom (pain).

Experiencing any of these symptoms?


If so, you may have TMD!

How can a bad bite cause all these problems?

The muscles of the temple area of the forehead play an important part in the posturing and closing of the jaw. If your occlusion (bite) is not correct, it can lead to abnormal tension in the muscles and may cause headaches. This abnormal tension also has an effect on pulling the jaw into a retruded position. This causes compression and inflammation of the joint. Symptoms arising can include jaw joint pain and noises, and ear problems.

The retruded jaw position also reduces the airway, resulting in snoring and sleep apnea. The muscles retruding the jaw also have the affect of pulling the head forward. Head forward posture strains muscles of the neck, tips the top vertebrae the Atlas, and disrupts all blood vessels and nerves coming through the base of the skull. Only a neuromuscular bite is proven to correct the Atlas position.

Bad Bite = Tipped Atlas = Poor Systemic Health

Headaches are generally classified into several basic types: Sinus, Cluster, Tension, and Migraine. All types can be caused by an improper bite. If the bite is not corrected the muscles remain tense for long periods and then suffer from poor circulation. Due to the lack of needed oxygen, the muscles accumulate waste products of metabolism. The result is a headache.

Neuromuscular Treatment

An Orthotic is a custom made appliance fabricated of plastic that can be worn over or fixed to the teeth to maintain the neuromuscular derived bite position. At this point, nothing is done to permanently alter your teeth or bite. After the resolution of the TMD symptoms, the healthy physiologic neuromuscular position can be made permanent.

TMD Therapy Options

Have you been treated by any of the following diagnostic instruments or treatment appliances and had little or no improvement in your symptoms?

  1. Night Guard
  2. Michigan Appliance
  3. DIR (Dynamics and Intraoral Registration)
  4. NTI (Nociceptive Trigeminal Inhibition)
  5. Arcus Digma

Listed above are a few of the many different types of therapies that may not be successful for the following reasons:

  1. The pathological jaw position was not changed or corrected by the treatment. [From therapy options above: 1) and 2)]
  2. The appliance was not worn 24 hours a day. [Therapy: All]
  3. The diagnostic instruments do not analyze the muscles. [Therapy: All]
  4. The muscles are not relaxed before the bite registration. [Therapy: All]
  5. The muscles are not objectively measured for their degree of relaxation. [Therapy: All]
  6. The diagnostic instrument measured the middle of the jaw joint from an ill-formed, pathological joint and condyle. [Therapy: All]
  7. A flat plane on an appliance causes the jaw to retrude, muscle tension and jaw joint compression. [Therapy: 1) and 2)]

Physiological Neuromuscular Dentistry eliminates the mistakes of the therapies listed above so that the new bite position will allow muscles of the head and neck to be relaxed, eliminating related TMD symptoms, and allowing joint healing to begin. The new bite position will also recapture the disk, decompress the joint, and center the atlas (top vertebrae) its correct position.