Sierra Studio - Migraine Headaches

So we must ask, what is it that hurts when you have a migraine headache? A number of parts of the head can experience pain.

There are a large group of nerves over the scalp, which can cause pain and specific nerves in the face, mouth and throat can also cause headache pain. Probably the most significant part of the head that is sensitive to pain are the muscles of the head and blood vessels along the surface and base of the brain. These muscles and vessels contain very delicate nerve fibers, which can be irritated by changes in the muscles and blood flow to and around the brain.

What is Neuromuscular Dentistry?

Neuromuscular Dentistry is a type of dentistry that is used to treat a variety of symptoms. This can include:

• migraine
• headaches
• jaw pain
• clicking or popping in the jaw
• neck and shoulder pain
• and/or ringing in the ears (tinnitus)
  

  "What is Occlusion (Bite)?"
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Many of these patients have obtained no relief from their symptoms due to either improper diagnosis or an assumption that there is no physiological cause for their problem. Many of these patient's symptoms can be attributed to what is known as TMJ or (temporomandibular joint syndrome) also known as TMD (temporomandibular joint dysfunction).

If you are suffering from any of the above symptoms, neuromuscular dentistry may be the right headache pain relief treatment for you. Click here to learn more about how neuromuscular dentistry can provide treatment to your migraine headaches.

Sierra Studio - TMJ/TMD

What is TMJ / TMD?

The terms TMJ / TMD, or temporomandibular joint disorder, are usually used to describe a group of symptoms which can include: Headaches, Face or Neck pain, Chipped,Worn or Broken teeth,Clicking or Popping in the jaw, and Congestion or Ringing in the Ears. A large number of people who have TMJ will experience constant pain in the jaw joints, teeth, face, head, neck, shoulders and back. They may also experience congestion and ringing in the ears, as well as bouts of vertigo (dizziness). Grinding and/or clenching of the teeth are also often reported.

How many people suffer from TMJ?

Many people in North America have experienced some form of TMJ at some point in their lives. Studies estimate that 25% to 35% of the adult population has TMJ problems. Women generally report a higher incidence of TMJ, but damage to the bone, teeth and gums can occur in both men and women.

Where is The TMJ?

TMJ refers to the “temporomandibular joint,” or jaw joint. The TMJ is located in front of your ears. It is the area where the head of the lower jaw meets the fossa of the upper jaw. The TMJ is the most complex joint in the human body. This joint contains a complex of blood vessels, nerves, muscles and bones that can all be effected by an injury, clenching or grinding of the teeth or a bad bite. TMJ can cause a variety of symptoms including: Headaches or Migraines; Clenching or grinding; root abfractions or worn teeth; Face, Neck or Back Pain; Numbness in arms and fingers; Ringing or Congestion in the ears.

What Are The Causes Of TMJ

Most cases of TMJ are the result of either a bad bite, which is known as malocclusion, or some type of trauma, such as a car accident. When someone has a malocclusion, it means that the teeth are not fitting together properly. When the teeth are not coming together properly, they are unable to support the facial muscles. This places excessive strain on the muscles, which results in pain in the face. In turn, the facial muscles recruit muscles of the neck, shoulders and upper back to help reduce some of the strain. This causes stress and pain in these muscles as well. These muscles are then forced into a strained position, resulting in pain throughout the face, head, arms, shoulders, and back. All of this excessive strain results in a build up of waste products, such as lactic acid, in the muscles. If you have ever lifted weights, you know that after a while, the muscles get tired and start to burn. This is the same process that happens with the jaw muscles.

How Can TMJ Be Treated

We treat TMJ using a Neuromuscular approach. We first will find the position of the jaw where the muscles are in their most relaxed position. We call this "happy muscles". Once we have found this relaxed position, we then will work to correct the "bad bite" by restoring the teeth to place the jaws in the "happy muscle" position. When the muscles are comfortable, the pain generally disappears.

Sierra Studio - Neck Pain

Neck and shoulder pain are often associated with talking on the telephone to much, or sitting all day at a computer station. However, a bad bite can cause the upper and lower jaw to be out of balance with each other. When this relationship is out of sync, the muscles of jaw can be placed in a constant state of contraction. This can result in referred pain to the neck, shoulders and back.

What is referred pain?

All of the muscles of our body work together to create different movement. Often times, when muscles are overworking they will recruit other muscles to help out. This is known as muscle recruitment. The muscles of the head and neck are all involved in the various functions of turning the head, chewing, talking, and breathing. When the muscles of the jaw are over-contracted, it will effect the muscles that hold you head up and the shoulders and back. This recruitment of other muscles results in their becoming out of balance, resulting in pain. A neuromuscular dentist does not treat these other symptoms, but often times they will improve or disappear as the result of proper bite correction.

Diagnosing the Problem

Before prescribing the proper treatment for your particular problem, a variety of diagnostic procedures may be necessary. A radiograph (x-ray) may be taken of your jaw joint. This provides a clear picture of your own particular TMJ anatomy and position of the various structures within the jaw joint. The visual radiograph is also used as a means for detecting diseases in the jaw joint. Jaw repositioners may be used. These appliances are worn for a given period of time. The appliance is refined and adjusted until it eliminates the bite disharmony and pain. In this way, the bite need not be permanently altered until the problem is accurately diagnosed via the splint and other procedures. Permanent treatment would then be prescribed to duplicate the effects of the appliance, e.g. equilibration or occlusal adjustment, orthodontics or restorative procedures such as crowns.

In order to study the relationship of the patient's teeth and joints, it is necessary to see how the joints guide the jaw without interference from the reflexes and muscles which are always accommodating to the fit of the teeth. To do this a record is taken measuring the relationship of the teeth to the jaw. Once this record of the joint guidance is taken, it can be reproduced on an instrument called an articulator, which simulates your own particular jaw movements and bite relationship. Then without interferences from reflexes and muscles, the bite can be studied for disharmonies and other interferences. Necessary restorative procedures-crowns and bridges may be built outside of the mouth, analyzed on the articulator and later positioned accurately in the mouth allowing proper fit and function. Using instrumentation such as this saves you time and discomfort as it eliminates the need to sit in the dental chair while the fit and function is being adjusted.

Sierra Studio - Neuromuscular

A “bad bite” or malocclusion will eventually lead to an imbalance in the relationship of the upper jaw to the lower jaw. This will result in an unnatural, strained position for the muscles of the jaw. The muscles do not like this strained position. They will compensate by constantly contracting. This will cause muscle spasm, pain and soreness. As they fatigue, there is a build up of lactic acid and other waste metabolites. These waste products are what cause the spasms and discomfort. At some point, the body tries to flush out the muscles with increased blood flow, which results in the pounding headache. Muscles work together as a team. This is known as muscle recruitment. When the jaw muscles, which are involved with chewing, biting ,talking, breathing and head posture are overused, they recruit muscles of the neck, shoulder and back. The tight, painful, contracted muscles of the jaw result in pain in the muscles of the neck ,shoulder and back. Not all of our patients experience these symptoms, nor do we claim to be treating them. However, many patients are happy when these symptoms are relieved with neuromuscular treatment.

Happy Muscles

Using state-of-the-art neuromuscular dentistry, we determine if the symptoms you are experiencing are the result of a bad bite. We then go thru a series of steps to not only relieve your symptoms, but to also correct the cause of your symptoms. Treatment usually begins with the relieve of muscle spasms and the associated pain. We use a unit called a Myo-monitor which helps relax the patient’s muscles. The Myo-monitor stimulates the Trigeminal Nerve and The Facial nerve using a very mild electrical impulse. This TENSing accomplishes 3 things. First, It pumps waste metabolites and lactic acid away from the stressed muscles. Second, it increases the blood flow to the muscle, which increases the oxygen, glucose, and energy to the muscle itself. Finally, it allows the jaw to relax into its ideal position. Tensing usually takes 45-60 minutes depending on how bad a patients symptom are and how tight their muscles are. Sometimes we will use an EMG machine to measure the level of tightness in the different muscles. Before tensing ,the EMG will show the hyperactivity of the muscles. After TENSing there is much less activity and the muscle are much “happier”.

Comfortable Bite

After the muscles are relaxed we start the next phase of treatment which is bite stabilization. We fabricate a temporary appliance, known as as an orthotic, which is worn on the teeth. The orthotic keeps the muscles in the "happy" position which was established with the use of the Tens unit. Once you are stable, we can move on to the next step, which involves correcting the bite to keep the jaws in this comfortable position. There are essentially four ways to correct your bite to this comfortable position. First, if the bite is not badly misaligned, we can use a process known as coronoplasty or equilibration. This involves adjusting the enamel to correct your bite. It is a relatively easy procedure. Second, we can create a more permanent orthotic. This is a removable appliance that fits over the back teeth and is designed to maintain the comfortable biting position. The third option is to completely rebuild the bite using porcelain crowns and veneers. A full mouth reconstruction is a permanent solution that will maintain the muscles "happy" position. The fourth option depends on the health of the teeth. Sometimes it is possible to use orthodontic treatment to move the teeth into a position that is comfortable for the muscles.

Sierra Studio - Sensitive Teeth

Many of us say we have "sensitive teeth." We usually mean that we feel twinges of pain or discomfort in our teeth in certain situations, including:

• Drinking or eating cold things
• Drinking or eating hot things
• Eating sweets
• Touching the teeth with other teeth or the tongue

There are two types of tooth sensitivity:

Dentinal sensitivity occurs when the dentin (middle layer) of a tooth is exposed. Normally, the dentin is covered by enamel above the gumline and by cementum below the gumline. Dentin is made up of tiny openings called tubules. Inside each tubule lies a nerve branch that comes from the tooth's pulp (the center of the tooth). When the dentin is exposed, cold or hot temperature or pressure can affect these nerve branches. This causes sensitivity.

Dentinal sensitivity can affect one or more teeth. Dentinal sensitivity occurs when the outer protective layers of enamel or cementum are removed, exposing the dentin. Some causes of dentin exposure include:

• Brushing your teeth too hard. This wears away the enamel layer.
• Poor oral hygiene. This may allow tartar to build up at the gum line, leaching minerals from the tooth.
• Long-term tooth wear
• Untreated cavities
• An old filling with a crack or leak
• Receding gums that expose the tooth's roots. Receding gums often are caused by periodontal diseases or by brushing too hard.
• Gum surgery that exposes a tooth's roots
• Excessive tooth whitening in people who have tooth roots that already are exposed
• Frequently eating acidic foods or drinking acidic beverages

Pulpal sensitivity is a reaction of the tooth's pulp. The pulp is a mass of blood vessels and nerves in the center of each tooth. Pulpal sensitivity tends to affect only a single tooth. Causes include:

• Decay or infection
• A recent filling
• Excessive pressure from clenching or grinding
• A cracked or broken tooth

If you experience a sharp pain upon biting, you may have a cracked tooth or a broken or cracked filling.

Both dentinal and pulpal sensitivity usually involve reactions to temperature or pressure. Sensitivity to cold drinks or foods is the most common symptom. Less often, the teeth are sensitive to hot temperatures. If a single tooth changes from cold sensitivity to hot sensitivity, the tooth's nerve may be dying. In this case, root canal treatment is necessary.

A Sierra dentist will look at your dental history and will examine your mouth. He or she will ask about your oral habits. Grinding or clenching your teeth can contribute to sensitivity. They will also will look for decay, deep metal fillings and exposed root surfaces.

A tooth may be sensitive to cold for several weeks after a filling is placed. The metals in amalgam (silver) conduct the cold very well, transmitting it to the pulp. Bonded (tooth-colored) fillings require etching the tooth with acid before the filling is placed. In some cases, this etching removes enough enamel to make the tooth sensitive. However, advances in bonding now make it less likely to cause tooth sensitivity.

Reducing Dentinal sensitivity — You might be able to reduce your chances of dentinal sensitivity by:

• Brushing twice a day and flossing daily
• Using a soft or ultrasoft toothbrush and brushing gently up and down, rather than side to side
• Using a fluoride toothpaste and mouth rinse
• Using a toothpaste that has the American Dental Association (ADA) Seal of Approval and provides protection against sensitivity
• Getting treatment for grinding or clenching your teeth (bruxism)

Reducing Pulpal sensitivity — If a tooth needs root canal treatment, there is no good way to prevent pulpal sensitivity other than to get the needed treatment. Delaying root canal treatment may result in further problems and is not recommended.