Neuromuscular Orthotic Therapy

An Othotic is basically a bite splint device that is worn on the lower teeth 24 hours everyday for a period of 3 to 8 months. It is designed to reposition the jaw to the correct neuromuscular position. An orthotic, sometimes called a Bite Splint, is a very effective method in relieving TMD symptoms. It provides an acrylic platform to bite against, sometimes moving the lower jaw to its best position that is more comfortable.

This treatment usually involves 2 phases. ie Phase I & Phase II.

Phase I :

This phase includes the Neuromuscular Bite registration after optimizing the position of the TMJ & Craniocervical complex, fabrication of an orthotic, and Optimization of the Orthotic-Dental Occlusion. First of all, we analyze the bite, decide which muscles are causing the pain, and where the current position of the bone is and the disc is. All this is done, with the aid of some of these most advanced equipments like the TENS unit, the T-scan, jaw tracking, Sonography, EMG's and advanced x-rays like Tomography, CT Scans and MRI's of the TMJ.

This will help us determine the best and the most comfortable position of the TMJ and the craniocervical muscles. Once that position is determined, we register the bite to which the orthotic is placed. The orthotic is placed on the lower teeth to keep the TMJ in that position. Orthotics are worn for 3-8 months or until most of the symptoms are relieved. Once an orthotic is in use, the symptoms start gradually disappearing. Disappearance of the symptoms concludes Phase I of the treatment.

Phase II treatment:

After 3-8 months when the patient is no longer suffering from any TMD symptoms, Phase II can be initiated. Phase II includes any of the following:

• 1. Wearing a long term removable orthotic, full or part time.
• 2. Replacing missing teeth.
• 3. Orthodontic treatment (Braces).
• 4. Restore all the lower and/or upper teeth with crowns and veneers to preserve the optimal occlusion (bite) that was achieved with the orthotic in phase I.

Any of the above or in combination could be chosen, depending on the patients' preferences and financial capability. If you are suffering from TMD, it is too early to think of phase II at this point of time, since it is very important to get you out of your symptoms and pain first.