Gneuromuscular Dentistry (GNM) is really a combined understanding and application of skill sets required to effectively treat the more complex cases – It goes beyond the present day concepts of “Neuromuscular Dentistry”(note the spelling). It’s Dentistry that focuses on body alignment,optimal mandibular function and accurate occlusion that results in optimal form. In reality gnathologics (gk. study of the jaw) are the foundational concepts to neuromuscular dentistry.
• Both Gnathologic and Neuromuscular understanding is required….its not a matter of one or the other – It’s BOTH!
• Clinicians need to understand to optimally apply the occlusal principles in a balanced way,thus “Gneuromuscular Occlusion”.
Neuromuscular Dentistry (NMD) is not only about the implementation of electro-diagnostic technology,scans,EMGS and jaw tracking data in the dental practice. It is about occlusion and it’s relationship to the trigeminal system as it relates to the postural system.
Gneuromuscular Dentistry relates the CLINICAL application of occlusal therapies to TMD,restorative/prosthetics and orthodontics dentistry and to their relationship to the central nervous system (CNS) as well as the autonomic nervous system (ANS). It’s not an academic exercise of knowledge,but rather an occlusal management discipline at it’s highest level of how the teeth,muscles and joints opitmally function (HEALTH, not in dysfunction) in relationship to the bio-physiology,neurology and to the masticatory system.
GNM A Discipline of Dentistry
The concept of GNM is a discipline in dentistry that requires attention to detail to the core gnathologic principles that every student of dentistry must learn and master if they desire to be world class clinicians. LEARNING the foundational gnathologic occlusal KEYS is crucial,thus enhancing a greater appreciation of technological advancements of jaw tracking and proper use and understanding of electromyography (a study of the patient responses of muscles activity relating to the muscle tonus and status of the masticatory system) which the clinician can objectively record and measure postural responses of abnormal occlusion relating to TMD occlusal therapy,restorative/prosthetic dentistry and or orthodontic dentistry.
Gneuromuscular Dentistry recognizes and values the use of computerized mandibular scanning (CMS) and low frequency Myomonitor TENS as well as electromyography (EMG),additionally with a combined and more complete perspective of occlusal management (gnathologics) which plays a huge role in recorded data outcomes (also called scans). Scans are objective CMS and EMG recordings of data which can assist the trained clinician to better understand their patient’s jaw,cervical postural and muscle activity conditions. Gnathological skills and training is the additional discipline that is a must when properly implementing CMS and EMG technology to the next level of dentistry.
Improper Use of Neuromuscular Technology
When clinicians begin to use these advanced techniques in an improper manner,not learning how to properly interpret the EMG and jaw tracking data correctly (even though in their mind that the data may appear to be normal or correct as per their understanding) it behooves the clinician to self assess ones training in gnathologics and understanding of their interpreation of neuromuscular instrumentation data. Advanced training to further learn how to properly interpret the data with these technologies to the next level is required,especially when restoring patients teeth based on this CMS and EMG data and ones interpretative understaning of this information through the various phase of reconstruction or restorations (phase I removables,phase I fixed orthotic,phase I porcelain orthotics and or phase II restorative).
If the scans appear to show abnormally low EMG activity and the jaw trajectory looks like it is right on trajectory sagittally and frontally and the patient is complaining that they don’t have a bite,then perhaps a reassessment as to one’s understanding of scan interpretation is in order (Level 1 through Level 5 Advanced NM Bite Refinement/K7 Training and Interpretation at Occlusion Connections) to learn a more complete Gneuromuscular occlusal concept.
If the patient is having a difficulty with the dentistry provided even if it was performed in the name of NM with instrumentation and one is not sure how best to proceed….don’t tell the patient that all the scans appear normal and that there is nothing wrong with the dentistry. Recognize that post individuals are not whiners and complainers for no reason. They have a legitimate concern that needs further investigation,occlusal understanding and another level of skill sets and training on the part of the dentist to better understand the problem. It is wrong to tell the patient that there is nothing wrong when the scans appear to be OK to cash this patient to the waste heap of “NM” failures. Let’s reconsider what we have been taught.
Knowledge,Skills and Good Judgement
Learn from those who really practice what they preach. Use your knowledge,skills and good judgment to help your patients and find a resolution to the problem. Be patient,compassionate,respectful of others work and listen to your patients carefully…sometimes they know more than the treating doctors…why because some of them are experienced and have read,learned educated themselves amongst the numerous practitioners they have visited,have been the recipients of many doctors treatments and therapies,yet continue to seek for real answers to real problems.
As long as Neuromuscular clinicians continue to pretend to hide under the covering of their scans (not really understand OCCLUSION management principles and the importance that microns matter) not fully comprehending what they mean as they relate to CLINICAL TMD pain treatment,restorative occlusal therapy problems and orthodontic/orthopedic issues,then scan interpretation is only a lopsided perspective of what NMD really advocates.
Gneuromuscular Dentistry –A Combined Discipline to Comprehensive Dentistry
GNEUROMUSCULAR Occlusion or Gneuromuscular Dentistry is the full package which combines the application of sound gnathologic occlusal mechanics of occlusion with the scientific and physiologic principles of NMD in a balanced manner. Gneuromuscular is a disciplne of dentistry that is now being recognized as key to comprehensive TMD,restorative and orthodontic dentistry that has been the missing link in our dental profession. Dentists must know and combine their understanding,skills and abilities to diagnose and effectively treat their patient’s at the next level. Our dental profession must upgrade their thinking and concepts and recognize that it is not a matter of just gnathologics or just neuromuscular dentistry,but a bridging of both disciples of mechanics and science in understanding and skilled application with technology that are now proven beyond a reasonable doubt significant to the health of our patients and dental profession.