Neuromuscular (NMD) dentistry is the foundation (BASIC) to understanding the physiology of the musculoskeletal occlusal signs and symptoms – teeth, muscles and temporomandibular joints. It addresses the 80% of TMD issues.
GNM (Gneuromuscular) dentistry is the ADVANCED level of CLINICAL application of the neuromuscular occlusal science, TREATING the simple to complex problems at a more detailed level – treating the whole body based on an occlusal DETAILED AWARENESS. It attempts to address the remain 20% of the unanswered questions and concerns of the TMD patient involving cervical neck pain dysfunction, TMJ primary issues, Class II division 2 bite problems in pain and the unresolving TMD anterior open bite problems.
To understand the differences in detail one must read further:
What Level of detailed attention does your occlusal/TMD problem require?
What is GNM?
It is the successful marriage of time tested gnathological principles implemented with ultimate/Optimized physiologic positioning (advanced NM protocols) in function.
A focus on detailed clinical application of gnathic and neuromuscular principles.
It advances the neuromuscular concepts beyond Basics (myocentric) – A NEW and Improved concept beyond the classical NM.
Focus on micro occlusion, precision and accurate jaw positioning as well as optimal functional relationships that go outside of myocentric.
Detailed in K7 data interpretation beyond classical NM teachings.
The sequencing of specific steps and the specific order in which the neuromuscular occlusal concepts are implemented is what makes a difference in the “thinking process”.
The “Missing Link” between occlusion and optimal function movements that impact the whole body!
Gneuromuscular (GNM) Dentistry is really a combined understanding and application of skill sets required to effectively treat the more complex TMD cases based on a comprehensive DIAGNOSIS – It goes beyond establishing a myocentric target. At OC the NM is not the same, but a new paradigm and new and improved concept married with Gnathological principles.
Gneuromuscular (GNM) is a blend of both gnathological concepts as well as neuromuscular (NM) dentistry principles.
Gneuromuscular acknowledges the anterior functional contacts and occlusal design schemes that are crucial to resolve the cervical neck, TMJ primary, Class II div. 2 and anterior open bite case problems that the NM concepts have not effectively resolved over the many years.
By combining the gnathological concepts with neuromuscular teachings the progressive minded dentists realizes that combining both concepts makes total sense. It is logical and clinically it blends the best of both worlds together to better solve the complex problems.
GNM conveys the bio-physiologic principles, concepts and methods based on muscle relaxation science (using the Myomonitor TENS and K7 technologies). GNM has enhanced the gnathological with the neuromuscular perspectives – A Step Beyond.
Because there has been years of historical philosophical battles between gnathological and neuromuscular teachings, the term GNM (gneuromuscular) which conveys a blended approach makes sense to both sides of the political arena helping to bridge a gap.
GNM brings to light the importance of “clinical application” of overlooked details helping doctors reach their maximum dental diagnostic understanding and clinical treatment skills in order that their patients can reach maximum dental improvement in both the quality of function and quality of stability with less.
WE BELIEVE IN THE PRINCIPLE OF “LESS IS MORE”
My teachings have incorporated the best techniques and protocols that I have developed from my observations and experienced within my dental practice. These techniques are now proven to bring a better result requiring skills and training that have helped me and other trained dentists in helping challenging TMD cases Better response times with effective resolutions and solutions to clinical challenges have come about since I have advanced these teachings of the past.
HOW STABLE IS YOUR CASE?
In my previous neuromuscular teachings I emphasized and focused on the neuromuscular (NM) aspects even though I touched briefly on some of the gnathologic concepts. But now, our approach and teachings have gone more in depth in the gnathologic principles AND its detailed CLINICAL APPLICATION, truly blending the gnathic and NM approaches which no one has ever done before.
“Caring for the TMD/ GNM patient is like a journey, where we may uncover things along the way (journey) that we cannot see at this moment”. Let’s remember, “It’s a journey, not a sprint”.
With GNM we understand why electromyography (EMG) recordings of muscles sometimes goes up after low frequency TENS (it is important for all dentists to understand why and under what circumstances EMGs may increase).
GNM acknowledges the importance of monitoring the cervical group LCG/ RCG rather than just the SCMs with our K7’s. We don’t ignore the cervical group EMG patterns even if they go up after TENS. We know why and how to address these patterns in our diagnosis.
• GNM trained dentists understand why EMG recordings decreases after muscle TENS and why EMG patterns goes up, especially in the cervical group as well. We know exactly what to do about them occlusally.
GNM understands why TENS does not always relax muscles.
GNM understand why TENS is very important in helping to find a more accurate mandibular position when recording a bite registration.
GNM dentist uses the Myomonitor TENS for specific and particular reasons.
The GNM trained dentists use the Myotronics K7 brand of technology specifically for particular reasons.
GNM has pioneered and developed specific “Bite Optimization” protocols using both jaw tracking and low frequency TENS when identifying the patient’s optimal mandibular myo-trajectory (disc reduced) for those case that involve internal derangements, masticatory dysfunction and pain.
GNM is conservative. Vertical dimensional changes of jaw relationships are not casually done unless masticatory dysfunction, pain and joint derangement problems exists.
GNM focuses beyond dental cosmetics, but recognizes the importance of physiologic masticatory alignment to support complete body balance and function.
GNM is very much focused on the “clinical application” of the NM concepts to help our doctors get the results they have been looking for with their patients.
It is focused on reaching Maximum Dental Improvement (MDI) for the whole body.
These are just a some of the few things that distinguishes GNM teachings from NM teachings. TENS does not always relax muscles. The GNM dentist knows why and implements that information strategically in their diagnosis. The OC teachings realizes why it is important for the GNM trained dentists to use J5 Myomonitor TENS. It is the training and understanding of these GNM concepts that further distinguishes our teachings and perspectives beyond other neuromuscular teachings.
As the Father of Neuromuscular Dentistry once said – “if you can measure it, it is a fact, if you can’t it is just an opinion”. That is the standard by which neuromuscular dentistry has set the bar within the dental profession in order to enhance the clinicians approach to diagnosis and treatment – using objective measuring and recording methods to scientifically support this position.
Neuromuscular Dentistry as Dr. Barney Janekelson (“Father of Neuromuscular Dentistry”) and Dr. Robert Jankeloon (son) defined it as:
1) the diagnosing and treatment of occlusal problems by objectively measuring and correlating it to muscle function and mandibular movement,
2) Restoring the masticatory muscles and TM Joints to an optimal function before restoring the occlusion and
3) Applying the same standards of diagnosis and treatment of the muscles as we do the teeth and joints, such as documenting and recording with objectivity like x-rays of the joints and teeth. The neuromuscular clinician documents and records EMGs of muscles activity, and uses instrumentation to document as well as treat jaw movement and position.
A true neuromuscular approach is really using objective measuring methods to support and validate one’s position from a true “physiologically rested” starting position. Not acquiring a jaw position from unrested muscles.
As many are aware, Dr. Chan is an advocate of Neuromuscular Dentistry in the purist sense. The dental profession also recognizes that he has stronger beliefs and understanding in the gnathic GNM principles. Because of this combined perspective he has been asked by many within the dental community to continue teaching these GNM concepts which rings positively within the hearts of many clinicians regardless of what perspective they believe. His technical skills in occlusion along with his comprehensive understanding of dentistry (TMD, restorative, orthodontics, lab technology) allows him the opportunity to expertly remove the guess work out of his dentistry and answers clinical questions that have not adequately been addressed within the dental profession. Blending objective clinical reality without the haunting guesswork of wondering why certain things are not working is what makes GNM effective in its approach.
This is why Occlusion Connections (OC) exists as a teaching center here in the United States – to advanced those dentists who own K7’s, their understanding as well as the gnathically minded clinicians who desire to further their confidence in the precision and accuracy of occlusion and gneuromuscular principles.