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TMD: Cervical Dysfunction Problems
When imbalances in occlusal contact (abnormal bite forces) exist between the upper and lower teeth and or when wearing an occlusal appliance,cervical tension and musculoskeletal problems can occur.
The muscles of the head, neck and cervical region can act as contributors to masticatory muscle tension that influence the function of occlusal contacts and posturing of the mandible. Abnormal occlusal bite contacts in the natural dentition (occlusion) and or when using an occlusal appliance that changes the position of one’s jaw relationship can be a contributor to neck muscles strains (examples, SCM, scalenes, occipital region) and shoulder tension pains.
A proper designed GNM Orthotic is key!
Abnormal rubbing or inadvertent tooth force contacts between the posterior teeth can develop over time contributing to the problems mentioned above. When having your dentist evaluate your molars, he/she may not actually find clear radiographic evidence of a root or periapical problem, no cavities or fractures of your teeth to justify a need for root canal (endodontic) treatment. If so, one may consider that perhaps your bite is acting in a manner that is not as happy as it could be. Back teeth should not be in contact when the jaw shifts left or to the right. It is acceptable to have the front teeth contact in these side posturing positions. If your back teeth are in a forceful position when your jaw is laterally positioned, it could be contributing to the symptoms described in this article. Your mysterious toothache or your mysterious neck and shoulder aches may not be from the tooth itself, but rather from how the teeth are abnormally contacting and further contributing to the various other symptoms associated with this problem. There is a logical answer to this problem.
- Unexplained tooth mobility and gum recession
- Unexplained achy teeth (especially molar regions)
- Atlas and axis are not able to stay balanced after chiropractic adjustments
- Occipital tension and pain behind the neck and base of the skull
- Cervical neck tension (Sternocleidomastoid muscle tightness)
- Trigger muscle pains to the top of the head (scalp region)
- Shoulder tension and pain
- Zygomatic/ masseter (facial ) tension and pain
- Temporal headaches
- Pain at the lower corner of the border of the mandible
These symptoms have been shown to be effectively resolved when proper GNM occlusal principles and therapeutic protocols have been properly implemented by a trained dentist. Your bite/ occlusion and the way it is adjusted may still be the problem).
Adjunctive supportive therapy maybe required to assist in cervical neck postural alignment. If the cervical therapist is having difficulty to maintain C1 (atlas) and C2 (axis) alignment the dentist will need to take responsibility in identify the occlusal interferences properly.
Studies have shown a significant association between myogenous TMD without joint degenerative (masticatory) diseases and cervical muscles. These findings along with studies shows a distinct correlations between occlusion, masticatory dysfunction and cervical muscles activities.
Read More: TMD Problems that Challenge Dentistry – Four Main Categories
To Read More:
Other Cervical Considerations:
- Pallegama RW, Ranasinghe AW, Weerasinghe VS, Sitheeque MA: Influence of masticatory muscle pain on electromyographic activities of cervical muscles in patients with myogenous temporomandibular disorders. J Oral Rehabil. 2004 May;31(5):423-9.
- Ehrlich R, Garlick D, Ninio M.: The effect of jaw clenching on the electromyographic activities of 2 neck and 2 trunk muscles. J Orofac Pain. 1999 Spring;13(2):115-20.
- Jiang T, Yang Z, Zhang Z, Feng H.: Electromyography activities of the head, neck and upper trunk muscles with mandibular movement in normal adults. Zhonghua Kou Qiang Yi Xue Za Zhi. 2002 Nov;37(6):431-4.
- Santander H, Miralles R, Jimenez A, Zuniga C, Rocabado M, Moya H.: Influence of stabilization occlusal splint on craniocervical relationships. Part II: Electromyographic analysis. Cranio. 1994 Oct;12(4):227-33.
- So K, Komiyama O, Arai M, Kawara M, Kobayashi K. : Influence of occlusal contact on cervical muscle activity during submaximal clenching. J Oral Rehabil. 2004 May;31(5):417-22.
- Clark GT, Browne PA, Nakano M, Yang Q., et. al.,: Co-activation of sternocleidomastoid muscles during maximum clenching. J Dent Res. 1993 Nov;72(11):1499-502.
- Kobayashi H.: Reflex responses of sternocleidomastoid muscle induced by mechanical stimulation of upper anterior tooth and forehead. Kokubyo Gakkai Zasshi. 1990 Sep;57(3):385-92.
- Bjornland T, Brodin P, Aars H.: Force-related changes in the masseter muscle reflex response to tooth-taps in man. : J Oral Rehabil. 1991 Mar;18(2):125-32.
- Sforza C, Tartaglia GM, Solimene U, Morgun V, Kaspranskiy RR, Ferrario VF.: Occlusion, sternocleidomastoid muscle activity, and body sway: a pilot study in male astronauts. Cranio. 2006 Jan;24(1):43-9.
- Holmgren K, Sheikholeslam A, Riise C.: An electromyographic study of the immediate effect of an occlusal splint on the postural activity of the anterior temporal and masseter muscles in different body positions with and without visual input. J Oral Rehabil. 1985 Nov;12(6):483-90.
- Kumar S, Narayan Y, Amell T.: EMG power spectra of cervical muscles in lateral flexion and comparison with sagittal and oblique plane activities. Eur J Appl Physiol. 2003 May;89(3-4):367-76. Epub 2003 Mar 25.
- Kumar S, Narayan Y, Amell T, Ferrari R.: Electromyography of superficial cervical muscles with exertion in the sagittal, coronal and oblique planes. Eur Spine J. 2002 Feb;11(1):27-37.
- Kumar S, Narayan Y, Amell T.: Cervical strength of young adults in sagittal, coronal, and intermediate planes. Clin Biomech (Bristol, Avon). 2001 Jun;16(5):380-8.
- Ceneviz C, Mehta NR, Forgione A, Sands MJ, Abdallah EF, Lobo Lobo S, Mavroudi S.: The immediate effect of changing mandibular position on the EMG activity of the masseter, temporalis, sternocleidomastoid, and trapezius muscles. Cranio. 2006 Oct;24(4):237-44.
- Zuniga C, Miralles R, Mena B, Montt R, Moran D, Santander H, Moya H.: Influence of variation in jaw posture on sternocleidomastoid and trapezius electromyographic activity. : Cranio. 1995 Jul;13(3):157-62.
- Zuniga C, Miralles R, Mena B, Montt R, Moran D, Santander H, Moya H.: Influence of variation in jaw posture on sternocleidomastoid and trapezius electromyographic activity. Cranio. 1995 Jul;13(3):157-62.
- Romoli M, Ridi R, Giommi A.: Electromyographic changes in bruxism after auricular stimulation. A randomized controlled clinical trial. Minerva Med. 2003 Aug;94(4 Suppl 1):9-15.
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