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Bio-Physiologic Neuromuscular (Structural/Functional) Perspective

• GNM is Not the Same as NM

This approach focuses on not only the subjective patient complaints, but also on objective assessment of the musculoskeletal occlusal signs and symptoms of TMD.

1. Measuring technology and instrumentation are used and include: 1) computerized mandibular tracking, 2) surface electromyography and 3) electrosonography of the TMJ.
2. The US Food and Drug Administration (FDA) approved the sale of these devices for the purposes of measuring activity that directly relates to the TMJ. The medical necessity of their use for each patient must be documented by the treating dentist and certainly are non-invasive approaches to document medical necessity.
3. These devices have been found to be extremely useful in aiding the clinician to arrive at a diagnosis for conservative treatment.  NIDCR fails to even recognize such.
4. The use of objective quantifiable diagnostic procedures should be implemented to quantify and qualify a patient’s dysfunction. This certainly adds essential, accurate information in the effective diagnostic and treatment process especially for patients with trauma episodes to the head and cervical regions.

Subjective feelings and educated guesses when treating the mandible, masticatory muscles of the head and neck and the temporomandibular joints will not produce cost effective results nor appropriate treatment times!