The Controversy: How Effective is the Neuromuscular Occlusal Approach in the Diagnosis and Treating TMD

The following rebutted response was in regards to a summary Report developed by the Canadian Agency for Drugs and Technologies in Health: Neuromuscular Occlusion Concept-based Diagnosis and Treatment of Tempromandibular Joint Disorders: A Review of the Clinical Evidence

OASIS – Canadian Dental Association

“How Effective Is the Neuromuscular Occlusion Approach in diagnosing and treating TMD?”

by JCDA Oasis | Mar 11, 2013 | Oral Medicine | See 55 Responses at: http://www.oasisdiscussions.ca/2013/03/11/tmd/#respond

False and Misleading Statements were made by the Rapid Response Report against the following:

Diagnosing TMD:

The use of electromyograms (EMG) is not supported by evidence.
There is insufficient evidence to determine the diagnostic value of kinesiography.

Treating TMD:

Electrical stimulation is not supported by evidence.
The efficacy of occlusal splints is uncertain.

REBUTTED RESPONSE:

Clayton Chan on March 16, 2013 at 2:42 am

The preponderance of evidence, it is there and has been in the medical and dental literature available to all who are of an inquisitive mindset to learn more about the bio-physiologic and neuro-muscular sciences – objective measuring technologies like EEG, EKG, EMG, CMS, ESG, A growing number of dentists have been searching for serious answers to clinical issues. Many clinicians who deal with complex issues of TMD and occlusal problems have seriously searched for clinical answers for years related to resolving TMD pain problems as well as searching for logical and reasonable answers to our occlusal dilemmas we all face daily in clinical practice. But now no longer!

Thanks to the large body of science and evidence that validates the efficacy of these objective measuring technologies that have given us the confidence to stand up for what we know is right and what is misleading. We are not fooled easily any more! The science and literature has been produced by serious clinicians and researchers who have dedicated their lives and their time to develop studies as well as taken the time to publish their findings on these topics of TENS, EMG and kineseography for years, while most of the dental profession has ignored most of this research, not published in the typical dental marketing journals we all know so well. As a clinical and researching community of dentists with a serious focus on analysis we recognize we cannot simply ignore all this work and sweep it under the table and pretend it does not exist, because each is a significant part of the whole.

At a more in depth level, governing boards and committees of the FDA comprised by well educated individuals of the sciences, medicine, dentistry, engineer, neurophysiology have scrutinized and analyzed the data and literature science on these matters of validity and efficacy to assist dentist with aids in the diagnosis and treatment of TMD problems. The FDA is the United States regulatory agency who has recognized that these technologies are safe and effective for use within the dental profession to keep patients from harm. They have very stringent parameters that must be fulfilled to meet their approval, but it did pass! The America Dental Association (ADA) with their regulatory committees and boards have also scrutinize the evidence and science, not causally or superficially, but have also done their job to make sure dentists within the profession as well as the consumer are safe and will not be harmed, thus granting TENS, EMG, CMS and ESG it’s ADA “Seal of Acceptance”. They analyzed and scrutinized the scientific literature.

The FDA and or ADA doesn’t propogandize false statements that have been noted on this site about NM Approach diminishing the NM science with false statements. They have learned the history and also recognized the politics as well as the science.

Read more on Neuromuscular Dentistry Politics – POLITICS AND THE FIGHT FOR SCIENTIFIC TRUTH at:http://occlusionconnections.com/Neuromuscular_Dentistry/neuromuscular-dentistry-politics/

How is it possible for any research to be recognized as notable and scholarly if it does not recognize the complete body of research and science that has been analyzed and scrutinized by so many with dedication and intensity on this subject of EMG, TENS and kineseographic technology from a bio-physiologic perspective (not just with 15 or so papers and narrowing it down to 1 or 2)! This topic of neuromuscular dentistry is huge. It has continued to grow and develop in numbers because it makes sense, not like some want to misrepresent it as. It has amazingly come to the forefront of notable levels that the dental profession can no longer ignore its validity. It may not fit everyone’s paradigm of TMD and occlusion understanding, but this is the reason why objective measurements are valued within the neuromuscular dental community, to raise the bar with credibility – to help remove the subjective bias when we treat our TMD patients and occlusal problems.

To read more on the Efficacy of Surface Electromyography in Dentistry –http://nmdfacts-emg.blogspot.com/

To read more on the Efficacy of Low Frequency TENS in the Diagnosis and Treatment of TMJ/ MSD – http://nmdfacts-tens.blogspot.com/

To read more on the Efficacy of Mandibular Tracking in the Diagnosis and Treatment of TMJ/MSD – http://nmdfacts-mandibulartracking.blogspot.com/

The objective of this CADTH report was not achieved because numerous clinical studies published in established peer reviewed journals by neuromuscular dentists/academicians were excluded. Further, the reviewers distorted and misrepresented the findings of many of the 15 studies that were reviewed and commented on. Of the total of 596 articles that were identified in the initial review, only one article was selected (Silva, et. al. ref. 28) to assess the efficacy of “occlusal splints prepared using the EMG values as a reference of ideal occlusion”.

It seems obvious that something is dramatically wrong!

Clayton A. Chan, DDS
http://www.occlusionconnections.com
Las Vegas, NV

Read Other Rebuttle Responses (55 Responses and Comments) at: http://www.oasisdiscussions.ca/2013/03/11/tmd/#respond

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