We all have the ability to function in an accommodative pathologic position. When the pathologic position exceeds our accommodative capacity, we begin to complain of Pain, Discomfort or Aesthetics.

Pin-pointing the Pain!

The understanding of pain is complicated mostly by the fact that the same painful stimulus may be perceived differently by different people, and differently by the same people at different times. The person's reaction to the circumstances surrounding the pain experience and the interpretation of the pain meaning may also be different.
Pain is personal, private and unique, but there is often a demand from clinicians that pain and pain situations be objective, public and reproducible.

Although the large majority of people suffer from the diseases of the Temporo-Mandibular Joint (T.M.J.), most do not associate their pain and/or symptoms to a "malocclusion" and prefer to blame the stress, the children at home or their work environment.
The jaw joint is the only articulation in the human body that ends its movement on hard tissue (the teeth) and when the jaw is misaligned, both the hard and the soft tissues are affected and many physiological problems can result, such as:

Headaches and Migraines,

One of the most common symptoms of Temporo-Mandibular Disorder (T.M.D.) is the tension headache. Many people who suffer from this type of headache describe it as a ring of pain around the head or like wearing a hat two sizes to small. Others will refer to it as a migraine headache.
T.M.J. related headaches are caused by a complex mechanism; essentially, there is a constant contraction of the muscles in the jaw which creates a tension or pressure in the face, head and neck. The constant tension in the muscles reduces the amount of blood that is able to reach the area. The body responds by sending more blood to the area, which results in an increase in blood pressure to the muscles of the head, thus a headache.
When someone is clenching and /or grinding their teeth, which are T.M.D. symptoms, they are also creating a constant contraction of the muscles, which results in pain.
In addition to medications, the pain from muscle headaches can be temporarily reduced by cutting nerves with brain surgery or using psychological therapy.
The problem with all these options is that they are addressing the symptoms rather than the actual cause of the symptoms and the damages of a malocclusion will persist.
By using neuromuscular dentistry techniques, we are able to rebuild the bite into a relaxed, comfortable position and decrease the muscular tension to an optimal level and most of the times the headaches or the migraines disappear.

Headaches Impact Test

Confusion Regarding the Etiology of Head and Neck Pain

Depression and Nervousness,

Although depression is in many ways a non-measurable symptom, it does occur in many patients who have T.M.D. Patients aren't likely to mention depressive symptoms at the dentist office due to the stigma attached.
Usually depression occurs because patients are unable to get any type of relief of their symptoms. This is often because their symptoms are misdiagnosed.
Research has shown that patients who suffer from chronic pain have a much higher incidence of depression. Chronic pain is frustrating for everyone – the patient, their family and friends, their employers, the insurance and their physicians.
Because the patients often don't respond to treatment, the physicians and the patients continue to search for a local cause, and a logical specific treatment. The search is unsuccessful in 94% of cases (Swanson), so the frustration increases.
Many patients with T.M.J. disorders fall into this category. Sometimes the work done using neuromuscular dentistry (N.M.D.) is sufficient to relieve the chronic pain.
Other patients may need to see a chiropractor or other physicians to treat various other symptoms. It is important to realize that often just finding the correct diagnosis can lead to great psychological as well as physical relief.
If you would like to know more about the treatment and Neuromuscular Dentistry click here!

Tinnitus or Ringing in the Ears,

The tinnitus corresponds to buzzes or whistles heard in one or two ears or in the head in the absence of any sound source in the surrounding medium. In the rare cases where the cause of tinnitus is clearly identified (objective tinnitus, disease of the ear, endocrine problem), the treatment of the cause will lead to the cure of tinnitus or at least to its reduction.
When the cause is not clearly identified as it is the most frequent case, the tinnitus is most probable the result of a dysfunction of the T.M.J.
The jaw mechanism is a complex network of muscles and nerves. When the bite is out of alignment, the muscles, nerves and vessels of the ears can be affected.
Tinnitus is the result of irritation of the malleus bone in the ear by ligaments, muscles of the ear or the Eustachian tube. In addition, the medial Pterygoid muscle can trigger this irritation. The tensor tympania is a tiny middle ear muscle that is attached to the malleus and when it contracts the tension on the tympanic membrane increases and too much contraction can result in a ringing sound.
If the cause of your tinnitus is an unstable bite, a neuromuscular dentist can realign your bite so the jaw works with minimal muscle tension. This will relieve the ringing in the ears that was caused by the unstable bite.
If you would like to know more about the treatment and Neuromuscular Dentistry click here!

Frequent Ear Congestion,

T.M.J. is often called the "great impostor" ; because a T.M.J. disease presents itself in a variety of ways and many times a physician or E.N.T. specialist will be chasing the pain without any evidence of a problem in the ear.
If you have ear symptoms that are not resolved, the problem is most probably due to a T.M.J. dysfunction.
The Eustachian tube is a tube that connects the middle ear to the back of the nose. Its primary job is to regulate the pressure in the middle ear. It's secondary purpose is to rid the middle ear space of any fluid, infection or debris. The Eustachian tube is normally closed to prevent contamination of the middle ear.
A common problem is a failure of the Eustachian tube to regulate pressure effectively. Partial or complete blockage of the Eustachian tube can cause popping, clicking, and ear fullness. This blockage can result from swelling and inflammation associate with an ear infection. It can also occur when the muscle controlling the Eustachian tube goes into spasm.
When the jaw is out of alignment, the muscles have to compensate for the malocclusion. This can lead to muscle spasm and resulting in partial blockage of the tube. By correcting the bite we can often resolve the congestion.
If you would like to know more about the treatment and Neuromuscular Dentistry click here!

Limited Mouth Opening,

Many T.M.D. patients find that their jaws will get stuck or locked. Sometimes they will have to move their jaw from side to side in order for them to be able to open. This is often the result of the jaw getting stuck on the disc that cushions the skull and the jaw.
Often times the patient will have to continue to open their mouth until the jaw actually "pops" open. This type of locked jaw is usually the result of the teeth not coming together properly.
When the bite is out of alignment, it can cause problems with the jaw joint, or Temporo-Mandibular Joint (T.M.J.).
By using neuromuscular dentistry, we are able to rebuild the bite into a relaxed, comfortable position without the use of braces or surgery.
If you would like to know more about the treatment and Neuromuscular Dentistry click here!

Vertigo or Dizziness,

Dizziness, otherwise known as Vertigo, is usually the result of a disturbance in the inner ear. It can occur as a result of: arthritis in the neck, malocclusion, disease of the ear or poor blood circulation.
As noted for the Frequent Ear Congestion on this page, migraines and ear problems can both be the result of a misaligned bite. Correcting the malocclusion can often improve vertigo.
If you would like to know more about the treatment and Neuromuscular Dentistry click here!

Facial Pain, Neck and Shoulders Aches,

Neck and shoulder pain are often associated with talking on the telephone to much, or sitting all day at a computer station.
A bad bite will cause the muscles of jaw to be placed in a constant state of contraction. This can result in direct pain of the facial muscles or referred pain to the neck, the shoulders and the back.
Pressure from the muscles on a herniated disc can also affect the nerves of the brachial plexus, which can result in tingling of the finger tips.
All of the muscles of our body work together to create different movements, often times, when some muscles are overworking they will recruit other muscles to help out. This is known as muscle recruitment.
The muscles of the head and neck are all involved in the various functions of turning the head, chewing, talking, and breathing. When the muscles of the jaw are over-contracted, it will affect the muscles that hold your head up, your shoulders level and your back straight.
This recruitment of other muscles results in their becoming out of balance, followed-on by pain.
Neuromuscular dentistry does not treat all symptoms, but often times they will improve or disappear as the result of proper bite correction.
If you would like to know more about the treatment and Neuromuscular Dentistry click here!

Unexplained Wear and Teeth Mobility,

As we get older, most people assume that the teeth will get loose and wear down as part of the aging process, but in reality the only time that we would see severe wear on teeth is due to a malocclusion or a parafunctional habit.
In a normal, relaxed state, the jaw is placed in a position where the teeth are not touching. The only time our upper teeth are actually supposed to touch the lower teeth is when we swallow; this occurs 2000-3000 times each day. Even when we are eating, our teeth don't come together because we have food between them.
A parafunctional habit is when teeth come together in a grinding or clenching motion. Usually, grinding or clenching of the teeth occurs at a time when we are unaware of it, such as when we are asleep.
Many people will wake up in the morning with a variety of symptoms as a result of teeth grinding or clenching. The grinding and clenching of the teeth is a direct result of the muscles of the jaw and neck trying to place the jaw into a relaxed position. The shape or the alignment of teeth get in the way of this position, thus we develop the parafunctional habit.
Often times the worn or broken teeth will be restored with crowns or onlays. Restoring the teeth in the same deficient occlusal position will result in these restorations eventually failing also. Sometimes, the gums and bone will recede as a result of the parafunctional habit, and teeth will be lost.
Using neuromuscular dentistry we will get the muscles comfortable before attempting to restore the teeth. Once the relaxed position of the muscles is found, the teeth can be restored to keep the jaw in this position. This creates a harmonious balance between the muscles, the teeth and the temporomandibular joints.
If you would like to know more about the treatment and Neuromuscular Dentistry click here!

Difficulty Chewing and Swallowing,

Clicking and Popping of the Jaw,

Tingling in the fingertips,

Postural Problems,

Sensitive Teeth.

Why always me?

After drug therapy has failed or after their primary care physician has ‘‘given up’’ on them, patients search for a pain clinic often convinced that physicians see their problem as unreal, exaggerated, or ‘‘all in my head’’.

If you are suffering from T.M.D. symptoms, know that you are not alone! Unfortunately the vast majority of people with Temporo-Mandibular Diseases is not diagnosed as having T.M.D. and is not treated correctly as a result.

All of T.M.D. symptoms can range in severity from mild to devastating. The most prominent case of T.M.D. was that of the actor, Burt Reynolds. The pain derailed his career, brought about drug addiction, and was a factor in his several divorces.
A great deal of his suffering was due to the fact that T.M.D. was only beginning to be understood as a disease entity at that time.

The craniofacial region is not only one of the most densely innervated areas of the body but also the focus of some of the most common pains (e.g. toothache, headache) and some of the most bizarre and puzzling pains (e.g. trigeminal neuralgia, Temporo-mandibular Disorders - T.M.D.) that afflict humans.

How do I get a malocclusion?

Most cases of T.M.D. are the result of either a malocclusion, muscular or skeletal illnesses or some type of trauma such as sports or car accidents. Factors that increase the risk of developing a malocclusion include:

• A family history of malocclusion.
  Jaw and tooth size are inherited traits that can cause too much or too little room for the teeth.

• Oral habits, such as thumb-sucking and mouth breathing.
  Restricted airways, particularly during facial developement, is perhaps the single largest cause of dento-facial abnormalities and malocclusion.
• Tooth loss, due to trauma or tooth decay.
  After a tooth is knocked out or removed (extracted), the bordering teeth drift out of place.
• Poor dental hygiene.
• Severe wear of teeth.

Although T.M.J. disorders might not be the result of a bad occlusion, the fact that during chewing, the bones of the Temporo-Mandibular Joints receive a variety of rapidly changing forces, the articular discs slide on the bones while their shape is simultaneously deformed.
The intricate choreography of these movements is easily disrupted by damage to any part of the T.M.J., accounting for its vulnerability and maintenance of the pathologic condition.

The Solution: Advanced Dentistry, Neuromuscular Occlusion!

Having a bad bite or a malocclusion means that your upper and lower teeth do not close together in the correct way, this includes underbites and overbites. When the teeth are misaligned, they cannot provide the support the muscles in the neck and face need for chewing and swallowing. These muscles are then forced into a strained position, resulting in an unbalanced jaw which can induce or maintain a pathologic condition.
Slide the cursor of the mouse on the following images to see some of the most common malocclusions.

Vertical Rotation	Anteriour-Posterior Deficiency	Lost of Vertical Dimension (Deep Bite)	Combined Vertical Lost & Anteriour-Posterior Deficiency

Although a person may have beautiful teeth or had orthodontics to line the teeth up for aesthetic reasons, the muscles and the temporo-mandibular joints may not be comfortable.

Neuromuscular Dentistry (N.M.D.) places the occlusion where the muscles that control the jaw position are at their best for optimal function and comfort of the entire masticator system. Although we do not claim to treat head, ear, neck or shoulder pain, patients are pleased to find relief from pain caused by T.M.J. dysfunctions.

If you would like to know more about the treatment and how Neuromuscular Dentistry works Click here!

If you or a loved one would like to meet Dr. Christine Hindie, Montreal dentist, for a Consultation in the Pain Clinic, please call or e-mail us today.

514.866.7111
DentalStudio@MontrealsExquisiteSmiles.com

150-1075 Beaver Hall Hill ~ Montreal ~ H2Z 1S5 ~ Quebec ~ Canada
Christine Hindié, Montreal dentist
Family Dental Center in Down Town Montreal, Neuromuscular Dentistry Montreal, Cosmetic and Aesthetics Dentistry in Montreal