TMD / TMJ
The terms used behind these abbreviations:
- TMD: Temporomandibular disorders (USA)
- TMJ: Temporomandibular joint (USA)
are umbrella terms for disorders of the facial muscles that can trigger a vast array of complaints, that largely evade any exact diagnosis in strict modern medicine.
After a long-standing belief was held that poor contact between teeth and a consequent non-physiological centricity were the main causes of TMD / TMJ complaints, we know today that the teeth actually play a more minor role in the development of complaints.
In reality, TMD / TMJ patients do not present with different bites compared with healthy patients.
Further examinations similarly tend not to find a specific cause for these complaints.
In cases of longstanding (chronic) complaints that are often connected with psychological stress factors, invasive procedures (jaw orthopedics / creation of dentures / attempting myocentricity with braces / even surgery) should be avoided as they usually cause more harm than good.
It is more effective, in both diagnostic and therapeutic terms, to take an orthopedic approach to the musculature issues.
In order to understand the enormous importance of neuromuscular influences, a basic understanding of the interrelationships between growth and development must be achieved, starting from the infant child, even when this can be difficult for those with no medical background.
Growth researchers agree that epigenetic factors are principally responsible for growth processes. The musculature, acting as the dynamic factor, has a significant influence in this area.
However, these processes cannot be understood unless the mind is taken into consideration.
Neither attempting to achieve a myocentric bite, nor concentrating on eliminating pain can be logically brought together as approaches when considering these findings. Only the sensorimotor concept of Dr. Helga Pohl http://www.koerpertherapie-zentrum.de/ has found coherent explanations.
If the muscles, nervous system and mind as inseparable components of a functional system all essentially determine skeletal growth, then they must not be considered on a separate basis when disorders occur. A spatially harmonious masticatory apparatus can be controlled effortlessly and will not cause any issues even in extreme situations.
Unfortunately, less and less people seem to present with these ideal conditions.
Dental and skeletal imbalances have become the norm, connected with disharmonious facial musculature.
Only in cases of defect-free development can the musculature satisfactorily carry out its genetically-prescribed functions, acting as a significant factor in development.
Fortunately, this delicate balance is compensated for in the majority of cases through neuro-factors and is not experienced as an issue.
If this system is not kept in check, this neuronal control can no longer compensate for the shortcomings of the facial musculature and disaster takes its course, bringing with it a huge drain on mental resources. This explains why physical pain is generally connected with mental stress conditions.
Chronic pain is primarily the result of musculature that has been put under strain for extended periods of time.
The cause is dysfunctional neuronal control of the facial musculature.
This control can no longer find the “relax switch”.
Valid treatment approaches involve finding ways to return the musculature to physiological conditions and restore the disrupted neuronal communications.
This is exactly what the Relaktor does: you could think of it as a sensorimotor therapist working from within the mouth.
This does not mean that mechanics (occlusion) do not play any role here, but rather that it forms only part of the problem. Only after relaxation should invasive corrections be attempted. Diagnostic approaches that ignore this fact are irresponsible.
Controversies in the diagnosis and treatment of functional disorders of the stomatognathic system (PDF).