TMJ, Bite, Occlusion, Dentist Charlotte

 

 

 


courtesy of www.myotronics.com

 

Dr. Plascyk is a dentist in Charlotte, North Carolina and like any concerned dentist he wants to make sure his dental treatment allows the jaw muscles and jaw joint (TMJ) to function properly. This will help avoid future discomfort, dental disease and wear and tear on the teeth and oral structures. It will also prolong the life of dental treatment that is completed. Some people use the terms "TMJ Dentist" or "Neuromuscular Dentist" to describe a dentist who ensures proper functin of the oral structures. However, officially, no one can call themselves a "TMJ" or "Neuromuscular" dentist because all dentists are expected to ensure proper function of the oral neuromuscular system and jaw joint (TMJ) in their day to day care. 

In addition to incorporating proper function of the oral structures in day to day care, many patients seek Dr. Plascyk's care to treat more extreme problems such as pain in the jaw joints and jaw muscles and incorrect funtion of the jaw joint and movement of the jaw.

 Let me clarify a few terms and concepts for you:

  • The term Occlusion refers to the bite of your teeth.

  • TMJ means Temporomandibular Joint or Jaw Joint (you have a left and right TMJ).

  • Many people use the term TMJ or TMJ Syndrome to describe muscle pain and/or incorrect function of the jaw joint.

  • Temporomandibular Disorder or TMD (not TMJ) is the correct term for muscle and joint pain and/or incorrect function (dysfunction) of the jaw joint.

  • TMD can have many causes. One cause is an unbalanced bite.

  • Most pain associated with TMD is muscle pain, not pain in the TMJ (jaw joint) itself.

  • TMD caused by an unbalanced bite is considered Occluso-Muscle Disorder.

  • Occluso-Muscle Disorder is one type of Occlusal Disease.

  • Correcting the jaw position and occlusion (bite) is the only way to correct TMD (TMJ) pain caused by Occluso-Muscle Disorder.

  • Other therapies (massage, adjustments, laser, etc.) will relieve symptoms but will not solve the TMD (TMJ) problem if it is caused by the bite (Occluso-Muscle Disorder).

Signs and symptons of Occlusal Disease includes:

  • TMD (caused from Occluso-Muscle Disorder)

  • Excessive wear of the teeth

  • Pain in and around the teeth

  • Hypermobile teeth (loose teeth)

  • Cracked and fractured teeth

  • Bone loss around teeth

So, to sum things up:

             If you have Occluso-Muscle Disorder you will have one or both of the following:

                                             1) pain (muscles/joint/teeth)
                                             2) damage (teeth/bone/gums/joint)
                                     

 The following are pictures of teeth that I routinely see in the mouths of my Charlotte, NC area patients. The damage to these teeth was caused by unbalanced bites.

 (click on pictures to make them larger)

 

So if your TMD (TMJ) pain is coming from your unbalanced bite (occluso-muscle disorder), your bite has to be treated to eliminate the cause of the problem. Likewise, if your excessive tooth damage and tooth pain is coming from your unbalanced bite, your bite has to be treated to eliminate the cause of the problem. Finally, if you have both these issues at the same time, your bite has to be treated to eliminate the cause of the problems. A TMJ or neuromuscular dentist, like myself, accomplishes this by performing a bite analysis and bite adjustment.

Finally, it is imperative that before doing final cosmetic, implant or involved dental care, I must create a stress-free jaw position, relaxed and pain-free facial and jaw muscles through a balanced bite. This will fix existing occlusal disease and prevent future occlusal disease.

The following is taken from Functional Occlusion, From TMJ to Smile Design by Peter Dawson (a world renowned authority on this stuff):

"Attention to occlusion would be elevated to a much higher priority if the following observations were more universally noticed and analyzed.

Occlusal disease is:

  • The #1 most common destructive dental disorder.
  • The #1 contributing factor to eventual loss of teeth.
  • The #1 reason for needing extensive restorative dentistry.
  • The #1 factor associated with discomfort within the masticatory system structures. This includes pain/discomfort in the musculature, the teeth, and the region of the temporomandibular joints (TMJs).
  • The #1 factor in instability of orthodontic treatment.
  • The #1 reason for soreness and hypersensitivity.
  • The #1 most commonly missed diagnosis leading to unnecessary endodontics.
  • The #1 most undiagnosed dental disorder until severe damage becomes too obvious to ignore."

 

 

 

 

 

 

 

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Paul S. Plascyk, TMJ, Dentist, Sleep Apnea Snoring
TMJ Dentist, Snore Charlotte North Carolina, NC
Bite Balancing, Equilibration, Occlusion, Splint, Guard Appliance
TMJ Splints/Guards, Occlusal Adjustment Dentists
Charlotte, North Carolina, NC 28277http://www.superpages.com/yellowpages/C-Cosmetics/S-NC/T-Charlotte/http://www.visitnc.com/  http://www.charlottesgotalot.com/
Paul S. Plascyk, TMJ Dentist, Sleep Apnea Snoring
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TMJ Dentist, Snore Charlotte North Carolina, NC
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Bite Balancing, Equilibration, Occlusion, Splint, Guard Appliance
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TMJ Splints/Guards, Occlucal Adjustment Dentists
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Charlotte, North Carolina, NC 28277
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TMJ Dentist, Snore Charlotte North Carolina, NC
Bite Balancing, Equilibration, Occlusion, Splint, Guard Appliance
TMJ Splints/Guards, Occlucal Adjustment Dentists
Charlotte, North Carolina, NC 28277

 Dentist Cosmetic Charlotte NC: Sleep Apnea, Snoring
Charlotte  NC Dentist Cosmetic Implant Porcelain Veneer

Snoring is partial airway obstruction caused by the soft tissue in back of the throat. Snoring can not harm you but it is likely to prevent you significant other from getting adequate sleep. Sleep apnea is a very serious medical problem. Sleep apnea occurs when the airway is closed by the soft tissue in the back of the throat. Sleep apnea can cause illness from lack of sleep and can even cause death.

The key with a sleep apnea and snoring appliance is keeping the lower jaw forward so the airway is not blocked. Ideally the appliance should allow free movement of the jaw without letting the jaw fall back. Dr. Plascyk makes a modified Herbst appliance to accomplish this. The appliance will keep the lower jaw forward, yet let the patient move the lower jaw freely from side to side and forward.

Dr. Plascyk makes many night guards (occlusal guards, bite guards) for his patients for many different reasons. Before giving a patient a bite guard or occlusal guard to wear while sleeping, Dr. Plascyk evaluates for sleep apnea. The evaluation determines whether the patient needs a sleep study. A sleep study can confirm a sleep apnea diagnosis, in which case Dr. Plascyk will make a sleep apnea appliance instead of a regular occlusal/bite guard.

 

- back to "Dentist: TMJ Facts" page -

  

Paul S. Plascyk, TMJ Dentist, Sleep Apnea Snoring
TMJ  Dentist, Snore Charlotte North Carolina, NC
Bite Balancing, Equilibration, Occlusion, Splint, Guard Appliance
TMJ Splints/Guards, Occlusal Adjustment Dentists
Charlotte, North Carolina, NC 28277

 

___________________________________ 

 

Dentist Cosmetic Charlotte NC: Bite Balancing
     Charlotte NC Dentist Implant Cosmetic Porcelain Veneer        

 

Like all concerned dentists, Dr. Plascyk incorporatesTMJ or neuromuscular therapy in his care. When necessary Dr. Plascyk performs bite balancing or occlusal equilibration procedures for his patients. Bite balancing or occlusal equilibration is a therapy that relieves stress on the TMJ (jaw joint) structures, the jaw muscles and the teeth. The two critical factors in a balanced bite are correct position of the lower jaw (mandible) in the TMJ or jaw joint and correct tooth-to-tooth contacts between the upper and lower teeth. When these two things are achieved, the patient will experience comfort and optimal function. Long term, a balanced bite will promote dental health instead of dental disease. It is my strong opinion (and other doctors would agree) that if everyone's bite were properly analyzed and treated when they were young, it would eliminate 90% of the dental treatment they need as adults.

The following is taken from Functional Occlusion, From TMJ to Smile Design by Peter Dawson (a world renowned authority on this stuff):

"Attention to occlusion would be elevated to a much higher priority if the following observations were more universally noticed and analyzed.

Occlusal disease is:

  • The #1 most common destructive dental disorder.
  • The #1 contributing factor to eventual loss of teeth.
  • The #1 reason for needing extensive restorative dentistry.
  • The #1 factor associated with discomfort within the masticatory system structures. This includes pain/discomfort in the musculature, the teeth, and the region of the temporomandibular joints (TMJs).
  • The #1 factor in instability of orthodontic treatment.
  • The #1 reason for soreness and hypersensitivity.
  • The #1 most commonly missed diagnosis leading to unnecessary endodontics.
  • The #1 most undiagnosed dental disorder until severe damage becomes too obvious to ignore."

Bite balancing, or occlusal equilibration, is often done for someone who has one or more of the following problems:

  • TMJ or TMD symptoms (pain and discomfort)
  • excessive wear of the teeth
  • periodontal (gum) disease
  • tooth pain
  • cracks in the teeth and fillings

Before equilibration or bite adjustment, Dr. Plascyk completes an advanced analysis on the patient's TMJ, muscles and teeth. This analysis is called an occlusal or bite analysis, and it includes jaw measurements, impressions of the teeth and photographs. Models are poured from the impressions and from the models, a device called a deprogrammer is made for the patient.

A deprogrammer is like a modified, removable orthodontic retainer. The deprogrammer does not allow the upper and lower posterior teeth to touch, which allows the jaw muscles to relax and become unstressed or deprogrammed. When the muscles are relaxed, the lower jaw can fit into the jaw joint in its most natural position. A deprogrammer is worn 24/7 for a short time and is only removed from the mouth to clean the teeth and when eating. Deprogramming can takes days or months to complete. Typically, it is accomplished within a week.

Once the correct jaw positioned is achieved, a recording of this jaw position is used to mount the models of the teeth on a device called an articulator. An articulator is a hinged device that duplicates the patient's jaw movements. Once mounted, the models are adjusted to determine how the bite will have to be balanced in the patient's mouth. The procedure to balance the bite for a patient can be simple or complicated. Each case is unique and different. The best case scenario is that the patient will only require an equilibration of the teeth. This means the top biting surfaces of the teeth can be delicately reshaped so the teeth fit with each other correctly when the jaw is closed. Sometimes braces or porcelain veneers are needed on the front teeth to balance the bite completely. Before any significant cosmetic or implant treatment, Dr. Plascyk always does a complete occlusal or bite analysis to ensure the best final result for my patients.

 

- back to "Dentist: TMJ Facts" page -

 

 Paul S. Plascyk, TMJ Dentist, Sleep Apnea Snoring
TMJ  Dentist, Snore Charlotte North Carolina, NC
Bite Balancing, Equilibration, Occlusion, Splint, Guard Appliance
TMJ Splints/Guards, Occlusal Adjustment Dentists
Charlotte, North Carolina, NC 28277
 
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Dentist Cosmetic Charlotte NC: Bite Guard
           Charlotte Dentist NC Implant Cosmetic Porcelain Veneer             

As a dentist who routinely incorporates TMJ or neuromuscular therapy in his care, Dr, Plascyk does a splint and guard therapy for his patients. A bite guard or splint is a piece of hard plastic that fits between the upper and lower teeth. The guard or splint controls how the top or bottom teeth come together upon it. This, in turn, controls the position of the jaw and reduces stress on the TMJ (jaw joints), jaw muscles and the teeth, which controls damage to the soft and hard tissues of the TMJ (jaw joint) and the mouth.

Two basic types of dental splints or guards are directive splints and permissive splints. Directive splints hold the lower jaw in a fixed position. Dr. Plascyk does not use these types of splints. Permissive splints or guards allow the jaw to move freely when the opposing teeth are contacting it. Permissive splints are the most common type of splints used by dentists.

Splints are typically made to 1) treat TMD (TMJ) pain and/or dysfunction caused by occluso-muscle disorder, 2) protect the teeth from excessive wear from occlusal disease or 3) for both problems.

Guards can be purchased in stores also. Unlike the typical bite guard made by a dentist, a store-bought guard is made of soft material. Since the material is soft and it is not made by a dentist, jaw position and movements cannot be controlled. Dr. Plascyk does not recommend them.

I have often found that patients are incorrectly treated with guards/splints when they have TMD (TMJ) pain caused by occluso-muscle disorder. Guards are often given to patients without any proper planning or follow-up. Guards have to be made correctly and worn correctly for them to work. Guards therapy also takes a lot of patience from the doctor as well as patient. I have found that guards are extremely effective for my patients if the correct time and effort is put into them. Finally, even if made correctly, guards/splints will not help TMD (TMJ) pain and dysfunction if it is not caused or  exacerbated by occluso-muscle disorder.

 

- back to "Dentist: TMJ Facts" page -

  

Paul S. Plascyk, TMJ  Dentist, Sleep Apnea Snoring
TMJ Dentist, Snore Charlotte North Carolina, NC
Bite Balancing, Equilibration, Occlusion, Splint, Guard Appliance
TMJ Splints/Guards, Occlusal Adjustment Dentists
Charlotte, North Carolina, NC 28277
 
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Dentist Cosmetic Charlotte NC: TMJ  Therapy
          Dentist NC Charlotte Cosmetic Porcelain Veneer Implant          

 

 

As a dentist who incorporates TMJ or neuromuscular therapy  in patient care, I treat a lot of patients with TMD (TMJ). TMD (TMJ) includes pain in the muscles and/or joint and/or incorrect function (dysfunction) of the TMJ (jaw joint). Diagnosing and treating pain in the head and neck area can be simple or complicated. When a patient experiences "TMJ" pain and/or dysfunction I may or may not be able to help them. If the pain is caused entirely or partly to an unbalanced bite (occluso-muscle disorder), I will be able to help them completely or partially.

My initial approach to TMJ pain relief is simple and inexpensive. By using initial noninvasive therapies, I can quickly determine if I can help a patient long term. Final or long-term therapy may involve simply wearing a guard or splint at night or bite adjustment therapies which may include fillings, crowns, porcelain veneers and orthodontics or Invisalign. Before getting into these types of final procedures, I make my patient comfortable as inexpensively as possible. If I can do this, then we can talk about long-term therapy.

I will first perform a jaw joint and muscle exam. In a typical case, I will make a temporary splint called a deprogrammer that will relax the facial muscles and put the jaw in a stress-free position. The deprogrammer should be worn 24/7 until the symptoms are gone. If symptoms do not improve, we will place the patient on anti-inflammatory medication and muscle relaxants. If the symptoms persist, I may redesign the deprogrammer. If symptoms continue, we will take a cone beam image CT scan on the upper and lower jaw to check for infections in the bone or other bone pathologies ("cavitations"). If the CT scan is normal, the patient will be referred to a physical therapist, chiropractor, ENT or neurologist.

The bottom line is that no permanent and more expensive therapy should be completed if I cannot get the patient comfortable with initial inexpensive and noninvasive TMJ therapy.

 

- back to "Dentist: TMJ Facts" page - 

 

Paul S. Plascyk, TMJ  Dentist, Sleep Apnea Snoring
TMJ  Dentist, Snore Charlotte North Carolina, NC
Bite Balancing, Equilibration, Occlusion, Splint, Guard Appliance
TMJ Splints/Guards, Occlusal Adjustment Dentists
Charlotte, North Carolina, NC 28277

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 Dentist Cosmetic Charlotte NC: TMJ Q&A  
Dentist NC Charlotte Cosmetic Implant Porcelain Veneer   

Dr. Plascyk incorporates  TMJ or neuromuscular therapy in his care. 

What is TMJ?
TMJ = temporomandibular joint. This is your jaw joint which is located in front of your ears. Often times when patients say they have "TMJ" they are referring to either pain in one or both of the joints (there is a right and left joint), pain in their facial muscles, headaches, sounds that they hear in the joint such as clicking, popping or cracking and finally unsmooth movement or locking of the jaw so they cannot close it or open it normally of the lower jaw. All these are symptoms of temporomandibular disorder or
TMD.

What causes TMD?
TMD is caused by many things. One cause is
occluso-muscle disorder. This is the only type of TMD a dentist can treat. Occluso-muscle disorder is an unbalanced bite that causes the symptoms of TMD.

What is bruxing?
Bruxing is excessive grinding or gnashing of the teeth. This happens at night when they are asleep. The signs of bruxism are seen on the teeth. The teeth of a bruxer will have signs of wear and fracture. If someone is a "heavy" bruxer the wear and fractures on the teeth will be more severe.

Can someone be a bruxer but not have TMD (TMJ)?
Yes. Not all bruxers have any signs of pain, muscle tenderness, sounds in the joints or problems with jaw movement.

Does everyone grind their teeth at night?
Absolutely yes. The question is whether it is damaging for a particular person. Everyone is a tooth grinder at night. But for many people the grinding (bruxing) is very minimal. Eith

 

 

 

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