Neuromuscular Dentistry

Dr. Baruch offers gneuromuscular dentistry services (GNM), and Tetri’s Smile is one of the few clinics in Florida that provide these services. At Tetri’s Smile Dental Boutique, we not only eliminate any visible defects, but address the underlying cause of the problem, at the deepest neuromuscular level. Come to my clinic – Tetri’s Smile Dental Boutique – for a consultation.

Dr. Tetri

A few things about him:

He was trained at Occlusion Connections’ (OC) advanced training center, by an innovator in the field of dentistry, Dr. Clayton A. Chan.

HE IS A FACULTY MEMBER AT NOVA SOUTHEASTERN UNIVERSITY.

Sign up for a consultation if you have:

restricted jaw movement/locking
severe tooth wear
clicking when opening the mouth
bite problems

We will discuss your symptoms, and establish a treatment plan that goes along with gneuromuscular dentistry (GNM).

Statistically, 90% of all TMJ dysfunctions are related to problems on the muscular level.

Why do we suggest GNM and not NMD?

Neuromuscular Dentistry (NMD) is a classical technique that focuses on calculating physiological parameters between cranial and mandibular structures (using electrodiagnostic measuring devices). The method of correct occlusion restoration is determined based on the data obtained from the patient.

Gneuromuscular dentistry (GNM) consists of complex physiological, neuromuscular, and gnathic examinations (CMS, EMG, TENS). This allows for us to not only determine the deviation from central occlusion and restore the optimal position of the mandible (find the resting point of the masticatory system), but also to establish its synchronous functionality with the central nervous and autonomic nervous systems.

GNM involves occlusal therapy (gnathology), orthopedic, and orthodontic treatment.

Diagnostics

Once bruxism or TMJ syndrome is confirmed, Dr. Tetri observes your medical history, conducts diagnostic imaging, and examines your clinical record. However, to give an objective assessment of a specific clinical situation, additional assessment from the dentist is required.

K7 CMS (lower jaw motion scan)

A computer program tracks the movement/position of the mandible in three planes simultaneously (up to 0.1 mm accuracy). This program also measures the rate at which the jaw opens and closes. In combination with TENS, it helps to determine the position of the mandibular joint as clearly as possible.

TENS (ultra-low-frequency electromyostimulation)

A special apparatus stimulates the facial and trifacial nerves, relaxes the muscles of the head and neck (spastic pathology is eliminated). In addition to the relaxing effect, TENS “upgrades” the muscles, determining the optimal position of the lower jaw.

We use a J5 myomonitor (wave range: 0.5–10 Hz; safe for the patient’s health), which has proven its effectiveness in relaxing the muscles. J5 Dental TENS helps eliminate muscle spasms that deform the jaw (pull, twist). It is indicated for diagnosis of the trifacial and facial nerves.

K7 EMG (electromyography – measurement of muscle activity)

Special surface sensors are placed on the face (in the area between the temporal lobe to the mandibular joint). They assess the position of the entire masticatory musculature (at rest and activity) relative to the correct occlusion. This procedure helps us find out the smallest deviations (accuracy up to 10–20 microns) and determine the degree of muscle contraction.

EMG combined with TENS helps to accurately diagnose the source of the problem (checks the neck muscles and mandibular joints). This gives the dentist a better understanding of how to adjust the occlusion in the best way possible.

ESG (electrosonography)

ESG is another measuring tool that helps us better understand the dynamic functional movements of the temporomandibular joints. It picks up any clicking, crepitations, or noises of different nature during the opening and closing of the mouth (high/low frequency). During this procedure, the frequency, speed, amplitude, and time at mouth opening/closing are taken into account. All measures are documented and used to detect differences in high and low amplitude sound patterns

CREATING A MOCKUP

Based on the data obtained, a three-dimensional, digital model of the smile is created. A visual transfer of the mockup to the oral cavity is performed (using special software). Thanks to this, you can clearly see the final result before you start treatment, with the help of the neuromuscular dentistry technique.

In order to diagnose occlusal problems, it is not enough to just use modern equipment. You need a dentist who is experienced in collecting and understanding the data – Dr. Baruch Tetri is one of them. There are many examples of successful work that was done with the use of neuromuscular dentistry.

Before After

Treatment

In most cases, the TENS machine is used first. It helps relieve muscle spasms and pain. The following may be prescribed (depending on the situation): a massage of problematic muscles, warm facial compresses, pain relievers or mild muscle relaxants.

Then, one of the following methods (or a combination) is applied (depending on the clinical picture).

Occlusal correction

For minor abnormalities, selective grinding of the tooth enamel is performed, in order to improve contact. Articulating paper and occlusal wax are placed inside the patient’s mouth to identify the areas of concern.

Orthopedic splints (orthotic)

In the advanced stage of periodontitis complicated by bruxism, flat, rigid, soft, upper, lower splints, with partial or full coverage, are placed on the lower jaw. They increase the height of the teeth by relieving stress on the muscles of the jaw (no straining is necessary to bring the teeth together). The type of structure used is determined by the dentist, depending on the case.

Restorative therapy

This includes the removal of dental defects with crowns, veneers, implants, followed by prosthetics. In some cases, full mouth reconstruction with ceramic/zirconia crowns is required.

Assessing the result is a mandatory step after treatment. We schedule routine check-ups every 2 weeks, over the course of 1–2 years (depending on the work done). For example, temporary crowns may be corrected during examinations (in order to stabilize the bite).

Summary

Gneuromuscular Dentistry by Dr. Baruch Tetri aims to establish the cause of the pathology. Then, he is able to resolve your problems on a deeper, more profound level.

We restore perfect occlusion and provide full functional and aesthetic dental rehabilitation. We improve the physical and emotional condition of the patient for many years to come (relaxed jaw joints, reduced and eventually stopped headaches, neck pain).