Healthy Jaw Position in Neuromuscular Dentistry

Until recently dentists often worked on the assumption that your natural bite position was the correct position, and dental treatments, therefore, were planned from the patient’s existing bite. Much of the time these treatment plans based on this assumption, even carried out perfectly, will not produce a result that is fully functional and comfortable.

The rapidly expanding field of neuromuscular dentistry, as practiced by Dr. Mahara at our Nanaimo dentist office, does not assume your habitual bite as the basis for planning treatment. Neuromuscular dentistry considers the entire system that controls the positioning and function of your jaw: teeth, muscles and joints. Your neuromuscular dentist at Downtown Nanaimo Dental Group seeks to establish a harmonious relationship among these three main factors, resulting in a correct and healthy jaw position.

Temporomandibular Disorder

TMD, or Temporomandibular Disorder, refers to an imbalance in the jaw-to-skull relationship. It is a chronic degenerative disease that often takes years to develop and affects millions of people.  Our dental team at Downtown Nanaimo Dental Group is specially trained to detect and treat the symptoms of TMD.

When the jaw is misaligned, both the hard and soft tissues are affected and many physiological problems can result, such as headaches, jaw pain, neck and shoulder pain, tinnitus, ringing in the ears, and clicking or popping sounds in the jaw joint. In a number of cases, these symptoms are the result of TMD.

TMD Diagnosis

Our neuromuscular dentist in Nanaimo uses advanced dental technology to determine if your symptoms are caused by a bad bite and if so, what your optimal jaw position is. Dr. Mahara uses computerized jaw tracking instruments called K7 to record jaw movement, resting position, and path of closure. Electromyography is used to measure your jaw’s muscle function in both its stressed and relaxed positions, and will also measure the jaw-to-skull relationship to see if there is a structural imbalance.  Sonography is used to record jaw joint sounds to detect any abnormalities. Additionally, x-rays of the jaw may be taken by your Nanaimo dentist to help evaluate the condition and positioning of the joint.

The majority of North Americans suffer from one or more of these symptoms, and yet in many cases, these patients’ symptoms are either misdiagnosed or dismissed as having no physiological cause. The good news is that Downtown Nanaimo Dental Group’s neuromuscular dentists can help alleviate TMD symptoms such as headaches, neck and shoulder pain, jaw pain, clicking or popping in the jaw, and ringing in the ears, known as Tinnitus.

TMD Treatment

At Downtown Nanaimo Dental Group we will place your jaw into its optimal position, relieving the symptoms associated with TMD.  While traditional dentistry evaluates primarily the teeth, bones, and gums, Dr. Mahara works with the hard tissues and the soft tissues, muscles and nerves. A trained neuromuscular dentist understands that your hard and soft tissues have a complex relationship and work to make that relationship a harmonious one. Dr. Mahara understands the necessity for including the muscles and the nerves which create the movement, pressures, and function of the mouth.

First, your Nanaimo dentist determines the optimal position of the jaw by measuring the relaxed position of the head and neck muscles and then repositions the jaw to achieve those exact measurements. A bad bite is relatively easy to correct. Treatment options include adjusting the bite, orthotics, orthodontics, or restoring the teeth to their correct positions.

Once your Downtown Nanaimo Dental Group neuromuscular dentist has diagnosed you with TMD, he or she can determine the best course of treatment for your specific needs.

Typically treatment will follow three steps:

  1. To relieve muscle spasms and pain:
    The immediate concern for neuromuscular dentists is to provide relief of your symptoms. The best way to do this is by using a technology called ULF-TENS. ULF-TENS stands for Ultra Low-Frequency Transcutaneous Electrical Neural Stimulation, but don’t let this term intimidate you. Basically, TENS is a way to relax muscles with a gentle massage of the muscles. The rhythmic pulsing relaxes the muscles by increasing blood flow and pumping out waste products. TENS also helps with pain relief by stimulating the body’s production of endorphins, the body’s natural anesthetic.
  2. To stabilize the bite:
    Often for this step a temporary device, known as an orthotic is worn over the teeth. The orthotic allows Dr. Mahara to make easy adjustments to the plastic without adjusting the teeth until the bite is stabilized. Once symptoms are relieved and the bite has been stabilized, your dentist will move on to the next step and permanently adjust your bite to the correct position.
  3. To Provide long-term management:
    There are a variety of ways to correct your bite in a more permanent way.

Four of the most common of these approaches are outlined below:


A dental orthotic is a plastic bite block that fits to the chewing surface of your lower teeth. The orthotic is made to fit your newly established balanced bite to eliminate your TMD symptoms. At the same time as eliminating your TMD symptoms, it will also allow Dr. Mahara to conclusively make a diagnosis of your situation. It also gives you the chance to see an immediate improvement of your symptoms.

Dr. Mahara will discuss with you the duration of time that you should wear the orthotic as it will depend on your situation.

After wearing the orthotic for a determined amount of time and when your symptoms have substantially reduced, you can now make an informed decision about the various options to maintain your new balanced bite.

Re-contouring the Chewing Surface of the Teeth

Sometimes a very detailed and elaborate process of re-contouring and reshaping your chewing surfaces is all you need to establish a healthy balanced bite. Once complete, this could reduce or eliminate your TMD symptoms.

Full Mouth Restoration Treatment

Full mouth restoration involves transforming and restoring as many teeth as it requires to create a balanced bite. First Dr. Mahara will run a test to record your existing bite and the source of your discomfort. Then we’ll find your balanced bite using state-of-the-art technology which will put your jaw muscles in the most comfortable position. We then produce a wax model in collaboration with a dental lab.

Dr. Mahara will provide you with orthotics that you will wear for a period of time, from a few weeks to a couple of months, depending upon your signs and symptoms. This will allow Dr. Mahara to see how responsive you will be to the full mouth restoration and give time for the jaw joint to heal, as well as time for you to adjust to your new bite.

Once you are comfortable in your new balanced bite and your symptoms have been substantially reduced, Dr. Mahara will custom make your restorations to maintain that position. To find out if full mouth restorations are right for you, contact Dr. Mahara today.

Neuromuscular Orthodontics

Orthodontics to correct TMD will be considered in cases where most of the teeth are not worn down and do not require any restorations such as crowns. The orthodontics, or braces, will be designed so that your teeth are aligned into a newly established bite.

Benefits of Neuromuscular Dentistry

Patients of neuromuscular dentistry at our Nanaimo office report experiencing a range of benefits from decreased or eliminated pain and discomfort to better overall health and longer-lasting dental restorations.

Call today to make an appointment at Downtown Nanaimo Dental Group, your TMD specialists.