A guide to neuromuscular dentistry and bite correction to treat TMJD, sleep-disordered breathing

Facial aches, tinnitus, chronic migraines, jaw stiffness, and other symptoms of temporomandibular joint disorder (TMJD) are often rooted in bite imbalances or “malocclusion.” Our dentist in Carlsbad, California, Dr. Al A. Fallah, is a Master of the International College of Cranio-Mandibular Orthopedics. The ICCMO is a leader in the study and advancement of neuromuscular dentistry and TMJD diagnostics and therapies. This approach is based on the idea that contacts made between teeth affect other musculoskeletal systems. The mouth and jaw joints do not exist in isolation from other parts of the body. Likewise, musculoskeletal dysfunction elsewhere can affect occlusion. 

Physiologic orthodontics presents treatment options that account for the intersection of physiology (how parts of the body function) and orthodontic treatments. Dr. Fallah first uses advanced diagnostic technologies to determine the optimal, healthy, and comfortable “bite” or position of the jaw. From there, we can work toward achieving and supporting these ideal positions. Precision bite correction supports healthy muscle and joint function to improve or eliminate the severity and frequency of conditions like TMJD. Examples of such orthodontic treatments in action at our office include: 

• “Expanders” – As its name suggests, these oral appliances expand the arch from side to side to create more space in the upper jaw. This device also draws the upper front teeth forward. Bite correction and TMJD therapies represent a process. So, we largely refer to the use of expansion devices as “Stage I” orthodontics. Devices include the Wilson 3D^® appliances to facilitate arch development, sustained maintenance of arch space, and single-tooth movements. Dr. Fallah will advise on how to wear these devices and any additional therapies or devices that may be necessary to achieve the desired correction (such as the use of facemask therapy).
• Braces – Stage I treatment with arch expansion devices provides a good foundation for the next step in treatment, which involves realigning the teeth. After all, the teeth now have more room within the treated, broader arch. Stage II orthodontics actively resolves conditions such as crowded teeth. 
• DNA Appliances – The effects of conditions such as narrow arches transcend TMJD symptoms; they can also affect the ability of individuals to continuously and effectively move air through the airway during sleep. These characteristics result in interruptions in sleep or a form of sleep-disordered breathing known as “sleep apnea.” Similar to the above expanders, the Daytime-Nighttime Appliance may be prescribed to open up the arch. Here again, Dr. Fallah will advise when and how to wear this device. Patients frequently enjoy better, more restful sleep when using the DNA appliance at night or for a few hours each day as needed. 
• Invisalign^® – On its own, clear aligner therapy has its limitations. This treatment, often marketed as a discreet and removable alternative to braces, only expands the upper jaw by around one to two millimeters. This movement is inadequate to sufficiently resolve sleep-disordered breathing (apnea) or TMJD. However, Invisalign® can still be an essential part of multi-phase treatment. It may be prescribed as a follow-up to treatment with DNA appliances. It may also be used instead of braces for those adults who desire alternatives to fixed metal braces or other, more extensive forms of reconstruction. 

Orthodontic treatment at the office of Dr. Al A. Fallah is about more than braces to “fix” crowded or crooked teeth. To find out more about your options and to schedule an appointment at our practice in Carlsbad, CA, call (760) 730-1600 today.