Gneuromuscular Dentistry

Gneuromuscular Dentistry
Dr. Tetri offers gneuromuscular dentistry services (GNM). Come to my clinic – Tetri's Smile – for a consultation. We are one of the few clinics in Florida that provide GNM services. We treat what other clinics cannot. At Tetri's Smile Dental Boutic, we eliminate not only visible defects, but the root cause of the problem at the deepest neuromuscular level
Dr. Tetri
A few words about me
I was trained at Occlusion Connections' (OC) advanced training center by the innovator in this area of medicine, Dr. Clayton A. Chan.

I AM 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 make a treatment plan with gneuromuscular dentistry (GNM) in my Dental Boutique.

Statistically, 90% of all TMJ dysfunctions are related to muscle problems.


Why do I 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.
Gneuromuscular dentistry (GNM) is an advanced complex of physiological, neuromuscular, and gnathic examinations (CMS, EMG, TENS), which allows not only to 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 functioning 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, the doctor collects a medical history, conducts diagnostic imaging, and examines the clinical record. However, to give an objective assessment in a specific clinical situation, this is not enough. A number of measures are required (determined by the dentist).

K7 CMS (lower jaw motion scan)

The computer program tracks the movement/position of the mandible in three planes simultaneously (up to 0.1 mm accuracy). It 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 J5 myomonitor (wave range: 0.5–10 Hz; safe for the patient's health), which has proven its effectiveness in muscle relaxation. J5 Dental TENS helps eliminate muscle spasms that deform the jaw (pull, twist). It is recommended for diagnosis of the trifacial and facial nerves.

K7 EMG (electromyography – muscle activity measurement)

Special surface sensors are placed on the face (in the area from 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. The procedure helps to 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 best to adjust the occlusion.

ESG (electrosonography)

Another measuring tool that helps you better understand the dynamic functional movements of the temporomandibular joints. It picks up clicking, crepitations, noises of different nature during opening and closing of the mouth (high/low frequency). During the 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 even before you start treatment with the neuromuscular dentistry technique.
In order to diagnose occlusal problems, it is not enough to 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 successful cases with examples of work on neuromuscular dentistry.

Treatment

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

Then one of the following methods or a complex is applied (depending on the clinical picture).
  • Occlusal correction
    For minor abnormalities, selective grinding of the tooth enamel is performed to improve the contact. Articulating paper and occlusal wax are made and placed (inside the patient's mouth) to identify problem areas.
  • 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 (they don't need to strain to bring the teeth together). The type of structure is prescribed by the dentist depending on the clinical case.
  • Restorative therapy
    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.
Checking the result is a mandatory step after treatment. We schedule routine check-ups every 2 weeks, over the course of 1–2 years (depends on the work done). For example, temporary crowns may be corrected during examinations to stabilize the bite.

Summary

In a regular clinic, traditional methods treat the symptoms, not the essence of the problem. Neuromuscular Dentistry by Dr. Baruch Tetri helps to find the cause of the pathology and solve it on a deeper, more profound level.

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