What is Physiologic Dentistry?
Physiologic dentistry is a branch of dentistry whose main philosophy is built around the fact that 90% of pain in the human body is from muscle. Therefore, if we can make muscles comfortable, we can reduce pain. We use ultralow frequency (ULF) trans cutaneous electro-neural stimulation (TENS) therapy to relax the muscles that control the resting position of our jaw and neck. We also use a myomonitor (EMG) to verify the level activity of these muscles so we know when they are relaxed. By placing the muscles in this relaxed position when they are at rest and in function, we decrease the amount of overall muscle tension which decreases the level of pain and sensitivity in the muscles and takes the pressure off of the temporomandibular joint (TMJ). Less tension in these muscles results in less lactic acid buildup in the muscles of the head and neck which decreases the frequency and severity of headaches.
What is a Physiologic Orthotic?
A physiologic orthotic is a dental appliance for the lower jaw which can be either removable or fixed (bonded to the teeth) and is designed to support the bite in the physiologic position. This position is the most relaxed muscular position achievable and is determined by relaxing the muscles of the jaw and neck using ultralow frequency (ULF) transcutaneous electro neural stimulation (TENS) guided by electromyography (EMG’s). These appliances are used to treat TMJ pain and headaches that are caused by muscle tension.
Fixed or Removable Orthotic
The fixed physiologic orthotic is bonded to the teeth and can’t be removed by the patient. It supports the jaw in the physiologic position and allows for decompression of the TMJ and relaxation of the muscles to treat headaches and neck pain. The advantage of this appliance is that it is very thin and comfortable and gets results very quickly. The disadvantage is that after 3-6mos of wear, the healing in the TM joints can result in a permanent change in the bite position. For that reason it is usually used in preparation for full mouth bite changing restorative treatment. If permanent changes to the bite are not desired, it must be removed after 3mos.
A removable orthotic is the most common therapeutic choice for most chronic TMJ or headache sufferers. It is worn on the lower arch and is removable by the patient for cleaning and eating. It supports the jaw in the physiologic position and allows for decompression of the TMJ and relaxation of the muscles to treat headaches and neck pain. It is bulkier than the fixed orthotic. It has the advantage of treating symptoms without creating permanent changes to the bite.