According to the National Institutes of Health brochure on TMJ Disorders irreversible treatments that have not been proven to be effective-and may make the problem worse include:

• orthodontics to change the bite
• crown and bridge work to balance the bite
• grinding down teeth to bring the bite into balance (occlusal adjustment)
•  mandibular repositioning splints (MORA) which permanently alter the jaw position and bite

The 1996 National Institutes of Health Technology Assessment Conference Statement booklet states that “evidence is insufficient to warrant prophylactic modalities of therapy. Additionally, available data are not persuasive that orthodontic treatment prevents, predisposes to or causes TMD. Therapies that permanently alter the patient’s occlusion cannot be recommended on the basis of current data.”

Bioesthetic dentistry

Bioesthetic dentistry is another name for bite modification. It is based on the idea that such diverse signs and symptoms as worn or cracked teeth, gum recession, a history of multiple root canal treatments, headache, TMJ problems, ringing in the ears, equilibrium problems, fibromyalgia, etc. are all related to a disharmony between the way the teeth meet and the correct position of the temporomandibular joint. The bioesthetic dentist has patients wear a bite appliance called a MAGO (Maxillary Anterior Guided Orthotic) for six to twelve weeks, which is supposed to get the bite to match the correct jaw position. This position is then maintained by tooth grinding, bonding, crowns or braces. There is no scientific evidence to support the claims made by the bioesthetic dentists, and patients should be wary of having such irreversible changes made to their teeth and bite without such evidence.

Neuromuscular dentistry

Neuromuscular dentistry is a dental treatment philosophy intended to correct a “malalignment”of the jaw at the temporomandibular joint and produce a balanced bite. The neuromuscular dentist uses several computerized instruments to measure your jaw movements and jaw muscle activity to determine the extent of your problem and to establish a “physiologic rest position” for the jaw. Here are some of the measurement techniques and procedures used:

• Sonography – measures vibrations from the joint when you open and close your mouth to identify joint derangements.
• Electromyography (EMG) – involves placing surface electrodes over the jaw muscles that pick up electrical impulses and send them to the recording instrument. It is used to measure the activity in the muscles during various movements.
• Jaw Tracking (Electrognathograph, Kinesiography) – analyzes mandibular movements three dimensionally. A headset is placed on the patient and a magnet is attached to the lower front teeth. Recording of the lower jaw movement is then made.
• TENS – ultra-low frequency electrical stimulation of the muscles to relieve muscle spasms and pain and help establish a “physiologic” jaw position.

Once the rest position of the jaw is determined, the patient undergoes extensive restorative dental procedures or orthodontics to maintain this new position.

Neuromuscular dentistry can cost from $3,500 to $25,000+ for 4-6 months to one year or more of treatment.  Insurance companies typically do not cover the TMJ- related costs due to the lack of  a scientific evidence base for such treatment.

According to the American Association For Dental Research’s March 3, 2010 Policy Statement on Temporomandibular Disorders (TMD)  “…the consensus of recent scientific literature about currently available technological diagnostic devices for TMDs is that except for various imaging modalities, none of them shows the sensitivity and specificity required to separate normal subjects from TMD patients or to distinguish among TMD subgroups.”  In other words, those who practice neuromuscular dentistry have their own standards for what are normal and abnormal readings which may lead to a “false positive” - meaning people may be told they have a TMJ problem when they really don’t, leading to unnecessary treatments.

Neuromuscular dentistry is NOT a specialty recognized by the American Dental Association.  Although a variety of healthcare providers advertise themselves as TMJ specialists, treatments available today are based largely on beliefs, not on scientific evidence.

The Latest in Science

• Orthodontics for treating temporomandibular joint (TMJ) disorders
• Occlusal adjustment for treating and preventing temporomandibular joint disorders

This page was reviewed for accuracy by Dr. Daniel Laskin, the TMJA's clinical consultant.