The way your teeth fit together

The way your teeth come together is a combined effort between your jaws, muscles and the temporomandibular joints. When the teeth fit together properly, the muscles and joints are in equilibrium and the muscles are relaxed. This is called neuromuscular balance.

If your teeth do not fit together properly, the muscles and joints have to make changes to accommodate the new position. This can cause your muscles to be strained as they become overworked.

When this happens you might notice clicking when you open and close your mouth. You may experience headaches or notice ringing in your ears, or even tingling in your face or your fingertips.

Even after dental treatments such as fillings, crowns and veneers, the way your teeth fit together may change. This may because the dental treatment has changed the shape or position of one or more teeth.

For some people, a change of even a fraction of a millimetre may cause neuromuscular imbalance.

Neuromuscular dentists are trained to understand the entire coordinated system that exists between your teeth, jaws and muscles. They know that maintaining the system in neuromuscular balance is important for the longevity of your teeth and dental treatments, and for your comfort, too.

So, how do you know if you have your optimum neuromuscular bite?

The first step is to get a detailed understanding of dental treatments you have had, any injuries that might affect your head and jaw, and whether you have sleep apnea. Common symptoms of sleep apnea include snoring, drowsiness during the day and difficulty concentrating. You also need to know about other conditions that affect your dental and overall health.

Then the neuromuscular dentist will use a MyoMonitor to relax your jaw muscles with a mild electrical stimulus, similar to that used by physiotherapists to heal muscle strains. The dentist will trace the movement of your jaw with a computerized jaw tracking program to log any abnormal muscle activity.

Based on this analysis the dentist can discuss the findings with you, using objective data, to help you decide whether you would prefer that your bite be left as it is or adjusted to a more optimal, or neuromuscular, position.

Once you decide that you would like to optimize the bite, you will be provided with a dental orthotic. It will retrain your jaw and muscles to return consistently to the new and better position.

You may be referred to a doctor, physiotherapist or other professional who specializes in correcting spinal and posture problems. Once this is corrected your dentist can maintain that healthy state with a dental orthotic.

After about three to six months and a few additional appointments to confirm that the new position is, in fact, your neuromuscular bite, you will be ready to embark a more permanent solution, using crowns, veneers and, if you have missing teeth, implants.

The human body is able to adapt to changes. But this happens at a price.

In the case of neuromuscular imbalance, the consequences can be headaches, jaw problems, chipped and broken teeth, back and neck pain, to name a few of the more common signs.

With neuromuscular studies, your dentist has additional information on the effects of these changes on your dental and overall health. He or she can give your solutions that will restore your smile – and your overall dental and physical health.

Dr. Sholina Kherani is a dentist with the Alberta Centre for Aesthetic Dentistry in Edmonton. Reach her with your questions and comments at

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