Efficacy of Mandibular Tracking in the Diagnosis and Treatment of TMJ/ MSD

Efficacy of Mandibular Tracking in the Diagnosis and Treatment of TMJ/MSD
  • Over 22 controlled studies that further support the rationale for mandibular jaw tracking.
  • 25 supporting referenced studies.
  • Numerous other studies that document the clinical efficacy and validity


There is again a large body of literature not only nationally but internationally supporting the efficacy of jaw tracking and as well as the use of TENS. Due to the length of this email I will not list them at this time. But I can reassure you there is the peer reviewed literature to support such positions.

The reason why most of us are not familiar with this is because most of us do not read out side our dental arena nor does the profession guide us to look outside the box in understanding scientifically the musculoskeletal occlusal issues which impacts our patients. The information is there has always been and continued studies are consistently substantiating the neuromuscular position each year. Our profession tends to rather ignore it and keeps us in the dark.

As you have indicate the academics will not easily nor have easily embraced such teachings and concepts. Too much is at stake as you may soon realize. Change int textbooks, change in curriculum, change in teaching concepts, change in testing, change in licensure protocols, change in too many areas, etc. There are some strong advocates as Dr. Michael Mazzacco, associate professor of the North Virginia School of Dentistry and Dr. Barry Cooper of Columbia University who teach and support these concepts in their respective universities. They are extremely academic and hold national recognition in their field of muscle physiology and TMD arena. They are very scientific. I am proud to be associated and know them well. There are others as Dr. Norman Thomas in Canada who is also professor and continues to study neuromuscular dentistry and teach it and is an authority in muscle physiological sciences, writes papers as well as a practicing dentists and treating clinician.

Tradition and comfortableness in present dental curriculum is always difficult to change. Insurance companies are also on the side line following the trends of tradtional health care and delivery services. Prosthodontics specialties will change once they see the masses of doctors outside of the present system make changes and continue to report patient resolution and treatment effectiveness. Academics and treating clinicians outside of academia see things from different prospectives. Those in the clinical consumer patient world want results and see effective consistent treatment times. That is perhaps why many who have been experiencing long term chronic conditions now are being effectively treated by trained dentists.  Some of these clinicians themselves have been around awhile seeing both sides of the issues for years. Perhaps through the masses of the every day dentist's awareness and promoting to the academics and universities will the established system begin to change. Look how long it is taking to still develop adhesive dentistry curriculum in mainstream academia. How can we expect any thing different in regards to Neuromuscular dentistry since it cuts across all facets of dentistry which includes, public health, prosthodontics, oral maxillo-surgery, endodontics, orthodontics, pedodontics, etc. It does effect all levels of dental care once we see the larger view and perspective. I don't expect the system to change quickly, but I enjoy the fact that our patients are seeing their lives change, the dentist and staff see changes and this approach is truly objective and scientific. If the egos, tradition, and self serving agendas are layed aside, perhaps the occlusally distressed patient, paining TMD patient can get better answers and more effective treatment in a more timely way in our dental profession.

In the long run I have found that the neuromuscular approach is less costly, more conservative, less invasive and meets the need of quality care. Amazingly, NMD has caught the attention of many dental schools and media around the country already. NMD answers to the needs of the treating clinician who wants real and practical answer of comprehensive treatment and care to our patients. CHANGE IS GOOD, BUT CHANGE CAN BE CHALLENGING TO SOME. It depends on the present mindset, where each one is at in his or her career path and what passed experiences we have been faced with, what teaching we have been presented. I have found at Occlusion Connections and through the teachings we present that most of the dentist are open to these concepts and technology.  They are mainly dentist and specialist who have been practicing for over 10-20 plus years or more. They are the seasoned veterians who have experienced the ups and downs of clinical dentistry. They are the ones who have tried a lot of things and have gone around the dental continuing education cycle. They are the ones that are not easily fooled, they are the ones that have tried all the trendy fangled dental toys, lasers, expensive CBT Imaging systems, etc. But they are street smart and are looking for real answer to musculoskeletal occlusal issues that they face with the patients daily.

What I, as well as other promenant neuromuscular clinicians and scientist in this country like Robert Jankelson, Jim Garry, and others have been advocating and presenting is not a toy or experiemental gimmick, but a totally different approach and philosophy to a more holistic way of treating patients from a more objectively based and scientific position implementing both the gnathological and neuromuscular concepts. Due to the amazing science and objectivity to this approach many are finding it mind blowing, yet confirming there beliefs and hunches, now with clear evidence. It is not hard to convince those that can see clear unequivocal evidence when tracking mandibles and simultaneous EMG with TENS. It is new to many, but certainly worth checking into!!! I would encourage you to keep asking questions until you are satisfied. They are great and and absolutely valid.

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