Dentomandibular Sensorimotor Dysfunction (DMSD)

Northwest Dental Center

Dr. Donald Johnson

Dental Specialist located in Coeur d'Alene, ID

This  medical condition involves the teeth, lower jaw, upper three neck vertebrae, and all the surrounding muscles and nerves.

The major pathway of nerves that control pain signals from the teeth, face, head, and neck to the brain is througth the trigeminal nucleus.

In DSMD, an individual has chronic pain or muscle stiffness caused by these nerve inputs resulting from an imbalance of tooth forces.

Symptoms

There are many symptoms associated with DMSD.  The following are the most common.

  • Headaches and migraines
  • Daily headaches of any type
  •  Vertigo (dizziness)
  • Facial pain
  • Tinnitus (ringing or fullness in ears)
  • TMJ (jaw joint) disorder
  • Pulpitis (sensitive teeth)
  • Sleep problems
  • Teeth grinding or clenching
  • Fractured teeth or grooves at the gumline
  • Restricted range of motion of head and/or neck
  • Poor posture due to job
  • Abnormal tooth wear or a bad bite

Treatment used in sports medicine and rehabilitation is used for people with DMSD.

Treatment of DMSD

Therapeutic Ultrasound

Therapeutic ultrasound treatment restores circulation to muscles through increased blood flow and heat. It also breaks up scar tissue and deep adhesions (areas where connective tissue fibers have formed over mucsle) via sound waves. Therapeutic ultrasound reduces trigger point sensitivity, manages facial pain, and reduces the stiffness and discomfort in trigger points.

Transcutaneous Electrical Stimulation

Sub-threshold micro-current stimulation reduces muscle spasms and referred pain through a very low level electrical signal to decrease lactic acid buildup and increase healthy nerve stimulation. Micro-current eletrotherapy can significantly help to increase the amount of mouth opening.

Low Level Laser Therapy

Low level (cold) laser therapy reduces pain and inflammation, accelerates healing in muscle/joint tissues, and reconnects neurological pathways in the brain stem.

Manual Muscle/Trigger Point Therapy

Manual muscle/trigger point therapy decreases and eliminates pain and tension in the trigger points by breaking up muscle knots and increasing blood frow. This results in decreasing inflammation and pain in muscles.

Homecare

As part of DMSD treatment, a home care system and intraoral orthotic device is used by patients for daily therapy at home. Exercises are also used at home.

Assessment Protocol

Review of headache and medical history is done. Dental and airway exam is done.
In the example at the left, a trigger point represented by an X can cause pain in the red areas around the eye and seem like a sinus headache.
T-Scan (a movie of your bite) measures the presence and amount of force imbalance in the teeth as well as interference in the bite.
Range of motion of muscles of the head and neck as well as the vertical and horizontal jaw movement are measured.
Advanced dental techniques and sports rehabilitation therapy has resulted in a very high success rate in providing long lasting relief from DMSD symptoms. Pain, dysfunction, and improper muscle activity are eliminated by balancing the muscles, joints, and teeth.

* Sessle BJ  Mechanisms of oral somatosensory and motor functions and their clinical correlates.  J Oral Rehab 2006;33:243-61.

* Koolstra JH  Dynamics of the human masticatory system.  Crit Rev Oral Biol Med 2002:13(4):366-76.

* Junge D  Oral sensorimotor function.  Medico Dental Media International, Inc. 1998

* Srbely JZ, Dickey JP, Lowerison M, et. al.  Stimulation of myofascial trigger points with ultrasound induces segmental...  Pain 2008;139(2):260-66

* Dijkstra PU, Kalk WW, Roodenburg JL  Trismus in head and neck oncology: a systematic review.  Oral Oncol 2004;40(9):879-89.

* Fikackova H, Dostalova T, Vosicka R., et. al.  Arthralgia of the temporomandibular joint and low-level laser therapy.  Photomed Laser Surg 2006;24(4):522-27.

* Quinn C, Chandler C, Moraska A  Massage therapy and the frequency on chronic tension headache.  Amerian Journ of Public Health 2002;92(10):1657-61.

* DiMatteo AM, Montgomery MW  Understanding Assessing and Treating Dentomandibular Sensorimotor Dysfunction, Fort Lauderale, Florida: Dental Resource Systems, Inc. 2012

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