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Neuromuscular Orthodontics TMJ

Various studies indicate that some signs or symptoms of TMJ are present in 30% to 60% of orthodontic patients prior to treatment. It has been estimated the 70% of children in the mixed dentition have some form of malocclusion. Studies show that 90% of the face is developed by age 12, so it is important that orthopedic and orthodontic problems be treated early in order to guide the growth of our younger patients. I find parents are very receptive to early treatment so that problems can be solved earlier before they become more serious and perhaps more expensive later on.

Functional orthopedics in terms of dentistry means treating the jaw posture, tooth relationship, muscle relationship and head and neck posture as a whole system. When evaluating each patient the upper and lower dental arch development is examined to see if they are too narrow and constricted, if there are any airway breathing problems, tongue posturing problems, tooth positioning problems, jaw posturing problems and/ or any head and neck problems.

The negative effect of extracting bicuspids for orthodontics.

Observe the effects of extracting four bicuspids (premolars) from the dental arches for orthodontic purposes. These identical twins had identical bad bites of crooked teeth (malocclusions). The twin labeled OE had four bicuspids extracted and orthodontic treatments of the traditional variety. Her twin sister, labeled OF, had her malocclusion treated the European Functional Jaw Orthopedics way using removable Functional Appliances as a part of her treatment plan, and most importantly, she did NOT have four bicuspids extracted as part of the treatment. Look Closely. Now remember, these photos are not repeats of the same person but individual pictures of two different persons, identical twins. After orthodontic treatment was completed, notice the difference in facial appearance of the girls’ faces. The girl on the left has had four bicuspids extracted and traditional American style metal braces. The girl on the right had her treatment done by means of European style removable Functional Appliances and did NOT have any teeth removed. Notice the wide face, the broader smile, the fuller appearance to the entire smile line, and the fullness and beauty of the lower facial structure!

CASE STUDY- 29 year old female, a oral surgeon suggested jaw surgery.


Treatment Time: 1 1/2 years using both functional appliances and fixed braces.

This patient decided to take the non-invasive Neuromuscular Approach rather than the surgical approach!

The patient must decide under what philosophy and approach they would like to be treated. The choice is yours. Conventional orthodontics verses Functional Orthopedic orthodontics.

Conventional or retractive orthodontics, looks at straightening teeth for esthetics and appearance and assumes that the facial muscles and jaw joints will accommodate to their new position. Teeth are considered for extraction if there is insufficient space to align the teeth. Making the teeth look straight is often the primary concern. Narrow and constricted arches will often result. This approach often does not consider the impact it has on the airway (breathing) of the individual. The head, neck as well as the jaw joint position is often ignored.

Conventional or retractive orthodontics
Traditional orthodontics treats receding lower jaws by surgically moving them forward. Traditional orthodontics, which involves the use of headgear and bicuspid extractions, does not consistently provide the patient with joint stability and can aggravate jaw joint problems. Joint stability is a principal concern to Dr. Buck and his team.

Those patients that have been treated by conventional orthodontic techniques have complained of having problems such as high vaulted palates causing breathing problems, under developed dental arch form, gum recession, unstable teeth, continual use of retainers, teeth not gearing properly, improper vertical position, as well as developing TMJ symptoms with persistent head and neck problems.

Functional orthopedic orthodontics emphasizes how the muscles, jaw joints and teeth affect one another. A proper gearing of the teeth to function in harmony with the jaw joints and muscles will allow the teeth to wear and function evenly, be stable and decrease any trauma to the surrounding supporting bone. Narrow dental arch forms are properly developed to a full contour--enhancing breathing and appearance. The "functional jaw orthopedic approach" is a very important approach that will help you achieve your goals of an improved profile and facial appearance, as well as the establishment of a proper joint position that ensures optimum TMJ health, appearance and comfort.

Functional orthopedic orthodontics
Narrow dental arch forms are properly developed to a full contour--enhancing breathing and appearance. The functional approach is far superior as the lower jaw is moved forward with jaw repositioning appliances while the child is still growing. parents and children prefer the non-surgical orthopedic approach.


By the use of dental appliances, a proper tongue and jaw position is created to eliminate negative forces on the teeth. Our functional orthopedic orthodontic treatment involves aligning the upper and lower arches by use of appliance therapy, and then aligning the individual teeth via the use of braces. The long-term results of this combined type of treatment, as opposed to using only standard braces, tend to be more esthetically pleasing, stable, and shortens treatment time. Crowded teeth with seemingly little space should certainly be properly evaluated to prevent permanent tooth extractions.

The combination of these two phases of treatment ensures beautiful faces, full lips and outstanding profiles.

State of the art computerized diagnostics and functional jaw scans are used before beginning the treatment

to determine the proper jaw position
to determine an optimal muscle length, function and comfort
to identify a correct treatment end-point for proper tooth positioning.

Our approach is to look at the fundamental and structural components of the face, which includes the jaw, the jaw joints and muscles. Once we can determine were these structures want to naturally function with the least strain, the teeth can then be moved to a proper position for function, stability and appearance.

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