Does your face hurt every time you have dental work?
We see many neuromuscular TMJ pain and bite destruction patients at Downtown Dental. Some patients just tend to have a lot of jaw soreness or inflammation when dental work is done. We incorporate a TENS unit into treatment in order to keep our patients’ jaw relaxed so they are more comfortable.
TENS is an acronym for Transcutaneous Electrical Neural Stimulation. That means when we place the TENS electrodes on a specific spot on the face we pass an electrical current through the skin to a nerve that controls the muscles of the jaw. These muscles begin pulsing the jaw. When someone closes their teeth together, this sends a signal to the brain and the brain begins to understand how to bring the teeth together maximally. This may, in fact, be a bad bite relationship causing pain in some patients and or tooth destruction in others.
How does the TENS unit work?
We’re getting into some geeky territory here, but here’s how a TENS unit relieves your pain.
The TENS unit begins pulsing the muscles along their normal resting length, which also begins to take the stress out of the joint. The Jaw begins to work along a consistent trajectory. After approximately 45 minutes to an hour, the jaw is consistently pulsing along what is called the neuromuscular trajectory. This is only achieved after a certain period of time. We can tell when this occurs by tracking the trajectory of the jaw. There is a little blip called the m-wave which happens to be the brain or central nervous system trying to affect the trajectory. When the m-wave disappears we know the patient has tensed for a sufficient period of time. When we take a bite at this position or make an orthotic a device to simulate the ideal bite this position is usually very comfortable.
Often we have also decompressed the TMJ (Joint)and eliminated clicking and popping. There is no training to this spot because it is based on the ideal muscular and joint position. The brain will quickly begin to recognize this trajectory and close there all the time. We call this the engram or program that the brain recognizes. Sometimes the engram is good, but a misaligned bite has a bad engram. By removing the pathological engram we are able to treat complex pain and migraine headache patients. We are also able to eliminate clenching and grinding.