Oral surgery & jaw joint (CMD) in Düsseldorf
CMD treatment
Our dental practice has specialised in this area of dentistry and is a qualified CMD centre in Düsseldorf.
What are functional disorders or CMD?
Clicking noises when chewing or yawning, hypersensitive teeth, grinding the teeth at night, snoring or breathing disorders during sleep, tension headaches, earache or ear noises, and postural problems of the spine can be symptoms that "the bite is not right".
If the upper and lower jaw do not meet in the ideal position, disorders and pain can result. Even slight deviations can be enough to impair the highly sensitive and extremely complex optimal functioning of the masticatory system and the neighbouring structures.
When it helps
Possible symptoms
- Clicking noises when chewing or yawning
- Hypersensitive teeth
- Grinding the teeth at night
- Snoring or breathing disorders during sleep
- Tension headaches
- Earache or ear noises
- Postural problems of the spine
Our approach
Craniomandibular dysfunction (CMD)
CMD refers to the effects of this misalignment between the skull (cranium) and the lower jaw (mandible).
Because the muscles of the masticatory system are connected to the muscles of the spine through functional chains, CMD symptoms often extend beyond the head. Neck and shoulder tension, blockages of the cervical spine or a pelvic tilt can also occur.
In many cases, people affected by CMD only have their symptoms treated – medication for headaches, physiotherapy or chiropractic for postural problems, simple splints for teeth grinding – without any significant improvement. Yet the cause is often a "wrong bite", i.e. a misalignment of the lower jaw, caused for example by misaligned teeth, teeth extracted during treatment with braces, faulty crowns or dental prostheses, or injuries to the cervical spine.
After the findings have been evaluated and a diagnosis made, individual treatment planning follows.
You can find further information on CMD, diagnosis and therapy on the website: www.cmd-zahnaerzte.de
How we treat your problems after the jaw joint diagnostics
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Fitting an occlusal splint
If the analysis has found that the teeth and biting surfaces influence the functional disorder, the faulty bite can be compensated for by fitting a removable occlusal splint made of plastic, i.e. an artificial biting surface in the correct jaw position. Depending on the complaints, this splint must be worn either only at night or around the clock.
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Snoring-therapy or orthodontic appliances
As an alternative to occlusal splints, special devices for jaw positioning or snoring therapy can also be used. To treat mild to moderate forms of obstructive sleep apnoea (pauses in breathing during sleep), intraoral breathing therapy splints can also be used as an alternative to conventional mask systems.
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Physical therapy
For example cold and/or heat applications, electrotherapy (TENS) to relax the muscles or reduce inflammation, laser irradiation, use of ultra-short waves.
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Guidance on your own exercises
Alongside specific guidance on self-observation or taking care, you can use special muscle exercises or massage techniques yourself to relieve the symptoms.
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Physiotherapeutic measures
These include, among other things, special exercises to strengthen the muscles, stretching, massage and manual or craniosacral therapy.
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Definitive re-adjustment of the relationship between upper and lower jaw
After successful pain relief or preliminary treatment, it may be necessary to completely re-adjust the bite position of the jaws and the interlocking of the upper and lower teeth. With largely healthy, natural teeth, orthodontic correction is usually the best option; but if dental prostheses are already present or needed anyway, the adjustment can also be made prosthetically, i.e. for example with crowns and bridges or other dental prostheses. In individual cases, further measures such as examinations or treatments by other specialists may be necessary. For years we have worked closely with specialists from various fields, such as orthopaedists and physiotherapists, to get to the root of your complaints holistically.
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Costs of diagnosis & treatment
The functional analysis services (FAL) and other services we provide are billed on the basis of the fee schedules for dentists (GOZ) and physicians (GOÄ). These costs are usually covered by private health insurers. However, functional analysis services are not part of the benefits catalogue of statutory health insurance, i.e. patients with statutory insurance are generally not reimbursed for the costs incurred. An exact forecast of the total costs is only possible after the initial examination. For all services you will receive from us a treatment and cost plan that gives detailed information on the individual examination and therapy steps required in our CMD centre in Düsseldorf.
The process
Important steps in recognising functional problems
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Medical history
Because of the wide variety of symptoms, an in-depth conversation between dentist and patient to carefully take the individual medical history is the basic prerequisite for classifying the complaints correctly. In this conversation we try to identify possible causes and connections.
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Initial examination: functional and structural analysis
The first examination serves to clarify the causes of your complaints. Where pain is present, we check whether there are connections with the masticatory system. Joint noises must be examined for their cause to find out whether treatment is needed. Specific loading tests (manual functional analysis) determine in detail which structures of the masticatory system are damaged. At the end of the initial examination it can be decided whether, and to what extent, further measures are needed.
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Instrumental diagnostics
Using modern computer-assisted procedures to diagnose muscle and joint problems, precise statements can be made about the condition of the masticatory system. These include electromyography (EMG, recording of muscle activity) and electronic analysis of the static and biodynamic loading of the jaw joints and the occlusion (the relationship between the upper and lower teeth), in order to determine the effects of faulty bite positions.
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Analysis of the jaw models
Impressions of the upper and lower jaw are taken to make jaw models. Using a face-bow, these models are mounted in a movement simulator (articulator) and analysed both in person and by a special computer system ("Cadiax" from Gamma).
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Determining the jaw position
Precisely determining the correct position of the lower jaw is of particular importance, as faulty bite positions, for example as a result of insufficient bite height, missing or tilted teeth, or old or faulty dental prostheses, are frequently the cause of functional disorders. In individual cases additional measures may be needed, e.g. imaging diagnostics using magnetic resonance imaging (MRI) to visualise the structures of the jaw joint, or special X-rays with which the skull, the jaw position and the position of the teeth can be measured.
Appointment
Questions about Jaw joint (CMD)? Talk to us.
We will be happy to answer all your questions in a personal consultation.
