Cranio Mandibular dysfunction

The causal system makes the most complex joint movements in the body. It owes that to its 3-dimensional movable jaw joints. In addition, the chewing system with up to 800 Newton can mobilize the largest punctual force. This is z. In periods of stress, when the human is pressing or crunching with his teeth. Traces of this are visible on an abraded bit (abrasion) and an altered bite height. This in turn leads to a disturbed interaction of cranium (lat. Cranium) and lower jaw (lat. Mandibula) with other possible consequences for the neuromuscular system. Then come on those symptoms, which summarizes the medicine under the generic term cranio mandibular dysfunction (CMD). Often it involves pain on teeth and masticatory muscles as well as in the area of ​​the head, shoulders and back. Pain in the temporomandibular joint and ears as well as tinnitus also appear as CMD symptoms.

Dissemination of CMD
About 20 percent of the population are affected by CMD and in need of therapy, so the projections in dentistry. The last German oral health study (2006) found that "functional problems" are among the most common problems. According to those surveyed, chewing, one of the central functions of the orofacial system, became increasingly difficult as people grew older.

Only recently (12/2011) has the Federal Dental Association pointed out that teeth grinding (bruxism) is increasing in the population. The basis was data from the Statistical Yearbook. Of 1,600 dentists surveyed, 80 percent had identified this development. Of the affected patients, 15 percent had more women than men (10 percent). The cases accumulated especially in the age of 35 to 45 years.

Interdisciplinary therapy
CMD requires interdisciplinary therapy. This makes the many symptoms clear. The first port of call of the patients are due to the symptoms usually ear, nose and throat doctors, orthopedists, naturopaths, physiotherapists or osteopaths. Often they notice postural disorders such as shoulder or pelvic obliquity or a disturbed muscular status. For the interpretation of the bite situation they need the interdisciplinary therapy with a dentist. He should have sufficient experience with functional diagnostics and therapy.

Dental functional therapy using a splint is one of the common forms of treatment. It is discussed whether splints for the upper jaw contribute more to the success of therapy than those for the lower jaw. This discussion continues occasionally with therapists such as the osteopaths, who want to avoid a pathological movement of the skull plates. The evaluation must take into account when and for how long a patient has to wear the splint. In any case, the therapy should be preceded by a clinical and instrumental functional test.

A therapeutic intermediate goal is first to break the wrong contacts in the bite with the rail. This is done, for example, by crunching rails, which, however, have to be renewed again and again because of the wear and tear and are not causal, but only symptom-related. The actual therapy goal must be a healthy bite with a physiological position of the temporomandibular joints.

In the network of the society for dental health, function and aesthetics (GZFA) an upper jaw splint is used, which guarantees a secure registration of the lower jaw position. Patients only wear this graceful, biphasic splint during the night for seven to ten weeks. If there are still complaints in other parts of the body, the dentists in the GZFA network include their co-therapists. Only in October 2011 did the GZFA submit an evaluation with 78 patient cases. For further networking, the GZFA carries out further education and builds a nationwide network for functional therapists and co-therapists.