Functional analysis at the dentist (if CMD is suspected)
From complaints through functional analysis to successful therapy
The human chewing system, consisting of teeth, jaws, muscles and jaw joints, can easily become out of balance. Even minor changes such as a tooth gap can cause a number of disturbances in the natural function of the jaw. These changes are not always noticeable or visible, so that a functional analysis can provide information about the health of the temporomandibular joints.
A functional analysis at the dentist provides conclusions about the perfect function of the temporomandibular joints and the chewing muscles. If discrepancies are found, one speaks of a malfunction of the temporomandibular joint. Basically, malfunctions of the temporomandibular joints can be divided into:
- TMJ disorders (arthropathy)
- Disorders of the chewing muscles (myopathies)
- Disorders of the occlusion (occlusopathies)
The group of all possible functional disorders is called craniomandibular dysfunction, or CMD for short. Read more: What is CMD?
Task of functional analysis
In principle, a functional analysis can be used to determine whether the bite is wrong and whether the position of the temporomandibular joints and the interaction of the chewing muscles are impaired. A wrong bite is present if the teeth of the jaw are not correct, i.e. if the upper jaw does not lie correctly on the lower jaw. One then speaks of an occlusion disorder that can be traced back to different causes. A shift of just a few millimeters can ultimately lead to complaints such as
to lead. It is thanks to this fact that the jaw is constantly overstressed because it tries to restore the correct bite position. It is therefore the task of the functional analysis to uncover even the smallest changes in the jaw and jaw joints in order to initiate appropriate therapy. Functional analysis is an indispensable aid, especially with regard to the functioning of the temporomandibular joint in the area of CMD diagnostics. A functional analysis is therefore always closely related to CMD therapy.
In order to be able to analyze and treat disorders, the temporomandibular joint is subjected to both a clinical (manual) and an instrumental functional analysis.
Nationwide doctor search for CMD doctors
Nationwide doctor search for CMD doctors
In our doctor search you can find doctors who are specialized in CMD in your area
When does a functional analysis make sense??
Both types of functional analysis record pathological changes in jaw function. Teeth and tooth retention apparatus, chewing muscles and occlusion as well as the temporomandibular joints are equally taken into account. Therefore, a functional analysis can not only provide important information when suspected craniomandibular dysfunction, but also proves to be particularly helpful in a wide variety of treatments. For example:
- for tooth restorations such as crowns, bridges and prostheses
- for diseases of the temporomandibular joints
- with joint noises (rubbing or cracking)
- for jaw pain
- if there are restrictions on movement (jaw lock)
- to treat bruxism
- for tension and pain in the chewing muscles
- for periodontitis with incorrect loading
- for monitoring the course within CMD therapy
- for the manufacture and adaptation of occlusal splints
- within orthodontic treatments
- as additional diagnostics for tinnitus (ear noises)
- as additional diagnostics for orthopedic questions
The possible uses of the functional analysis are very diverse and sometimes even go beyond treatment at the dentist. No wonder that this diagnostic procedure is used frequently. It is painless, non-invasive and provides particularly meaningful results.
Cost of a functional analysis
Since the costs of a functional analysis have not yet been covered by the statutory health insurance companies, they must be borne by the patient. The cost of a functional analysis depends on the actual workload and varies from € 80-200 depending on the level of difficulty. However, this is often only a fraction of the total cost. Additional costs arise for additional diagnostic measures and possibly for the treatment of a functional disorder of the jaw. Learn more about the cost of TMJ therapy.
Clinical functional analysis
In a manual or clinical functional analysis, possible changes are analyzed through observation and scanning. First, an exact medical history is taken. Questions should be answered that limit the type of pain as well as its location, duration and strength as well as possible triggers. The chewing and head muscles are then examined with their fingertips for their sensitivity to pressure.
In addition, special attention is paid to whether there are restrictions when opening the mouth such as a jaw lock. The examination of body and head posture also plays a major role in the manual functional analysis, because all deviations from the norm can indicate craniomandibular dysfunction.
In order to clarify all causes, a check for early contacts is then carried out. The patient has to bite on a coloring sheet. A wrong bite can be identified from the impression. Early contacts arise when e.g. a tooth filling is too high and when gritting the affected tooth meets the opposite tooth much sooner than the rest of the row of teeth. This results in a wrong bite, the occlusion is no longer correct.
Such a comprehensive clinical functional analysis provides important information about possible causes. It represents a basic examination, the results of which form the basis for the initiation of further diagnostic procedures and suitable therapy. As a rule, it is supplemented by an instrumental functional analysis.
Instrumental functional analysis
An instrumental functional analysis is only carried out after a clinical functional analysis. Based on the first diagnostic results, the chewing movement and the position of the temporomandibular joints are analyzed in more detail. In this way, the dentist can not only make further diagnoses by looking at X-rays and clinical findings on teeth and gums, but also make statements about the health of the temporomandibular joint using special measuring methods.
First, the positional relationship between the upper and lower jaw is recorded with the help of a so-called bite registration. With this soft plate, which usually consists of wax, plastic or metal and on which the patient bites, the contacts and position of the jaws can be measured. A facebow is used for further analysis. It makes it possible to determine the exact positioning of the jaw to the temporomandibular joint and the rows of teeth to the skull.
A plaster model is made from the data obtained, which is then inserted into the articulator, which imitates the chewing movements. This gives conclusions about the functional condition of the jaw and which treatment measures need to be taken.
In the meantime there is also the possibility to carry out the instrumental function analysis with the help of a computer-aided procedure. The movements and the chewing pressure of sensors are recorded and the measurement data is displayed digitally.
Diagnosis: CMD – what’s next??
With the data obtained, an individual and appropriate treatment plan can be created. The measures taken to treat craniomandibular dysfunction differ according to the type and extent of the malfunction and can be different for each patient. The effort can vary widely and can be as simple as it is complex.
As a rule, splint therapy is started first. This provides for the production of an individual occlusal splint, which has a positive influence on the position of the temporomandibular joints and counteracts accompanying symptoms such as grinding of teeth, abraded teeth and muscle tension. Another and, above all, permanent treatment method to correct a malalignment of the jaw can be the provision of dentures.
Even the adjustment of existing dentures, which was identified as the cause of the TMJ disorder, can bring the TMJ back into the correct position. Existing dentures can be a cause of the symptoms, for example, due to long-term wear or incorrect loading of the teeth.
A CMD can also have far-reaching consequences outside the mouth, so that these are often not causally linked to diseases of the same. For example, regularly occurring headaches, migraines, back pain, body aches and problems in the gastrointestinal or intestinal tract can be caused by a "wrongly adjusted" TMJ and indicate characteristic CMD symptoms. In any case, it is worthwhile to look outside the box in the dental field and to consider the relationships between organs.
functional analysis In the case of problems with the temporomandibular joints and the chewing muscles or with therapy-resistant tension and pain in the…
Question: Can milk teeth fester and swelling (if it were pus) can swell quickly? Answer: Yes, milk teeth can fester. I can also explain the rapid…
To be welcome. Around the corner. Not one of many. Your Health. Especially in the details. It’s worth taking a bite. Your Health. Monday Tuesday…
caries free from the beginning The enamel of milk teeth is particularly sensitive and therefore more susceptible to tooth decay. If the caries bacteria…