CMD – In the maze of specialization

Pain in the masticatory muscles, the jaw joints, teeth grinding…

What is CMD – Cranio-Mandibular Dysfunction

CMD is a medical term for complaints in the chewing system: pain in the jaw joints, the chewing muscles, problems with opening the mouth, alleged false bite, teeth grinding and also headaches, neck and back pain, tinnitus, dizziness, difficulty swallowing. Yes, pain from top to bottom is often assigned to the fashion diagnosis CMD.

Cranium = Skull
Mandibula = Lower jaw
Dysfunction = Functional disorder

However, the causes of the problem are not as clear-cut as some specialists believe, and often the treatment misses its target and would have been better not to have taken place.

A true CMD story with a fatal course

His teeth grinding disturbed the 35-year-old Rafael from Berlin and what could be more obvious than to leave the solution of the problem to his dentist. Already in the first session the alleged root of the problem was recognized: Grinding of the teeth and a bite splint should correct the fit of the bite and the balance of the muscles. However, Rafael’s problem intensified after the treatment. Now he even feels pain in his chewing muscles. As a critical patient he sought the famous second opinion. The new specialist adjusted the teeth again and exchanged the first made, allegedly wrong splint for a new one. Unfortunately again unsuccessfully. In search of the great sage and driven by pain, Rafael now begins a 3-year odyssey. It leads from Germany to international specialists in the USA, Israel, Switzerland and Austria. After 3 years, Rafael has more than 60 different bite splints, 8 fitted insoles and extensive physiotherapeutic experience. Countless negative experiences in the jungle of dental and splint therapy as well as bills in the six-digit range meant that only a few rudimentary tooth stumps remained in his mouth and he complained of pain throughout his body. As is not uncommon after such ordeals, Rafael also became the famous exception where all efforts fail. In the end, his unsuccessful experts advise him to seek treatment in a psychiatric clinic away from their art.

Misguided methods

Many affected people who have problems like Rafael’s do not travel around the world, but have similar experiences in their circles. In CMD patients, the healthy irretrievable tooth substance is still being interfered and splints are being experimented with. However, these passive applications are hardly suitable for positively changing incorrect movements and malfunctions. Splints and support have also been used in orthopaedics for a long time. Today this is rarely accepted by the designated specialists. Adapted training has replaced the old methods. The patient is actively involved in his recovery and thus achieves his desired goal. In CMD therapy such findings are hardly considered. Even the unequivocal research results of recognized scientists, who explain that biting does not play a causal role in CMD, have little influence on the treatments. A press release on new guidelines for dentists could, however, attack traditional thinking and procedures in the future. It reveals that there is no treatment for bruxism (teeth grinding), the main feature of CMD. Bite correction is still very much in demand among the mostly self-appointed CMD specialists. Deviations in tooth fit and temporomandibular joint movements are even corrected with the private performance of electronic measuring systems. This may seem impressive, but the measurement results are of little use and turn out differently every time they are repeated – at least on living people.

Causes can exist since early childhood

With FaceFormer exercise therapy, good and lasting results are achieved

Malfunctions, bad posture and bad habits are the main causes of CMD. They often develop in childhood and have shown up early: Middle ear infections, malpositioned teeth, nasal polyps; mouth breathing and other childhood diseases are typical signs of malfunction. They are treated by doctors mainly symptomatically.

The actual causes remain unconsidered or are not even known. If they are neglected, however, they remain for a lifetime and constantly cause other health problems. CMD is only one of the possible consequences of such long lasting functional disorders.

Effective treatments

But what should someone who suffers from one or more symptoms assigned to CMD do? The statement that there is no therapy is one-sidedly related to dentistry. However, effective methods have been developed by other disciplines. Treatment aids can only be effective if they aim to unlearn what is wrong and replace it with correct, biological functional procedures. We know from experience that performance can be improved and changed through practice or training alone. To learn new things, we have to repeat exercises over a longer period of time. This applies not only to learning knowledge, but also to movements, biological functions, postures or habits. Systematically learned knowledge is stored in the human brain and is available to us on demand – even unconsciously. Along the way, we perceive improvements in small learning steps. The training is only complete when the new, correct behaviour has become a habit. Victory over the wrong thing is now certain and relapses can be ruled out.

Training is the king’s way

Good and lasting success is also achieved with FaceFormer exercise therapy for CMD. It is used regularly over a limited period of time. With a few minutes of daily training, the learning effort is low. Exercising correct respiratory functions, mouth closure, harmonious muscle tension of the masticatory muscles and tissue in the mouth/throat area, the natural position of the tongue, ear functions and head balance are important elements of the method.

The original text was published in the special publication “Bewusst Leben” as a supplement to the Ruhrnachrichten (09/2019).