Mainly, craniomandibular dysfunctions are about pain or movement disorders in the jaw joint (arthropathies) or the chewing muscles (myofascial pain), restricted mouth opening, an allegedly incorrect bite (occliopathy) and other symptoms. Headaches, neck and back pain, ultimately pain from top to bottom, as well as tinnitus, dizziness and swallowing difficulties are also often assigned to the complex of causes of CMD.
We regard cranio-mandibular dysfunctions, CMD for short, as a disturbance of neurophysiological movement patterns with accompanying functional deviations and misdirected stimuli on nerve pathways. If this is so, the muscular-functional system and not the skeletal system – including the teeth – should be the focus of treatment. Irrespective of other CMD treatments, we recommend using FaceFormer therapy in addition or exclusively in all cases.
CMD is the generic term for a functional disorder in the masticatory system that is associated with numerous, completely different symptoms and complaints in almost all areas of the body.
Cranium = skull
Mandibula = lower jaw
Dysfunktion = functional disorder
Spiegel Online rightly describes CMD as a fashionable diagnosis. In a rapidly growing market, with a parallel increase in so-called CMD specialists, patients are confronted with costly treatments. These can often last for years. The alleged problem – an incorrect bite – is supposed to be solved with bite splints, grinding, building up, crowning, pulling or replacing teeth. However, there is no sound justification for this procedure. Ultimately, there is a lack of scientific evidence as to what role the bite block actually plays and how it should ideally be formed individually. After all, countless people around the world continue to live with dramatic tooth loss. They are far removed from “bite block ideals”. Pain or suffering are alien to them in this context. In fact, there is no relevant overbite either in a normal, resting low position or when chewing. In this respect, the question arises as to whether a futile effort to achieve this makes any sense at all. It is more likely to be coordinated muscle functions that are the cause of CMD.
An athletic 35-year-old man from Berlin experienced the course that a treatment reduced to the correction of the bite can take: Originally, he only wanted to do something about his teeth grinding and started with the corresponding therapies at his place of residence. After initial failures, the appearance of pain in his face and a growing awareness of the problem, he subsequently sought out numerous renowned CMD specialists not only in Germany, but also in Switzerland, Austria, the USA and Israel. Within two years, they prescribed more than 60 bite splints – supposedly with different effects – and excessively maltreated his teeth. So far, he has not been helped. In addition to the countless negative experiences, six-figure bills and a few remaining rudimentary tooth stumps, he now also complains of considerable pain in his entire musculoskeletal system. As is not uncommon after such an odyssey, he was finally recommended to stay in a psychiatric clinic.
Common methods of treating CMD focus mainly on the teeth to correct the bite block. Bite splints and manipulation of teeth are the means of choice. Often, physiotherapeutic, osteopathic or logopaedic treatments and even the provision of shoe inserts also accompany these measures. On the positive side – at least a holistic, functional treatment approach can be recognised.
On the other hand, changing the bite block with splints and dental treatments does not always seem plausible. The splint itself is an apparatus that interferes with the sensitive system of the oral cavity. It is doubtful whether correct neuromuscular and functional stimuli can be achieved with it. The provoked stimulus-response mechanism may even automate incorrect movements that cannot be easily resolved after long periods of use. Initial applications of splints, on the other hand, can be useful to reduce acute pain. However, they should only accompany cause-oriented treatment for a short time.
Mostly superfluous and negative are tooth correction by grinding, building up, crowning etc. to achieve an imaginary bite. Even slight head/body balance changes cause constant displacements of the lower jaw. Therefore, an ideal bite block cannot be determined, cannot be achieved in this way and is probably not even necessary. After all, it is not bite block – but on the contrary – a non-contact state of suspension between the teeth that is typical and permanent. The bite block is also insignificant when chewing, since the lower jaw and teeth do not perform hinge movements but grinding movements. Therefore, much more attention should be paid to the resting position of the jaw, tongue posture and chewing than to the bite block. High-tech measuring devices have a much lower value in this determination than the patient’s own perception.
The FaceFormer method –
Effective therapy against CMD
As a cause-oriented treatment method, FaceFormer therapy supports the correction of essential neurophysiological functions:
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