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Find Relief for TMJ Pain in Comox

Neuromuscular Dentistry (NMD)

Neuromuscular dentistry (NMD) is a treatment modality of dentistry developed in the 1960s that objectively focuses on correcting misalignment of the jaw at the temporomandibular joint (TMJ). The misalignment of the bite and the TMJ results in a number of signs and symptoms that can be painful and long-lasting. Despite this it is sometimes misdiagnosed by physicians or dismissed by the patient as having no physiological cause.


NMD acknowledges the multi-faceted musculoskeletal signs and symptoms that relate to postural problems involving the lower jaw and the cervical region of the neck. It also recognizes the need to solve the root of the misalignment problems by understanding the relationships of the teeth, muscles, TMJ, and nerves. In short, NMD is the art and science of finding a person’s optimum jaw position so that a harmonious relationship is created between the teeth, the muscles of the face and neck, and the jaw joints. The result is a neuromuscular bite.


Temporomandibular Joint Disorder (TMD)

Signs and symptoms of TMD resulting from a misaligned bite can include:

  • Headaches & migraines
  • Facial pain
  • Back, neck, & shoulder pain
  • Tinnitus (ringing in the ears)
  • Vertigo (dizziness)
  • Chipped & worn teeth
  • Sensitive teeth
  • Jaw & jaw joint pain
  • Limited jaw movement or locking jaw
  • Numbness of the fingers & arms
  • Clenching/bruxing
  • Postural problems
  • Pain behind the eyes
  • Pain in the occipital (back), temporal (side), frontal (front), or infra-orbital (below the eyes) portions of the head
  • A bite that feels uncomfortable, “off”, or as if it is continually changing

Treatment of TMD

If Dr. Phil Nasralla diagnoses you with TMD, he can use neuromuscular dentistry to correct your bite and determine the best course of treatment for your specific needs.


NMD uses computerized instruments to measure your jaw movements, muscle activity, and joint sounds, and to identify joint derangements. An ultra-low frequency Transcutaneous Electrical Nerve Stimulator (TENS) unit is used to relieve the symptoms and relax the lower jaw and its muscles in order to establish an ideal physiologic rest position (neuromuscular bite).


Once the ideal bite is determined it must be stabilized with a temporary plastic device worn over the teeth, known as an orthotic. The orthotic allows Dr. Nasralla to make adjustments to the plastic without adjusting the teeth until the bite is stabilized and symptom-free. This may take several months.


The next step is to permanently adjust the bite to the correct position so that one no longer needs to wear the plastic orthotic. This can be achieved through braces (orthodontics) and/or reshaping of the teeth (coronoplasty) or through bite reconstruction (rehabilitation).


Patients of neuromuscular dentistry experience a range of benefits from decreased or eliminated pain and discomfort to improved overall health and longer lasting dental restorations.


Contact us at 250-339-2252 for your neuromuscular assessment.


To become a new patient of Dr. Phil Nasralla please fill out our new patient dental questionnaire.

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