What is CMD?

“CMD” is an acronym for craniomandibular dysfunction. This describes a disorder of the interaction between upper and lower jaw, masticatory muscles and jaw joints and also often the entire statics of our spine.
Through muscles and nerves, our masticatory system is intensely connected to other parts of the spinal column and locomotory apparatus.
All parts of the spinal column and locomotory system influence each other and can cause functional disorders.

What are the symptoms of CMD?

  • Sensitive teeth and dental necks
  • Pain in the facial and masticatory muscles
  • Grinding and pressing of teeth
  • Pain in the jaw joint
  • Premature tooth wear
  • Breaking out of tooth fragments
  • Cracking sounds in the jaw joints
  • Constrictions in the mouth

Outside the chewing organ, the following symptoms may be an indication of CMD:

  • Hip and knee pain
  • Headache, migraine
  • Neck pain
  • Ringing in the ears (tinnitus)
  • Backache
  • Shoulder pain
Dizziness
  • Vision disorders
  • Mood swings
Insomnia

How does CMD arise?

In ideal conditions, our teeth are meant to fit together evenly, similar to cogwheels. Masticatory muscles, joints and teeth are in harmony in an optimum state. A number of afflictions can come up if disruptions occur within this system, as the entire harmony of the body statics gets out of sync.

Craniomandibular dysfunctions (CMD) can be asymptomatic for years as the joints, muscles, ligaments and tendons can compensate for improper mechanical strain. Suddenly symptoms arise, often together with other stresses and strains, such as professional or family difficulties, another dental treatment, illnesses or overburdening of the tissue.
In the case of malocclusion, perpendicular weight is not placed evenly on the teeth anymore. The masticatory force is distributed unevenly and leads to disharmony, leading to the above-mentioned consequences.
At the outset, it’s often fillings, crowns or bridges that are not set precisely, which leads to vertical weight not being placed evenly on the teeth. Further reasons for abnormal occlusion (i.e. “an incorrect bite”) can be misaligned or missing teeth.
A deep overbite leads to a forward bent head and changes the position of the cervical spine. Other risks of a CMD include an asymmetric body posture, e.g. at work in front of the computer, which also adds strain to the jaw joint.
The positions of both temporomandibular joints correlate very strongly with the position of the pelvis. Thus a head joint blockage can lead to blockages in the pelvic area and provoke an (apparent) leg length difference. Impairments such as the shoulder-arm syndrome or sciatic and knee problems are also often associated with dysfunction of the masticatory system – with CMD.
As to the cause, psychological factors can also play a part, as chronic psychological stress increases the activity of the chewing and head muscles. When consciousness is switched off at night, the stress of the day is processed via the permanently active mastication muscles with your teeth. This leads to grinding of the teeth.

Adequate treatment for CMD?

Acute causes of a CMD, such as too high crowns or fillings and slanted teeth, are removed by correcting/grinding off the tooth surfaces. The protheses are also checked for signs of wear and tear, as poorly fitting implants often trigger a CMD. Minor corrections are sufficient in most cases; only rarely must the tooth replacement be completely renewed.
A biodynamic functional brace made out of plastic helps to recreate normal occlusion. It is removable and is worn at nights – with it, even pressure on the jaw muscles is provided. As the jaw muscles are interconnected with your neck muscles, and they in turn are attached to the muscles at the back, the brace also affects the body statics. Only if the brace has a positive effect on the body statics will the symptoms improve or even disappear completely.
Typically, a brace is used approximately three months to give the structures of the joint and the muscles the chance to assimilate. Malpositions have usually existed for a long time and require a careful, partially incremental adaption.

The importance of early treatment cannot be overstated. CMD and temporomaxillary joint disorders develop in stages and become increasingly worse. A small problem can thus become the source of constant pain.

CMD therapy

The clinical picture of CMD is very complex – for this reason the therapy runs depending on the symptoms in cooperation with dentists, orthopaedists, psychologists, specialist doctors, physiotherapists, osteopaths.