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Frequently Asked Questions

Have Some Questions for Dr. Vicky?

How does TMJ cause the symptoms?

How does TMJ cause the symptoms?

How does TMJ cause the symptoms?

Hi, this is Dr. Vicki from Smile Design Studio. People always ask me, how does the TM joint cause pain like headaches, neck pain, ear problems. Well, basically, if you think about it, where the joint sits is actually related to where our teeth fit. So where our teeth fit, the joint and the muscles have to sit. Now as you know, our bites and our teeth and our smiles come out in all different shapes and styles and alignments. So basically, if your teeth are a little bit misaligned and not necessarily just within themselves. You might have a perfect set of teeth but if the teeth are not in perfect alignment with where the body needs to sit because where the teeth fit is where the joints have to sit. And that’s where we function. And that’s where the muscles have to sit. So if the teeth were sitting in a place where it was not in harmony perfect harmony with how the body needed to be aligned. We have no choice because we’ve got to function. We got to chew, we got to eat, we got to talk, from where our teeth fit. So, you know, our bites change over the years. We lose the first set of teeth. We grow. We get another set of teeth that sometimes comes out crooked, we get teeth taken out, we have braces. So there are so many changes that can happen to our bites. And what happens to our bites and where our teeth ultimately fit is where these have to sit and they have to adapt. And sometimes what happens is if say if we get teeth taken out and everything pulled back maybe the jaw is pulled back too far. And then it impinges on the ear canals and then it can cause blockages in the ear or ringing in the ears sometimes is too far back as well and causes neck tension. Or, worst case scenario if the bite was uneven where we’ve lost a tooth on one side. And it started to collapse on one side and we had a slight shift in the center of the jaw. So if the jaw joints were shifted this way, this way, or this way or this way it causes an uneven muscle tension across both sides of the head. And this can then cause a head tilt, which then can lead to neck pain on one side or both sides, and all the way down the spine. It can cause a curve in the back. Also what can happen is that if the teeth have been worn down and the body up too far, it can then cause a lot of muscle tension up in the temporal area and cause lots of headaches as well. So what we often look at all the different factors that may cause a difference in the change of the position of the jaw, which then leads to all these symptoms. And usually a set of symptoms will be related to a certain problem. So we can then look at the relationship and see how we can correct it long term rather than just giving drugs and treating the pain with palliative treatment of the symptoms only, we get down to the cause and we use Neuromuscular Dentistry to do this. So if you want to find out a little bit more. Have a look at our videos. But also feel free to give us a call and come in and have a chat.

Does Botox work to treat TMJ?

Does Botox work to treat TMJ?

Does Botox work to treat TMJ?

Hi, I’m Dr. Vicki from Smile Design Studio. A lot of my patients who suffer from pain ask me are Botox injections helpful for treatment of pain. And yes initially, if it is a muscle tension caused pain. Then Botox work extremely well, but only in the short term. Basically what Botox is; it is a botulism toxin and what it does it actually paralyzes the muscles temporarily, it reduces the activity, reduces the tension and therefore reducing pain and activity. So if say, that getting a lot of pain from clenching their jaws at night having facial muscle pains or if they’re getting temporal headaches you can actually put Botox into these areas and it will almost deaden the muscle down and actually calm everything down. So it’s a very quick, short term and effective immediate treatment. But if those muscles are extremely tense they’ll need a really high dose because these are big muscles, and they’re big movements. They’re not like wrinkle relaxers, you need a big dose. So it makes it rather expensive to do on a regular basis and ongoing. And also, I like to treat things very holistically and very naturally and long term use of it is not really been tested. So I am actually more on the side of trying to treat the cause and stopping the problem from coming up rather than symptomatic treatment, which Botox is ultimately. It needs to be repeated between three and six monthly and it becomes rather expensive. But is effective for real quick short term pain relief. So if you want to find out more about Botox or alternative treatments for pain, please give us a call.

How do we treat lockjaw?

How do we treat lockjaw?

How do we treat lockjaw?

Hi, I’m Dr. Vicki Ho from Smile Design Studio. I treat a lot of patients who come in to me because they have locked jaws. Now some people have jaws that are locked shut. So it means they can’t open fully and others come in because their jaws lock open. Now they are all related to the jaw joint not being in the correct position and therefore things don’t line up properly and it doesn’t work. Okay so if you imagine a jaw joint. It sits kind of like this. This is the joint and sits in a fascia and in between the joint and the fascia there is a piece of cartilage, which is a lubricating cartilage, which basically when you open the jaw. It doesn’t only just pivot like most joints just pivot. But this one not only pivots it also comes right out the joint and right back again. So basically, when you open really wide you’ll feel a little bump here. And that’s with the jaw coming right out and it goes over a little bump on the bone, and thats the movement. It translates. And it goes back. And when you go from side to side. The whole joint actually moves from side to side. So it’s a great capability to adapt and move. Now what makes the movement smooth is the movement of the ligaments and the cartilage that comes with it. Now if the cartilage is not in the right place. The disc, its a disc that sits in there. If it’s not in the right place. It can act as a doorstop. So for example, if the jaw joint was further back than ideal not in the center, but further back. What happens then the cartilage, which normally sits on top of it is now in front. So therefore, when you go to open, and when a jaw tries to translate, the cartilage now acts as a doorstop and it stops it from opening fully. So that’s why the jaw cannot open and it locks shut. Okay, now what happens when it locks open. This is when the jaw opens too far. Maybe the ligaments are too loose. It comes wide open. And it goes over. There’s a lump on the bone here and it gets stuck in front of it. So these are two different ways that jaws get locked. The most common lock is actually locking shut. But if you have a really big yawn sometimes the jaw joint can come in front of it. So what you can do immediately after that happens is just move your jaw from side to side to try and free It from where it’s trapped. Usually when you’re locked shut try to protrude the door or move it from side to side to see if it can capture the disc back into the right place that will allow the movement of the jaw to open. Now if you’re locked open, then tried in message and moved the jaw again, side to side, forward and back to see if you can unlock yourself from the bump in the bone. And so it just got caught and needs to go back. So message and give us a call if you have any problems.

How do we treat TMJ?

How do we treat TMJ?

How do we treat TMJ?

Hi, I’m Dr. Vicky Ho from Smile Design Studio. A lot of patients come to me for treatment of TMJ dysfunction. Now these patients have tried usually numerous different treatment modalities from chiropractic to physiotherapy to medications like Endone and Endep and they’ve been for brain scans and MRIs. And nobody can usually find out what is actually wrong with these people. So sometimes they get sent for psychiatric evaluation as well. And a lot of the time my clients have had long term chronic pain. So they’re actually very depressed. So there’s a lot of things that come into this. Now the problem is that a lot of the treatment that’s out there today actually just deals with the symptoms. You treat the symptoms and it’s an ongoing thing because you don’t get down to the root cause. So my interest in treatment of people was actually to treat the root cause. What is causing the TMJ to start with. Why are people in pain? You know do we just give them medication to block out the pain or do we get down to the root cause. So this is my goal. This is my mission and what we do is with Neuromuscular Dentistry we can get down to the root cause. We use a nerve and the muscles, we track the EMG’s we take. We track the jaw. We use a neurotransmitter to show us where the jaw needs to go and therefore where the teeth need to be to line the jaw up. So that everything lines up better. And we get rid of the pain. So that’s a very brief overview of what Neuromuscular Dentistry is. If you want to find out a little bit more, please give us a call, come and have a chat and we will see how we can help you.

Most common symptoms for TMJ

Most common symptoms for TMJ

Most common symptoms for TMJ

What are the most common symptoms of TMJ syndrome? Well, a lot of people complain about headaches and they may be in the temporal region or they may start from the base of the skull and come up over the head. It can also manifest as neck pain, which may be on one side or on both. And stiffness and lack of rotation of the neck. This can track all the way down the spine to the lower back, and the hips. So people often complain of lower back pain as well. Now, some people also experience ear congestion. This may be one or both ears. And usually it’s almost like a blockage or It could be just loss of hearing as well. And some people then associated with that, they have vertigo or dizziness. Some people also experience pain behind the eyes. Some people have clenching, grinding, muscular pain and clicking in the jaws. Now you may not have all of these symptoms. You may have a variety of some of them but a lot of these are related to the jaw joint being in the wrong place. And that’s causing uneven muscle tension and impingement of some nerves. So if you would like to hear and learn more about TMJ syndrome and if you think that you might suffer from it. Please give us a call.

The basis of Gneuromuscular dentistry

The basis of Gneuromuscular dentistry

The basis of Gneuromuscular dentistry

GNM Dentistry – Neuromuscular Dentistry plus Gnathology where the nerves and the muscles help us find the ideal position of the jaw and the TMJ that is ideal for the muscles and the nerves rather than where the teeth fit. We use a tans or an ultra low frequency neurotransmitter to cause involuntary contraction in the muscles of the head and neck, the involuntary twitch of the jaw is plotted by a computerized mandibular scanner so that we can see the actual trajectory of the muscles contractions. We compared this trajectory to the ones caused by the habitual bite. And often we find that this is on a completely different pathway. We then construct a orthotic for the patient to wear in the trajectory of the muscle contractions. And this would align the jaw to where the muscles and joints physiologically want to be rather than being dictated by an occlusion or a bite that is not in harmony with the body. When the muscles and the joints are aligned to where they actually want to be all pain and parafunction reduces dramatically. We also find that not only does the pain go. But muscle strength and output improves across all areas of the body. We find that most patients in the corrected bite who had symptoms like headaches, neck stiffness and soreness, shoulder pain, vertigo, blocked ears grinding and crunching symptoms are all improved and reduced.

What is Neuromuscular Dentistry?

What is Neuromuscular Dentistry?

What is Neuromuscular Dentistry?

Hi, Im Dr. Vicky Ho from Smile Design Studio. I often get asked what is Neuromuscular Dentistry? Well as you know dentistry deals with teeth and gums. Okay and Neuromuscular Dentistry deals with not only teeth and gums but also the nerves and the muscles of the head and neck region. That are really in close relationship with the teeth. How this is so. Basically where our teeth fit. Is our bite and where our bite is will determine where our joint sit and where our muscles sit. So, if they’re in the wrong place it can then cause haywire with our joints and our muscles that then lead to a whole range of symptoms called TMJ dysfunction. So what we do as Neuromuscular Dentist, we actually look at the relationship between the teeth, the nerves and the muscles. And we get them in sync with each other and how we do this? Let me show you. When the muscles, nerves, and teeth are not in harmony with each other. The bite causes the jaw joints and the muscles to sit in a position where the muscles are not at rest or under tension. And we can see the effects of this when we take EMGs of the muscles. Here we have a scan of a girl who suffers headaches every day. As you can see, the most active muscles are her head muscles the LTA and the RTA which stand for temporalis. We use a neurotransmitter or TENS to rejuvenate the muscles and then take a scan again after one hour in this second scan you can see that the muscles are a lot calmer and less agitated. In this third scan, you can see the difference in the muscles of the head where her jaw is at rest versus the second half where her teeth come together mainly the jaw position causes her temporalis to fire thus causing headaches when she clenched her teeth in her sleep all night. We used a neurotransmitter not only to rejuvenate the fatigue or tense muscles, but also to determine the new bite by its gentle physiologic involuntary contraction of the muscles that guide the jaw to the ideal pathway, we’ve plot this position using a jaw tracker as seen on this graph, the natural contraction of the muscles are caused by the neurotransmitter where the big movements are caused by the teeth tapping together. As you can see on scan the pathways are totally different where the jaw and the muscles want to be and where the teeth fit are on different pathways. When we take a bite using this tense guided pathway the position of the jaw is then held with an orthotic and the body does not have to fight anymore. And can relax and start to decrease the pain and tension. This is a brief summary of what Neuromuscular Dentistry is.

What is the Difference between an Occlusal splint and a Neuromuscular Orthotic?

What is the Difference between an Occlusal splint and a Neuromuscular Orthotic?

What is the Difference between an Occlusal splint and a Neuromuscular Orthotic?

I often get asked what is the difference between a normal occlusal splint and a neuromuscular orthotic. Well, there’s a world of difference really. Physically they look like two pieces of plastic that sit in the mouth. But functionally they work completely differently. The occlusal splint is normally taken with two impressions and it probably takes about 10 minutes of chair time to take the impressions. And what they do, they use the patient’s original bite and we basically open the bite up by two millimeters and construct the occlusal splint in between with a two millimeter flat splint. So that the jaw literally is just held apart by this piece of plastic and the teeth will grind on the plastic. But they will not grind on each other and therefore, it produces some protection for the teeth. What we find with a normal occlusal splint is that people still probably grind and they grind through it. And so it offers good protection for the jaw that it’s sitting on, but not so good for the opposite jaw. It can reduce the grinding a little bit. But more so it actually reduces the wear on the teeth. It doesn’t really stop the person grinding and it does not remove any symptoms that may be associated with it. Now the neuromuscular orthotic is different because what the neuromuscular orthotic is made from is basically using a neurotransmitter to find out exactly what the natural contraction of the jaw muscles are. And as a result, we actually then use the neurotransmitter to take the bite for the new orthotic. And what this does it positions the jaw in exactly the place where the muscles want to be in their natural physiological state rather than where the teeth fit as such. So we take a recording according to what the muscles want to do. And we make an orthotic and the orthotic is not flat like like the general occlusal splint. It actually has teeth shapes and it completely positions the jaw in a different location. So that ultimately posture the jaw in where the body wants to be rather than where the teeth actually fit right now. And when people are in that position. They tend to have all the muscle pain and the tension in the neck and the head reduced. And also, it produces a very definite bite for the jaw to rest. And it generally will stop the grinding. So that’s the difference between the two. One takes about 20 minutes, no, 10 minutes to construct the occlusal split and the other one is probably around between five hours of work minimum. So there’s two different processes completely different product, but completely different results as well.

What is TMJ?

What is TMJ?

What is TMJ?

Hi, this is Dr. Vicki from Smile Design Studio. Patients often ask me, what is TMJ? Well TMJ is the short form for temporomandibular joint. And this is the jaw joint. This is the only joint in our body that’s on both sides of our body. And it has a great capacity to adapt, because it can not only pivot on its joint, but it can actually also come right out. When you open really wide and you feel it, the jaw joint actually comes right out of joint and it goes back in. It can also move from side to side. So it allows the jaw to move this way and that way. So that’s why this jaw joint actually is a very, very adaptable joint. And it’s quite flexible. However, what tends to happen is that because it’s on both sides of the head. If the jaw joint is out of alignment say, for example, one side higher than the other because the bite’s cantered or if the jaw joints being pushed back a bit too far, because the bite has got a retrusive fit to it and it causes a jaw to go back. It can actually impinge on other tissues. It can also cause an imbalance in the muscles of the head and neck region. So if there’s an imbalance in the muscle tension on both sides of the head. It can cause the head to go off center. And this then causes a whole range of muscle problems, which they call TMJ dysfunction. And this includes headaches, neck pain, clenching and grinding, jaw clicking, jaw pain, muscular pain and pain behind the eyes. There’s quite a lot of symptoms that are related to tm joint. So if you want to know more about TMJ dysfunction, please give us a call and come in for a consult.

Why do jaws click or lock?

Why do jaws click or lock?

Why do jaws click or lock?

Hi, Im Dr. Vicky from Smile Design Studio. Patients always ask me, why do my jaws click or pop? And why do they lock sometimes? Well, the jaw joint is a very complex system. And it’s a very unique joint in that it doesn’t just stay in the joint. It actually comes right out of the joint in order for the jaw to move. So this joint not only rotates on its pivot but it actually comes right out and back in. And it can actually go from side to side. So when you open really wide the jaw joint comes right out of the joint. And when you go from side to side it actually pivots there and all along with these movements, there’s a piece of cartilage that sits right in between the joint and the fascia and this cartilage is like a little cushion and it’s a lubricating cushion that comes with it. And completely smooths the whole motion. So that allows us to chew, talk and function properly. Now what happens is sometimes when teeth are worn down. Okay, when we grind out teeth. The teeth are worn down and we bite up further than where we used to with shorter teeth. So as we bite up further, here the jaw, of course, as it rotates up it rotates back as well. And now it puts more pressure on the back wall of the joint. And what happens then some people then get ear problems. They get ear blockages or tinnitus and it can also lead to neck pain. But what happens then when it’s actually banked up against the back wall the cartilage that was in the center of it is no longer in the center. More at the front. So when it’s at the front. It then blocks the smooth opening of the jaw because it’s almost acting like a doorstop. So the jaw has to click back onto this cartilage, which is that popping or clicking sound. And then after that it can freely move again. So this is usually caused by the jaw joints sitting in the wrong place and it’s not aligned with the disk. That’s within the jaw. Okay And this is then related to where the teeth fit, which causes the jaw to sit further back. So it might be in people who have really retruded teeth. It might be in some people who have had braces and had 4 teeth taken out. Everything is pulled back and then therefore, the whole jaw joint is sitting further back or could be also in people who have ground their teeth down. And now they’re biting further up and therefore rotating the jaw backwards. So these are the reasons why jaws click. Now if you’d like to find out how we treat that please give us a call.

Why Do People Suffer From TMJ?

Why Do People Suffer From TMJ?

Why Do People Suffer From TMJ?

Hi, this is Dr. Vicki from Smile Design Studio. People often ask me, why do people suffer from TMJ? Well, basically the TM joints are controlled by the bite in a way. If you have a look where our bite fits, is where those muscles have to sit and where those muscles sit the jaw joints have to sit as well. Now if the teeth of the bite was offset, for example, if the bite was a little bit crooked and it then was rotated, and the jaw was slightly rotated one way because the teeth fit that way, then what it would do it would cause an uneven muscle tension between this side and this side. As a jaw joints rotate around or say if the teeth were not level horizontally and they were on a cant and you noticed some people have crooked smiles. They have a cant. It would also cause an uneven muscle tension on both sides. What this then results in is the muscles have to work one side more than the other to keep the body upright or what also happens is when you’ve got an uneven muscle tension on both sides of the head. It causes the head to tilt and when the head tilts then we compensate by tilting our shoulders the other way to keep us upright. As a result, it curves. The whole spine and it can cause symptoms all the way down the back. So a lot of people who have TMJ in the wrong place caused by a bad bite will also then have scoliosis of the neck and neck problems. And then they can suffer headaches as well. Now if the jaw joints are too far back i.e. if the bite is more retrusive and it makes the jaw sit further back than it really wants to. It puts pressure on the ears. So it can then cause ear symptoms and vertigo as well. So these are the reasons why a bite can then cause not so much joint problems sometimes it causes clicking but then all of the symptoms that are associated with TMJ syndrome. And that’s why when we look at helping people with long term, who suffer from headaches neck pain, ear problems, vertigo you would often have to look at the position of the jaw as well. So this is what we do with neuromuscular dentistry. If you would like to learn more about neuromuscular dentistry and how we can help you. Please give us a call.

Why Do People Grind Their Teeth?

Why Do People Grind Their Teeth?

Why Do People Grind Their Teeth?

A lot of my patients grind their teeth at night. Now, they ask why you know I can’t control it? I’m asleep and I don’t even know I’m grinding. But sure sometimes they wake up with pain in their jaws, pain in their teeth and it can cause a lot of sensitivity in teeth. It can also cause notching by the gum line. And also, of course wear on the teeth to make them shorter and shorter. Now, why do people grind their teeth at night? Well, as you know at night when the body sleeps, rests and recuperates that’s when all the healing occurs. And that’s when the body, the subconscious moves in and it starts taking over the healing of the body. Now if the jaw joint or the teeth are actually forcing the jaws to sit in the wrong place. The body intuitively knows this. And while she’s sleeping it tries to get the jaw in the right alignment i.e. get rid of the teeth that makes them sit in the wrong place and grind them away. So that’s what happens and that’s why people grind their teeth at night. Now some people also find they clench you know unconsciously during the day because basically there’s so much tension built up and the body knows instinctively that perhaps the jaw joints and the muscles are sitting in the wrong place and the teeth are what’s controlling that. So the body wants to try and get rid of that. So what is in effect happening is a muscle – tooth war. Okay and the clenching and grinding is a response to that. And how do we stop it? Well, there are lots of different ways. So tune in and we’ll talk about that next.