The successful diagnosis and treatment of temporomandibular joint disorders (TMJ or TMD) is a challenge. However, in many cases, we can overcome this challenge using scientific tools to assess the state of your jaw system, including the motion of your jaw, the function of the joint, and the activity of the muscles. The latter is particularly important, because most pain related to TMJ is muscle pain. By assessing the state of your muscles, we can determine an optimal relaxed position for your jaw and design an orthotic (bite splint) to hold your jaw in that position.
Now researchers have developed a system to expand that jaw muscle monitoring beyond our office, making it something you can do on your own using your smartphone. Their preliminary system shows great promise, and could offer many benefits for the future.
Testing Wireless Monitoring
In this small, prospective study, researchers wanted to see if they could develop a wireless electromyography (muscle tension measurement, EMG) device that worked as well as wired versions. The wireless EMG have three lobes, are about an inch by an inch-and-a-half in diameter, and weigh about as much as a quarter. They can stick to the skin to be worn throughout the day.
To determine whether the wireless EMG worked as well as wired devices, researchers had 12 test subjects perform a number of jaw muscle tasks while wearing both the wireless and wired devices. They found that, for the most part, the two measurements agreed and worked equally well. However, for some light muscle activity, such as smiling and delicate tooth contact, the wireless device didn’t work as well as the wired device.
They determined that this was a promising start for the prototype, but it would need further refinement before it was ready.
Benefits of Wireless Monitoring
In addition to the lab tests, researchers had volunteers wear the wireless EMG for eight hours while going about their daily tasks. The devices were well-tolerated and seemed to provide good data. While none of the volunteers had TMJ (this was required for inclusion), the EMGs did pick up some worrying data on some of the subjects, possibly indicating early signs of a future problem.
This is probably one of the most promising benefits of wireless daily monitoring: better screening and diagnosis of TMJ. People who suspect TMJ might be instructed by their doctors to wear the device. They could then learn whether they had TMJ, bruxism (teeth clenching and grinding), or other conditions related to jaw muscle tension. It would be particularly useful in detecting sleep bruxism (assuming that it could be worn overnight).
But the wireless EMGs could also help us get a better understanding of TMJ. With more data from around-the-clock wear, we could get a better idea about what causes TMJ, how it develops, and how to improve treatment.
Speaking of improved TMJ treatment, one successful treatment for TMJ that is currently hard to implement is biofeedback. Biofeedback is when someone exercises conscious control over their body to reverse unconscious effects. With an easy-to-wear EMG, people would be better able to practice biofeedback to counter their jaw tension throughout the day.
Another benefit would be better design and function of oral splints. By monitoring daily activity, we could get a better idea of exactly how to design the best splint for you. Then we’d also be able to monitor its effectiveness, and potentially refine the design and fit to perfection.
And, the monitor could help us decide when and how to step down your splint wear. Most people start wearing out the splint 24 hours a day, but gradually transition to wearing it just at night. The EMG could help us transition more smoothly by showing how your muscles responded to longer and longer periods without the bite splint. Then we could know when was the best timing to use the splint less so you could avoid the potential return of symptoms.
The Latest in TMJ Treatment
Although this new phase in TMJ monitoring isn’t ready yet, you can trust that when it is ready, we will evaluate its actual effectiveness and usefulness. If it seems like a true benefit to our patients, we will incorporate it into our practice.
At the River Edge Dental Center for TMJ, Sleep Apnea, & Reconstructive Dentistry, we are committed to deploying the most recent technologies in TMJ treatment. We are constantly monitoring the newest technology and incorporating beneficial ones into our practice.
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