Be really grateful if you could answer a quick question. I'm currently researching dentists and one thing that's thrown me is references to centric relation. I am familiar with the philosophies behind the 2 schools - functional jaw orthopedics and NM dentistry but confused by the use of a term - centric relation. Is functional jaw orthopedics - which I know you and others are happy with, based on the principle of centric relation?
I spoke to a dentist on the phone yesterday who seemed to know his stuff, but when he mentioned his treatment was based on centric relations I was thrown. There are some references to it on this board, all of which I've read, but I still can't get a handle on it. I know what it is, but don't know if this means he practices functional jaw orthopedics or not. Is centric relation something to be wary of? Is it fine if a dentist bases their philosophy on this? Think if I could just understand this term I might have finally understood all the different possiblities open to me, as I would be very happy to see a dentist who practices functional jaw orthopedics.
[This message has been edited by hbep (edited 09-05-2003).]
I don't mean to hi-jack your thread but I had a question of my own that I think you can answer. Whats the difference between functional jaw orthopeadics and neuromuscular dentistry? From my basic understanding and the reaserch that i've done, functional jaw orthopeadics is mainly concerned with the mechanics of the jaw and the relationships of the bones, while the muscles are a secondary issue. Neuromuscular dentistry is primarly concerned with the balance and functions of the muscles and believes that if the muscles are relaxed and working correctly the TMJ's will assume their most comfortable and efficient position, as will the disc. Is this correct??
Just to update you on my current situation, i've put my maxillio-facial surgeon on hold while i get some second opinions. Iv'e got some information off patrick grossmann and stephen j. bray and hope to book a consultation with both of them in the near future. I'm just trying to save up the money first. Just yesterday i had an appointment with my regular dentist, who i have found belongs to the British Society of Occlusal Studies(BSOS). I told him all my symptoms and the whole story with the maxillio-facial surgeon and he agrees with me that an operation is only addressing the symptom and not the cause. Anyway it turns out that he does a splint therapy program all in for £600, which I thought quite resonable. so I decided to get the first splint in his program made. He calls it a de-programmer and it's made from accrilic(sp?) and only costs £45. It's just meant to relax my muscles and is compleatly reversible. If i see any changes i may continue the program, if not, then i will get consultations at the other two private practises, or i may just get them anyway.
all still very confusing at this time. I will let you know the results of my de-programmer.
My dentist also thinks that the bite raising appliance that coventry & warks hospital made for me could of been agrivating my problem by pushing my jaw backwards in my sleep!! I cant believe it sometimes, crazy!!
I really can't answer your question about centric relation. My research has been confusing as well. With the old centric relation, the dentist used what is called a chin point maneuver to find where the jaw should center in relation with the maxilla or upper jaw They would quickly push on the chin and maneuver it down and back. I don't know if this term centric relation has migrated to the Functional Jaw Orthodontics theory of finding the place where the jaw should center by getting the condyles in the exactly correct position in the fossa or not. My dentist doesn't use this term. The old chin point maneuver is now out of favor because both the FJO and neuromuscular dentists have found that the best position for the jaw is not back and up, but down and forward. Guess it depends on if your specialist is of the old school or the new school what his theory is. The name isn't as important as what the procedure is.
Thank you so much for your reply - very helpful. This was exactly the issue I'd become confused about, and you have finally clarified things for me. At least now I know where the confusion over the term lies - old or new school and can simply ask a dentist, if they refer to this, what they mean when they refer to centric relation. I guess, on further reflection, it means the same thing - the ideal position for the jaw - but where that position is believed to be, has changed with further study, advances etc... I clearly need to see someone who has kept up to date on the latest research.
Sounds like your understanding of NM dentistry and FJO dentistry is pretty much on the ball - if you see Gen Den's answer above, there is an excellent description of the aim of Functional jaw orthopedics and yes, NM dentistry tackles the muscles with the aim of achieving the same end - the correct position for the jaw.
Fantastic news about your own dentist - sounds very promising. I've also been looking at BSOS and rang someone else up in London who (I think) from what he said, practices functional jaw orthopedics. I don't know if you are also familiar with the Cranio Group, they also have lists of dentists who treat tmj in the UK. I am sorry, but not surprised to hear what your dentist said about the splint you'd received from the dental hospital. Unfortunately the dentist I spoke to explained that dental hosps in the UK will not move forward on newer types of tmj treatment until there is 100% proof - a number of controlled studies, that they work. I have been using an NTI splint (not from them, from another dentist) but waited to get the splint they made me. Within two days of wearing it I was considerably worse. The dentist I spoke to explained often the type of splint they gave me aggravates the problem further by making you clench harder on it. Anyway, needless to say I've thrown it on the cupboard, and am continuing with the NTI until i can save enough money to see someone who does FJO or NM dentistry. I have pretty much given up on the dental hospital.
Please do keep in touch and let me know how things develop. I will obviously also do the same. Should you see Stephen Bray or Patrick Grossman I would be extremely interested to know what you think. Also, should you be happy with the treatment from your dentist I'd be really interested to hear about that too. If he's good I may travel to see him. I am now in contact with someone else (not on this board) in the UK who is probably going to seek out a private dentist for tmj treatment. Hopefully btwn us we can exchange enough info to make some progress with this horrible condition.
Apologies if this post is rambling - so light headed today I'm having problems writing this.