Drs S & N WADDELL Dental Practice

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Myofacial Pain

The muscles that we eat with are known as the muscles of mastication. They control the movement of our lower jaw in all three dimensions, left/right, up/down and forward/backward. The lower jaw itself is composed of two bones that fuse in the midline at our chin and each of these bones exists on all three axis.

 

Beyond this, each of our teeth lies on two curved planes that relate to the range of movements our jaws allow. This complex interaction of muscles, jaws and teeth provide a complex gearbox of variable position, slippage, reflex and power.

 

If this were not complex enough, this system operates in a top heavy, posturally controlled area that sits above our shoulders and is attached through a series of seven small cervical vertebrae to the flexible thoracic spine.... our head.

 

Our heads would not balance here naturally without all the rest of the musculo-skeletal system and the nervous system that controls it.

 

In anatomical terms we divide head and neck muscles into groups such as those already mentioned above, the muscles of facial expression, those of the tongue and throat, the major ones of trapezius and sternocleidomastoid, the spinal groups, superficial muscles and some smaller groups.

 

Anatomically separated but in reality functioning interactively as well.

 

It may come as a surprise to realise that the position of our lower jaw is affected by head posture.

 

Complex systems go wrong, compensations and overworking of incorrect muscle groups therefore occurs. Our self diagnostic circuits confuse us and the muscles that hurt us are felt at the wrong location.

 

Many years ago Janet Travell mapped these "trigger areas" so that pain felt behind the eye for instance could be correctly related to perhaps the lateral pterygoid muscle on the inside of the lower jaw. Once we know which muscle is really hurting we can look at why it has cramp and inflammation.

 

This initial correct diagnosis of pain moved this previous referred pain area from "pinning the tail on the donkey" to a proper diagnostic science.

 

Why are dentists involved. Well it goes back to the first two paragraphs above, it can be a discrepancy of tooth position or joint problem or even a missing tooth that forces a muscle to overwork and become painful and inflamed. Unlocking the complex gearbox can alleviate years of unexplained recurrent pain.

 

Some Practitioners link myofacial pain through its "aetiology of tooth interferences" into Bruxism. Cross-referencing in bruxism, the destruction and wearing away of tooth contrasted with in myofacial pain, the inflammation and damage to the compensating muscle.

Bruxism