CMD specialists & information on craniomandibular dysfunction

Leading Medicine Guide Editors
Author
Leading Medicine Guide Editors

Craniomandibular dysfunction (CMD) is a collective term for malfunctions in the interaction between the skull (cranium) and lower jaw (mandible). The dysregulations can be structural, functional, biochemical or psychological in nature.

Around eight percent of people in Germany are affected by craniomandibular dysfunction.

ICD codes for this diseases: K07.6

Recommended specialists

Article overview

Craniomandibular dysfunction is widespread and yet hardly known. Not all sufferers need treatment, but for some the quality of life is severely impaired by the symptoms.

The most common type of craniomandibular dysfunction is a malocclusion, where the upper and lower jaws do not fit together properly. This leads to disorders in the masticatory system and can have unpleasant effects on the entire body.

The causes of craniomandibular dysfunction

Craniomandibular dysfunction is described as a multifactorial disorder. This means that several factors are involved in the development of the dysfunction. The most common cause is misaligned teeth (for example a malocclusion). When the upper and lower jaws do not mesh properly, doctors call this condition malocclusion. Misaligned teeth can be genetic, but can also be caused by gaps between teeth or fillings or crowns that are too high or too low. Malocclusions can also develop after orthodontic treatment. The surrounding muscles, such as the head and facial muscles, react to the strain on the temporomandibular joints with strong tension in order to compensate for the misalignment of the jaw. If this compensation is not successful, it can lead to permanent muscle tension in the body's musculoskeletal system.

Another common cause of craniomandibular dysfunction is teeth grinding (also known as bruxism), which mainly occurs at night. Permanent teeth grinding that goes beyond the normal level leads to severe wear and tear on the teeth and, in the worst case, to a shortened set of teeth. Constant stress and mental tension can also promote craniomandibular dysfunction. Stress can lead to constant tension in the jaw area.

Other risk factors for this type of disorder are

  • traumatic changes to the temporomandibular joints or cervical spine
  • Heavy fingernail biting and chewing gum
  • Operations in the head and neck area
  • Poor posture and bad sitting posture
  • Inflammation of the joints

Symptoms that indicate craniomandibular dysfunction

The symptoms of craniomandibular dysfunction are extremely varied and non-specific. It therefore often remains undetected or is only discovered after a long period of time. If several symptoms occur at the same time, you should have yourself examined for craniomandibular dysfunction.

The following symptoms are characteristic of this:

  • Headaches
  • sleep disorders
  • earache
  • tinnitus
  • Jaw and tooth pain
  • Difficulty swallowing
  • facial pain
  • dizziness
  • Visual disturbances and/or sensitivity to light
  • Neck pain
  • Back pain
  • Numbness in the limbs

However, various other symptoms can occur that are not usually associated with craniomandibular dysfunction. These include, for example, nausea, tingling in the fingers, loss of appetite, mood swings or depressive moods.

Correctly diagnosing craniomandibular dysfunction

Early diagnosis of the disorder is important, as progressive strain on the temporomandibular joints worsens the chances of recovery. Craniomandibular dysfunction is usually diagnosed by a dentist.

Zahnfehlstellung Angle-Klasse III.jpg
By Dr. Georg Risse from the German Wikipedia, CC BY-SA 3.0, Link

A so-called functional analysis or functional diagnostics is available for the diagnosis. In the first step of the clinical functional analysis, the dentist takes a thorough medical history. The patient's medical history provides information about the symptoms and possible genetic predispositions. The medical history is followed by palpation of the temporomandibular joints and masticatory muscles to detect tension, deviations in movement or noises. To detect a malocclusion, the patient must bite on a colored foil. If the impression shows changes, an instrumental functional analysis follows. A bite registration is used to determine the positional relationship between the upper and lower jaw. A bite registration is a soft plate (made of wax or plastic) that the patient bites down on. The position of the jaw in relation to the skull is measured using a facebow. The data obtained is used to produce a plaster model that imitates the patient's chewing movements with the help of an articulator. The articulator not only simulates the chewing movements, but also various treatments so that the dentist can select the therapy with the best results.

The treatment options for craniomandibular dysfunction

The treatment of craniomandibular dysfunction depends on the cause of the condition and requires a holistic approach. As a rule, several specialists work together on the treatment. The dentist corrects misaligned teeth by prescribing a bite splint. The plastic bite splint relieves the discomfort within a short time and helps to move the jaw into the correct position. Depending on the severity of the symptoms, the splint is only worn at night or around the clock. For patients who do not wish to wear a bite splint, various procedures can be used to permanently correct the bite position. Chewing surfaces can be reground or built up using ceramic onlays, crowns or implants.

Knirscherschiene

Orthodontic measures can also be considered for the permanent correction of misaligned teeth. Physiotherapists, orthopaedists and osteopaths are involved in the treatment of incorrect posture or muscle and joint disorders.

If depressive moods or other psychological problems play a role in craniomandibular dysfunction, additional treatment by a psychologist is advisable.

Stress should be reduced through suitable relaxation measures such as sport, autogenic training or muscle relaxation.

These different therapeutic approaches can be used in addition to each other if necessary.

 

You can find CMD specialists here

The first point of contact for pain and complaints in the jaw area is often a dentist or orthodontist. They can usually carry out functional diagnostics and take a medical history to identify CMD. However, not every doctor is familiar with the condition and it is not always recognized due to its diverse symptoms. It is therefore best to consult a doctor who is a member of the CMD umbrella organization and is therefore always up to date. If symptoms also occur in the shoulders, neck or hips, it is also advisable to consult an orthopaedist to confirm or reject the connection with CMD.

Whatsapp Facebook Instagram YouTube E-Mail Print