The protocol for assessment of the condition is typically done in several stages: *A physical examination with head health, headache, pharmacological and complete medical histories. Additionally, dental, periodontal, occlusal, orthodontic, and airway examinations are encouraged as part of the initial screening process. *Next, a panoramic radiograph (also called a curved surface tomograph) is used to identify or confirm dental conditions which may contribute to painful DMSD symptoms. Computed tomography (CT scans) can also be utilized at this point for further aid in assessment and treatment planning. *Muscle palpation is used to evaluate where the individual is experiencing trigger points. These are areas of high sensitivity in the facial, head, and neck muscles. When these areas are pressed, it causes pain either in that muscle (localized pain), or in another area (referred pain). A muscle palpation examination is performed to aid in the discovery of “latent trigger points”, or trigger points which cause no pain unless direct pressure is applied. Digital portion Tekscan's T-Scan This tool is used for digital force analysis to measure the presence and amount of imbalance at closing of the mouth, during closure, and during mastication (chewing). The computer displays the results of how the forces in the mouth spread along the arch, the center of force, the center of force trajectory, and the left/right force balance. This means the dentist can show patients which teeth are generating the most force, and facilitates the dentist’s knowledge of what adjustments need to be made to teeth and soft tissue to create a stable dental foundation. Range-of-motion (ROM) assessment This test digitally measures an individual’s cervical range of motion from a standing position and displays the results in terms of flexion and extension, left and right lateral flexion, and left and right rotation. Limited cervical range of motion is a disability, and being able to understand what is normal—and where their own mouth, head and neck are during the examination—helps people see how this disability is affecting their condition. This is also when the amount a person can open their mouth is measured. Along with normal opening movement, the jaw should slide symmetrically from left to right at least 25% of the total mouth opening distance. Finally, during the range of motion assessment, a record of jaw joint vibrations and sounds are made. Normal jaw joints glide without noise or vibrations. Depending on the assessment findings, patients are classified as needing 1 of 4 levels of care (see Table 1: Levels of Dental Headache Care) to treat and manage their pain and balance their dental foundation. Every level has a regimented therapy protocol designed to provide the most effective, long-lasting care for each individual. Once the type of headache pain and extent of dental foundation imbalance is determined, treatment options are discussed. Historically, the treatments for headache pain included one or a combination of herbal remedies, stress-reduction exercises, massage, acupuncture, non-steroidal anti-inflammatory drugs (NSAID), narcotic pain relievers, anti-seizure medications, chiropractic adjustments, anti-depressants or sedatives. The combination of advanced dentistry techniques and sports rehabilitation-derived therapies used in treating dental force imbalances in dental headache care has resulted in a dentist reported 93% success rate in providing patients with real, lasting relief from their DMSD symptoms. The methods used control muscle force and force balance, restore proper function and range of motion, and change the way the brain perceives stimuli, so pain levels,<unk> , and improper muscle activity return to normal. By balancing the muscles, joints, and teeth, and controlling the way the body feels pain in the head and neck areas, long lasting pain relief can be achieved. Once the individual has had the proper dental adjustments to restore normalcy to the dental foundation, and has been prescribed and fitted for their at-home orthotic (worn in the mouth for the short term, typically only during the 4- to 12-week rehabilitation period) for muscle re-training, the sports rehabilitation-derived components of therapy begin.
Dentomandibular sensorimotor dysfunction
Temporomandibular joint dysfunction
Velopharyngeal inadequacy
Oropharyngeal dysphagia
Orofacial myofunctional disorders
Somatosensory disorder
Velopharyngeal insufficiency
Pressure of speech