Functional­ Diagnostics

Jaw pain, persistent headaches, tinnitus or a painful clicking when chewing – behind these multifaceted complaints there is often a CMD (Craniomandibular Dysfunction). This functional disorder of the masticatory system affects the interplay of the jaw joints, chewing muscles, teeth and the entire stomatognathic system. At our dental practice in Gelnhausen, we diagnose and treat CMD using modern methods and a consistently holistic therapeutic approach – so that you can live free of symptoms in the long term.

What is CMD (Craniomandibular Dysfunction)?

CMD (Craniomandibular Dysfunction) is an umbrella term for a group of diseases and functional disorders affecting the temporomandibular joint (TMJ), the chewing muscles and adjacent structures. The TMJ is one of the most complex joints in the human body – it is loaded thousands of times every day and is closely connected to the cervical spine, posture and the entire neuromuscular system. When this finely tuned interplay falls out of balance, complaints can arise that extend far beyond the jaw area and manifest seemingly independently at various locations throughout the body.

CMD frequently develops as a result of a malocclusion, Bruxism (teeth grinding), teeth clenching, one-sided loading or psychological stress. Chronic postural imbalances, accidents, orthodontic treatments or the loss of individual teeth can also trigger or promote CMD. Because the symptoms are often diffuse and radiate into various regions of the body, CMD is frequently identified late – and those affected often consult several specialists from different disciplines before receiving a conclusive diagnosis. Early dental functional diagnostics are therefore crucial.

Typical Symptoms – when the jaw affects the whole body

The clinical picture of CMD is extraordinarily varied. Complaints range from localised jaw pain to symptoms that at first glance appear to have nothing to do with the masticatory system. A characteristic feature is that many patients are referred from specialist to specialist over a long period of time – until the orofacial cause is finally recognised and treated specifically. The following symptoms may indicate CMD:

• Pain in the jaw joint, particularly when chewing, yawning or speaking
• Clicking, grinding or crunching in the jaw joint (TMJ sounds)
• Restricted or deviated mouth opening, occasional "locking" of the jaw
• Headaches and migraines, particularly in the temple and forehead area
• Earache, tinnitus (ringing in the ears) or persistent pressure sensation in the ear
• Neck pain, shoulder tension and shoulder-neck syndrome
• Back pain, particularly in the lumbar and thoracic spinal region
• Bruxism (teeth grinding) or teeth clenching – often unconsciously during sleep
• Tension headaches, dizziness and visual disturbances
• Muscle tension in the chewing muscles (masseter, temporalis)
• Pain when chewing hard or chewy foods
• Dental wear (abrasion) of the tooth hard tissues, sensitivity
• Difficulty swallowing and a feeling of tightness in the throat area

Our Diagnostics: Systematic Analysis of the Entire Masticatory System

A well-founded functional diagnosis forms the indispensable basis of every successful CMD therapy. At our practice, we carry out a systematic, multi-stage examination to identify the precise cause of your complaints. We combine proven clinical examination procedures with modern analytical methods to obtain a complete and accurate picture of the functional state of your masticatory system.

Within the framework of the clinical functional analysis, we examine the mobility of the jaw joints, systematically palpate the entire chewing musculature and assess the opening path, range of motion and joint sounds using a structured examination protocol. Where required, we supplement the diagnostics with instrumental methods such as computerised occlusal analysis (T-Scan) for precise evaluation of tooth contacts and occlusal relationships, as well as imaging procedures – from conventional radiography and Digital Volume Tomography (DVT/CBCT) through to MRI of the jaw joint, in order to accurately assess the condition of the articular disc and the bony joint components.

• Clinical functional analysis using a structured examination protocol (screening and extended functional analysis)
• Systematic palpation of all chewing and temporal muscles as well as the neck musculature
• Occlusal analysis – assessment of bite position, tooth contacts and guidance movements
• Computerised occlusal analysis (T-Scan) for objective contact measurement
• Diagnostic imaging (radiography, DVT/CBCT, MRI) where required for joint structure assessment
• Full-body postural analysis in cooperation with partner physiotherapists
• Detailed medical history, pain history and evaluation of pain diaries

Therapy: From the Occlusal Splint to Holistic Treatment

The treatment of CMD is strictly guided by the individual cause and severity of the complaints. As a rule, we begin with reversible, non-invasive therapy – the centrepiece of modern functional therapy: the individually fitted occlusal splint. Whether a Michigan splint for relaxing the chewing muscles and relieving the jaw joints, an anterior repositioning splint for disc displacement, or a Bruxism (teeth grinding) guard for protecting the tooth hard tissues – every splint is fabricated at our practice with the highest precision based on individual impressions, and is regularly checked and adjusted.

Beyond splint therapy, we work closely with physiotherapists and osteopaths who specialise in the jaw joint. Manual therapy, targeted muscle relaxation exercises, postural training and physiotherapeutic measures effectively complement the dental treatment. Where necessary, occlusal corrections through targeted selective grinding, orthodontic treatment or prosthetic restorations can permanently stabilise function and prevent relapse.

• Individual occlusal splint (Michigan splint) for muscle relaxation and joint relief
• Anterior repositioning splint for disc displacement with recapture
• Bruxism guard to protect against further loss of tooth hard tissue through Bruxism (teeth grinding)
• Physiotherapeutic support – mobilisation, muscle relaxation, postural training
• Biofeedback and cognitive behavioural strategies for stress-related Bruxism (teeth grinding)
• Occlusal selective grinding therapy for targeted bite optimisation
• Interdisciplinary collaboration with orthopaedics, ENT, neurology and psychosomatics
• Long-term aftercare with regular check-ups and therapy adjustments

Long-term Success and Prevention: Permanently Free of Symptoms

CMD can be successfully treated in the vast majority of cases – provided the diagnosis is correct and comprehensive and the therapy is carried out consistently. Once acute symptoms have subsided, regular aftercare is essential to prevent relapse and ensure the long-term success of treatment. We accompany our patients over the long term and adapt the therapy concept as needed to changed life circumstances, new dental restorations or orthodontic measures.

If you are suffering from one or more of the symptoms described, do not hesitate to contact us. The earlier CMD is identified and specifically treated, the simpler, faster and more sustainably the therapy leads to its goal – and the more complaints and secondary damage can be permanently avoided. Book an examination appointment at our dental practice in Gelnhausen today.

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