Sleep Apnea , TMJ Disorders and Basic Concepts of Dentistry Challenged in Sleep and Health Journal

Dec. 12, 2009 - PRLog -- Treatment of sleep apnea is rapidly becoming a major part of dentistry.  It is also making many dentists question some of the basic tenets in dentistry.  Many dentists base setting a patients bite on a concept called Centric Relation.  Centric relation is an old concept that has changed many times over the years. The story in Sleep and Health Journal (http://www.sleepandhealth.com/node/512)  exposes many of these concerns.

Wikipedia defines Centric Relation as "In dentistry, centric relation is the mandibular jaw position in which the head of the condyle is situated as far superior and anterior as it possibly can within the mandibular fossa."  It is very unlikely that most dentists would agree with that definition.    Wikipedia also discusses Centric Relation as where the condyle of the jaw is palced by the dentist in edentulous patients.  The concept of CR was initially established for treating patients without teeth.  The original concepts of TMJ disorders were also formulated in edentulous patients by Dr Costen an Otolaryngologist (ENT Physician) not a dentist.  Wikipedia states   "This position is used when restoring edentulous patients with removable or either implant-supported hybrid or fixed prostheses. Because the dentist wants to be able to reproducibly relate the patient's maxilla and mandible, but the patient does not have teeth with which to establish his or her own vertical dimension of occlusion, another method has been devised to achieve this goal. The condyle can only be in the same place as it was the last time it was positioned by the dentist if it is consistently moved to the most superior and anterior position within the fossa."  

The term Centric Relation (and the position of the jaw it describes) has changed continually over the years with over 28 different definitions.  It is still taught in dental schools for finding where to set the bite.  The entire concept of using Centric Relation to determine the bite is challenged in the Sleep and Health article.

Neuromuscular Dentistry  (http://www.sleepandhealth.com/neuromuscular-dentistry) is a rapidly replacing the concepts of centric relation though it is still considered controversial by many dentists and is certainly not universally accepted.  The advent of Dental Sleep Medicine for treating sleep apnea (http://www.ihatecpap.com) has already created problems for the concept of Centric Relation because the CR position does not maintain  the airway in patients with sleep apnea.

Neuromuscular Dentistry has also hit the news because of the PPM mouthguards used by the undefeated New Orleans Saints who credit these high tech neuromuscular dental appliances with their success.

A new website http://www.ihateheadaches.org explores how Neuromuscular Dentistry will change the practice of medicine when treating many migraine and tension-type headache patients.

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Slep and Health Journal presents topics on all aspects of health especially sleep health. information on sleep apnea, sleep apnea treatment and cpap alternatives are available at www.ihatecpap.com This is the premiere site for the promotion of Dental Sleep Medicine and Sleep Apnea Dentists.