Treating Headaches & TMD with Disclusion Time Reduction (DTR)

According to the National Institutes of Health (NIH), more than 10 million Americans suffer from Temporomandibular Joint Disfunction (TMD). They define TMD as “a group of conditions that cause pain and dysfunction in the jaw joint and the muscles that control jaw movement.” TMD symptoms include pain, muscle tension, headaches, limited movement, joint noises, arthritis, and anatomical changes, and can affect swallowing, speech and cause referred pain in other muscles of the upper body.  To diagnose TMD, we look at the status of the head and upper spine: bones, muscles, joints and teeth.

Headaches and TMD

Many people suffer from wear and tear and damage to the system. For some, it is severe … like heavy tooth grinders, trauma … things that result in severe breakdown to the bones/joints/teeth. Most of the time, people find a way that works for them to cope and manage their symptoms, using medication, and frequently, with a dental solution that works OK.

But most people that have been told that they have TMD don’t have any structural damage. Their symptoms are primarily headaches, face muscle tiredness/ache, jaw pain and/or tooth sensitivity. Sometimes their jaw pops, clicks, locks, or feels weird, or occasionally they grind their teeth. For some people, it is not a big deal, but others take a lot of medication. Some won’t sleep without their bite splint.

Depending on their level of symptoms, people look for solutions: massage therapy, chiropractic care, stretching, low level laser therapy, medication, plastic bite splints, or just avoiding certain foods.

Current research evidence has shown that the way teeth fit together, and how they work during chewing, affects the underlying muscles and bones. Changing the shape and fit of the teeth has a big effect in the supporting muscles. New dental work, heavy tooth wear, orthodontics, teeth shifting or removal will change the way the teeth fit and can make the symptoms worse. Sometimes 1 filling can throw off the balance. Orthodontists usually do a good job of getting the teeth looking straighter but they don’t assess how they work.  Most of the people who seek our care had braces in their youth.

We use computer-based measurement systems (T-Scan, JVA, BioEMG) to assist diagnosis and treatment for our patients. We check the health of the Temporomandibular Joint (TMJ). We look at the muscles to see if they are carrying muscle tension. And we look at the teeth to see how they fit together during biting and chewing. If indicated, we may take x-rays or other imaging. We have to be concerned about other medical conditions that can cause similar symptoms.

A majority of the time, people have minimal or no underlying structural damage. We usually find that the TM Joints are mostly healthy, the muscles are tight but the teeth do not fit properly. The good news is that for these people, using these technologies together, dentists have developed a treatment with very favorable outcomes.  Disclusion Time Reduction (DTR) is a precise system to accurately balance the way the teeth work while monitoring muscle physiology, to reduce muscle tension and get people feeling better.  When people do have moderate to severe breakdown, we use traditional techniques but add the DTR finishing procedures to create better balance which helps people feel better and may reduce continued breakdown.

Disclusion Time Reduction (DTR)

Disclusion Time Reduction Therapy uses 2 different technologies that work together.  Most of the treatment is sanding off some of the enamel on multiple teeth, but sometimes treatment includes adding tooth-colored fillings materials to build up other teeth.   The T-Scan – a pressure measuring system,  scans the tooth contacts in microseconds, measuring the timings of how the teeth fit when chewing, calculating the forces and balance. We use the computer to guide the changes. At the same time, we monitor the muscles of the face and temples with a BioEMG. EMG measures muscle activity – how hard the muscles are working, or if they are resting.  When the teeth come into balance, the muscles show signs of relaxation, and we know we have achieved the desired result.  Because timing is critical, measurement technology is the only way to monitor physiologic success.  Often, patients can feel the muscles start to relax before they leave the office. Usually complete therapy takes 2 – 4 visits over a 4 – 6 week treatment period.  DTR tends to be very stable, but sometimes, future touch-ups are needed.

DTR is evidence based. It has a high degree of success for people suffering with specific symptoms.  Although we treat some men, a typical patient is female, with headache patterns in the temples, cheekbones and/or over the eyes, sometimes with muscle tension in their neck or face, sometimes there is a pop or click when they yawn, age 20s to 50s, had braces or extractions or teeth were never straight and maybe she grinds her teeth sometimes. Usually, she is a bit of a perfectionist, and sometimes has a hard time turning off her brain when she’d rather be sleeping. Frequently… professional women or women who tend to push themselves, and it tends to run in families …… The thing is, you know who you are because you deal with it all the time.

Do you suffer from this? Ask us about DTR and let us know about your symptoms at your next visit.

For more information:  Although I do some things differently than Dr. Nick, he has made some fabulous videos that explain and show Disclusion Time Reduction.  You can connect to his YouTube channel here:


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PO Box 7007
Missoula, MT 59807