Introduction to Neuromuscular Orthodontics

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Introduction to Neuromuscular Orthodontics:
Dr. Dierkes is the original neuromuscular orthodontist in the Atlanta area having learned of its significance in the early 80’s. Neuromuscular orthodontics and TMJ treatment differs from “traditional” orthodontics in the emphasis that is placed upon the activity of the muscles that move the jaw. Neuromuscular orthodontics positions the teeth and jaws in such a way as to maintain balance between the jaws, TMJ, teeth, and muscles. It recognizes that the muscles that move the jaw must be in a comfortable, relaxed position in order to not be in conflict with the teeth and the jaw joint. In another consideration, it emphasizes the position of the upper jaw as the template to which the lower jaw and the teeth must fit. Saying it another way, rather than violate the position and shape of the upper jaw, the position and shape of the upper jaw is either enhanced or at least not violated. Traditional orthodontics can violate the upper jaw position through the use of headgear, extractions, or by simply not addressing an underdeveloped or malpositioned upper jaw, which in turn can violate the functional and structural integrity of the jaw joints.
Neuromuscular orthodontics develops the upper jaw to its most optimal position and shape, then determines the most optimal lower jaw position where the muscles are relaxed and at rest. This is a three dimensional position in space and is often irrespective to the position of the teeth. We also factor in the jaw joint anatomy in determining the best lower jaw position for long-term stability. Our colleagues often refer to our practice as a TMJ-centered orthodontic practice, which it is.
Dr. Dierkes’ friendships and relationships with several renowned doctors over the years helped shape his diagnostic and treatment philosophy as he developed the most comprehensive and progressive approach to orthodontic and TMJ treatment.
In the mid 80’s, Dr. Dierkes met and established a friendship with Dr. Janet Travell, formerly President John F. Kennedys’ personal back physician. Dr. Travell authored the textbook, Myofascial Pain and Dysfunction, which has enabled doctors worldwide to understand and identify referred pain. Over time, she influenced his thinking regarding the relationship of thyroid function and adequate B vitamins for achieving normal muscle physiology so important in the TMD and growing orthodontic patient. She reinforced the importance of adequate thyroid activity to normal connective tissue integrity, which we must be concerned about in managing the care of the orthodontic and TMD patient for a successful outcome that embraces the best possible long-term stability.
Dr. Dierkes also worked with Dr. Robert Jankelson and others in the development of a balanced approach to comprehensive neuromuscular orthodontics for the TMD patient. He worked closely with some of the most famous orthodontists in the world including Dr. James McNamara from Ann Arbor, Michigan. With their combined efforts and research in Europe, the first early orthopedic/orthodontic approaches in the United States were developed to help prevent the removal of permanent teeth as part of the orthodontic process.
Dr. Dierkes was also able to personally study with Dr. Rolf Frankel from East Germany. It was his relationship with Dr. Frankel over the years that helped developed predictable arch development or expansion techniques offering long-term stability unparalleled anywhere in the world. It is the arch development techniques that have established the smile lines so characteristic of Dr. Dierkes’ patients.
Dr. Dierkes has taught his technique to countless other orthodontists over the years. It is one of the differences that has somewhat “trademarked” his approached that has earned him the recognition of being one of the top orthodontists in the country. Eastman Kodak used one of his patients in a two-page advertisement capturing the “perfect smile.” Another patient of Dr. D’s received the Best Smile award at Roswell High School in 2005. Still another one of his patients received the Best Smile award at Roswell High School in 2006. Dr. Dierkes and his staff are honored with this recognition and are appreciative of the gifts that he has been given.
As a result of these contacts and experiences over the years, Dr. Dierkes has developed an “All Things Considered” approach to orthodontic and TMJ care where he considers the relationship of teeth, bone, muscles, TMJ, airway (breathing patterns), food allergies, nutritional deficiencies and excesses, and endocrine imbalances that may adversely influence bone and soft tissue metabolism. Dr. Dierkes’ own research at the University of Michigan pointed out the importance of adequate amounts of vitamin C for the best connective tissue matrix as a means of providing the most optimal long-term stability. His MRI research pointed out the relationship between malocclusions (bad bite) and damaged jaw joints. He has identified a relationship between airway problems, unfavorable facial skeletal development and endocrine and/or nutritional deficiencies that have led to the development of a more holistic, drug-free and non-surgical management of patients who are “mouthbreathers.” Establishing a more normal, nasal mode of breathing during sleep will help insure a more normal development of the face and jaws.
There is a definite difference in our approach to orthodontic and TMJ care. Dr. D has been gifted in the integration of the best techniques from some of the finest doctors in the world. It is this integration that has helped him develop a more holistic approach to care. As a result, there is so much to consider for each patient, and with that, an obligation to communicate effectively these considerations to each patient and family. He has been somewhat of a pioneer in patient education to help patients make informed choices in their care.
Equally important to the most optimal treatment outcome is the relationship that we establish and maintain with our patients. Parents are welcome to join their children during appointments. Maintaining direct communication is Dr. Dierkes’ approach to achieving a close working relationship with parents, patients, and other health care professionals with a definite air of mutual respect.
We invite you to M-Brace the Difference™ with neuromuscular and TMJ-centered orthodontic care.
J. Michael Brace the Difference™ Dierkes

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