A complete discussion of the cervical spine and its relationship to the craniomandibular system would require a several day seminar. The comments to follow will begin to develop the impact of mandibular posture to cervical dysfunction and pain. The resting relationship of the movable mandible to the fixed maxilla is influenced by many factors. These include dental occlusion, respiration, TM joint anatomy, muscle function, cervical posture, and tongue position. Of course determining which is the cause and which is the effect is why a comprehensive diagnosis is necessary prior to proceeding with any treatment for craniofacial pain and dysfunction.
In all humans, mandibular orthopedic relationship to the maxilla is determined by maximum tooth-to-tooth position. The muscles, TM joints, and cervical spine accommodate to posturally reposition the mandible in order to allow maximum intercuspation of the teeth. Accommodation to bite discrepancy occurs in the entire upper quadrant, especially the cervical spine and more specifically the upper cervical spine, C-1 and C-2. Structural relationships within the upper quadrant are extremely complex and so entwined that abnormalities or stress within one area can produce pain and dysfunction in another. When the individual’s ability to accommodate is exceeded, symptoms occur.
In patients who present with mandibular orthopedic discrepancy as well as cervical discomfort, jaw orthopedics must be evaluated as the primary or secondary stressor for cervical pain and dysfunction. The proper application of Ultra Low Frequency TENS combined with specific masticatory and cervical muscle response, as revealed through electromyography, provides diagnostic data, which frequently reveals the true source of the patient’s cervical pain. Any treatment recommended can thereafter be directed properly resulting in efficient, effective and lower cost therapy.
More regarding this complex subject of Trigeminocervical relationships to come.