Why “Neuromuscular Dentistry” Isn’t Evidence-Based Care for TMD

"Well-designed studies have demonstrated that neuromuscular dentistry often achieves worse outcomes than evidence-based, conservative options we’ve trusted for years."

Neuromuscular dentistry, which claims to resolve TMD problems and headaches by positioning one's bite in an ideal position, has been around for a long time. But we never bought into it even when I was an oral medicine resident at Penn Dental back in 2010. The neuromuscular pitch was always the same: use fancy gadgets like jaw trackers and surface electromyograms (EMG)s to find a so-called “ideal” bite, and then perform a mouth full of crowns or orthodontics to hold the jaw there. The problem is, despite all the marketing, this approach has never really been proven to work [1].

Well-designed studies have demonstrated that neuromuscular dentistry often achieves worse outcomes than evidence-based, conservative options we’ve trusted for years. These are modalities I have discussed on my description for TMD care and blogs - such as temporary oral appliances, stabilization splints, physical therapy, medication, or counseling. The National Institute of Dental and Craniofacial Research (NIDCR) warns against making permanent changes to the bite or jaw, which in many instances actually make things worse [2].

Although neuromuscular dentistry may start with an initial conservative Phase 1 treatment consisting of jaw exercises and splint therapy, overtreatment is its biggest risk. I’ve met patients who were told they needed a Phase 2 treatment consisting of full-mouth rehab or major bite adjustment when what they really needed was that initial conservative care plus counseling how to maintain TMD symptoms in remission if they were prone to flare-ups. Several documented cases exist where irreversible and expensive treatments have left patients with new, lifelong problems [3].

Chronic TMD is complex and may feel frustrating to live with, but it rarely comes down to one mechanical “bite position.” The most up-to-date research emphasizes a multimodal, biopsychosocial approach: physical therapy, counseling, splints when appropriate, and lifestyle changes. A 2025 review made this clear—there’s no magic bite position, but there are a lot of effective conservative tools we can use together [4]. Just contact us if you need help with your TMD problems or want a second opinion.

References

[1] de Leeuw R, Klasser GD. Orofacial Pain: Guidelines for Assessment, Diagnosis, and Management. 6th ed. Quintessence Publishing; 2018.

[2] National Institute of Dental and Craniofacial Research (NIDCR). Summary of Treatment for Temporomandibular Disorders (TMDs). Updated 2023. Available at: nidcr.nih.gov

[3] Greene CS. Managing temporomandibular disorders: a decade of clinical progress. J Am Dent Assoc. 2010;141(6):672–679.

[4] López-Valverde N, et al. Management of Temporomandibular Disorders: A Comprehensive Review. J Clin Med. 2025;14(12):4326. doi:10.3390/jcm14124326