Neuro-Muscular Dentistry: the “diamond” concept of electro-stimulation potential for stomato-gnathic and oro-dental conditions

Abstract

Oro-Pharyngeal Dysphagia - or simply dysphagia - is the difficulty (persistent) in swallowing/passing food and/or liquid from the mouth to the pharynx into the esophagus and finally the stomach; a deglutition disorder (a symptom, by definition, often due to neuro-degenerative/−muscular, drug-induced or localized structural pathologies such as head and neck tumors, lesions and associated surgical and/or radiation injuries) linked to severe consequences on Quality of Life (QoL), including malnutrition, dehydration, and even sudden death. Likewise, Temporo-Mandibular Jaw and Joint disorder(s) – or simply TMD – is a multifactorial etiological condition, regularly encountered in the dental office. Whether due to malocclusion, bruxism, stress and/or trauma, TMD destabilizes the whole cranio-mandibular system structurally and functionally, via affecting mastication, teeth, supporting structures, comfort and aesthetics, and thus, QoL, again. While several treatment regimens do exist for such conditions, some of which have been standardized for use over the years, most continue to lack proper evidence-based literature support. Hence, (1) caution is to be exercised; and (2) the need for alternative therapeutic strategies is amplified, subsequently, the door for innovation is wide open. Indeed, neuromuscular electrical stimulation or “NMES”, is perhaps a fine example. Herein, we present the interested oro-dental health care provider with an up-dated revision of this therapeutic modality, its potential benefits, risks and concerns, to best handle the dysphagic patient: an intra-disciplinary approach or strategy bridging contemporary dentistry with speech and language therapy; a rather obscure and un-discovered yet critical allied health profession. A pre-clinical and clinical prospectus on employing inventive NMES-based regimens and devices to manage TMD is also highlighted.

The Effectiveness of Repetitive Transcranial Magnetic Stimulation for Post-stroke Dysphagia: A Systematic Review and Meta-Analysis

“…Furthermore, an estimated 41% of stroke patients in the United States experience difficulty swallowing (Crary et al, 2013 ), and nearly 51.14% of stroke inpatients have deglutition disorder in China (Zhang et al, 2021 ). Post-stroke dysphagia is an impaired swallowing function caused by an imbalance in the coordination of swallowing muscles and neural regulation, which prevents the patients from eating normally (Sandoval-Munoz and Haidar, 2021 ). Dysphagia is mainly manifested as salivation, coughing from drinking water, and prolonged eating times (Wilkinson et al, 2021 ).…”

Stomatognathic System Changes in Obese Patients Undergoing Bariatric Surgery: A Systematic Review

“…Increased fat in the chest and abdomen can shift the elastic equilibrium point between the chest and lungs, thereby reducing FRC [ 42 ]. Obesity also significantly interferes with respiratory function by decreasing lung volume, particularly expiratory reserve volume, and FRC [ 84 ].…”

Modified minimally invasive surgery in reconstructing the temporomandibular joint disk by transplantation of the temporalis myofascial flap

“…The prevalence of TMD ranges from 15 to 54% in different populations, and most affected individuals can present with characteristic symptoms such as clicking, joint pain, limited range of mouth opening, masticatory difficulty, mandible dysfunction, etc that the peak of the development of the symptoms is between 20 and 40 years of age [ 5 , 6 ]. Recurrent attacks of severe chronic TMD many times may result in the degeneration/ derangement of articular disk, so as to further lead to functional morbidity like compromised speech, mastication, and deglutition, and even unaesthetic outcome in poor situation [ 7 – 9 ].…”