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What is CMD and temporomandibular joint syndrome (TJS)?

The specialist term craniomandibular dysfunction (CMD), also known as myoarthropathy, is a collective term for a group of clinical symptoms which start in the chewing muscles, the jaw joints and associated structures.


Headache, migraine, tinnitus, pain in the back, shoulders and neck, spinal and joint problems.

Are you one of the people who often suffer from these symptoms? The symptoms mentioned are only a few of the problems which can be caused by our teeth or by the jaw joint.

The shoulders, spine and joints and even the knees are often affected. Many patients suffer from teeth grinding and ear noises or from regular migraine attacks.

Diagnosis and early detection

An incorrect bite and its consequences

The DIR concept (Diagnostic Intraoral Registration): Planning security for patient and dentist

If the upper and lower jaw do not meet each other in the ideal position, this is referred to as an “incorrect bite”.

The dentist asks the patient detailed questions about the problems they are already suffering from and examines them by carefully touching the jaw and the masticatory (chewing) muscles.

This manual, clinical examination is summarised and evaluated using a state-of-the-art diagnosis system; the patient receives a clearly understandable result, a secure diagnosis and, if necessary, treatment planning.

The effectiveness of the functional diagnostic DIR method has been proved in numerous medical studies. In essence, it determines the actual and target positions of the jaw joints.

In some cases it is necessary to manufacture what is known as a bite correction splint, which can often lead to a significant relaxation of the tensions caused by the displacement, even after a short period of wear.

Scientific studies confirm the reduction in pain of patients with chronic pain who use the DIR bite splint. The physical statistics have been proven to improve the sometimes dramatic situation and even the load on the feet becomes more symmetrical.

Once the permanent freedom from pain is achieved, further treatment by the dentist may be necessary in order to secure the success of treatment in the long-term.

It is generally sensible and advisable to carry out a diagnosis examination on the jaw joint, muscles and existing tooth contacts, even before treatment is made.

In our clinic, Dr. Steffen Ulbrich uses the DIR system and concept successfully and is the first dentist in Switzerland to do this.

Holistic dentistry and physiotherapy

Teeth - jaw joint - spine: these form a strong entity for your health

Every person possesses a pressure fall-back system in the fully toothed jaw which starts from the posterior teeth.

If the pressure fall-back system is destroyed, by a lack of, or increased tooth contact – e.g. by falsely positioned crowns or tooth fillings – then an optimal bite is no longer present. The increased strain on the chewing muscles, which try to even out the displacement, leads to an overload and to pain in the neck area and chewing muscles, extending ultimately throughout the whole body.

The jaw is therefore the interface between the body and the soul, in general the interdependence between the teeth, jaw, brain and muscles described above is referred to in dentistry as the natural principle of the regulatory circuit, or the mouth-body connection.

Parallel to functional treatment, it can be necessary to relax specific groups of muscles or to treat them symptomatically.

Here the dentist works together with a physiotherapist, so that the causes and symptoms can be treated therapeutically and simultaneously.

Collaboration between specialists is carried out systematically and successfully in the Klinik Prof. Sailer.