Interview: Why prosthodontists should be keeping a close eye on myoarthropathy

Myoarthropathy (MAP) is becoming more prevalent in performance-oriented societies in particular. Emotional stress is one of the main causes of jaw clenching and teeth grinding and consequently of complaints related to the chewing muscles and jaw joints. As a result, prosthodontists should be keeping a close eye on myoarthropathy. Learn more about this condition in the following interview with Dr Johannes A. Müller of the University Centre for Dental Medicine (UZB) in Basel, Switzerland.

Dr Müller, in which field do you work at UZB?

At the University Centre for Dental Medicine in Basel (UZB) you also address the topic of myoarthropathy. What is this condition all about and how prevalent is it?

Dr. Müller: Our job is to diagnose and treat painful chewing muscles and/or jaw joints as well as impaired jaw movement and restricted jaw opening in particular. These complaints are often caused by overloading as a result of clenching and/or grinding, in other words bruxism. MAP comes in third place among the main complaints seen in dental medicine, after caries and gum disease. At UZB, we have a centre that is specialized in treating orofacial pain. At the centre, which is headed up by Professor Türp, we professionally diagnose and treat these problems.

Is the condition of MAP on the rise?

Dr. Müller: Day-to-day stress plays a significant role in the development of MAP. Therefore, there is a growing awareness of this condition, particularly in achievement-oriented societies, where the pressure to perform is very high. Switzerland is amongst these countries. Nevertheless, we do not have any hard facts that confirm an increase in cases.

How does the planning and fabrication of removable dentures influence the clinical picture of MAP?

Dr. Müller: Removable dentures are not known to trigger MAP. To have such an effect, a denture would have to be very badly made and not tolerated by the patient.

On the contrary, however, removable dentures could have a preventive or therapeutic effect with regard to MAP. This would be the case, in situations where the patient has lost not only molars but also premolars. If the patient feels that he or she is functionally impaired by the loss of posterior teeth, dentures may help to achieve stable chewing function and prevent the development of MAP symptoms. 

Could you please give dentists and dental technicians a few useful tips for planning removable dentures for patients with MAP.

Dr. Müller: Dentists and dental technicians should not plan any permanent prosthetic solutions as long as the patient has the MAP-related complaints. In situations where a patient is completely tense and a reproducible jaw relation record cannot be taken, splint therapy is usually prescribed in combination with other measures – e.g. relaxation therapy and physiotherapy. In principle, patients should receive a permanent denture only once the MAP symptoms are under control. In most cases, MAP cannot be completely cured. However, as is the case with chronic back pain, the aim is to alleviate the patient’s discomfort to the best possible extent.

Dr Müller, thank you very much for this interview.

Personal information:
Dr Johannes A. Müller is a Dentist in the department for Reconstructive Dentistry at the University Centre of Dentistry (Universitären Zentrum für Zahnmedizin, UZB) in Basel, Switzerland.