In considering the function of the Temporo mandibular joint dentistry accepts that there are influences beyond the dental arches that affect how the teeth might come together in an occlusion. This is just the beginning of whole body dentistry, how one part of us affects another. Similarly voice training must look beyond the intrinsic muscles of the larynx and its immediate suspension and discover how the functioning of other parts of the body affect the voice, beginning with the function of those structures that are directly attached to the vocal mechanism.
The mandible and the larynx (breathing and sound making) are both separately suspended via muscles and ligaments from the two temporal bones of the skull, but both are directly joined by sharing muscles of the tongue in breathing, swallowing, speech, and singing. For this reason it is quite impossible to attempt to solve a voice problem without reference to the function of the jaw and in many cases the voice problem will be found to arise from temporo mandibular dysfunction. The voice teacher will then need the assistance of a dentist to help to sort it out.
Conversely the dentist can be aided by a voice teacher trained in early development and functional anatomy. As we crawl, stand, toddle and finally walk during the first six years of life the tongue changes its position from lying entirely in the mouth to facilitate breast feeding to its mature position with two thirds of its bulk in the pharynx. Vowels are now shaped and sounded in the pharynx and the anterior one third of the tongue articulates consonants against the roof of the mouth. The remaining sounds are made with lip muscles. The voice teacher can ensure that the tongue articulates speech at the back of the mouth and in the pharynx and after the activities of talking and singing comes to rest against the posterior portion of the hard palate. This action of the tongue maintains a forward and down position of the mandible in relation to the skull and the developing anterior teeth are not subjected to pressure from the tongue for articulating consonants like ’t’ and ‘d&rsquo. Instead pressure of the tongue aids development of the upper arch of molars and encourages nose breathing.
The alternative is that the tongue does not shift far enough backwards and there is too much of the tongue in the mouth articulating consonants against the anterior teeth and vowels in the mouth. The tongue now displaces teeth, rests in the floor of the mouth and the mandible hinges at the TMJ and is driven back and up into the joint rather than translating down and away from it. As gravity, movement and rhythm are the main agents for shifting the tongue it follows that the development of the voice is dependant upon the child being able to run about and balance well on two feet, but some children do not develop good balance for reasons of birth trauma, environment, or just not enough encouragement to run, jump and skip. As a result they are likely to also have developmental problems in voice and dentition so both the dentist and the voice teacher need to have a cranial osteopath or a cranial chiropractor on the ‘team’.
I have a client of eight years old who sang in a choir badly enough and enthusiastically enough to develop nodules on his vocal cords. (It seems impossible). Having observed him unable to keep himself still while singing, his face displaying all the terror of someone falling off a bicycle at high speed, I sent him to Dr Jonathon Howat, cranial chiropractor, who has corrected the effects of birth trauma and a severely misaligned pelvis. His tongue will now complete its shift with my voice and body exercises and his mouth already opens differently. The tension has gone from his voice. However, he is now in mixed dentition and the correction to his balance has revealed an undeveloped maxilla and a slight deviation in the development of the teeth. Early orthodontic procedure will now sort this out before it develops into a major problem later in life. Angela Caine AGSM, LRAM.
The film clip on this page demonstrates how this imbalance in the use of the voice and function of the TMJ can occur at any age, causing TMD. It highlights the need for clinicians to work together and the importance of the interdisciplinary research of BSSCMD.
|Document Title||Type||Doc. Size|
|Correcting Structural Misalignment in Performers||181k|
|Voice Exercises Assist Orthodontic Treatment||537k|
|Julias story for BSSCMD||Windows Media file||4.6mb|
I'm basically writing to say thank you. Before treatment I had minor locking, clicking, headache pain, neck pain. Now I have minor clicking and no pain whatsoever. I literally cannot remember the last time I had a headache. I reckon many of your patients don'
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You may remember that we came to you with our daughter in April 2007. She was being treated unsuccessfully at Mayday Hospital for what you were able to diagnose as TMJ dysfunction. A splint was made for her to wear over her bottom teeth and this gave her considerable re
Having experienced a lot of pain for a number of years I discovered quite by chance through a friend the work Helen had been doing for TMJ, after the second visit to have a splint fitted, I went home to London and from Haslemere to London the difference was unbelievable
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Page Summary: Cranio Mandibular Disorders, Jawache, Jaw Ache, Aching Jaw, Jaw problem, Jaw Impingement, Mandibular Disorders, Mandibular Problems, TMJ Research, TMJ Treatment, TMJ London, Temporomandibular Disorders, Temporomandibular Joint Disorders, TMD, TMJ