Addressing the Neuromuscular Component of Malocclusion, TMD, & Airway (w/Dr. Maryam Motlagh) [Ep.143]

In this episode of the DOC Podcast, I welcome Dr. Mary Motlagh to discuss one of dentistry's most critical yet overlooked issues: why beautiful dental and orthodontic work fails over time, and what we can do to achieve lasting stability.

Dr. Motlagh, a restorative dentist with over 25 years of experience, shares her transformative journey from creating stunning cosmetic cases that broke down within years to developing a comprehensive physiologic approach that consistently delivers 15-20 year stability. Through compelling patient stories and clinical insights, she reveals the hidden connections between airway health, TMJ function, neuromuscular balance, and long-term treatment success.

This conversation challenges fundamental assumptions in dentistry. From how we diagnose and treat TMD to the extraction debate, early intervention timing, and what "evidence-based" really means. Whether you're an orthodontist frustrated by relapse, a restorative dentist dealing with occlusal breakdown, or any dental professional seeking better outcomes, this episode offers a paradigm shift in how we approach comprehensive care.

Timestamps

[2:27] Meet Dr. Motlagh
[4:43] Why beautiful veneer cases started failing
[5:45] Muscles dominate and airway always wins
[9:54] Why teeth break at the gum line despite perfect crowns
[13:37] Evidence-based dentistry: beyond randomized trials
[16:52] Dentists are trained as tooth mechanics, not doctors
[22:57] How posture affects occlusion
[27:47] Signs and symptoms we miss: scalloped tongue, tinnitus, vertigo
[37:15] The 17-year-old who couldn't open her mouth for 2 years
[42:57] The extraction and airway debate
[48:20] Introduction to MyAligner and the diagnostic phase
[49:30] Ultra-low frequency TENS and neuromuscular CR
[57:27] Case presentation: correcting facial asymmetry in 40 minutes
[1:05:35] Final message: it is essential to screen for TMD and airway issues

Notable Quotes

• "We were trained as tooth mechanics and not the doctors of the oral cavity. We learned to look inside the mouth, not sit back and look at the face, look at the body, look at the connection of the orthopedic alignment of the head and neck." - Dr. Maryam Motlagh
• "When you do the diagnostics more thoroughly, your work gets easier and becomes more profitable because you cut a lot of the noise out, a lot of the headaches. It's not profitable to do a hundred aligners on somebody - you're paying the patient to treat the case at that point." - Dr. Mike
• "This is a complex problem, but once you see it, you cannot unsee it, and it becomes such a simple solution." - Dr. Maryam Motlagh

Links