You cannot treat a disease that you do not know. Dental education did not prepare you for chewing system damage. Oh, we are great cavity and gum disease detectors, but are nearly blind to joint & muscles of chewing system.
Dental schools educated on caries and gum disease, but I had no training grinding/clenching disease or joint & muscle health.
Dentist are left in dark about the most destructive force in oral cavity, destructive grinding. Yet, we can gloriously reconstruct it with latest in technology & reconstruction skills.
This early damage comes form clenching/grinding and tension in muscles. Occasionally, neck discomfort or traumas may aggravated the chewing muscles. The jaw joint typically has sustained only minor damage.
General dentist should manage minor TMD damage & moderate chewing muscle inflammation. In minor damage cases, the collection of the varied subtle hints in four tissues of chewing system. Dentist training primarily looks at wear on teeth as number one hint of TMD damage, but at this early stage the wear is not indicative of TMD damage. The four tissues of chewing system must be tested and examined to determine the extent of damage in order for dentist to start educating patient to potential damage; so that, preventive therapies can be installed to prevent destruction of chewing system.
Below are examples of Mild Damage to the TMD 1) clicking 2) progression clicking 3) Tight, stiff, or sore jaw muscles 4) mild wear teeth 5) episodic sore teeth 7) tension headaches 8) chewing fatigue 9) sensitivity 10) moderate wear 1st molar
Use of conservative therapies could be helpful in mild TMD 1) If successful, you don't need referral 2) If unsuccessful, then a referral is necessary to Orofacial pain specialist 3) Conservative therapies should be implemented by patient/dentist at any level damage 4) insurance companies require these CT tools to be 1st line of care before orofacial pain specialist referral
Conservative therapy for mild jaw joint damage includes:
Mild Jaw Joint Damage examples include: 1) Damage: a) Mild Tearing Lateral Ligament, b) Moderate muscle inflammation 2) Causes: a) Tension muscles, b) Grind/Clench, c) Maybe: Trauma, Neck 2) Minor causes: Dual bites, Malocclusion, Pain system, Open Lock
Appliance therapy for mild damage includes: 1) Biteguard: mostly protects teeth 2) Hybrid: protects teeth and some protection muscles & joints
Caution: Do not treat a moderate to severe damage TMD. As a caring dentist you want best outcome for patient. If you encounter, please refer to Orofacial pain specialist for treatment. 1) restricted opening, 2) frequent jaw pain, 3) post filling jaw pain, 4) sudden bite changes, 5) atypical toothache, 6) earaches w/o infection, 7) moderate clench/grind, 8) frequent broken fillings 9) chip tooth 10) broken porcelain 11) adjust every crown 12) worn broke nighguards 13) open locks 14) high anxiety 15) broken teeth 16)bone buttressing
You cannot treat a disease that you do not know. Dental education did not prepare you for chewing system damage. Oh, we are great cavity and gum disease detectors, but are nearly blind to joint & muscles of chewing system.
Dental schools educated on caries and gum disease, but I had no training grinding/clenching disease or joint & muscle health.
Dentist are left in dark about the most destructive force in oral cavity, destructive grinding. Yet, we can gloriously reconstruct it with latest in technology & reconstruction skills.
This early damage comes form clenching/grinding and tension in muscles. Occasionally, neck discomfort or traumas may aggravated the chewing muscles. The jaw joint typically has sustained only minor damage.
General dentist should manage minor TMD damage & moderate chewing muscle inflammation. In minor damage cases, the collection of the varied subtle hints in four tissues of chewing system. Dentist training primarily looks at wear on teeth as number one hint of TMD damage, but at this early stage the wear is not indicative of TMD damage. The four tissues of chewing system must be tested and examined to determine the extent of damage in order for dentist to start educating patient to potential damage; so that, preventive therapies can be installed to prevent destruction of chewing system.
Below are examples of Mild Damage to the TMD 1) clicking 2) progression clicking 3) Tight, stiff, or sore jaw muscles 4) mild wear teeth 5) episodic sore teeth 7) tension headaches 8) chewing fatigue 9) sensitivity 10) moderate wear 1st molar
Use of conservative therapies could be helpful in mild TMD 1) If successful, you don't need referral 2) If unsuccessful, then a referral is necessary to Orofacial pain specialist 3) Conservative therapies should be implemented by patient/dentist at any level damage 4) insurance companies require these CT tools to be 1st line of care before orofacial pain specialist referral
Conservative therapy for mild jaw joint damage includes:
Mild Jaw Joint Damage examples include: 1) Damage: a) Mild Tearing Lateral Ligament, b) Moderate muscle inflammation 2) Causes: a) Tension muscles, b) Grind/Clench, c) Maybe: Trauma, Neck 2) Minor causes: Dual bites, Malocclusion, Pain system, Open Lock
Appliance therapy for mild damage includes: 1) Biteguard: mostly protects teeth 2) Hybrid: protects teeth and some protection muscles & joints
Caution: Do not treat a moderate to severe damage TMD. As a caring dentist you want best outcome for patient. If you encounter, please refer to Orofacial pain specialist for treatment. 1) restricted opening, 2) frequent jaw pain, 3) post filling jaw pain, 4) sudden bite changes, 5) atypical toothache, 6) earaches w/o infection, 7) moderate clench/grind, 8) frequent broken fillings 9) chip tooth 10) broken porcelain 11) adjust every crown 12) worn broke nighguards 13) open locks 14) high anxiety 15) broken teeth 16)bone buttressing
a) soft biteguard: increase grinding, bulky, decrease airway space
b) soft-hard guards (Hybrids): increase clench, can’t…
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