INTRODUCTION TO TM DYSFUNCTIONS

The American Dental Association stated that 34% of the population of the U.S. suffers from TM dysfunction.  Dentists have the prime responsibility to diagnose and treat this common disorder.  TM disorders are progressive and worsen over time; therefore, just like orthodontics, it is imperative that the problem be treated as early as possible.  Dentists are encouraged to treat their younger patients with a functional, non-extraction philosophy in order to prevent TM dysfunction. 

Two years ago, I received my Diplomate status in the American Academy of Craniofacial Pain.  This has enabled me to develop a system for treating these patients very efficiently and effectively.  At the present time, I would estimate that 40% of my practice is devoted to helping these patients eliminate their numerous medical symptoms and return to a relatively pain-free life. 

When patients present with structural problems (anteriorly displaced discs) within the TM joint, then the dentist must become involved to rectify this problem by using splint therapy to obtain a more stable jaw relationship.  It has been estimated that as many as 90% of headaches are related to anteriorly displaced discs and clenching and bruxing.  Numerous clinical cases with full records will be shown on how to find the correct maxillo-mandibular relationship in Phase I Diagnostic Splint Therapy and then how to finish the cases in Phase II Orthodontic Case Finishing.

 

COURSE CONTENT

  1. Anatomy of the TM Joint
  2. Muscles of Mastication
  3. Causes of TM Dysfunction
  4. Clinical Examination
    1. Patient history
    2. Range of motion
    3. Muscle palpation
    4. Postural assessment
  5. Joint Virbration Analysis (JVA)
  6. TMJ X-Rays Tomograms
  7. Differential Diagnosis
    Intra-capsular vs. Extra-capsular
  8. Five Stages of Internal Derangement (Disc Displacement)
    1. Clicking, slight pain
    2. More clicking, intermittent locking, moderate pain
    3. Chronic closed lock, severe pain
    4. Early degenerative joint disease
    5. Advanced degenerative joint disease (crepitus
  9. Bite Registration for Splint Therapy (Phonetic Bite)
  10. Types of Splints
    1. Aqualizer (temporary)
    2. Flat Plane (acute injuries)
    3. Repositioning (anteriorly displaced discs)
    4. Anterior Deprogrammer (clenching at night)
    5. Pivot Splint (chronic closed lock)
  11. Referral Pattern for Trigger Points
  12. Neurological Tests to Determine if the Mandible is in the Correct Position with the Repositioning Splint
  13. How to File Insurance Claims for TM Disorders
  14. Phase I - Splint Therapy 4 months
    Phase II - Orthodontic Case Finishing 12 - 24 months
  15. Internal Marketing for a TMJ Practice
  16. External Marketing for a TMJ Practice