This video is an excerpt from the June 2015 Dawson Faculty Office Hours with Drs. Jeff Scott and Steve Hoard. Moderating is Dr. Pio Modi (PM). To watch the full office hours and to sign up for future office hours, visit the Videos and Webinars page.
The following is a transcription of this video excerpt.
Question: What do you do with a pain patient who has more pain after wearing a B-Splint?
JS: The first thing is: take it out. You knew that already. The point is - the pain got worse. Now I don't know exactly what pain that person had to start with (because that information wasn't provided with this question) - was it joint pain or muscle pain?
If you're wearing a B-Splint, typically that's an anterior deprogrammer, that appliance is designed to help with muscle incordination and clenching. Now we can't get rid of clenching completely. We just decrease the amount of muscle contractive force by 70% by putting an anterior deprogrammer in. So you say, well it's not going to 0, but a person that's had a lot of headaches and pain from clenching will get a lot better by wearing a B-Splint.
One of the key components of a complete exam is the palpation of the masticatory muscles.
During this part of the exam, we are looking for signs of muscle tenderness or pain. This pain is an indication of hyperactivity resulting from incoordinated muscle activity caused by a build-up of lactic acid due to the muscle(s) being overworked as they hold the jaw in an avoidance pattern during closure to maximum intercuspation.
In the practice of complete dentistry the dentist is committed to an examination, diagnosis, and treatment planning process and has developed the skill of recognizing the signs of instability in a patient’s masticatory system.
It is our responsibility to offer the patient the most conservative treatment method to achieve the desired end result- a stable, comfortable, healthy dentition and supporting structures that matches their esthetic desires. The most critical skill to be developed in evaluating a patient’s occlusion is locating and verifying centric relation. If the examination reveals stable healthy TMJ’s and load testing is negative, Centric Relation serves as the starting point to determine the amount of discrepancy between CR and MIP.
I attended the first Dawson Academy dental course in St. Petersburg, Florida in my first year of practice. What I heard was not a product-driven technique, but rather a comprehensive system of practice that included an emphasis on simplifying complex cases which begins with a complete new patient exam.