By Dr. Malcolm Kerstein
I have been practicing dentistry for 46 years. My continuing education work with The Dawson Academy and the Pankey Institute started over 40 years ago and I have worked extensively with Niles Guichet and the Society for Occlusal Study (S.O.S.) for many years with his study club in Orlando, FL.
I moved to the small town of Punta Gorda on the central west coast of Florida to live by the water, sail, and work a little. It was obvious to me that no one in the area was doing comprehensive occlusal work. In fact, there appeared to be an epidemic of Occlusal Disease in Charlotte County! I filled my schedule four days a week seeing, diagnosing, and treating people who had head, neck and TMJ issues.
Using Mark Pipers TMJ screening and Parker Mahan’s myofascial pain palpation exam along with Pete Dawson's Bimanual manipulation to locate and confirm Centric Relation, I was able to identify occlusal disharmonies that were causing problems for my patient’s.
I was using (and still use) a Centric Relation Orthotic in the maxilla, for diagnostic and treatment purposes. In an average week my practice would make six to eight Orthotics. A modified Lucia jig was used for 24 hours, then I would see the patient to complete the orthotic at CR, and an anterior guidance incline with paper marks "dots in back, lines in front". This is a wonderful technique with amazing, predictable results and has been a practice builder itself.
Patient Education Program
About two years ago, I thought it would be helpful to the practice, and a service to the community, to go more "public" with the work that I was doing with the study club that I founded. I decided to run a series of teaser ads in the local paper. The ads were in white print on black background and simply stated, "HEADACHES, NECK-ACHES, FACIAL PAIN-COULD THESE BE CAUSED BY YOUR BITE?"
A follow-up to the ad was an announcement about a free seminar at PANTHER HOLLOW DENTAL LODGE, where my practice resides. The reception area was converted to a small lecture room and we would hold a session every month or so during the winter season. We kept the presentation light and fun.
The last three programs that were held used the T-Scan to demonstrate perfected occlusion (helped by Dr. DeWitt Wilkerson) and showed a "movie" of a balanced, harmonious occlusion and a very fast disclusion time in right and left lateral excursions, as a function of a perfected anterior guidance.
Near the end of the program I would ask for a volunteer to be screened for occlusal causation of their facial pain symptoms with the T-Scan. Almost everyone wanted to be screened with the T-Scan and we only had time for one. I would try to pick someone who seemed to have the best chance to demonstrate some dramatic recording to the group.
The program that was put on for the local community is working and it is a lot of fun. Most importantly, almost all the participants that attend this program will schedule appointments for an examination and most will agree to first stage treatment. With the success of the program, we always have a list of happy pain free patients that will come to future meetings and tell their "success story" and it is very powerful.
The practice has networked the T-Scan program into all 13 of our operatories and we have started to train our hygienists to take recordings on patients, who have trouble keeping their mouths open during a hygiene visits due to muscle soreness, or those that have signs of Occlusal Disease.
Coming Soon: Part 2 - How Dr. Malcolm Kerstein cut his follow-up appointments by more than half with the T-Scan system.