If we have a symptomatic TMD patient and are trying to figure out, can we make this patient better or comfortable? How can we stabilize the joints?
Do we have to treat every noise or click that we observe in our patients? And the answer is not necessarily. What I am going to say is we always have to go back to the complete examination.
So one of the big issues and changes in dentistry now is airway and how do we deal with it with our complete concept of dentistry. So one of the things we have to do now as part of the complete exam is we have to add an airway screening into our examination. We've actually already done this in our protocols at The Dawson Academy.
So why do we use an articulator?
When we are trying to work out models two-dimensionally and three-dimensionally, what are the correct solutions for our patient? And simply it is just a mechanical device that gives us a way to be able to observe and work out what is actually happening in our patients.
As Dr. Dawson has said, “Successful outcomes for patients with temporomandibular disorders can be some of the most rewarding experiences in a general dental practice.”
In a study of over 45,000 households, 1 in 5 have suffered from orofacial pain in the last 6 months, illustrating the large opportunity our profession has to provide successful outcomes that can greatly impact patients’ lives.
When dealing with a symptomatic or a suspected TMD patient, we want to follow a series of protocols, no different, really, than we deal with most of our patients.
As we deal with our functional interdisciplinary team, one of the most important and probably difficult specialists for you is going to be your orthodontist, and communicating with the orthodontist can be a bit of a problem.
First off, if you can find an orthodontist that actually believes in function and joint position, you're ahead of the game because it makes it much easier for you.
Unfortunately, for most of us, we're not going to have an orthodontist that believes in those principles, so we're going to have to kind of do some of the work for them.
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When we're treatment planning, we like to utilize what we call the WIDIOM rule. Would I Do It On Me?
This process of complete dentistry isn't about doing the most restorations on a patient. It's doing the least amount of dentistry to solve all of the patient's functional and aesthetic issues.
The complete examination is probably one of the most important things you can do as we go through this process of complete dentistry. It's where you're going to make all the treatment decisions from, it's where we're going to identify what the problems are, whether they're functional, bacterial, or aesthetic.
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Tooth decay, periodontal disease, endodontic issues, tooth wear, mobility, migration, muscle soreness, TMD and esthetic issues are a few of the potential problems facing our patients.
Despite the desire to correct the patient’s problems with the least amount of dentistry, oftentimes extensive dentistry is required. Unfortunately, due to financial restrictions patients may be unable to get the needed treatment.
Following a systematic approach to complete care, including the patient in a discussion of problems and solutions, addressing financial needs and creating a patient centered treatment plan is the key to success. Even a patient with extensive treatment needs may be able to get the care they required.