Hi, everybody. My name is Dr. Leonard Hess. I am one of the senior faculty members here at the Dawson Academy, and I would like to take a few minutes to discuss with you when to use an NTI appliance and when not to.
The question comes up, what does airway have to do with TMD or what does TMD have to with airway problems? And the answer is sometimes there's very little overlap, sometimes there's quite a bit of overlap, and sometimes there's total overlap.
Splints are more than just a piece of plastic you give to patients when you don't know what else to do with them
Occlusal splint therapy can be a great treatment option for those suffering from occluso-muscle disorders and TMD. Given the wrong type of appliance, however, splint therapy can actually do more harm than good for our patients. With an improper or poorly fabricated device, patients can develop increased pain to the joint, an open bite and other serious implications.
So what do we do with the patient that has TMJ pain or has TMD? So this is the symptomatic patient now. So kind of what we'll say is kind of look at maybe a broader swipe and go inside.
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.
If we've been practicing for any length of time at all, we're going to see some clinical failures. I think sometimes the perception is if we're faculty at The Dawson Academy, that it never happens, and you should know that we all see clinical failures. We just want to limit them as much as possible, and so there's really going to be two reasons that something fails.
Why is the physiologically correct position in centric relation the most superior position in the joint space itself?
Now, if you're like me and you went through dental school earlier, maybe 20 years ago, you were probably taught that centric relation was actually a distalized position of the condyles.
It was a very frustrating experience not only for the dentist, but also for the patients because you're trying to put the mandible and the condyle into a very unnatural position.
So when you're trying to decide if your patients have an internal derangement or an occlusal muscle problem, how do we go about doing that?
First part is the screening questions you ask before you start to testing.