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General
TMJ (disorder) Treatment
Dentists use a variety of treatment modalities which may be divided
into Phase I, Phase II and Phase III Therapy. The purpose
of Phase I Therapy is to eliminate muscle spasms, TMJ swelling and
dislocation (if possible), and generally reduce any type of pain. This
treatment usually includes the use of splints, exercises, medication,
local anesthetic injections, injections of other medications, physical
therapy and chiropractic treatment. The purpose of Phase II Therapy is
to definitively correct any discrepancies, if necessary, between the
upper and lower jaws. This means to get the bite right. Phase II
Therapy may include adjustment of the dental occlusion, orthodontics,
reconstruction of the teeth, surgery, or a combination of some of the
above treatments. It is important to note that Phase II Therapy should
not be attempted without successful Phase I Therapy modalities.
Phase I Treatment. Phase I treatment for TMJ is conservative
treatment, producing no irreversible changes. Generally, the use
of an intra oral splint, sometimes medication is required, the
combination of chiropractic treatment or physical therapy are
recommended in some cases depending on the extent of the injury, and
life-style changes are all very effective in treating most truly TMJ
problems. Other disorders which mimic TMJ (for example, temporal
tendinitis, Ernest syndrome) are often treated with Phase I therapy
with medications, injections of local anesthetic and other medications,
and soft tissue treatment.
Phase II Treatment. Phase II treatment is, by definition of
the American Dental Association, non-reversible, invasive
therapy. This is done when you have been evaluated and released of
Phase I treatment. Doing so by having satisfied your treatment
expectations and have a stable jaw joint. Each individual is different
unlike phase I not everyone will be prescribed the same phase II. Some
of the recommendations are; adjustment of the occlusion (adjusting the
"bite") which is done in our office by painlessly filing each
tooth until there is a precisely even and comfortable fit. Some of you
my need orthodontic treatment which of course will be done by an
orthodontist and not in our office. The placement of crowns and bridges
and for some replacing missing teeth is necessary. It is rare but surgery
of all types may be necessary and most certainly produce changes which
can't be reversed. Therefore, it is most important that no one
undergoes Phase II Treatment until a correct diagnosis is
established and proven as the cause of the symptoms.
Last of all, if a TMJ sufferer is experiencing severe emotional
and/or psychological problems (which if often the case for many
reasons), failure to address these most important issues will virtually
guarantee a surgical failure. Psychological (as well as physical)
problems must be considered as sources of unresolved pain complaints
involving the TMJ or associated structures.
If you or a family member or friend who suffers with a TMJ problem
has doubt or unresolved pain, get a second or even third opinion
before any Phase II Treatment is initiated.
Phase III Treatment. Phase III treatment is the
long term management of a patient following successfully completing
Phase I and Phase II treatment. Phase III (the maintenance phase)
involves the use of a night time/stress splint. Regular personal TMJ
therapy and cautious use of the jaw to avoid new and additional injury
to the jaw joints and muscles.
How We Treat Sleep Apnea
After receiving a sleep study, which is
directed by your physician, we can fabricate a custom appliance
designed to treat Sleep Apnea. In our office we use the newest version
of the TAP Appliance, the TAP III.
(picture)
The appliance holds the lower jaw forward, preventing the tongue and
the soft tissue of the throat from collapsing into the airway.
(picture)
(Demonstrative Picture) The TAPIII allows you to adjust the device
and the degree to which the mandible (lower jaw) is pulled forward.
This allows you to be actively involved in the treatment of your own
sleep-disordered breathing. If you begin to snore at anytime while
using your TAPIII you can turn the Adjustment Key to adjust the
protrusion of the lower jaw in order for it to remain in effect and in
a comfortable position to stop these episodes
The simple steps to receiving your very own TAP
appliance:
1)
At your first appointment we will perform a CT
Scan to evaluate your airway and determine whether or not you are a
candidate for such a device. Impressions of your teeth will be taken in
order to fabricate the bite recorder and your custom TAP. Last you will
have an evaluation with Dr. Dwight where he will be able answer any of
the questions you have and explain what treatment will in tale, what is
expected of you during this time and what you can expect from us during
the process.
2)
Your next appointment will include determining
your bite using a ball baring bite recorder (BBB’s), this is then
placed into your mouth and another CT scan will be taken to be sure
that this will open your airway. We send the bite and your impressions
out to the lab where your appliance is made.
The appliance is delivered to you at this appointment 16 days later.
We will see you in two weeks after the delivery of your TAP III to
assess the progress and effectiveness of your appliance, after which we
are here at your request.
To Stop Suffering From Migraines
Better than any prescription,
we offer you the unique option of an NTI, with the referral of your medical
doctor. This appliance works by keeping the molar and canine teeth from
touching minimizing the muscle contraction intensity, therefore minimizing
the degree of condylar rotation (jaw opening) during your migraine
episodes, Nociception to the Trigeminal is inhibited. Therefore it is
not the presence of incisor (front tooth) contact that is therapeutic,
but the absence of posterior and/or canine contact.
(picture)
What you will need at your
first appointment:
-A
referral from your medical doctor
-Insurance
cards if applicable
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If you are a minor you will need your parent
At this appointment you
should plan an hour or more out of your day, we will begin with an
x-ray and impressions of your teeth in order to fabricate an appliance
that is unique and can only be used by you. The Doctor will perform an
evaluation, diagnosis, and discuss with you any concerns and questions
you have. You can then choose to schedule the delivery of your NTI and
join several others in their comfort, free from migraines.
We would be glad to send
you some literature in the mail while you anticipate your first
appointment. Just mention it to the receptionist when you call to
schedule and we will get it in the mail that day.
(printable coupon)
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