Diagnosis & Treatment of TMD

Course Objectives

This two-day introductory TMD course will assist dentists to diagnose and treat the simple cases with repositioning splints during the daytime and anterior deprogrammers at night.  This TMD course will show you how to take construction bites to determine how much you need to increase the vertical and advance the mandible when fabricating splints.  Dentists will be encouraged to refer the complex cases to practitioners whose practices are designed to treat these patients.

Several cases will be shown on how to go from Phase I splint therapy to orthodontic case finishing.  Approximately 50% of my existing orthodontic patients are coming from my TMD practice.  Once the TMJ’s have been stabilized and the patient is pain-free, the majority of patients want to proceed with a more permanent solution to their problems, which most often involves orthodontic treatment.

Dentist’s who want to treat TMD patients are encouraged to join the American Academy of Craniofacial Pain (AACP).

Course Content

Anatomy of the TM Joint

Muscles of Mastication

Causes of TM Dysfunction

Clinical Examination

  • Patient history
  • Range of motion
  • Muscle palpation
  • Postural assessment

Joint Vibration Analysis (JVA)

TMJ X-Rays Tomograms

Differential Diagnosis

  • Intra-capsular vs. Extra-capsular

Five Stages of Internal Derangement (Disc Displacement)

  • Clicking, slight pain
  • More clicking, intermittent locking, moderate pain
  • Chronic closed lock, severe pain
  • Early degenerative joint disease
  • Advanced degenerative joint disease (crepitus)

Bite Registration for Splint Therapy (Phonetic Bite)

Types of Splints

  • Aqualizer (temporary)
  • Flat Plane (acute injuries)
  • Repositioning (anteriorly displaced discs)
  • Anterior Deprogrammer (clenching at night)
  • Distraction Appliance (chronic closed lock)

Neurological Tests to Determine if the Mandible is in the Correct Position with the Repositioning Splint

  • Parachute Test
  • Wall Test

How to File Insurance Claims for TM Disorders

Phase I – Splint Therapy 4 months

Phase II – Orthodontic Case Finishing 12 – 24 months

  • Porcelain Onlays

Internal Marketing for a TMJ Practice

External Marketing for a TMJ Practice

Philosophy

In 2005 I received my Diplomate status in the American Academy of Craniofacial Pain. This has enabled me to develop a system for treating these patients very efficiently and effectively. At the present time, I would estimate that 40% of my practice is devoted to helping these patients eliminate their numerous medical symptoms and return to a relatively pain-free life.

When patients present with structural problems (anteriorly displaced discs) within the TM joint, then the dentist must become involved to rectify this problem by using splint therapy to obtain a more stable jaw relationship. Numerous clinical cases with full records will be shown on how to find the correct maxillo-mandibular relationship in Phase I Diagnostic Splint Therapy and then how to finish the cases in Phase II Orthodontic Case Finishing.

Benefits

The American Dental Association stated that 34% of the population of the U.S. suffers from TM dysfunction.  Dentists have the prime responsibility to diagnose and treat this common disorder.  TM disorders are progressive and worsen over time; therefore, just like orthodontics, it is imperative that the problem be treated as early as possible.  Dentists are encouraged to treat their younger patients with a functional, non-extraction philosophy in order to prevent TM dysfunction.

This introductory course will enable the dentist to evaluate what patients require, TMJ stabilization prior to restorative orthodontic or prosthetic treatment.

Course Fees & CE

Continuing Education Credits

14 hours of CE lecture

Course Fees

Doctors:  $1,295
Staff:  $495
includes extensive course manual