Care and Management Guidelines for Patients With Temporomandibular Disorders: OC’s Guidelines for Effective Therapy
Clayton A. Chan, D.D.S., M.I.C.C.M.O. – Director of Occlusion Connections
- OC is the most conservative and teaches specific and justifiable protocols to effectively treat TMD.
- We advocate a comprehensive evaluation that entails not only of the patient’s history, physical assessment, psychosocial cursory evaluation, and a pharmacological assessment, but additionally an evaluation of the patient’s physiologic resting and functional body responses that go beyond subjective complaints.
- The clinical modalities and techniques advocated are recognized by a majority of dentists treating TMD in their practices as therapeutic and successful treatment. (We teach a comprehensive diagnostic data gathering process as part of the examination which includes postural analysis, photo and radiographic analysis, including lateral cephalogram, CT, electromyography (EMG), Sonography (ESG) and computer mandibular scanning (CMS) analysis combined with low frequency TENS. MRI concepts are also presented). These devices are well supported by sound scientific studies. The American Dental Association’s Council on Scientific Affairs has awarded surface electromyography (SEMG), Computer Mandibular Scanning (CMS), and Sonography its “Seal of Acceptance”, as diagnostic aids in the management of temporomandibular disorders. The “choice of adjunctive diagnostic procedures are based on published peer reviewed data showing diagnostic efficacy and safety.”
- This multi-dimensional means of observing typical signature patterns confirming injury and hidden pathologies not typically visualized on cursory examination are incorporated in the clinicians senses, exponentially enhancing his/her special visualization and conceptual grasps of the functioning or dysfunctioning body parts, organs, and neurovasomuscular systems, while utilizing to the fullest the physical findings from the clinical examination of the patient.
- OC’s protocols fall well within the scope of ADA’s draft protocols and are founded on sufficient and scientific evidence that support sound and conservative methodology (modality).
- We agree that the lower removable orthotic is the most conservative appliance that is “based on the use of conservative, reversible and evidence-based therapeutic modalities”. At OC we teach at least 4 different orthotic designs based on different situations, adhering to gnathological as well as neuromuscular principles
- While no specific therapies have been proven to be uniformly effective, many of the conservative modalities OC teaches and advocates have been proven to be at least as effective in providing symptomatic relief compared to other forms of invasive treatment.
- Our patients who have presented with complex TMD problems, who have seen numerous clinicians within the medical and dental community who have tried to use the “Standard modalities” (“not uniformly effective” allows the judicious use of our modalities and teachings that are obviously “specific and justifiable” as well as conservative.
- We believe in a balanced approach recognizing that there is value and validity to both the psychosocial model as well as a bio-physiologic/neuromuscular occlusal model when diagnosing and treating our TMD patients comprehensively.