OBJECTIVE DOCUMENTATION - RAISING THE STANDARD OF CARE
Clayton A. Chan, DDS, MICCMO
Founder and Director of Occlusion Connections
DIAGNOSTICS - Objectivity vs. Subjectivity
In this age of evidence-based treatment and diagnosing it is imperative that objectivity is used by the treating clinician when addressing TMJ/ TMD. Due to the variety of symptoms and patient complaints it is imperative that objective gathering techniques be used rather than subjective, educated guesses when all else has failed.
By implementing technology when appropriate in gathering measurable quantifiable data, as a part of a prudent protocol to verify objectively the true condition of the paining patient, one can begin to accurately diagnose, present a mode of treatment and treat effectively these types of problems reliably and consistently.
Radiographs of the Jaw Joints:
When treating the temporomandibular joint and it’s accompanying symptoms, it is imperative that radiographic imaging of the jaw joints be used to visualize and ascertain: the joint position (posture), bony surface anatomy and abnormalities of the surrounding structures. Diagnostic radiographs (Tomography) of the joints are the most accurate in most cases. Other modalities to visualize the jaw joints can be used to enhance further understanding, when needed.
It is important to realize that radiographs are a “static” reproduction of three dimensional structures. Radiographs are helpful but should not be considered the only tool to access living, moving and functioning structures, especially when they are compromised and injured. To read about other radiographic modalities see OTHER DIAGNOSTIC MODALITIES.
Computerized Electro-diagnostic Instrumentation:
This type of diagnostic modality tests muscle function and stability of jaw movements in real time (dynamic). Computerized electro-diagnostics are able to record, measure and track jaw movements in three dimensions (horizontal, vertical and saggital). Radiographic imaging techniques are not able to do this! The following are examples of two recordings (scans or tracings) that are implemented. There are ten different jaw recordings/ scans that can be used in diagnosing and treating TMJ disorders effectively.
From the recorded data produced by the recording instruments, the doctor is able to distinguish between normal verses abnormal and pathologic verses physiologic movements of the jaw. Muscle activity is simultaneously recorded, thus enhancing the understanding of the dynamic living human anatomy (the mandible, the surrounding muscles, the jaw joints and posture of the head and neck).