Diagnostic Classification Confusion
Master International College of Craniomandibular Orthopedics
The NIH Technology Assessment Conference Statement concluded that, “there are significant problems with present diagnostic classifications of TMD, because these classifications appear to be based on signs and symptoms rather than on etiology.” They further state that, “…scientifically based guidelines for diagnosis … are still unavailable.” There are many treating clinicians who strongly disagree and believe that there is a etiologicaly reference to the cause, although multi-faceted, it can be diagnosed using scientific and objective methodology. To state otherwise only skeep the public and learning dental professional in confusion and prevents progress to this treatable dis-ease and dys-function.
The medical and dental community usually diagnoses TMJ based on range of motion tests, listening for sounds in the joints, examining the teeth, and manual palpation of the jaw joints as well as the muscles of the face, and head. Typically the dentist may ask for information about your pain and other symptoms, injuries, oral habits, and previous medical and dental treatments. A subjective assessment and examination may be completed, but often without confirmation of objective measured instrumentation and analysis, which is now becoming a standard with the community scientific methodology and standards and those clinicians who are seeking a higher standard of objective care for their patients.
There is a group of clinicians within the medical and dental community who recognize that technology and bio-physiologic instrumentation is valid and valuable asset to any clinician seeking answers to diagnosis and treatment of TMD. They adhere to all the standards of care in addition to continue to pioneer higher standards to objectively measure with technology those aspects of the diagnostic process they typically would formerly subjectively assess. Computereized mandibular scanning (CMS), Electromyography (EMG), low frequency TENS relax muscles as well as Electrosonography (ESG) are all high tech means available to our profession to help in quantifying the dysfunction of mandibular and jaw joint movement, quality or inequality of head rotational, side bending and hyperflexion and flexion movements of the head and neck, as well as identify positional relationships between the maxillary and mandibular arches relating to the TMJ’s and muscles of mastication.
Finding your bite physiologically and objectively is key to TMJ success and resolution!
Managing your bite precisely to meet the proprioceptive demands of the central nervous system implementing both gnathological as well as neuromuscular principles is key, thus, the need for trained Gneuromuscular dentist who understands all aspects of your case is crucial to your dental health!
