December 11, 2012 at 3:44pm

There are many factors that must be considered when TMJ/TMD and orofacial pain patients wonder when their pain will be resolved.  Its hard to put a “realistic” time frame on things when there could be multi-layered issues involved.

By the way, improvement doesn’t mean “cured” or total resolution. Most cases with chronic pain (depending on the pain problem) can improve within 24-48 hours when wearing a properly fine tuned and adjusted lower anatomical orthotic. Other chronic pain cases (depending on their problems and conditions) may take longer. It’s hard to predict each how each individual case will respond to treatment. Not all muscles, not all joints, not all teeth/occlusal schemes and not all CNS systems function the same. Some cases have other factors such as stress factors, emotional factors, biochemical factors that play into the picture. There is no guarantees for neither the patient or the treating dentist and other health care professional involved in the case to know how the patient will actually respond to treatment…but in general most cases respond and patients experience improvement. Most patients realize what is improving and what other aspects in their condition are not improving, thus follow up visits naturally are required since the body is dynamically changing and altering. Different cases naturally change more than others…thus a need to adjust the orthotic more frequently when necessary in order to keep pace with the postural changes that can occur as muscles seek a neutral position. How much change will occur?…again no one knows the specifics on this. How many visits are required?…again it is very hard for anyone to know except that we know from physiologic science that the body is seeking a neutral position. As long as the body is not neutral there can be strains and muscle tightness. As the orthotic is refined and adjusted over time most patients feel the improved differences in their bite and muscles… That is why each case is individual and will vary depending on the conditions (whether they are wide goal posted – with a greater adaptive capacity to accommodate to changes vs. narrow goal posted type cases – with very little adaptive capacity to accommodate easily and quickly) now add the various contributing combinations of problems mentioned above then one will realize how complex TMJ/TMD really is. – Clayton A. Chan, D.D.S. – Las Vegas, NV

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