June 7, 2014 at 6:40pm

” What I am indicating is after all the internet discussions and proposed remedies, techniques and recommendations by so many with great theories one would think by now the dental profession and lay TMD public would have it all figured out by now…but in fact what it seems is more opinionated ideas.

If a country was going to send a man to the moon and accurately land a space vehicle on the lunar surface, I am sure there are many “zillion” ideas and opinions on how to do so, but few have produced such evidence to do so. Those scientist and mathemeticians as well as engineers, I am sure did not depend on their feelings, engineering experience, neither hours of flying experience to get to the moon, but rather clear cut objective measured calculations of many factors.

In Dentistry dentists don’t seem to know how to fly to get the proper jaw relationships…in fact they are flying by the seat of their pants. Certainly they have had some flying experience, with some crashes, but also with successful landings, its not all bad…but again when flying to the TMD moon one can’t just depend on experience, literature, opinions, and all the proposed ideas of cranial movements, structural body alignments, various appliances, even “neuromuscular” NM ideas such as airway obstruction and apnea are now the present day excuses….. the best way to clear through the fog and maze of this huge mountain of knowledge is for the dentists to get serious with themselves and their patients to begin to measure the physiology as astute TMD lay folks have mentioned…check out the muscle activity before and after TENSing and see where the mandible then re-positions itself.

The dentists needs to reconsider what the objective data means to each case as it relates to the joints conditions, the posture, the breathing, the upper to lower jaw positioning, etc, before they inadvertently prescribe an appliance and placing it in someones mouth. But no, it’s too much work and effort for them. Measuring and discussing the physiologic data is outside of their arena, TENSing the patients muscles and combine that with jaw tracking is way too far beyond their great classical training…so they dodge and banter on just about everything under the sun but the factors that matter….

Every dentist has an opinion and a view about TMD problem. But one should ask:

  1. How are they relaxing the muscles?
  2. Are they relaxing the muscles prior to delivering any appliance?
  3. Do they care about muscles since muscles drives and causes the jaw to function? Is muscle healthy all that important?
  4. How are the dentist determining one’s jaw position if muscles are a primary factor?
  5. Are they guessing it?
  6. Are they hoping that it will align and accommodate to some comfortable position joint position?
  7. How are the determining the joint and condylar positions of their patients ….let alone establishing physiologically sound muscle support?
  8. Are they manually manipulating it and guessing it with good intent…but subjectively assessing what they consider success?
  9. What objective measured means do they determine their success?

Just because a patient says they are comfortable and happy doesn’t mean it is physiologic….how about the fact, the patient just adapted…That doesn’t tell us anything about the science of physiology and neuromusculature!

Do dentist believe these pain muscle TMD problems are occlusally related? Perhaps not… some think it is a psychological issues and want us all to believe that the bite has nothing to do with TMD…so they call it orofacial pain, rather than a cranio-mandibular occlusal disorder.

Some think occluding of teeth has nothing to do with TMD pain problems. Is the dentist willing to take the time to adequately study each TMD case beyond CBCT, MRI and tomography?

Since we all know one can’t see “muscle” problems in these diagnostic modalities. The list and questions goes on and on. We should all ask ourselves, how many of these great ideas and opinions are based on objective physiologic measured data of one’s status and condition. If not all their ideas and theories are just that…an opinion and idea.

Let’s remember Opinions and theoeries don’t treat or resolve the problems. But it takes measured calculations that are specific to landing the space craft on the moon successfully and getting the astranauts back safely…It can’t be based on some guess work and hope. There is plenty of ideas about how the space craft is suppose to fly, where it is suppose to go…great theory on the laws of aero dynamics, space shuttle design, how to walk in space, etc..etc. etc. But how will one get to the moon and back?

I am banking on those dentist who objectively measure with K7, those who can make sense of TENSing and understand why they use it as well as understand the micro occlusal adjusting abilities of landing the GNM orthotic precisely without crashing the case. It’s not just a psychological experience!”

Dr. Clayton A. Chan, D.D.S.

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