As some dentists have indicated all these technologies are great and helpful. What none of these technologies do is make a diagnosis and neither do they treat a case. They are only tools and are as useful as any doctor is willing to understand them and have the knowledge about the pros and cons, strength and limitations of each of these devices. Clinical problems do present themselves and we all have to make choices as to apply the right tools and techniques for the right conditions.
Nothing will replace a dentists skill, knowledge and understand of how to do great dentistry and treatment based on ones thorough understanding of TMD and occlusal issues, joint derangement, pain and masticatory dysfunctions, etc. We all have successes cases! And we all have failure cases that we know in our hearts have haunted us privately. That is what draws us all together and humbles me to realize I don’t know it all and neither does any instrument I have or use. It is only my keen understand and experience of doing cases of all aspects and challenges that helps me be a better clinician. The tools and devices are only as good as the operators hands, mind, skills and dedication to treating patients. It all takes time. A diagnosis is naturally limited to ones awareness and clinical experience. What we treat and do is only based on our clinical awareness. Methods of how we each do our treatment and what we propose to our patients is based on where we are at on this journey.
Based on all these factors as dentists we all will be pressed and challenged sooner or later when a difficult TMD case comes our way to test how strong and able a protocol, a philosophy, a particular technique or teaching we believe and understand in is. Sooner or later we are all tested and when we are, one begins to see the strengths or weakness in that particular approach. What we have learned or don’t understand will causes us to seek better answers to meet the needs of that problem which once again can arise in future. Dentists are constantly being challenged. When failures arise, the TMD fb folks are relentless behind the scenes on and off forum, in private messagings, etc, and word spreads fast.
Our present understanding about a particular method or way of doing things will naturally be challenged to see if our skills, our abilities and our training can truly withstand the scrutiny of our clinical approach to dentistry and these folks who are the recipients of our dentistry. There are particular cases that will push each dentist to the limits of ones beliefs and philosophy. It does happen with all of us. We dentists just need to be well prepared for those unique and particular cases that unintentionally want to be the exceptions to a rule, naturally testing the soundness of a particular rule or philosophy or methodology. Sound philosophies, techniques and approaches which are based on physiologic principles are able to stand in the long run. Those methods that don’t past the scrutinizing test of the consumer patient will pass and go by the way side as many other things already have within dentistry (like HIP, swallow bite, Empress, upper most rear most, hinge axis theory, zinc phosphate, large particle composite, blade implants, as examples, etc., etc.).
Each dentist who stays on these TMD forums will be tested sooner or later by this group of astute TMD/TMJ educated folks. The lay TMD folks have nothing to loose and everything to gain by what they learn from each of us. As dentists we are being tested daily as to our thinking, understanding and soundness in our approach to therapy….and this forum group is relentless at asking the tough questions with much experience, education and knowledge behind each post they make.
I know for sure, there is no cookbook recipe or any one way fits all when it comes to TMD treatment and this forum is a testament to that. But I do know for certain that certain key principles of occlusion and TMD are firm and proven to withstand the test of time. Those are the things I try to follow, advocate and practice in my life as a dentist.
– Clayton A. Chan, D.D.S. – Las Vegas, NV