Narrow Goal Posted (Low Accommodation) versus Wide Goal Posted (High Accommodative) TMD Characteristics

HOW OCCLUSALLY SENSITIVE ARE YOU?

TMD patients who experience pain, masticatory dysfunction and joint derangement problems can be highly sensitive individuals while others may not be so highly sensitive when dental procedures and occlusal treatment are rendered. It has been noted that humans can sense a single strand of hair between their front teeth.  Human hair on average is between 15-17 microns thin. (An Encyclopedia of Scientific Essays, the diameter of human hair ranges from 17 to 181 µm: 15 µm — width of silk fibre. 17 µm — minimum width of a strand of human hair).

Those individuals who are highly proprioceptive and occlusally aware can be categorized as having a narrow goal post to accommodate small changes in the dental occlusion or it can also stated that their central nervous system (CNS) presents as a low accommodating sensing ability.  Other patients may naturally be unaware that small changes can occur in dentistry and or make a difference to their central nervous system.  We can identify these individuals as wide goal posted or having a high accommodating capacity to change.

In dentistry a simple change in a dental fillings or having a new crown placed and or when any tooth or group of teeth are occlusally altered by equilibrating (teeth adjusting procedures) and even orthodontic tooth movement procedures may trigger discomforts in the bite causing some individuals to feel changes more than others.  This is why it is important that every dental patient recognize whether they are a narrow goal posted (low accommodative capacity) type individual or whether they are a wide goal posted (high accommodating capacity) type dental patient.

The following are just some general characteristic profiles that can be used to help identify a narrow goal posted vs. a wide goal posted dental patient.

NARROW GOAL POSTED CHARACTERISTICS – LOW ACCOMMODATIVE CAPACITY 

• Well defined/developed dental arch form (well rounded)
• Less tooth crowding
• Lower incident of restorative dentistry – natural dentition
• Less tendency of over jet/overlap of anterior dentition
• Class I dental relationship tendency
• Centric occlusion (CO) vertical dimension of occlusion is closer to the ideal vertical norms (maxillary central incisor gingiva to mandibular central incisor gingiva measures 15.5-18.5 millimeters).
• Clenchers
• May require more follow up detailed adjustment visits than others.

WIDE GOAL POSTED CHARACTERISTICS – HIGH ACCOMMODATIVE CAPACITY

• Narrower V shaped arch tendency
• More crowding of teeth
• Higher incident of restorative dentistry (fillings and crowns)
• Greater tendency of over jet/overlap of anterior dentition
• Class II dental relationship tendency
• Centric occlusion (CO) vertical dimension of occlusion is closer to the ideal vertical norms (maxillary central incisor gingiva to mandibular central incisor gingiva measures less than 15.5-18.5 millimeters).
• Bruxers

__________________________

Continue Learning

• TMD Problems that Challenge Dentistry – Four Main Categories
• TMD: Cervical Dysfunction Problems
• MD: Temporomandibular Joint Primary Problems
• MD: Class II Division 2 Type Problems
• TMD: Anterior Open Bite Tendency Problems
• Degenerative Joint Disease: Clinical Considerations