Learn about the effects of TMJ Disorder.
Read the full transcript »
Male Speaker: The next patient you will see is a housewife from Canada just below the Arctic Circle, how she found her way to my office in the Washington DC suburbs is beyond me. For the next few minutes you will see footage taken by this woman's husband in their home, several months to years prior to coming to see me. These patients are frequently institutionalized or warehoused because no one takes the time to diagnose or treat them. As you watch this footage, think that if you do not treat these patients, who will? They have seen multiple healthcare providers, sometimes as many as 65 healthcare providers and they have received non-diagnosis after non-diagnosis after non-diagnosis or outright misdiagnosis time and time again. This is the patient's second visit to my office, I saw her about two weeks previous to this at which time I rebuilt a lower appliance that some other dentist had made to give her relief and took impressions for a new appliance which I would then make and deliver it during this appointment. At that first appointment we also did a thorough diagnostic workup to include tomographic imaging and MR imaging. Male Speaker: Okay. Lay back then. Female Speaker: I just landed--I am living, I usually get--just like I am fading off-- Male Speaker: Yeah. Female Speaker: You know with what. You think you have just bam—it just hits me or everything just like I am pulling away, I can't hear anything, it's just like drifting off into sleep. Male Speaker: You had a body experience. Female Speaker: Yeah. Out of terror. Male Speaker: How frequent does this happen to you? Female Speaker: Twice a week. Male Speaker: Twice a week? Female Speaker: Yeah. Male Speaker: For how long has it been going on? Female Speaker: Oh! Before I started seeing you, it was--daily. Male Speaker: Daily. Female Speaker: And it's been going on for four and a half years. Male Speaker: For four and a half years. But since I made that provisional appliance for you redid what your old appliances, it's gotten better. Female Speaker: It's gotten better, they are not as severe and they are not as frequent. Male Speaker: Any percentage of how much better they are? Female Speaker: Oh gosh! I would say it's improved by 50%. Male Speaker: Okay. Female Speaker: They are not as powerful, actually probably higher because it’s now as stabilitating probably 80% improvement. Male Speaker: And that's just with one visit remaking your old appliance. Hopefully, we will get the remaining 20% with this. This is what it looks like and I will lighten this contact slightly and lighten the second contact slightly. Notice the tore I built to the appliance to keep her tongue alleviated and her throat open and increase the oxygenation My appliance is out of her mouth and you can see the reaction she is having now without the occlusal support. Intervals like this will become fewer and fewer as treatment progresses. I am putting the appliance back in the patient's mouth and having her seeded to place. Notice the immediate reaction that she has once it is in its proper place. It didn't get, you are just scaring everybody. Female Speaker: Thank you. Male Speaker: Well, let's see, you know quickly walk through. Female Speaker: Do it again. Male Speaker: Yeah. Female Speaker: But sometimes walking is. Now it did not-- Male Speaker: Not an option. Okay. As you can tell the appliance is not as good as it should be, you can immediately tell how effective the appliance will be, you don't have to say come back in two or three weeks and report to me. Female Speaker: Would you like to lean back, you can have my help? Female Speaker: No, that makes it worse--you think almost forwarded is usually better. Male Speaker: The patient is hanging her head forward to move her mandible downward and forward, this decompresses the tissues of the temporomandibular joint, it's a form of mandibular advancement that the patient has serendipitously discovered. Female Speaker: Usually my rig