JOINT PAIN, MUSCLE PAIN OF NECK, SHOULDER AND MASTICATORY REGION
"Correcting the Abnormal Mandibular Jaw Closure Patterns"
A strong emphasis is placed on treating temporomandibular joint (TMJ/ TMD) dysfunction, Musculoskeletal dysfunction of the head and neck, and the Occlusal disorders. Craniomandibular Orthopedics combined with a neuromuscular approach to dentistry is taken as an non-invasive preventative approach to dental care.
Patient reports – PAIN FREE AND HAPPY after many years of debilitating pain. 3 days later patient visits office very excited and overjoyed!!!
Patient's previous pain sites.
Dr. Clayton and his team place great emphasis in dental health including the areas of gum health, jaw posture, occlusion, muscle balance, teeth appearance and nutrition, realizing that a conservative and preventive approach is of utmost importance for long-term comfort and optimal health of the whole body.
Dagger pain in right eye, right joint, neck and shoulder pain resolved. Debilitating pain eliminated and patient comfortable since November 2004.
After a thorough examination, radiographs of the joint and diagnostic computerized scanning, TENS and simultaneous EMG's, Diane's "physiologic" bite was found. A lower anatomical orthosis was fabricated to the specific dimensions determined by the doctor and confirmed with the objective recordings.
The lower removable orthosis is clear. It is finely adjusted and made comfortable.
Three (3) days after. Patient comfortable and pain free. Note the facial change an appearance. This is the power of "Finding the Bite" and neuromuscular occlusion.
PHASE I THERAPY
Orthosis Therapy with TENS INCLUDES THREE FOLLOW UP VISITS
PHASE II THERAPY
Once the patient is asymptomatic , free of pain and off medications the doctor will evaluate whether that person can function pain free without the orthosis. If they can further stabililzation treatment many no longer be required.
If the patient is not able to function comfortably without the orthosis the following options should be considered to complete the bite at the neuromuscular position:
1. Orthodontics Treatment - If the patient has healthy teeth with minimal restorative crowns, conservative orthodontic and orthopedic (non surgical) techniques can be implemented to grow the teeth, bones and gum tissues to the desired neuromuscular position. (Transitioning the orthosis with the natural teeth/bite at the proper position is possible).
This approach demands complete control of the bite and surrounding muscles during orthodontic/orthopedic treatment, especially during the verticalization process therapy. Proper jaw joint positioning in harmony with a physiologic relationship of the lower jaw to the cranium is absolutely critical to prevent relapse of the TMJ pain.
This approach does take time typically 18-24 months/2 years treatment).
2. Restorative Treatment - If there is already numerous crowns and fillings and/or provisional (temporary crowns) along with worn down teeth, a comprehensive full mouth restorative approach should be considered. If there are a few missing teeth bridges or implants may be required.
This approach is more extensive, but results are excellent as to the appearance of the teeth and smile. It demands a thorough understanding and control of the bite and muscle management by the clinician during the transitioning process (from the orthotic position to final crown treatment).
The bite must feel proper, comfortable and able to chew free of any interferences after treatment, without the reoccuring TMJ pain.
Orthodontics may be required at the beginning of treatment if the posterior crown root ratio is deficient. It is quicker and efficient, but there is sacrifice of tooth structure where required.
3. Semi-Permanent Orthosis - This is for those with cases with numerous missing teeth and existing partial denture appliances. It is typically a cast metal overlay appliance that fits over the existing worn down teeth. It is designed for long term use and fabricated to the neuromuscular position.
It is less costly than the full mouth restorative approach, but an excellent long term option if finances are an issue.
4. Combination of Ortho and Restorative - If there is narrow arch forms, crooked, mal-aligned crowded teeth, a beginning phase of orthodontics may be indicated to arch develop (expand), level, align and straighten the roots/teeth first. Arch development may be indicated to improve intra oral volume and tongue space.
Deficient vertical dimension of the posterior teeth may be present compromising the joint position and muscle stability, thus orthodontic verticalization may be needed to lay the proper bone and teeth support before a more extensive restorative/crown phase of treatment is rendered to prevent long looking teeth and odd crown to root ratios in the posterior bicuspid and molar regions.
Talk with your dentist as to what may be the best and reasonable approach for your case.
We feel proud and honored that we can provide our patients with comfortable, improved life styles, dental health and smiles. Our desire is to provide timely and effective treatment that addresses the source of the problem rather than band-aid remedies.
@2006 CLAYTON CHAN, DDS
702 . 271 . 2950
9061 WEST POST ROAD
LAS VEGAS · NV · 89148