How to Stabilize the Joints

By: Dr. Leonard A. Hess, DDS
Clinical Director, The Dawson Academy
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If we have a symptomatic TMD patient and are trying to figure out, can we make this patient better or comfortable? How can we stabilize the joints?

Go Back to the Complete Examination

What does the examination tell you and what do we think is going on? Ask yourself:

  • What is the joint diagnosis?
  • Do we have healthy joints and it is a muscle issue thing?
  • Do we have intracapsular problems whether it is a lateral pull or a medial pull?
  • Do we have degenerative joint disease and the occlusion is unstable?

So when we look at it from this way what we are really trying to figure out is if it’s a dental problem related to the oral facial pain or the symptoms of this patient? And can we solve it?

We Want to Try to do This in a Reversible Means

So here is the one important thing: we do no irreversible dentistry until we can get a patient comfortable.

We are going to use reversible means to try to get there. We are going to use splints. We are going to pick our splints based on the potential diagnosis, and the joint diagnosis, and we are going to go from there.

We are going to monitor the splint, for what we are going to say comfort and stability. So can we eliminate the symptoms of the patient? Can we make them feel better? Can we stabilize the occlusion and if we can is it possible to do that over a period of time?

Once the Joints are Stable – Go Through Normal Treatment Protocol

If we get there and we get to that stability, now we can go through our normal treatment planning channels and figure out ideal treatment.

Another thing in here is just to go back to that examination now because we know also that you have got to check or airway.

So any symptomatic patient, it may solely a dental occlusal problem, but we have to make sure that airway is not part of it as well because that is going to affect where we are going to go with our treatment.

Keep Reading: How Do You Know If You Achieved Centric Relation?

Dr. Leonard Hess, DDS

Dr. Leonard Hess, DDS

Dr. Leonard Hess began teaching continuing education courses in 2005, and the topics include occlusion, smile design, treatment planning, preparation design, and practice integration of complete dentistry. He’s taught full-day continuing education courses at the American Academy of Cosmetic Dentistry’s national meeting, The Greater New York Dental Meeting, AACD National Meeting, Pacific Dental Conference, Ontario Dental Association meeting, and The Yankee Dental Conference. Dr. Hess also has taught courses in Japan, Germany, Poland, China, and Canada. Dr. Hess is currently serving as the Senior Clinical Director at The Dawson Academy. He also owns Union County Center for Comprehensive Dentistry in Charlotte, North Carolina.