|
TMJ TREATMENT
BY STANLEY H. MASAKI, DDS
Many TMJ specialists treat TMJ with dental splints.
Dr. Masaki prefers to adjust the dental bite by sculpturing
the chewing surfaces of the teeth to alleviate the symptoms
of TMJ. By harmonizing and synchronizing the intricate meshing
of the teeth with the movements of the lower jaw, the mechanical
stress is minimized on the surfaces of the teeth and the jaw
joints. This allows the jaw joints and muscles to relax and
undergo stress-relieving changes. Time is needed between visits
(about a week) for these changes to take place. Bite adjustments
take about an hour per visit. Treatment usually takes 5-6
visits, sometimes more, over approximately 2 months. Once
the bite adjustments have been completed, most patients are
very comfortable, if not completely pain free.
In order to treat TMJ effectively, Dr. Masaki feels that
the dental bite should fulfill two basic criteria: (1) The
proper parts of the posterior teeth or "centric stops"
should make contact so that the forces on the teeth are directed
vertically. (2) The dental bite should be "dynamically
balanced" so that all of the back teeth contact with
equal pressure when the teeth are gently tapped together by
the dentist and not by the patient.
Dynamic balancing of the dental bite is a technique developed
in 1985 by Dr. Masaki. The doctor holds the patient's
lower jaw with both hands under the jaw bone while standing
behind the patient. He gently taps the teeth together with
his fingers under the jaw bone in different positions in order
to feel the vibrations of different groups of teeth making
contact. The teeth are marked with a silk ribbon similar to
carbon paper. Using the vibrations in the jaw bone as well
as the markings of the ribbon, he reshapes the teeth in order
to fulfill the two criteria described above: (1) proper centric
stops, (2) dynamic balance. When completed, the upper and
lower teeth contact each other like a well-balanced "platform"
which in turn stabilizes and protects the jaw joints.
At the following visit, the patient is asked about any changes
in his symptoms. Many TMJ symptoms are related to specific
bite conditions on the teeth. After each visit, the bite will
have improved but will need further adjustments. The bite
is continually adjusted at each visit until stability is achieved,
and the number of visits required is unpredictable. Treatment
is completed when the dental bite becomes stable and remains
little changed when checked for "dynamic balance."
Bites do change with the passage of time and the patient may
need minor bite adjustments in the future.
It takes time and patience to complete this treatment as
it depends on the proper manipulation of the mandible and
interpretation of the vibrations in the jawbone. It is an
extremely operator-sensitive procedure and is a variation
of a very popular technique (Dr. Peter Dawson's). Dr. Masaki
has been doing bite adjustments for over 25 years and his
rate of success is high.
|
