TMJ Dysfunction in Reno, NV & Surrounding Areas Expert Explains TMJ Dysfunction
When I first moved to Nevada in 1982, I was the new Orthodontist in town from New York City and had just completed my Orthodontic residency at New York University the year before. TMJ issues were not widely covered in our program and that seems to be true for most even to this day. We were told that if patients had a painful, clicking jaw, send them to the oral surgeon for treatment because we had very little to offer our patients with TMJ dysfunction in Reno, NV, and surrounding areas.
Going Against the Status Quo
I became alarmed when the patients I referred to the oral surgeon came back with their TMJ meniscuses (disc) removed and replaced with Teflon Protoplast artificial discs. I had several friends who were orthopedic surgeons and I learned from them that this was tried with knee meniscuses with very bad consequences. The Teflon Protoplast implants caused a giant cell macrophage attack from the immune system due to the fact that they were a foreign body and they had to be removed after becoming painful and limiting range of motion. I brought this up at our local Northern Nevada meeting and was basically told that I was out of order telling an oral surgeon how to practice and should sit down and shut up. “Get a rope, He’s from New York City.”
I stopped referring patients to oral surgeons and started my own journey to learn as much as possible about treating patients with TMJ problems. From Myotronics in Seattle to the University of San Francisco pain clinic, Rocobado Physical Therapy courses, to John Barnes Myofascial Release techniques, I became a seeker of answers to my patients’ troubles. Some time by the late 1980’s all patients who had those Protoplast Implants placed suffered the exact giant cell macrophage reactions and had to have the implants removed. Hate to say I told you so, but…
My treatment has evolved over the years, always adding or subtracting what is working or not. The most important part of the puzzle is an accurate diagnosis. A complete examination with a 3D cat scan of the TMJ allows me to see what we are dealing with. A T-Scan computer-aided bite evaluation is critical to know if a bite problem exists. Patient history of trauma, a blow to the jaw, a motor vehicle accident, chronic clenching and grinding, etc, are critical to understanding the puzzle. My treatment is not cookie cutter. It can be as simple as a bite plane to prevent nighttime clenching and grinding. It becomes more involved depending on the extent of headaches and clicking and popping of the jaw. Interestingly enough, a recently formed company called Trudenta uses very similar treatment protocols that I do, but they charge over $80,000 for their consulting services and have dentists billing $7,000-$9000 for their treatment. Our fees are substantially lower. I cannot recall the last patient who had to have jaw surgery for their TMJ issue in my office.
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