TMJ Treatment Part 2 of 4 - Dental Minute with Steven T. Cutbirth, DDS

[@haroonshah3555]

Just wonderful each time you watch any of the videos by Dr.cutbirth it's so much informative and enjoyable. Your teachings and presentations are so much communicative and understandable and simple as if you teach children .thanks a lot for your efforts.

[@centerforard]

So glad the videos are helpful. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513

[@Pachpan]

please always keep posting! such a great help !!

[@centerforard]

Thank you. Don't forget about DentistryMasterClasses.com. These are not only comprehensive cases but all the Dental Minute videos and comprehensive cases in an organized library so you can refer to them and not have to remember the titles and find them on KZbin.

[@ssSkullZzz]

I wish more dentists in my country knew about this point 13:30 Doc, for me it all started with a small tooth decay in my bottom 2nd and 3rd molars, so I went to the dentist and he removed the decay and did the fillings (I later realised that he over filled the 3rd molar), I couldnt tell if my bite was off that day cause my entire mandable was numb for almost 5 hours, for the following 6 weeks I had extreme muscles pain near the tmj area and swallowing difficulties, I knew something is not quite right but I didn't know what it is, so I did my own research, and realised it has to be the fillings that is causing my muscles to fatigue, cause I never had any problems in my jaw muscles prior to that, and just like the table example you mentioned; it felt like my mandable is moving between 2 or maybe 3 different bites during the day, so I went back to the same dentist, and I asked him to remove a piece of the fillings from that 3rd molar, he tested the bite using the red-blue paper, and according to him everything was normal, I tried to explain to him that this cant be normal, I know my bite is not right, and that I am biting on inclined surfaces, he said "it is absolutly normal to have a weird bite after fillings, the teeth will adapt, and that a nightguard will help cause Im just stressed and I clinch a lot", I used the nightgaurd for a couple of days, but I ended up going to another dentist and I showed him the overfilled molar and he kind of did fix it, my bite is somewhat back to normal, but I guess the condyles-fossa relation need a reset just like you did in the "Fundamentals of Occlusion" video, I can not stress enough how important that video is, I will make sure to tell my dentist about it, you can not just manipulate Centric Occlusion and ignore Centric Relation, it's just not right. specially after the patient made it clear that there is muscle pain around the tmj area. Greetings from Jordan.

[@centerforard]

Thanks for your comment. Occlusion is the fundamental of my practice. Almost everything else I do in dentistry revolves around proper occlusion.

[@mikefredo9046]

Great video! Such a fantastic work! Doctor! Can occlusal problems cause swallow problems(difficulty to swallow)?

[@centerforard]

Tongue issues can cause swallowing problems. I'm not sure about TMJ issues causing swallowing problems.

[@michaelaNkristin]

My teeth have never been equilibrated, but I was in braces for TMJ. My symptoms got worse. Three years later I had internal resorption on a front tooth (maybe bc of the braces?) so I got a dental implant. Along with my TMD pain I am currently dealing with daily pain from my implant and seeing a physical therapist every other week to loosen and stretch my shoulders/neck. My dentist and periodontist suggest I get a custom splint to wear at night which I haven’t gotten yet since I’m still wearing the temporary. I’m afraid to get the permanent tooth because of the amount of pain I’m in. Aleve and Advil don’t relieve the pain. I also hit more on my left side than my right. Any suggestions? I feel helpless.

[@centerforard]

So sorry, I cannot diagnose you unless I examine you. It can get complicated.

[@victoriaboland4662]

I’m going through something similar it’s awful :( how are you now?

[@fovos7359]

Doc is it possible to take splint therapy without changing the bite

[@centerforard]

Yes, but when the patient removes the CRO splint, they will then be biting into a malocclusion, or whatever their presenting natural occlusion was. Ideally, you would like the occlusion to be in CRO both with and without the splint. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513

[@SShow-fd3kv]

I have the same problem :( would you please advice me where in Germany can i get this treatment?

[@centerforard]

Sorry, I have no idea.

[@victoriaboland4662]

I have a question!:) shouldn’t you wear a tmj splint for 6 months give or take before equilibrating things? To settle all the muscles etc.. that’s the treatment I’m currently doing, did this patient wear one for a while prior to equilibrating the teeth?

[@centerforard]

No. So long as you know how to manipulate the patient into centric relation, you do not have to wait prior to equilibration. You will equilibrate, then monitor and rise tune the equilibration over several months in case the teeth move/settle a small amount. The monitored equilibration should not be very much. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513

[@victoriaboland4662]

@@centerforard I am the one who’s the patient! I think there was a misunderstanding haha. My doctor is instructing me to wear a splint for a while prior because I have AD with reduction and early degenerative disc disease. Then plans on equilibrating but now I’m wondering is wearing the splint a waste of time

[@greggray3741]

Do you think Neuromuscular Dentistry is helpful for fixing a bad occlusion? Seems to be a debate between that method and Pankey.

[@centerforard]

I have never tried NMD, or whatever they call it. CRO and the treatment I am describing makes perfect sense to me. I have used this method for the past 20 years and am not aware of any patients that were not treated successfully. The teeth fit together with the condyle seated maximally in the fossa with no perceptible CR-CO slide and the eccentric movements worked out properly as described. The patient wears a flat plane, CRO occlusal orthotic appliance while sleeping as I describe in the video.. Aren't all joints supposed to be maximally seated when that joint system is under stress, i.e., the knee joint maximally seated when a person is running. NMD makes no sense to me.

[@SimplexPuma]

Hey Doc! Thanks so much for these videos! I’m a bit confused by your usage of the term “Centric Occlusion”. You seem to be using this term as a synonym to MIP (Maximum Intercuspal position) and differentiate this position from what you call “Centric Relation Occlusion”. According to the glossary of prosthodontic terms, CRO and CO are synonymous, could you explain for me your usage of these terms and how they differ from MIP? Thanks!

[@centerforard]

CO has nothing to do with CR. CR is the condyle seated maximally in the fossa, regardless of the occlusion of the teeth. CO is maximum intercuspation of the teeth, regardless of the condylar position. We are trying to achieve CRO, which is maximum intercuspation of the teeth with the condyle seated maximally in the fossa (CR). Watch my video on occlusion in the video library of DentistryMasterClasses.com. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513

[@SimplexPuma]

@@centerforard Hi Dr. Cutbirth. Thank you for your response! I believe I have found the reason for this discrepancy in the term "Centric Occlusion". The newest 9th edition of the glossary of prosthodontics defines CO as: "centric occlusion ∖sĕn΄trĭk a-klōō΄zhen∖: the occlusion of opposing teeth when the mandible is in centric relation; this may or may not coincide with the maximal intercuspal position; comp, MAXIMAL INTERCUSPAL POSITION" However, looking back, the 4th edition of the Glossary in 1977 defined this term as you use it: "Centric occlusion: The centered contact position of the occlusal surfaces of the mandibular teeth against the occlusal surfaces of the maxillary teeth. " Looks like at some point the definition of this term has changed so now in dental school we are taught that CO is the relationship of the teeth when the joint is in CR. What you use CO for is now taught as "MIP" in school. Thanks!

[@centerforard]

The term "Centric Relation Occlusion" refers to the teeth in maximum intercuspation with the condyle seated maximally in the fossa. CR has nothing to do with the occlusion of the teeth and CO has nothing to do with the condylar/fossae position. Watch my videos on "Occlusal Concepts." Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513

[@sylvester6063]

Sir why do we need to add composite?

[@centerforard]

When performing an equilibration, you can either polish away tooth structure or add composite to balance the occlusion bilaterally. Adding composite is a good way to "add" some occlusal height to some teeth if you have polished away tooth structure to the most anterior contact when the patient bites down in centric occlusion. Occlusion is a long conversation. Watch my videos on occlusion in the library of DentistryMasterClasses.com. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513

[@aashajain7376]

I have TMJ disorder but don't have any pain My problem is that my teeth are shifting inwards (inclined) and other thing is my jaw deviate on opening. Please help me

[@centerforard]

I cannot diagnose your condition without examining you. Go see a dentist trained in treating TMJ dysfunction.

[@aashajain7376]

@@centerforard please doctor tell me what problem i have.. i went to many so called TMJ specialist but none of them able to understand my problem of teeth inclination

[@centerforard]

Sorry, I cannot diagnose your condition without examining you.

[@therandiked]

hmm ink paper . I have heard Tscan and EMG are much better for bite balancing

[@centerforard]

I do it this way by manipulating into centric relation. There are probably several ways to do most things. The way I am teaching you to do all the procedures in these videos is just one way that works. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513

[@azizatarmissi1907]

It is very nice

[@centerforard]

Thank you.

[@sarahchevallier1125]

wow

[@centerforard]

Glad the video was helpful.

[@azizatarmissi1907]

You grinding a natural teeth

[@centerforard]

Yes, minimally, if that tooth is the premature contact or I may add composite to the biting surface of a natural tooth if that/those teeth are too short, depending on many variables.. The idea is to balance the bite so the patient hits on both sides at the same time when they close their teeth together, just like a table in a restaurant that rocks. How do you correct the rocking table? You either polish a little off the table leg that is too long or place a sugar packet under one or more of the table legs that are too short, creating a stable, non-rocking table.

[@richburatinobitch9647]

Dental Minute with Steven T. Cutbirth, DDS did you remove cr to co contacts manipulating to cr? Or you just remove all unnecessary contacts in co like you showed in this video and they automatically removes all cr to co slide contacts ? Thanks

[@centerforard]

Watch my video on occlusion. Or better and easier, subscribe to DentistryMasterClasses.com. In DMC.com there is an organized library of all Dental Minute and DMC.com videos and PowerPoint presentations. You can refer to them and study them.