As a Prosthodontic Centre , we at Smiles…by Design are focused on restoring and replacing missing or damaged teeth and jaw structures, and it plays a significant role in the management of Temporo Mandibular Joint Disorders ( TMDs). Prosthodontists often serve as the lead for a multidisciplinary team to manage complex cases. The primary goal of the treatment in managing TMDs is to regain patient comfort, achieve occlusal (bite) stability, and facilitate the restoration of function. Their scope is generally non-invasive and focuses on conservative therapies, as current evidence suggests that most TMD symptoms are multifactorial and often respond well to reversible treatments
Diagnosis and Evaluation: We use standardized diagnostic Criteria for Temporomandibular Disorders (DC/TMD), to thoroughly evaluate the patient's condition, including physical symptoms (joint pain, muscle tenderness, limited movement) and relevant psychosocial factors. This is done with A face Bow and a Semi Adjustable Articular ( Hanau wide view )
Oral Appliance Therapy (Splints/Night Guards): This is a primary prosthodontic intervention. Various types of removable intraoral appliances are used to manage symptoms:
Stabilization Splints: These hard acrylic splints provide a temporary, ideal bite to reduce abnormal muscle activity, distribute forces evenly, and protect teeth from the effects of bruxism (clenching/grinding).
Anterior Repositioning Appliances: Used in specific cases of disc displacement, these appliances are designed to alter the position of the jaw to reduce joint pain or clicking.
Restoration of Damaged Dentition: TMDs can be exacerbated by missing or severely worn teeth. Our team address these issues with crowns, bridges, dentures, and dental implants to restore proper function and stability once the patient's pain is under control and their condition is stable.
Occlusal Management: As experts at rehabilitation or correction of existing unbalanced occlusal conditions our team manages the functional bite to ensure a harmonious relationship between the teeth, muscles, and joints. We aim for simple, stable, and comfortable occlusal schemes, avoiding aggressive or irreversible changes to the natural tooth structure unless absolutely necessary for the overall rehabilitation plan.
Multidisciplinary Care Coordination: To add, we work alongside other healthcare professionals, including physical therapists, physicians, and psychologists, to provide a comprehensive and integrated treatment plan for complex TMD patients.
It is important to note that prosthodontic treatments are often part of a wider management strategy and may not "cure" the underlying, often multifactorial, cause of TMD. Irreversible occlusal procedures , like extensive grinding down of healthy teeth) or surgeries are generally avoided, with an emphasis placed on conservative, reversible therapies first . More often than not we play a crucial role in improving a patient's quality of life by managing pain and restoring function within the masticatory system
Prosthodontists play a critical role in managing Temporomandibular Joint Dysfunction (TMD) by restoring occlusal stability, managing bruxism, and providing oral appliances to relieve joint/muscle pain. They address the relationship between jaw function, bite, and muscle activity using stabilization splints, occlusal adjustments, and prosthetic rehabilitation to ensure patient comfort.
Stabilization Splints: The primary, reversible treatment, these bite guards are used to stabilize the occlusion, reduce muscle tension, and protect teeth from grinding.
Occlusal Therapy: Prosthodontists evaluate and adjust the bite (occlusion) to eliminate premature contacts that may trigger TMJ, muscle stress, or headaches.
Prosthetic Rehabilitation: For patients with missing or worn teeth causing improper bite, Prosthodontist rebuild the vertical dimension to restore proper joint alignment.
Diagnosing TMD: Symptoms managed include pre-auricular pain, clicking/popping sounds, restricted jaw movement, and muscle pain.
Multidisciplinary Approach: While Prosthodontist handle the dental aspects, TMD management often requires collaboration with neurologists, physical therapists, or pain specialists due to its multifactorial nature.
Initial Evaluation: Before extensive dental work, a Prosthodontist will typically use a temporary splint to ensure the jaw is comfortable, as permanent, irreversible changes to the bite are not ideal initial treatments.
Bio-psychosocial Factors: TMD often has chronic, complex origins beyond just a bad bite, which makes precise, personalized treatment planning crucial.