Hi there. I'm Doctor Derrick Johnson, with Integrated Dentistry. I wanted to talk to you today about a specific case with someone who had TMJ problems. We talked about some principles in earlier videos, with joints, muscles and teeth, how that system needs to be in harmony for everything to work, and how there can be a whole host of problems that kind of fall under this category of TMJ, or TMD problems.
Let's take a look at this case. I'm going to look at the screen here. What we're gonna see is, this is someone who … They just do not have the arch space to hold all these teeth. Their bite is really out of alignment. When Susanne came to me, she was complaining of headaches, inability to chew and eat food without pain. She had mainly facial pain and headaches and jaw pain. This is a pretty advanced problem that she had, as far as the teeth are way out of alignment. I wanted to give her the simplest correction that I could to give her the most results.
What I did … I'm gonna show you the after picture. Notice here the alignment of the teeth. This canine is way out of position. These back teeth are hitting really hard. It bites open over here. I wanted to apply this principle of, when the joints fit, the teeth fit. We wanted to get as many teeth hitting in harmony as possible. Here is her after picture. We needed to do some crown work in the back. We shaved these teeth. She had nice simultaneous contact, where her jaw was fitting, all these teeth were fitting evenly.
One of the tools that we used before we started, to diagnose this problem is … Here's an articulator. We had some models of her teeth, so we could see exactly how her jaw joints were hinging, how her jaws, muscles and teeth were relating. We also made Susanne an appliance. This is an orthotic appliance. This is different than … You know something think, “Oh, yeah I wear a night guard.”
This is a precision appliance … We call it an orthotic. It's designed to work and be in harmony with your jaw joints. It's much more specific than just wearing a night guard. Sometimes night guards can help people, sometimes not. It's much better to have a precise appliance, especially when you're dealing with some of these issues that come along with TMJ, or TMD problems. Anyway, that's a little case review. Thanks for watching.
Dr. Johnson: Alright. I'm here with Susanne. We just finished up a pretty big phase of her treatment. Susanne, tell us kind of why we did the treatment, kind of what your experience was with it, and kind of what you found out as far as discomfort and things that you had been feeling for. Years, and where that's at.
Susanne: Well, it's actually 100% improved from the time I came in here to get an estimate on my bite change. I had jaw dislocations. I was suffering from general aches and headaches at night. Waking up in the morning with headaches and not sleeping well.
Dr. Johnson: Right.
Susanne: That has improved tremendously. Looking at the pictures of my teeth, and actually seeing that my bite has become aligned with my other teeth. When I eat … I can eat and not feel that discomfort from different food, which I love, hard food, vegetables, fruit. Basically, my bite has tremendously improved.
Dr. Johnson: Did you know … Coming in, did you know a lot of the problems that you were having, were related to your bite?
Susanne: No. I had no idea. I sat here and cried, because all that was revealed to me, what needed to be and how that needed to change. I just knew it was the right thing to do.
Dr. Johnson: Okay.
Susanne: I needed that.
Dr. Johnson: Well great. If you don't mind, I'm gonna show … Can put your picture on the screen that we're looking at?
Susanne: My teeth?
Dr. Johnson: Yeah. Yeah. Here is … This is where we started with this picture. There's a lot of teeth that were out of position. Basically, joints, muscles, and teeth, when they're out of position, can cause a lot of muscle pain, tooth problems, joint problems. Yeah. Here, we're going to the after picture here. This is just one side. I'll just show you one side. We did the same thing to the other. We just have a much more uniform bite, and the teeth aligned. We did that through the use of some porcelain crowns, just on the back teeth. Alright.
Susanne: I was grinding my teeth at night. Now I have a mouth guard to protect 'em from cracking, further damage to my teeth. So I'm pretty happy with that.
Dr. Johnson: Alright.
Susanne: I mean very happy. It's fabulous actually.
Dr. Johnson: Alright. Hey, thank you for commenting on that Susanne.
Dr. Johnson: Alright.