Dr. Halligan

I’d choose to share an e-mail I got last week and also then comment. The short article referred to is ‘Rethinking Equilibration,’ and is obtainable on my web site. This email is similar to at least three rather I have received this month, in various other words, his is not a specifically unusual request for help, yet it does point out one area the dentistry the needs higher attention.

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Hello Dr. Halligan,

I check out your wonderful article and also it sounds prefer my situation.

Three year ago, i was 44 years old with a history of fillings, crown work and periodontal disease. I got quarterly cleanings from mine dentist and also periodontist. Ns wore a bite splint at night that extended my peak teeth. I had tested an adverse for TMJ in 2011, but my jaw and joints were frequently sore and uncomfortable.

Rather all of sudden in 2017, my bite change to where I to be hitting just on mine left side. And also I likewise developed a dull pains in number 14, a long before root-canaled and also crowned tooth.

My continual dentist check me twice and also couldn’t recognize the source of the pain. The referred me to an oral surgeon that felt it was a gum issue and that I should see my periodontist.

My periodontist said it wasn’t a gum issue and the pain ns was feeling in 14 was concerned my occlusion. He claimed he would perform an equilibration to also it out. He simply used the occlusal contact document and began drilling. He perfect in probably 10 minutes.

The an outcome was comparable to what the patient in your write-up experienced. Contact points top top the molars to be removed and also my jaw felt favor it to be floating. The bite was totally off and also uncomfortable. I went ago to the periodontist and he do the efforts to exactly it.

No shock absorb is the perfect means to describe it. The bite is still not correct and my jaw is continuous sore and also uncomfortable. My bite splint no longer fits correctly and I think the is impacting mine sleep.

Second opinions have actually varied indigenous orthodontics for 2 years adhered to by veneers and also gum grafting, a full reconstruction, basically, come three different dentists who claimed they would choose to carry out a suitable equilibration. However, i really don’t to trust anymore grinding of my now-sensitive teeth and also would like a restorative approach, yet don’t know how that would certainly work.

Any advice or directions would certainly be considerably appreciated. I live in Northeast Ohio. 

I have an meeting in February v a various oral operated doctor to reevaluate me for TMJ, however I’ve likewise noticed a general decrease in mine aesthetic appearance because my this were soil down and also my speech has been affected as well.

Thank you and also best regards,

(Name omitted)

Ok, Doctor, what execute you think?

If you’ve been analysis my site for a while, or if you know me personally, you understand what to carry out next: achieve CT scans or MRI, execute not reach because that the donut diamond, and also do not start restorative dentistry without learning what’s going on with the foundation of occlusion, the joints—the condylar-disc assembly and also how castle relate to the cranial base. And then fix that problem before proceeding with any kind of other treatment.

MRI of a left TMJ through anterior key displacement and also posterior displacement of the condyle.

And yet this man has seen a periodontist, an dental surgeon, an orthodontist, and three basic dentists, and so far nobody has actually looked in ~ the joints. Maybe the following oral operated doctor he sees will carry out that. Fingers crossed.

If your car suddenly noted to one side, you’d instantly think damaged springs or swollen shock absorber. You probably wouldn’t let the air the end of the tires on the opposite next to make the automobile level. You’d get to her favorite mechanic and also let him determine the cause and also then resolve it.

Do I know for certain that the male who composed the email has a displaced bowl on the left side with subsequent posterior displacement the the mandibular condyle on the side? without MRI or CT scans, no i don’t. However it would be a pretty safe bet, and I’d be happy to placed a twenty on that in las Vegas.

There room plenty of various other possibilities such as muscular convulsion pain, occlusal problems including lateral interferences, also sleep issues. Yet my twenty is tho on anterior bowl displacement on the left side.

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Bottom line? constantly remember the the condyle-disc assembly, so regularly ignored and overlooked, is the foundation of occlusion. Sudden change in the bite? the not about the teeth.