by Rob Veis, DDS
For more on this topic, go to www.dentaleconomics.com and search using the following key words: intraoral appliance, TMJ, TMD, appliance therapy, orthotic therapy, Dr. Rob Veis.
Up to 75% of the population has at least one sign or symptom of temporomandibular dysfunction at any given time, and 34% of the population reports having a temporomandibular disorder (TMD). The diagnostic range of TMD includes headaches, musculoskeletal pains, neurogenic pains, psychogenic pains, and pains from major diseases such as cancer and AIDS. The prevalence of headaches alone in the U.S. encompasses an overwhelming 78% of adult women and 68% of adult men.
Orthotic selection and the treatment of these and other common conditions can be daunting. Proper bite registration, appliance fabrication, and delivery are essential. Also essential is knowing which patients should be treated with oral appliances and which type of appliance is warranted in individual cases.
Intraoral appliances are your absolute best option for the ever-prevalent problems of adult bruxism and tooth wear, tooth mobility and stabilization, TMJ disorders, periodontal trauma recovery, and more.
Why intraoral appliances?
- Because in terms of versatility, ease of use, comfort, and overall retention effectiveness, they have no equal.
- Because there is one for every purpose — combating the deleterious effects of bruxism, periodontal splinting, orthodontic stabilization or treatment of patients with TMJ dysfunction, e.g., local (neck, shoulder or sinus) pain, clicking in the joints, pronounced malocclusion, impaired excursion in opening of the mouth or deviant motions of the jaw.
- Because just one of any type per week will add more than $20,000 to your bottom line at year's end. That number jumps to $40,000 should you opt to do TMJ therapy just once a month.
- Because virtually every adult needs or will need one.
Intraoral appliances come in a variety of designs and, as with most appliances, selection is often a mixed bag. Traditionally, they are constructed from either a hard acrylic or a soft polyvinyl material.
The hard orthotics provide the patient with an adjustable occlusal surface, but usually require substantial chair time to ensure a comfortable fit. The soft versions, although more comfortable, do not readily lend themselves to adjustment and repair.
The amazing Talon®
There is a splint that combines the best features of both hard and soft, while eliminating the aforementioned drawbacks — the Talon® Splint.
“Talon” refers to the material — a soft, thermoplastic, resilient polymer — used for the retentive portion of the splint. Unlike other thermoplastics currently available, Talon retains its original flexibility for years, thus eliminating the need for any other form of mechanical retention.
Once the Talon material is processed, hard acrylic is then chemically bonded to it in order to form the occlusal surface. Because of this hard occlusal surface, precise adjustment is easy — allowing you to maintain a proper proprioceptive response with the opposing dentition.
The soft nature of the retentive portion of the appliance completely eliminates pressure points, ensuring immediate patient adaptation and ultimate comfort. Positive retention is achieved without the use of metal clasps and the Talon can be designed without speech — inhibiting lingual extensions. Your adult patients will love that.
There is no polyvinyl friction and no time-consuming delivery appointments spent trying to find “tight spots” on the appliance. Perhaps most significant of all, the Talon configuration can be applied for all orthotic designs.
Should you still need convincing, care is by-the-numbers easy — soften under warm water prior to insertion; keep moist when not in use (retainer case with wet paper towel); clean with a brush after hardening under cold water.
The final word
The integration of orthotic therapy into your treatment offerings is a simple, patient-responsive, profit-effective way for you to address a full range of patient needs. The payoff in skill enhancement, treatment versatility, and business growth is considerable and ultimately accomplishable. It's time to start exploring your options.
Editor's Note: Orthotic appliance selection, therapy, and adjustment will be one of the seminal topics for discussion at this year's ATPA (Appliance Therapy Practitioners Association) Symposium March 12-15 at the Green Valley Ranch and Resort in Las Vegas.
Dr. Rob Veis is chief executive officer of The Appliance Therapy Group® (ATG), comprised of Space Maintainers, Inc.®, Success Essentials®, Second Opinion® The Smile Foundation®, and The Appliance Therapy Practioners Association®. For more information, visit www.TheATPA.com or call (800) 423-3270.