• "An understanding of how muscle function and tooth position relate to healthy joints is the foundation of successful TMD treatment."

    - Dr. Martha Rich

Introduction to TMD Treatment

For Dental Professionals

Functional disorders of the jaw are often complex and multifactorial in nature. By utilizing a multi-phase approach to treatment for patients with TMD and other forms of chronic pain, you and your patient can work together to unravel all the factors that may be contributing to the disorder before making any permanent changes to the bite.

In an Introduction to TMD Treatment, Dr. Rich explains the foundational concepts of neuromuscular dentistry in relation to temporomandibular joint disorders and their fundamental differences from gnathological concepts. Utilizing case studies from her own practice, as well as in-class demonstrations, Dr. Rich will help you understand how to use neuromuscular diagnostics, removable appliances, and complimentary therapies in order to achieve stabilization for patients with minor or transient forms of TMD. The diagnostic differences between a minor or transient TMD patient and more complex cases will be covered, but treatment and stabilization of complex or severe TMD cases will be reserved for Advanced TMD Treatment.

Presentation Formats:

Standard Course:         2½ days
Custom Course:            Please contact Dr. Rich through the Contact Page for more information.

Day 1:

Overview of Neuromuscular Dentistry:

    • Basic components of three-dimensional jaw function
    • Theory and differences from gnathological concepts
    • Functional occlusion vs. centric relation
    • Introduction to trigger points, TENS therapy, joint remodeling, and muscle function in relation to tooth position and vertical dimension
    • Functional treatment vs. surgery

Initial Exam and Preliminary Diagnosis:

    • Neuromuscular diagnostic tools and techniques for initial exam
    • Lifestyle considerations in diagnosis and treatment planning
    • Including the patient: Why your patient’s perspective may be one of the most valuable diagnostic tools you have
    • X-rays and 3-dimensional jaw scans: When you need them, and when you don’t
    • Complimentary therapies for muscle release and structural readiness for change: When and why to prescribe them

Day 2:

Nightguards and Splints:

    • Symptoms and conditions where a nightguard or temporary splint would be the appropriate first step
    • How to use TENS as a diagnostic and therapeutic tool. Alternative therapies for intolerant patients
    • Upper vs. lower, flat-plane vs. occlusal surface, soft vs. hard
    • Treatment length, adjustment frequency, and coordinating complimentary therapies
    • Activity uses outside of sleep
    • Stabilization and weaning, including introductory discussions of Phase II treatment when weaning is unsuccessful
    • Case studies

Day 3:

When Minor Cases Become Complicated:

    • When a nightguard or temporary splint turns into an orthotic – consequences of long-term use on bite and stabilization
    • Options for patients who do not stabilize
    • How to determine if advanced TMD treatment may be necessary