Hi Everyone and welcome back to my YouTube channel! My name is Priya Mistry and I'm a
General dentist with a practice dedicated to taking care of patients with TMJ problems.
Today's video is going to be about the four levels of treatment that we offer at our office,
so if you're a current patient or you're thinking of pursuing treatment with us,
I hope this video is helpful! I'm really trying to get the point across that there's not a
one-size-fits-all sort of treatment at our office and we really evaluate each individual
before we decide on a treatment plan. We look at our cases based upon degree of difficulty
with four levels, four being the highest. The first level of treatment we'll start with - Level
One - is considered the least difficult. These patients typically have just a little bit of
popping or clicking within the joint, or some joint noises. Sometimes they'll come in with that
and they'll say, "I want a sleep apnea appliance". So they typically just need a little bit of help
getting their jaw joint back in order and getting their sleep better,
in terms of oxygen saturation, feeling rested, etc. For these patients, we make them an appliance
and we check on them maybe one to two times afterwards to make sure that it's effective,
they're getting the results that they want. Level Two - there's a lot more dysfunction
in the muscles that's involved. So what that means is that these people will have jaw pain,
headaches, neck or shoulder pain, so a lot of muscular issues going on.. and they may have a
little bit of mild clicking or popping, but it's usually more about getting the muscles calmed down
for these patients. We give them a daytime appliance and a nighttime appliance.
They wear the daytime appliance with us planning to taper them off of that usually within
8 to 12 weeks or so, and it varies - everybody's a little bit different. The daytime appliance - the
purpose of it is just to get results faster. These patients usually are not comfortable,
they're in a lot of pain and they typically don't have a whole lot of joint involvement as well.
What we do for these patients is once we give them their daytime and nighttime appliances,
we see them every week for physical therapy and for checking the splints.
Then we see them every two weeks as their symptoms get better, then every three, then every
four.. until we can release them from treatment, meaning they're not having these symptoms anymore.
Level Three is where there is joint involvement as well as pain in the head, neck,
and jaw. What that means is these patients have more significant clicking, popping,
crackling within the joint. They've experienced episodes of catching or locking, so the disc
within the joint is pretty unstable and then they also have headaches, neck pain, jaw pain.
So for these patients, we also give them a daytime and a nighttime appliance and we see them weekly
for physical therapy and jaw manipulation. So we see them every week till their
symptoms start to get better, then every two weeks, then every three..
until we can release them from treatment. Level Four - these patients are actually locked closed,
so they can barely open their mouths more than one or two finger widths and they're in a lot of pain;
and so for these patients, even getting the custom orthotics made can be a process because they can't
open their mouths wide enough for us to even get impressions. For them, we do a lot of therapy
to release and relieve the muscles around the head, neck, and jaw we do specific jaw
manipulation to get them open enough to get the orthotics made. And then once they are made,
same thing as Level Three - we see them weekly for physical therapy and jaw manipulation,
then every two weeks, then every three.. until we can release them from treatment.
So these are our four levels of treatment and again they're not hard and fast, there's always
exceptions to every rule; but this is just sort of a basic guideline that we follow when diagnosing
and evaluating our patients. So I hope this was helpful to you guys. If you liked what you heard,
please click "Like" below and SUBSCRIBE to my channel! There's so much more to come! Thank you!
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