T m d is a spectrum of care from joint related right down to muscular ated. Probably about 90 % of the patients i see are down at that muscular end, as you say. Of those 80% who don't need further intervention despite not getting better with arthroskby, it becomes very clear that they haven't got a joint related pathology. And of those that don't, when they've got significant pathology in the joint, that go on to joint replacement.
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Episode notes
What happens when conservative care fails? What if you have prescribed patient education and the ‘best’ occlusal appliance and none of it is working? That’s where surgery MAY be indicated for certain diagnoses. Listen or Watch my podcast with Professor Andrew Sidebottom Maxillofacial surgeon (who is limited to the management of TMJDs) to help us make timely and appropriate referrals to provide the best possible outcome for our patients.
Protrusive Dental Pearl: Head over to the Protrusive Dental Community Facebook group where I posted an 8-minute walk-through video on how to screen which patients are at risk for getting a bite change or AOB after an occlusal appliance and how you can minimize that risk.
The highlights of this episode:
12:47 Why you need to provide Conservative Care first
15:57 TMD is a Spectrum
19:21 Early Surgical Intervention?
21:42 Acute disc displacement without reduction
26:40 Imaging used when managing TMD patients
35:10 Pain Management
41:03 Arthroscopic procedure for TMD
50:29 How much does TMJ Surgery cost in the UK?
53:22 Successful management of temporomandibular disorders
Check out these studies as mentioned on the podcast.
