The fight over your bite
There are a number of reasons why healthcare providers disagree over how to help TMJ-D patients. Depending on the model from which the problem is being viewed, the diagnosis and treatment will vary.
What I am referring to as the ‘problem’ is the symptoms I believe occur when a bite is misaligned—the headaches, jaw pain, facial pain, clicking, popping, etc. that ICCMO explains in detail through this website.
When I say model, I am talking about the medical, chiropractic, dental, physiotherapist or other healthcare provider model.
The medical model is the traditional approach to the diagnosis and treatment of an illness or disease practiced by physicians. It typically places the patient’s problem into a category or diagnosis, that has a specific treatment, with the goal of treating the acute or immediate problem with something like pain medication to take the problem to a lesser or more manageable level.
Unless they can determine a specific disease, the treatment is often limited to this model of discovery. In this case, the treatment most likely is medication, often with no investigation of the cause. I recognize our medical system is under huge strain, and many physicians are forced to see more patients than they would like to accommodate, and may have little time to explore an underlying case.
Many times patients are seen in emergency room situations, which often don’t give the attending physician time to find deeper solutions for the problem. Giving a prescription becomes the patient’s perception of the standard of care.
Patients expect to walk out with a prescription rather than a lifestyle modification. The de facto standard of care has, in fact, become a prescription. The doctor knows it will work and he feels they’ve done a service for this person, but often this is not a solution for what may be an acute or chronic problem.
Let’s look at the chiropractic model
The primary outcome for most chiropractors is joint function and mobility. They are all in agreement the head, neck and back should be in alignment; they provide adjustments by manipulating the neck or other parts of the body to treat the pain or stiffness. But if the patient is unable to maintain that alignment, their only option may be to have repeated appointments.
The patient sees the chiropractor a number of times until function and mobility have resumed to a tolerable level, and is then sent on his way, until misalignment and its painful symptoms reappear. The patient then returns for more chiropractic visits and the process repeats itself.
I believe these chiropractors are not getting all the information they need to understand why the alignments are not being maintained, and that there is a causative factor outside of their scope of care that may be destabilizing their adjustment.
The situation with physiotherapists is similar to that of chiropractors. They are trying to regain range of motion for their patients, but again, they may also be lacking some of the information they need in treating the imbalance – ‘why is this individual’s neck and back not resolving with the treatment? Why are the trigger points reoccurring?’ Once again, it may be the causative factor lies outside their realm of care.
Let’s move onto the dental model
Within dentistry, there are ‘Camps’ with differing beliefs about occlusion. The dental landscape with regards to occlusion is laid out with groups of dentists who have a belief system on how to both diagnose and treat TMJ Disorder- related problems. Each of these Camps contains ‘off-shoots’ that have tweaked and altered their ‘way’ of treatment to improve and eliminate their patients’ symptoms and problems.
Because all these dentists are professionals and care for the wellbeing of their patients, they are passionate about how they see the occlusal landscape. There is no right or wrong. Yet….
So… let’s Talk More. Explore More. Research More.
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