DIAGNOSING & TREATING CO-MORBIDITIES OF OAT / BRUXISM
O f the many challenges that face dentists treating sleep disturbed breathing with oral appliance therapy , dealing with the potential co-morbidities of intracapsular Temporomandibular joints issues , facial pain , and dental occlusal changes are among the most challenging ; not because they are difficult to diagnose , treat , or manage , but because we as dentists are not well trained in these areas .
No area of dentistry is associated with more controversy and more confusion than issues that deal with the Temporomandibular joint . This is unfortunate , and when the anatomy and physiology are considered , neither of which is controversial , the diagnosis and resolution of joint issues associated with oral appliance therapy becomes straightforward and predictable .
Oral facial pain is often misdiagnosed and muscular pain tends to be overstated . Diagnosing the source of pain becomes critical , and can be accomplished with ease with a properly performed history and clinical examination . Here again , an understanding of the anatomy and physiology will
eliminate controversy and provide an improved model to resolve pain and allow appliance therapy to be continued . Occlusal changes are often the most frustrating and difficult to deal with , as well as the least understood . In this case our dental training concerning occlusion works against our potential to put occlusal changes in perspective and manage to the patient ’ s best interest accordingly .
The potential for occlusal changes , the types of changes often encountered , and a fresh look at the risk / benefit quotient when it comes to these changes can be eye opening and provide an improved understanding or the role of occlusion in general .
On February 17th – 18th , I ’ ll be presenting on these very topics at the North American Dental Sleep Medicine Symposium in Clearwater , FL . I will review the anatomy of the joint and the musculature including the critically important an often-ignored ligament insertions .
BARRY GLASSMAN , DMD
BARRY GLASSMAN , DMD
Normal physiology will be explored , and then the potential damage done as a result of mandibular repositioning will help clarify the types of injuries that can result from oral appliance therapy . Potential treatment options while dealing with the oral appliance will be reviewed , with an eye on the goal to resolve the co-morbid injury to allow continued oral appliance therapy . Combining this presentation with a presentation on bruxism is a perfect combination to aid in the occlusal management of our patients who experience changes with oral appliance therapy as well as to put bruxism and its relationship to OSA in appropriate perspective . I look forward to seeing you in Clearwater .
You may contact Dr . Barry Glassman for further information at DrBGlass @ gmail . com