TMJ TREATMENT: BILL - Ueckert Dentistry

CASE STUDY DETAILS

Patient: Bill H

Dentist: Dr. Gregg Ueckert DDS

Case: Neuromascular Dentistry

Procedure: Bite Rehabilitation

Patient Background

Course Of Treatment

Treatment Outcome

PATIENT BACKGROUND

Bill owns and runs a successful construction company in California and came to us as a new patient wanting to improve his smile. After taking some time and asking the right questions it became apparent that Bill had TMD issues due to his poor bite position.

BITE REHABILITATION

BEFORE

AFTER

Bill was noticing muscle fatigue while eating tougher foods like jerky that he had never noticed in the past. He was awaking with tension headaches about 5 times each week and having to take advil to ﬁnd relief. He had pain at the back of his head and in his neck as well as lower back pain. While sleeping he was noticing his arms and hands would “fall asleep” and start tingling. When he tried to close on his back teeth he felt like his front teeth would touch ﬁrst and he would have to pull his jaw back to get his back teeth to come together.

Bite Rehabilitation Pain

Diagnosis

Bite Rehabilitation Data

Bite Rehabilitation Symptoms

After spending some time with Dr. Ueckert, it became apparent to Bill how important the bite position really was. A bad bite dictates a poor lower jaw to upper jaw relationship that leads to poor head position and misalignment of the neck and spine descending all the way down to the SI joint in the pelvis. This misalignment is what was causing all of Bill’s symptoms and the cure was going to be giving Bill a more orthopedically correct bite position that would allow the rest of the body to align itself ideally.

COURSE OF TREATMENT

Following a Proven Process

Dr. Ueckert explained to Bill that the ﬁrst step was gathering objective baseline data to allow him to identify the perfect bite for Bill without any guess work. These test would allow Dr. Ueckert to ﬁnd exactly where the lower jaw should be at rest and where it should be when the teeth are together. Once the new bite was found an appliance called an orthotic would be made allowing Bill to test drive the new bite before making any irreversible changes to Bill’s teeth. An ideal bite will help remove the stresses, twists and torques in Bill’s body due to his poor bite improving his head position. Once the head position was corrected with the new bite in the orthotic Bill’s symptoms should begin to improve.

Finding the Perfect Bite

Finding the right bite was the ﬁrst step in the process of stabilizing the lower jaw and bite position and allowing the body time to heal and function ideally.

Bite Rehabilitation Sensor Array

Bite Rehabilitation K7 TENS

A comprehensive exam was completed that included:

3-Dimensional Jaw Tracking to identify abnormal jaw movements
Electomyography to test the muscles for imbalances and function
Electo-Sonography to test for abnormal joint function

Bill Describes Treatment

Orthopedic Therapy

Bite Rehabilitation Adjusting Bite

Bite Rehabilitation Bur Adjusting Occlusion

After ﬁnding the bite position, a clear acrylic orthotic is made for the patient to use full time. It is precisely made to give the patient an ideal upper to lower jaw relationship and also give the patient the perfect functional bite. Dr. Ueckert then spends time adjusting and reﬁning the bite position and contact point of each tooth with the orthotic at each follow up visit. After Bill began using the orthotic full time, he noticed that his symptoms were going away including the numbness he was having in his arms and hands at night when he was sleeping. Bill was now sure he was in good hands and was looking forward to his new teeth and a more comfortable life.

Bite Rehabilitation Before Bite

Bite Rehabilitation Orthotic Bite

Bill soon realized that the orthotic was not that bulky to wear and was quite comfortable to chew with and actually felt better than his old bite. It allowed his jaw to rest and function at an ideal spot and gave him conﬁdence about moving forward and getting the smile he wanted. With his symptoms diminishing it just reinforced the point that he was doing the right thing for himself not only cosmetically but from a general health standpoint as well. Bill felt great! Dr. Ueckert took the time to explain to Bill that he would be following a proven step by step process. We start with a removable appliance to prove that the new jaw position is stable and comfortable to him. We needed to give the body time to heal so that the bite would stabilize. After the healing phase, porcelain restorations would be made to support the jaw at the exact same position as the orthotic. Bill understood that ﬁnding the bite ﬁrst was the most important part of the process.

At Last …a Beautiful Smile and Pain Free Bite

Bill’s case ended beautifully with a bite that eliminated his TMD issues. He no longer had trouble eating chewy things and having his muscles tire. The pains he was having at the back of his head, neck and lower back were gone and at night his arms and hands no longer fell asleep. That is the power of an ideal Neuromuscular bite position! Not only does it look natural but it allows the body to function optimally and without pain.