Understanding TMD is invaluable in the modern dental practice. It can enable you to enhance your treatment protocol and provide significant relief to patients in pain.
On the other hand, a thorough background and hands-on experience can also tell you when it’s best to step back from treatment and refer your complex patients to someone else.
Once you dip your toes into treating TMD – having successes with simple anterior deprogrammers and helping patients in pain – it becomes exciting to be ‘The Healer’ rather than ‘The Driller.’ But once one finds themselves treating more complex TMD – involving more robust disc disorders and complicated by other upper quarter signs and symptoms – one needs to step back and ask themselves if their practice model can sustain and efficiently treat this population. I have found that after a decade of training and treating it, my practice model just could not integrate a busy general and cosmetic practice with effectively treating and getting reimbursed for complex cases.
Elevating Care By Referring
About 3 years ago, I made a conscious decision to triage my TMD patients. My new protocol is to do a complete joint, muscle and occlusal exam on these patients and develop a working diagnosis. Then they would leave with a Quick Splint, if appropriate. If patients did well with it, then we would transition them into a definitive anterior only appliance with a lower slider for parafunctional control at night. For the patients that did not respond well, I knew that they needed more time and effort than what I could efficiently provide. In these cases, I ‘elevated their care’ to people who treated TMD all day long.
Making the Best Choice For Your Practice
One of the recurring stories I hear from colleagues and alumni of CMS is: “I do not have anybody close to refer to.” Unfortunately, that isn’t a good enough reason for diving into the deep end of TMD and allowing trial and error to suck your time and bank account dry. For patients to get the best care, they need to take planes, trains and automobiles to someone that can help them.
Although I have very deliberately made the decision to limit my treatment protocol to very specific issues, it took me a decade of training and credentialing to be able to know what to hold and what to fold. As such, if you have an interest in TMD, I highly encourage you to pursue it and then decide for yourself what your comfort level is. Our new CMS course is a perfect way to get additional training and background in the field.