In Part 2 of this series, I described a case study of the benefits of appliance therapy where a patient with severe headaches finally agreed to try a joint and muscle exam. I also explained why it is important to place patients in the driver’s seat of observing their treatment.
by Dr. Lee Ann Brady
An appliance can be an incredible learning tool for both patient and dentist.
The Importance of a Simple Request – Appliance Therapy
“When you first take your appliance out in the morning gently bring your teeth together and make a note of which teeth touch first. It most likely will not feel like your bite and only a few teeth will touch. This means the appliance is working and your muscles are relaxing. After you brush your teeth and eat breakfast make a point of touching your teeth together. Now I would expect it to feel like the bite you know. Between now and when we see each other again, those first teeth that touch when you wake up may change and that will be important for me to know.”
The above quote is an example of the request I make to patients after they first receive an appliance. Once you have convinced them that their pain or other symptom can be resolved with an appliance, the work then becomes to gather useful information.
This step takes into account the patient-centered approach I discussed in Part 1 and 2 of this series. You must be open and communicative with your patient so that you can work with them to achieve results.
It is important to enable the patient to learn what the appliance reveals about occlusion and their joints and muscles alongside you. The process must begin with an invitation to the patient to learn. As the dentist, you understand the science behind appliance therapy, but the patient has an inside look at their own experiences and conclusions that is equally important to consider.
The request works on three different levels:
- The desired result should be revealed: Hopefully, muscles will release, joints will seat, and it will become a reproducible position over time.
- Is the first point of contact that the patient observed the same as the one that we find during an appointment at the office?
- The most important accomplishment is getting the patient to come to an understanding that their teeth touch in a different place when their symptoms have disappeared and their muscles have relaxed.
Once again, I cannot stress enough the significance of this intuitive approach to appliance therapy. What the patient realizes on their own will be instructive and motivating.
For more from Dr. Brady, read her post on balancing parenting and a career in dentistry.