Treatment is not always over after diagnosis and fabrication. Instead, patients frequently find their way back to the office complaining about jaw pain. Fortunately, there are relatively simple solutions. Dan Tache, DMD, has pondered these solutions for the better part of a decade after leaving a traditional practice in 2008 to pursue orofacial/TMD pain treatment full time.
As a diplomate of the American Sleep and Breathing Academy "ASBA" and an educational presenter for Sleep Group Solutions, Tache´ plans to share his expertise during 2018 the Sleep & Wellness Conference April 13-14 in Las Vegas. “On occasion, custom oral appliances create discomfort due to cramping muscles that cause patients to feel like their bite is off,” says Tache´. “Patients can’t chew, their ears hurt, sinuses hurt, and often patients must abandon treatment, or use it less, because of the discomfort and the fear of irreversible problems.”
In many instances, dentists are ill prepared to deal with what are often simple problems. Those who attend Tache’s seminar will hear remedies, specifically ones focused primarily on the pterygoid muscles. “There are a set of stretching exercises that can reverse the pain rather quickly if the doctor can properly inform his/her patients,” says Tache´. “I will also explain the etiology and causes of the common side effects brought on by mandibular advancement devices.”
After describing specific stretches, Tache will illustrate how to modify custom appliances to minimize the amount of advancement—mostly by increasing the vertical height of the appliances. “There are ways to modify the splint that uses less advancement and more modification of the vertical height of the appliance, as well as contributing to airway stability,” says Tache. “Nasal valve collapse may compel us to over-advance the mandible when we could use nasal valve stabilizing devices to augment splint therapy.”
It may sound circuitous, but Tache is convinced that the logic can be effectively demonstrated, primarily because, “some airways will respond to y axis titration, or making the appliance higher, and you must know how to do that.”
Tache’s presentation will be one of 16 taking place at this year's annual conference hosted the the ASBA.
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