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By Cheyanne Frank, DMRT
Looking to offer an exciting new way to do your job even more effectively and profitably while also providing your patients with care-focused pain relief? There are more than 80 million Americans suffering from symptoms that dentists and their teams can now treat. An innovative assessment and treatment system (TruDenta, Dental Resource Systems, Fort Lauderdale, FL www.DRSdoctor.com) is available that enables dental practices to offer patients an objective evaluation of muscle and force dysfunction, as well as pain management through physical rehabilitation of the musculoskeletal physiology. This patented system—comprised of comprehensive equipment, technology, software, and therapeutic protocols— offers predictable, reliable and long-lasting results through conservative care for patients suffering from chronic and migraine headaches and other symptoms of dentomandibular sensorimotor dysfunction. Dentomandibular sensorimotor dysfunction is a disorder of the head and neck, temporomandibular joints, jaw function, dental forces, and the neurology of these structures and functions from imbalanced or improper forces.
Among the system’s many benefits is the dentist’s ability to provide a visually engaging assessment of a patient’s condition, while the dental team—particularly dental assistants in their roles as primary dentomandibular rehabilitation therapists (DMRTs)—can actively participate in delivering scientifically proven treatments for patients who are suffering from dentomandibular sensorimotor dysfunction. The Food and Drug Administration (FDA) has cleared all elements of the equipment and treatment methods. In addition, the system’s assessment protocol is consistent with American Medical Association (AMA) guidelines. The patented devices can quickly and painlessly determine if patients are suffering from dental force related conditions amenable to treatment through a unique and consistent approach. you and your practice can literally show potential TruDenta patients the causes of their symptoms, thereby increasing patient education and case acceptance.
Another attractive aspect of the system is that the complete therapy program is available in one office, which makes it convenient to patients and dental staff alike. Best yet, dentists and their dental teams receive extensive and expert training in the proprietary system at the University of Nevada Las Vegas or NOVA Southeastern dental schools.
As someone who has undergone the training and helped implement it at our dental practice, I can attest to this type of dental care’s exciting potential. This approach to providing a conservative pathway to care and pain relief has had a major positive impact on our practice and, most importantly, on the quality of life of many of our patients.
To those of you considering broadening your horizons and looking for ways to expand the level of care that your practice provides, this systematic assessment and therapeutic technology may be the answer. To help minimize the inevitable learning curve, I offer some tried-and-tested methods that have proved successful at our dental practice. Feel free to adapt them to meet your own practice’s individual team needs and patient expectations.
The transition to incorporate assessments and treatments for dental force imbalances and dental headache care into your practice may be difficult initially, since as professionals, we strive to have full mastery of the expert knowledge involved in order to proceed with utmost confidence and expectations. However, the systematic approach allows you, your doctor, and your team to build your knowledge and expertise gradually. You move forward by building upon the knowledge you gain as you progress through the sequenced training process.
Individuals with temporomandibular joint disorder and dental force related headache issues will benefit from this treatment. I may not know yet what form the benefits will take, but I do know from both the training I received and my own personal treatment experience that they will occur. When a new patient presents, my initial statement is: “I can help you. I’m so glad you found us!” Chances are, hearing the enthusiasm and confidence in your voice will leave patients feeling more receptive to learning about and embracing the possibilities of this approach to care.
It can be challenging to educate patients about their condition and how conservative rehabilitation can help them so that their acceptance of treatment is ensured. An effective way to accomplish this is to invite them for a complimentary 20-minute consult with the doctor. This offers sufficient time for patients to express their needs and concerns while enabling the doctor to properly explain different components of the rehabilitation therapy. In our practice, we find that using the TruDenta Scan at this time helps improve patients’ knowledge of their condition and acceptance of treatment.
As the primary DMRT, when new patients come in, I always introduce myself, whether or not I’ll be in the room assisting during the consultation. I want to be a familiar face to them before discussing the therapy and financial options with them. If I have the opportunity, I will listen in on the conversation that the doctor has with this patient. Then, when I discuss the therapies, I can repeat what the patient has already heard. This not only reinforces the information, it also increases the patient’s level of trust and confidence in me, our team, and our consistent, collaborative knowledge and ability to successfully treat their individual conditions.
Focus on what matters most to each particular patient. I ask patients if they have any questions, making sure to fully address any specific needs or concerns they share with me. Typically, this is the time they express the cost concern. If they have insurance, I contact the company right away to determine what benefits are provided before presenting the patient with the final total. Depending on the patient’s treatment level status and estimated insurance payment, I also tell the patient about financing options our office provides. Some offices—perhaps yours could be one—may discuss credit card processing and payment plan options.
The majority of patients suffering from the symptoms of dentomandibular sensorimotor dysfunction have been in pain for a long time. They have come to your dental practice as a last resort. They likely already have had the MRIs, CAT scans, EMT visits, and even jaw surgeries. If they had been successful in achieving long-lasting pain relief, they would not be seeking the services of your dental practice. For most, this is a quality of life issue. Emphasize that point with your undecided patients. After all, what price would someone who has been enduring chronic and severe functional, pain, and aesthetics issues caused by their condition not be willing to pay for freedom from suffering, and restored health and function? And how grateful—and loyal—will they be to you and your dental practice for working with them to develop a solution that makes this therapy possible?
The sooner patients begin experiencing the positive results, the more invested they will be in accepting and following the treatment plan. Once they commit to begin treatment, we immediately schedule their appointment. If my room is ready and I have the time, we get them started right away. If they schedule a later appointment, I send them home with information materials to prepare them for what to expect at the upcoming treatment.
Give the patient literature, the Web site address (www.TruDenta.com), and then have the primary therapist follow up by phone the next day to answer any questions. Additionally, I send a card, thanking them for trusting me with their care and letting them know how excited I am to be on this new pathway of care with them.
When patients come back for their first treatment, as part of the assessment process, I perform the mandibular range of motion (ROM) and trigger point evaluation. At some point during this process, our doctor comes in and reviews the findings while revisiting the results of the TruDenta Scan. Even if he is not involved in that day’s therapies, he greets and reassures the patient. This helps build and strengthen the triangle of trust between the DMRT, doctor, and patient.
Devote 10 minutes before every therapy to ask the patient how he or she is doing. My patients say this is what they most appreciate; being able to talk about their anxieties allows them to release whatever emotional stressors they may be experiencing. As it increases the patients’ positive emotional and physical response, this valuable bonding time also enforces their trust in you, and the doctor.
In our own practice, we have determined that the most effective way to overcome any patient issue is through consistent communication between the office team and the patient. We already know from established patient relationships those who struggle with the symptoms and effects of dentomandibular disorders. Revisiting this information each time such patients come to the dental office is a great way to introduce or reaffirm our assessment of their condition. If your office has a morning staff meeting, use this opportunity to identify these patients, and plan to have a conversation at each point of staff contact with them.
Work as a team to educate patients about this systematic approach to treating dental force imbalances and providing dental headache care, and how it can benefit them. Everyone can—and should—contribute. For instance, even if your practice’s hygienists have not attended the training at NOVA or UNLV dental schools, encourage them to “use what they know”. Give them a treatment, explain the “what” and the “why”, and let the excitement from their own positive experience be the bridge between them and the patient. Show the hygienists testimonials and have them share them with individual patients, whenever and wherever time and interest allow. In this way, when the doctor comes in, patients will feel reassured that the message they are receiving is relevant and compatible to what the doctor will tell them. If further explanation is warranted, you as the primary therapist can utilize the patient’s history forms and continue the conversation.
This systematic and conservative approach to treating dental headaches and dental force imbalances has created exciting new possibilities for our practice and everyone in it. The ability to create a staff-driven profit center provides great opportunities for the team to grow and express ourselves. It also provides an avenue for enhancing our practice’s reputation among patients and other healthcare professionals.
You and your dental team can experience similar benefits and success. As a DMRT, you are an essential component of the assessment and rehabilitation process at your dental practice. By using your knowledge and confidence, you can significantly contribute to the health and well being of your patients, as well as the financial health and well being of your dental practice and its team. It truly is a win-win-win scenario.
In many cases, only dental professionals can help the estimated 80 million Americans suffering from the painful symptoms caused by improper dental forces, called dentomandibular sensorimotor dysfunction (DMSD).
READ MORE "...it is imperative to include the training for orofacial pain, particularly those from temporomandibular joint and musculoligamentous tissues.” JADA Cover Story, 10/2015, Vol. 146, Issue 10, Pg. 721-728
20% of your existing patients suffer from DMSD, as do 20% of all Americans. Your team members quickly assess patients for "red flags" (which indicate DMSD), utilizing TruDenta's patented technologies.
The National Institutes of Health estimate that over 80 million Americans suffer from one or more of the symptoms of DMSD, including:
• Chronic Headache
TruDenta uses digital force measurement technology, powered by Tekscan®, for evaluating the amount of bite force that is present during closure, at closure, and while chewing. The technology is so advanced that it actually calculates the bite force and motion on a tooth-by-tooth basis. This digital exam literally shows a movie of the bite force in action revealing abnormal forces in the nerves, muscles and ligaments that are often the cause of symptoms.
Bite balance is also calculated to identify potential issues within the overall chewing system. READ MORE
A normal opening for an adult is 53 mm to 57 mm. Limited or restricted range of motion (less than 40 mm) is a reduction in an individual’s ability for normal range of movement. Along with opening movement, an individual should be able to slide their jaw to the left and to the right at least 25 percent of their total mouth opening in a symmetrical fashion.
When restricted movement exists, an imbalance in the system is present, and breakdown of the system is likely to occur. READ MORE
The TruDentaROM is a system of hardware and software that digitally measures cervical range of motion (ROM) impairment based upon AMA guidelines. This directly affects the proprioceptive feedback system of the dental occlusion, TMJ, and the muscles of mastication.
ROM impairment is another “red flag” which assists doctors in accurately diagnosing symptoms that are often dental force related. This data enhances medical insurance collections and the collaboration with referring medical doctors. READ MORE
A typical case requires less than one hour of doctor time in the diagnosis and minor occlusal adjustments during the rehabilitation period.
Treatments are performed by a trained team member once per week, in less than one hour. The most severe cases require 12 treatments. Therapies are spa-like, non-invasive and require no drugs or needles. Most patients report dramatic results after the very fist treatment. Note: The majority of patients utilize an orthotic only during the treatment period, up to a maximum of 12 weeks. READ MORE
The goal of therapeutic ultrasound treatment is to return circulation to sore, strained muscles through increased blood flow and heat. Another goal is to break up scar tissue and deep adhesions through sound waves.
Therapeutic exposure to ultrasound reduces trigger point sensitivity and has been indicated as a useful clinical tool for managing myofacial pain. Additionally, ultrasound also has been shown to evoke antinociceptive effects on trigger points. READ MORE
Sub-threshold microcurrent stimula¬tion reduces muscle spasm and referral pain through low electrical signal. It also decreases lactic acid build-up and encourages healthy nerve stimulation. In particular, microcurrent electrotherapy has been shown to help increase mouth opening significantly.
• Reduces muscle spasm and referral pain through low electrical signal
• Decreases lactic acid build-up
• Encourages healthy nerve stimulation
• Increases mouth opening significantly
Low level laser/light therapy is one of the most widely used treatments in sports medicine to provide pain relief and rehabilitation of injuries. Over 200 randomized clinical trials have been published on low level laser therapy, half of which are on pain.
Low level laser/light therapy decreases pain and inflammation, accelerates healing of muscle and joint tissue 25 to 35 percent faster than without treatment, and reconnects neurological pathways of nerves to the brain stem, thereby inhibiting pain. READ MORE