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The statistics are eye-opening: The National Institutes of Health estimates that between 15 and 45 million Americans show some type of temporomandibular joint disorder (TMJD) issues;1 the National Headache Foundation declares that more than 45 million Americans experience recurring headaches, and of these about 28 million suffer from migraines.2,3 A recent survey estimates that almost 10 million Americans also suffer from Tinnitus (ringing of the ears), and additional research suggests that dental force related problems may account for up to 80 percent of headaches.4
That’s the bad news. The good news is that there is currently available an innovative assessment and treatment system (TruDenta, Dental Resource Systems, Fort Lauderdale, FL www.DRSdoctor.com) that offers dental practices an exciting new opportunity to build their practices while providing hope, help, and treatment to 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 resulting from imbalanced or improper forces.5
For current and prospective patients suffering with chronic headache and migraine symptoms, this approach to achieving long-term pain relief can be a welcome treatment option. It is a drug-free, needle-free, and virtually painless therapy program available in one office, making it attractive and convenient to patients and dental staff alike. Dentists use the system to objectively assess and monitor patients’ individual problems and develop the best treatment plan. From there, it is the dental assistants, or dentomandibular rehabilitation therapists (DMRTs), who perform the treatments and regularly meet with and counsel the patients.
The TruDenta system and approach to care empowers dental assistants to have a more fulfilling and satisfying role in treatment. It enables them to connect more with patients as they simultaneously contribute to increasing practice profitability by freeing up the dentist to see more patients who might need other types of care.
The system of proven hardware and software represents an expert application of current research attributing dental force imbalances to muscle dysfunction in the head and neck area. Digital assessment technologies combine with treatment methods shown effective in sports medicine and physical therapy. DMRTs obtain hands-on training and education through onsite hands-on instruction and offsite courses at either University of Nevada Las Vegas or NOVA Southeastern dental schools. While exciting, the prospect of mastering and playing such an important role in helping to implement the dentomandibular rehabilitation treatments into your practice also may seem overwhelming initially. It is understandable to experience some insecurities and concerns about fitting the system into your already demanding, stressful, and patient-filled schedule. Educating and “selling” its benefits to patients also can seem daunting.
To successfully incorporate the dental headache care into your practice, consider these methods that have proved successful at dental practices already incorporating—and benefitting from—this systematic approach to care.
1. Dive in confidently. Don’t wait to “know it all.” Use the scientifically supported information and training provided to move forward, knowing you will continue learning by doing. A systematic approach to dental headache care is based on established protocols and procedures that have been clinically proven effective. Following these established steps offers reassuring knowledge and instills confidence among all parties involved. When patients suffering from dentomandibular sensorimotor dysfunction issues present, greet them with enthusiastic assurance: “We can help you. We’re so glad you found us! Let us tell you about this exciting new system.”
2. Commit to education. Work as a team to educate patients about dental headache care and how it can benefit them. Invite them for a 20-minute complimentary consultation with the dentist. During this session, patients can express their concerns to the dentist; the dentist, using the system’s objective, digital evaluation protocol and tools, can properly assess and establish the best treatment recommendation. Many practices find that using the TruDenta-Scan at this time increases patients’ understanding of their conditions and acceptance of treatment.
3. Bond and build trust. Whenever new patients present, introduce yourself, regardless of whether or not you will be assisting during the initial consultation. By establishing yourself as a welcoming, familiar face before discussing the therapy and financial options with them, you are subtly building a bond of trust and making patients more receptive to you, the dentist, and your entire team’s ability to provide effective help for their conditions. Whenever possible, listen in on the conversation that the dentist has with the patient. When it’s time for you to discuss the therapies, you can repeat and reinforce to the patients what has already been communicated by the dentist. Patients are thus reassured that your dental team members are effective, knowledgeable communicators with the innovative tools, expertise, and enthusiasm to alleviate and correct their conditions.
4. Focus on the value of benefits. When discussing costs with undecided patients, emphasize that what’s at stake is not as much a financial issue, as it is a quality of life issue. Ask them: What wouldn’t you give to be free from pain, and once again enjoying overall well-being and the activities you love? Concentrate on what’s most important to each particular patient including, impairment of time with children, family and employers.
5. Repeat. Repeat. Repeat. Research indicates that patients are more likely to accept recommended treatment and services when they are told the pertinent information two or three times. So, at every point of patient contact, have your colleagues reinforce and explain aspects of the process and benefits for that particular patient. This not only helps educate patients, it enhances patients’ perception of your practice and all its team members as knowledgeable professionals well equipped to successfully answer their dental needs and concerns.
6. Make it about them, not you. Your role is to educate patients on how they can benefit from comprehensive and clinically proven dental headache care assessment and rehabilitation tools to achieve function and minimize/eliminate pain. They need to feel that everyone at your dental practice—from you and your dentist to the hygienists and office manager—is sincerely committed to their oral health and not just trying to make a quick sale on another expensive “gimmicky” treatment.
7. Get them started as soon as possible. You’ve told them; now it’s time to show them. The sooner patients begin treatment, the sooner they will start to experience life-changing results. Once they agree to begin treatment, schedule their appointment as soon as possible. If a room is available, and you and the patient are free to begin treatment, do so. If you need to schedule a later appointment, send them home with detailed information about their upcoming treatment. As further follow-up, mail them a card thanking them for trusting you with their care. Let them know how excited and motivated you are about collaborating with them on this new pathway pain relief.
8. Enlist patients as part of the treatment team. Make them active, informed participants in the treatment plan, which will consist of integrated therapies (therapeutic ultrasound, manual muscle therapy, transcutaneous electrical stimulation, low-level laser therapy, and intraoral orthotics) administered by you over a series of visits. Counsel them on the importance of their role. The treatment will not be effective or lasting without their commitment to establishing and properly following a regular regimen of home care. This typically includes use of a home care kit in order to quicken, achieve, and maintain a successful outcome.
During the course of treatment, your dentist will review progress and revisit outcome goals. You and your patients will be amazed by how effective this treatment monitoring is for strengthening the triangle of trust between you, the dentist, and patient.
And be sure everyone at your practice is on board as part of the treatment team and can serve as sources of consistent, positive reinforcement and information.
9. Listen. Invest 10 minutes before every therapy to ask patients how they are feeling. Many patients greatly appreciate this, noting that being able to express their worries provides great emotional stress release. When utilized, this valuable communication enforces their trust in you, and the dentist, at the same time that it increases the patients’ positive emotional and physical response.
10. Maximize the opportunities. For dental assistants, providing therapies to relieve the chronic pain associated with dentomandibular sensorimotor dysfunction is an opportunity to grow and express our skills and talents, as well as establish a reputation for the practice among other healthcare professionals. Don’t overlook any opportunity. Each established patient knows someone who is suffering in some way—from headaches, lack of sleep, jaw pain, or muscle soreness. Sharing information with them at each opportunity opens doors for new patient referrals, current patient treatment opportunities, and the possibility of improving many lives.
Incorporating dental headache care into your dental practice is well worth the effort. A systematic approach and pathway to conservative care offers restored balance, functional harmony, and dental foundation stability in a drug-free and virtually painless manner for patients. These patients are often at their wits end for finding a lasting, effective solution to their chronic and debilitating dentomandibular sensorimotor dysfunction conditions. In the role of primary therapist in this life-altering therapy, dental assistants can help restore patients’ oral health and quality of life. They also develop and enhance their professional skills, increase their level of job satisfaction, and contribute to the growth and success of their practice.
1. National Institute of Dental and Craniofacial Research. http://www.nider.nih.gov/DataStatistics/ByPopulation/Adults/ 2. National Headache Foundation. http://www.headaches.org/education/Headache_Topic_Sheets/Migraine. Accessed July 3, 2012. 3. Headache. US News and World Report. 2006. http://health.usnews.com/health-conditions/brain-health/headache. Accessed July 3. 4. Dental Resource Systems, Inc. http://www.drsdoctor.com. Accessed November 21, 2012. 5. DiMatteo AM, Montgomery MW. Understanding, Assessing & Treating Dentomandibular Sensorimotor Dysfunction. Ft. Lauderdale, FL: Crème della Crème Copywriting & Communication; 2012.
Cheyanne Autumn LaRue Frank, DMRT, has been a dental assistant for 15 years. She has been a resident of Reno, NV for 20 years and has worked at the dental office of Shane W. Sykes, DMD, for one year. Ms. Frank is married with two sons, ages 11 and 7. She is a certified personal trainer and fitness instructor with a background in Kinesiology, and is a former Mrs. Nevada title holder.
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