Thoughts Can Cause Mouth Breathing

by Brian Hale, D.D.S., San Antonio, Texas

Thoughts can cause mouth breathing from the overarching paradigms one holds: which can affect what a patient eats and drinks and how they exercise (or not), to their world-views and threat perception (what causes ‘stress’), to sleep hygiene, to dependence and co-dependence and on and on…. All these will lead to parasympathetic / sympathetic imbalance which will burn the patient’s sympathetic mechanisms out while they live in a constant state of “Fight, Flight, or Freeze” which activates mouth breathing (or apnea!). Chronically, this profoundly lowers the immune function, learning, sleeping, constant elevated Muscular-Skeletal tone (cracking knuckles, abdominal bracing, forward head posture, etc), and a continued downward spiral of poor choices that reinforce the faulty world views. Much more to say here…

Down to actual thoughts themselves (the self-talk, the narrative in one’s mind) which creates a stress / fear reaction which elevates Fight, Flight or Freeze reactions and mouth breathing. The average patient has ~68,000 thoughts per day and 90% of those are negative. So that is ~61,200 negative self-talk events per day!

One of challenges in overcoming this is the Dunning-Kruger effect; which says that your patients don’t just “not know the truth” –they are not just empty vessels waiting to be enlightened– but they are full of decades of false ideas, theories, heuristics, and experiences. Or “…incompetent people do not recognize—scratch that, cannot recognize—just how incompetent they are,”

Thoughts

http://theness.com/neurologicablog/index.php/lessons-from-dunning-kruger/

A good book on false heuristics is “Thinking, Fast & Slow” by Daniel Kahneman.

Basically, anything that causes imbalance in the body is bad whether it’s bite, posture, airway, nutrition or ideas.

Or as someone said “Thoughts, traumas and toxins”.

 

 

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Thoughts Can Cause Mouth Breathing

A Suffering TMJ Patient’s Testimonial

 

Chris Stewart a patient of record  of Clayton A. Chan Dds on TMJ/TMD Disccusion Group FACEBOOK

So this is kind of a testimonial/update of my case.

I have come back from Las Vegas from my last appointment, this is the first time I have no more appointments scheduled for treatment in the future and when I do go back there are only small bits still to do on my teeth and bite.

I started TMJ treatment back in 2007 by a well known dentist in England. I was with him for 4 years. I had a serious TMJ disorder, Wilkes stage 3 a really bad overbite, collapsed arches, loud clicking in the right TMJ joint, pain, headaches, undeveloped face, slurred my words when I spoke, nervous system issues, breathing problems, very bad posture I can go on and on. So I was given a flat planed splint which relieved alot of the symptoms the only problem was I kept grinding my way through them and in total went through 8 new ones. I did alf work and had ortho which ended up me improving me but then going back to how I was. It was simple now looking back that my occlusion and bite was never in the right place to keep me stable. It was a ongoing battle with the dentist to get things right. I was confussed and felt alone and that I was a nuisance to the dentist as he told me it was all in my head, I was the only one he had like this and the famous line of ‘stop searching for the holy grail!’ I say famous as he used to quote it to other patients of his.

I was not going to give in and was determined to get answers so I searched on facebook and other forums to come accross a guy called Clayton A. Chan Dds in Las Vegas who wrote these really long detailed, logical posts in response to patients questions put to him. He had created a form of dentistry called GNM dentistry (which stands for Gneuromuscular Dentistry) which isn’t the same as NM dentisty which patients get confussed about, everything made sense, I had a complete buzz of excitement as it was so refreshing to hear a TMJ dentist about measuring the jaw position and talking about the different protocals and stages of treatment, talking about micro occlusal adjustments and also taking time out to answer worried patients on here.

I gave up hope with the UK dentist and it then dawned on my that there were no GNM dentists in the UK. So I weighed up my options of whom I could go to see and thought I would not mess about this time and go right to the top and see the guy that teaches all the other guys. At this point in December 2012 it felt like a crazy thing to do to fly 10 hours on a plane to see a dentist and a punt at that. But my health means the most to me, much more than money so I was prepared to risk it.

I arrived in Las Vegas and it was like a breath of fresh air. The dentist took tons and tons of photos, tests, X-rays, Cat scans moulds you name it he did. He blocked out 4 days for me and saw no other patients just me. I was entering into phase 1 of GNM treatment. Phase 1 was all about just getting stable. The dentist put electric pads on my face (tens) and relaxed all the muscles. He then hooked me up to a K7 device which tracked my jaw in this relaxed state so the computer to find the strongest and most natural position for my bite to be. With that data a orthotic was made in the lab by the same dentist. On day 3 I was given it. It was fabricated to have my actual teeth marks on it so it felt like I was biting on my real teeth. It felt stable yet uncomfortable at the same time. I flew back to the UK and actually had to swap it in and out with my old orthotic at first…..I thought oh no its not going to plan. So I persisted and flew back and had it adjusted a few times. I’d say after the 3rd visit back and forwards I was completely stable. The plan at this point was to get a UK dentist to take over from there but I thought about it and realised there was no one that worked to the same level of detail and also if I let them do anything it could wreck what had been done.

So I got back on the plane and rushed onto phase 2 of GNM treatment which I maybe should been so hasty about. In phase 2 I was given a unique alf style device which had loads of coils and springs to activate later down the line. The main focus was on my upper arch, It was expanded to give me more tongue space and we also decided to open up the gaps as I had my premolars pulled out top and bottom (4 teeth in total!) when I was 13. The plan was to put the teeth back and give me as much stability as possible. I asked around and hadn’t heard of any patients doing this before so it felt quite new and experimental.

There was about 2 years of ortho and getting the teeth into position, it was no easy task as the previous dentist has actually made my case worse by pulling the back molars forward creating less occlusion support. In this period my teeth were moving which made my bite more of a moving target and in turn bringing my symptoms back so the dentist kept having to track the jaw on K7 and keep adjusting at the same time to keep it stable again.
There were lots of occlusal adjustment and micro occlusal adjustment. The GNM treatment involves lots of protocols when adjusting the orthotic. Lots of tap tapping on blue/red paper and green wax to take off interferances which can cause neck pain back pain and headaches. I realised how the small high spot on the orthotic can cause any of these symptoms. These rounds of adjustment would go on for hours and hours moving my jaw in every possible direction to get the bite completely comfortable and solid.

Throughout the treatment I was having atlas orthogonist adjustments (AO) at first and then towards the end I switched to Nucca, purely because the AO lady moved out of town. I actually found Nucca to be the best. My posture was just getting better and better I had a few blips along the way were when the bite went off but overall my syptoms were disappearing as the months ticked by.

At the start of this year, my bite was closed down slightly to finish off the case, I transitioned out of the removable orthotic (which to note did not break or crack over 3 years at all) into a fixed orthotic in the mouth. So it was like teeth bonded onto my actual teeth. There was this eureka! moment at this point, at 3 years into treatment my whole body clicked into line, my midlines of the teeth top and bottom now lined up I walk evenly through both feet, the left side of my body woke up and I have a posture I only dreamed of. No pain, no headaches, I still have a slight click on the right side but not as loud as before and it comes on early rather than late which is better. This may go over time, I’m hopeful. In the last appointment just gone I had the premolar teeth on the top put back in and I would now say my bite is almost 99% perfect. The Nucca guy has confirmed I have moved from a class 2 case to class 1. My atlas had 7 degrees of rotation now it has pretty much none. So its crazy I feel the dentist has reversed damage to my body that in life doesn’t normally get reversed.

I know I am very lucky to be in this position now but what it does show is that it is possible to sort a TMJ problem from start to finish and also that the bite controls everything.

I still have a slight breathing/voice issue but nothing like it was compared to before. Clayton Chan has learnt a way to treat TMJ like no other dentist on this planet, he teaches dentists from all over the world to treat patients in the same way that he does at ‘Occlusion Connections’ in Vegas. He doesn’t guess, he measures and finds where your optimal bite is meant to be using modern day technology. He is very caring and gentle in the way he treats you. He takes on alot of emotional baggage a TMJ patient presents and understands the anxiety and stress that goes on. He’s all about the detail and is a perfectionist. The guy is genius and special he should knighted the whole lot. He devotes his whole life to dentistry and I am lucky to find him and be treated by him. I would also now knowing what goes on be very comfortable being treated by any of the other GNM dentist that have done most of the courses on the OC website.

At 34 years of age I find I have been given a new body and mind back I had to stop football and alot of exercise due being injured all the time so I now wonder about what the new possibilities are.

So keep searching for the ‘holy grail’ as it is out there!!!!!

Occlusion Connections™
FINDINGAGNEUROMUSCULARDENTIST.WORDPRESS.COM

– Clayton A. Chan, D.D.S. – Las Vegas, NV

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A Suffering TMJ Patient’s Testimonial

MRI of Disc Using the K7 Optimized Bite Protocol

The following Magnetic Imaging Resonance (MRI) images are of a 34 year old male, TMD patient who had 4 bicuspid extraction retraction orthodontics previously. Skeletal Class II retrognathic mandible was noted prior to treatment.  Using K7 jaw tracking and TENS Optimized Bite protocols (as per Dr. Clayton A. Chan) the “optimized mandibular and bite” position was determined.  MRI confirms both left and right disc are optimized and functional.

Enlarged MRI View of the Right Temporomandibular Joint.  

Using a 1.5 Tesla MR Imager images through the TMJs were obtained without contrast.  Left image is right TMJ in the closed position (“normal”).  Right image shows condyle in open position.  “There is no disc dislocation”.

MRI TMJv2 - Clayton A. Chan, DDS

MRI View of  Same Right and Left Temporomandibular Joint in Optimized Bite Open and Closed Position: 

MRI - Normal Optimized Bite  Right  open and closed  - Clayton A. Chan, DDS

MRI - Normal Optimized Bite  Left  open and closed  - Clayton A. Chan, DDS

 

MRI - Normal Optimized Bite  Left  open and closed (Enlarged) - Clayton A. Chan, DDS

FINDINGS:

  1. Right and Left TMJ: condyle is small with normal joint position with the disc on closed mouth imaging.
  2. Right and Left TMJ: On open-mouth imaging it moves anterior with disc.  There is not dislocation.

CLINICAL CONSIDERATIONS:

Does the Optimized Bite Protocol Bring the Condyles Too Far Down the Eminence?

Only the doctor who is taking the “optimized bite” can bring the condyle “too far down the eminence”.  It is not the optimized bite protocol that brings the condyle too far forward…it’s the clinicians understanding or misunderstanding of where to identify the optimized myo-trajectory.

Secondly, some may say that when using the optimized bite protocols the condyles are “too far forward”.  We have to ask,  relative to what?  This is the question I would ask.

Is to too far forward relative to what we are use to seeing radiographically when a condyle has no bend in the neck? Or when the condyle has a bend in the neck and the condyle is down the eminence more than you typically see ask yourself if this bend is contributing to the body of the mandible to be too far forward (abnormal pathologic or normal physiologic)?  Are the teeth too far back (maxillary teeth tipped back) or maxillary pre maxilla too retrognathic contributing one’s perception and understanding that a condyle is “too far down and forward” within the fossa.  Think of all the structures involved.  Don’t just think of joints.  Think teeth, mandible body, muscles and also joints as a whole unit.  Look at the face profile as well.

If the patient is functioning with good open and close velocity, no slow downs, no bradykinesia, or dyskinetic movement (Scan 7) with round velocity patterns… is the seemingly “too far forward” position on tomography of the joint a bad thing?

If it is too far forward you will have functional occlusal problems, postural head, neck and overall body instability as well as patient complaints of ringing in the ears, the patients habitual trajectory will not be coincident with the TENS optimized pulse myo-trajectory.  Those would be some of the objective measured features that would indicate a condyle is too far down and forward.

The doctors should NOT be going by what the condyle looks like by radiographs within the glenoid fossa only, but more importantly how is the unit of the body including the masticatory system and body structuring functioning as a whole (healthy or pathologic function)…and we can see the function with our K7 scans.

I think we doctors have been strongly influenced by traditional joint imaged based thinking more than an appreciation and understanding of physiology and K7 (functional data ).  We never really learned what is actually healthy patterns nor understood what health or pathologic K7 scan were portraying and telling us in a dynamic and real time manner.  That is why Scan Interpretation is key to diagnostic understanding.  The K7 operator should understand the K7 data better before concluding and promoting certain concepts wrongly or not completely.

– Clayton A. Chan, D.D.S. – Las Vegas, NV

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MRI of Disc Using the K7 Optimized Bite Protocol

Flat Plane Splints: Is It Really That Great?

 

I believe is that the mandible will not hold in a proper AP position with a flat planed splint when there is spastic hypertonic muscles. When the mandible pulls back the joints will decompress slightly which is less than optimal.

The profession uses flat splints because they think it is easier to managed and adjust because most dentist don’t have detailed adjusting skills. Neither do they know how to find an accurate and precise mandibular and joint position that meets the patients needs…so the flat plane splint supposedly is use to let the mandible roam around and will to search for the position themselves…when the dentist couldn’t find the right position…so no matter how accurate you land the marks on that day of adjusting, it may not be the same jaw position as the mandible relaxes.

More time is spent and the patients get frustrated.

 

– Clayton A. Chan, D.D.S. – Las Vegas, NV

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Flat Plane Splints: Is It Really That Great?

The Cause, Pathology, Diagnosis and of Temporomandibular Joint Disorders by Dr. Clayton Chan

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“The relatively small joint can become relatively incurable”.  THIS IS NOT TRUE.
(Some clinicians give’s their perspective from an orthodontist/orthotropic perspective, which is his opinion).

We Can Agree on Temporomandibular Joint Anatomy and Abnormal Positioning

We all agree on how the anatomy and function of the temporomandibular joints work. He references Lund’s scandanavian study regarding children whose joints were supposedly fractured joints and that 95% of these cases all reformed back to normal. The question is what part of the masticatory system is NORMAL. How does one define NORMAL? Observation awareness of normal or by objective physiologic measurements to define normal?

Many dentist agree that condyles can change and alter on the surface morphology, but the notion that fractured joints can reform back to normal 95% of the cases is far beyond the norm and clinical reality of what many TMD clinicians are observing when treating adult TMD and imaging these temporomandibular joints routinely.

We agree that habitual occlusion often may show condyles up and back in the fossa, while teeth apart may show condyles down and forward. His “orthotropic” theory is not unique to the dental community, but in fact the community of dentistry have recognized these issues for many years prior to his proposed theory as recognized by Costen (Costen’s Syndrome) from the early 1934. Otorhinolaryngologists and members of the dental profession have recognized varying degrees of differential diagnosis of recurring facial pain. Literature acknowledges these TMD muscular occlusal issues, occipital pain, sensitive teeth, abnormal tongue habits and posturing along with airway breathing issues and more that can contribute to the disturbance of temporomandibular joint function. Even more a disturbance of the musculature that drives the joints and upper and lower jaws.

90% of TMD Pain Comes from Hyperactive Muscles

Remember it is the muscles that are 90% of the TMJ patients complaint and problem of TMD disorder. Our profession for some odd reason tends to focus on the TM joints themselves as if they are the source of the problem, (it is NOT). The fact of the matter is the hyperactive muscles is the problem to which many pain patients seem to realize, but the dentists as a whole tend to overlook. This is where we differ in our emphasis to TMD diagnosis and treatment.

The pathology observed as either malocclusion from any cause or destructive changes of one or both mandibular joints is a result of a driving force (MUSCLES). Pain comes from ABNORMAL MUSCLE ACTIVITY, and to lesser degree from the TM joints themselves. The resultant abnormal pressure to the glenoid fossa contributes to condylar changes as well as partial or complete closure of the internal auditory canal, accounting for the “stuffy deaf” ear congestion sensation so common to TMD are from muscles. The diverse and seemingly unconnected neuralgic pains are due to either direct nerve compression within the abnormal joint all stemming from abnormal muscle activities that are a driving force that contributes to abnormal tooth wear, tooth fracture, tooth loss, gum recession, condylar changes within the fossa as well as tension/migrainous type pains to the head, neck, occipital regions, shoulders and neck regions.

Why Do Specialist Focus on the Temporomandibular Joints

Why do specialists focus on these small joints when the bigger and larger issues is technical the musculature to which most of those who are on these forums are complaining about (their pains). It is what is if not partially impairing them and or disabling them because of the abnormal muscles not functioning in harmony with good occlusion. The abnormal muscle functioning that is going on causes the underlying boney structures to strain, distort, bend, flex and alter….thus leading to an out of balanced structural, occlusal and masticatory system.

As a reminder to all, the masticatory system is not comprised of 80% joints, and 5-10% teeth/occlusion and only 10% muscles and nerves, but rather a different percentage to these areas of anatomy when we study them and convey are theories should be altered to reflect clinical and TMJ form realities. If we asked our forum members what entities of their TMD are giving the ill feelings I believe a greater majority would say 80-90% of their TMD pain is related to muscles. Lesser degree to joints, etc.

RELAX THE MUSCLES, support the calm muscles with proper occlusion that fits calm muscles and you have happy joints and resolution of TMD. You ignore the muscles, focus on joints, ignore teeth teeth and or try to build splints to unhappy joints without recognizing muscles and you have confusion and opinions.

OBJECTIVE MEASUREMENTS lead to Different Conclusions and TMD Understanding

Objective measurement test studies of swallowing movements have proven that aberrant tongue posture between the teeth contributes to intrusion of the posterior teeth (mal alignment of teeth and jaws), stunted vertical growth patterns of the teeth and jaws. As a result the condyles will compress themselves furthering joint and disc derangement problems. Swallowing with teeth a part is not a normal thing, but rather a pathologic force (different than Dr. J. Mew’s “orthotropic” belief). Abnormal tongue swallowing habits only perpetuates abnormal joint positioning with clicking and popping joints. A truly centered joint doesn’t function with clicks and pops during opening and closing jaw movements. If it does it only further contributes to a war between muscles, joints and teeth. Hyper active muscles will try to close the jaw to some over closed bite/occlusion thus intruding or compressing the disc and condyles in the fossa.

Certainly I believe in a PHYSIOLOGIC RESTING FREEWAY SPACE should exist when the muscles are at their resting length, comfortable and no pain. Teeth should brace together when the patient normally swallows. The tongue should not be inserted between the teeth during the swallowing act. If it does this is abnormal. But patients with TMD problems as noted above do not have normal inter occlusal freeway space, neither normal swallowing patterns, rather the freeway space is usually infringed upon and muscles are hyperactive due to the lack of proper VDO support and or the mandible is functioning and closing posterior to where their lower jaw wants to optimally function and close…this is what contributes to TMD. Joints do not remodel to a centered position with the fossa when pathologic muscles strains and over closed biting forces exist. Condyles remodel in a pathologic manner exhibiting on radiographic imaging as bend condylar necks, flatten anterior and super surfaces of condyles, and anti gonial notching (extra bone growth at the corner of the lower posterior part of the mandible). These are all clear clinical signs and indicators of pathology and dysfunction.

I believe CLENCHERS can be resolved and the over closed bite cases can be resolved.

The reason why some says what they say, I believe is because they have never measured swallowing patterns to compare normal from abnormal using the K7 to see where the occlusion goes during the swallowing act. I don’t believe these professors and TMD advocates fully are familiar with EMG measurement technology that measures and compares physiologic rest position vs. habitual resting freeway space between teeth.

Because these doctors (orthodontic professors) don’t measure their TMD patients their understanding of resting modes of muscles vs functioning modes will be different than mine. Their views are just their opinion and not what I clinically observe in my 100% TMD pain TMD, orthodontics/orthopedic and restorative practice. I measure using my K7 and I see TMD differently based on objective data. That is the difference.

To Read more: What does the K7 Techonology Measure?

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The Cause, Pathology, Diagnosis and of Temporomandibular Joint Disorders by Dr. Clayton Chan

A Bit of History: Dr. Clayton Chan on Occlusal Panel of TMD and Occlusal Experts 2003

I happen to run come across this picture in my files…

It was taken at the California Dental Association in Anaheim, CA in 2003.

Panelist: Drs. Thomas Basta Clayton Chan, Terry Donovan, Charles McNeil III

Moderator: Dr. Carl Reider

CDA 2013 Occlusal Panel Debate

– Clayton A. Chan, D.D.S. – Las Vegas, NV

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A Bit of History: Dr. Clayton Chan on Occlusal Panel of TMD and Occlusal Experts 2003

Types of TMD Cases Dr. Clayton Chan Treats

Many folks have asked the following: 

1) How many TMD patients you have treated cumulatively?

2) What share of these have been complex cases?

3) What is your outcome statistics in complex cases?

  1. a) % of full recovery / outstanding result
  2. b) 30% improvement of clinical / actual significance on a day-to-day basis
  3. c) no improvement, or no functionally significant improvement
  4. d) became worse
  5. e) complete disaster

4) What is the average cost incurred throughout a treatment period?

Here is some thoughts regarding the above: 

1) I have been practicing dentistry for many years so I have seen many TMD cases. It keeps me on the edge of wanting to learn more.

2) Over the years the TMD case I see and treat seems to be more complex in nature now more so then before. Many are referred by other health care professionals to me. As you know TMD comes in all forms from simple, moderate, complex to very complicated. Not all TMD problems are the same.

3) Right now 100% of my cases are complex and challenging. Most of my patients come from out of state or out of country. These patients who come have seen multiple health care providers, tried many forms of therapies, modalities and had many forms of diagnostics prior to coming to my office for treatment. So, I focus only on one patient and never do I see multiple patients on the same day. I might end up spending 2-3 days (depending on the need) on the patient’s problem and no one else on those particular days (it is very focused on the patient). Me and the patient for those days, no one else booked in another room waiting for me.

4) My patients vary having restorative reconstruction problems to have orthodontic problems and or a combination of issues. Almost all my patients come from out of state or out of the country. Both lay folks as well as dentists are my TMD patients.

5) All of the cases I have treated and have completed treatments with have acquired an excellent result that they are happy with the outcome. But these results didn’t come over night or in just a few visits. Many of these cases involve both a Phase I stabilization for a period of time (usually) more than 1.5-2 years time (it may require a number of visits). Then they proceeded to a Phase 2 level of treatment (when they are ready..they tell me…I don’t tell them…) which involves either orthodontic/orthopedics (no surgery), restorative rehabilitation or a combination of both. I do have some patients who are in a phase 1 level of GNM orthotic treatment who are happy staying in their orthotics for various reasons and they are very pleased with that level of success.

6) Generally the TMD patients who come respond to our treatment rather quickly. There are a few who respond slower, but most see great results of pain elimination depending on their problems. As I have posted and discussed numerous times on various TMD forums) these patients have problems in the masticatory regions, joints problems and pains relating to TMD with cervical dysfunctions, TMJ as a primary problem, Class II division 2 TMD problems as well as anterior open bite TM/TMD problems. These cases may also have psychological and emotional issues along with these structural issues from long term traumas at various levels. In general we see positive results compared to previous methods. That is why keep doing what I do. (By the way, dentists from all over North America and some from Europe, Southeast Asia and Russia recognize the results we are getting with our patients using GNM approach. They come to discover the results are real and valid so they come to OCCLUSION CONNECTIONS to learn the principles of what we do. Dentists want to know how we do it and what we teach and practice, so we teach them. They then realize TMD and occlusion is very involved and not so simple as some may think. That should tell you something more about what we do and why we do what we do. Please read the OC website:www.occlusionconnections.com.

7) I have had a few failure cases that I can count on 1 hand over the course of these many years I have been practicing and treating TMD and occlusal problems. Cases that have been on extensive narcotic medications and are fearful of not weaning off of them I find them to be harder to get resolution. I have learned from these problems and understand why. I learned: 1) that some cases are beyond my level of expertise and abilities, 2) some patients were too anxious and had unrealistic expectations about their problems. I could not meet their time frame within the few visits they allotted me and themselves to be treated. I feel very sad for these individuals. But I know I did my best with what I was able to do and understood. I also learned, impatience can be an enemy to the resolution and be less anxious makes things much easier. There is hope for everyone if they only stay calm and not be so anxious and fearful.

8) Most of my patients definitely get better, not worse.

9) I don’t have any disaster cases as far as I know except those few I admit were failures to me. Again, I feel sad and hope they found an answer to their TMD problems. I know I did not cause more TMJ harm to them when they came to me for those 1, 2 or 3 visits.

10) Fees are commensurate based on time involved, effort, experience, judgment, knowledge, training and skills of the clinician. Some cases take a lot more time than others, no case is the same. Some require more visits and others less. Some require longer office visits and other require short shorter office visits.

Some TMD patients ask a lot of in depth questions and want detailed answers (requiring lot more time to discuss and explain), while others understand the process and don’t require as much time to explain things in the office. Over all the cases I see are typically very complicated in nature and require a lot of time and focus to address their issues.

In phase 2 treatment some realize they need some ortho, others realize they require more complex ortho+orthopedics to transition their bites (GNM orthotic) to the final optimized position, while others may require restorative/prosthetics because of previous full mouth rehab failures. Other cases may need a combination of all the above. I am able to do ortho, orthopedics and reconstructive restorative procedures myself without referring my cases out to other specialist. This way, I can better control the bites, the problems as well as treatment outcomes specifically and accurately to get the results we are looking for. Remember, I am not a specialist. I am a general dentist who focuses on treating my patients comprehensively when they need such.

Some TMD patients have all their 28 units of teeth, while others have missing teeth, or crowded crooked teeth, others have had previous joint surgeries, others with various forms of joint derangement problems, others with locked joints, disc problems that have not recaptured, others can open their mouth but with dyskinetic movements. Some have come with all kinds of medications (maybe require detox management), making their problems much more complicated than those who are not on medications. Some patients are clenchers and others are not, maybe with grinding problems. Lower back problems, pelvis and shoulder problems, etc. Clenchers are more complicated and take more time. The K7 data and tests we use helps us discern and understand underlying CNS issues as it relates to the TMD patients structural and autonomic/parasympathetic system. Some folks are wide goal posted (not as detailed occlusally) while others are narrow goal posted (supper occlusally detailed). These are the kinds of patients we see…not the easy cases. Again, no case is the same.

But the gnatho-neuro-muscular principles (GNM) we apply and practice are what we use along with our K7 and TENS protocols following our GNM OC Optimizing the Bite protocols. THAT IS WHAT I DO. 1 CASE AT A TIME.

Please understand I am not God. I can’t cure everyone. Only our Heavenly Father can do that. All I can do is do my best. If every TMD forum member would recognize, “THERE IS HOPE FROM HEAVEN FOR YOU”. Remember, God is the great provider. Not the dentist. NO matter how great they are. God is the one who treats. He is the REAL HEALER.

(I was a former trained laboratory technician who later in life went to Dental School and studied dentistry). Today, I am passionate about this area of TMD and occlusal dentistry. I believe I have found better answers that have satisfies my analytical curiosity to better help my patients.

LIfe is a journey….we learn and meet many along the way.

– Clayton A. Chan, D.D.S. – Las Vegas, NV

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Types of TMD Cases Dr. Clayton Chan Treats