Title : Holistic approach to TMJ treatment in Team: dentist, physical therapist, speech therapist
Abstract:
The authors present their concept based on a cooperation between a dentist, physiotherapist and speech therapist in an interdisciplinary treatment environment wherein temporomandibular joints (TMJs) can be addressed. The position of the head is conditioned by the alignment of the first cervical vertebrae. The upper cervical column determines the symmetry of TMJ function. Asymmetrical head position will produce a fulcrum. The whole orthognathic system is stabilized by the resting position of the tongue and its normal function, as well as the occlusal contacts. All these elements determine a healthy and functional system. Any significant asymmetry within any element will produce compensations in other elements of the stomatognathic system. How the patients holds his/her head and how it translates to the TMJ function. How to evaluate the resting position of the tongue and which structures affect its resting position and function. What type of therapy should be applied to a patient with abnormal tongue resting position and which manual therapy techniques can be applied in the mouth. When and/or at which stage of therapy should a physiotherapist or a dentist refer the patient to a speech therapist. The authors will present how these factors are interrelated. They will show how to assess the particular elements as part of a basic physical therapy evaluation. They will also discuss indications for referring patients to other specialist in the dentist-physiotherapist-speech therapist team. Some elements of a manual examination of the viscerocranium are included in the presentation, in particular, the role of head position, TMJ function, and tongue resting position. New understanding of the system will allow specialists to take a wider look at the diagnosis of TMJ dysfunctions, not only as they relate to the mouth, but also the head and neck. Participants will learn a new tool that will help them quickly assess which of these elements may be the cause of TMJ overload and where the root cause of the dysfunction is situated. Clinical cases will be discussed as part of the presentation.
