A typical day in the office.  You are busy, you are running behind and your hygiene patient says, “Doctor I have a sore jaw, and it clicks”. You know that you have NO time to deal with this. And all too often the patient is told “you need a night guard”.  That is the quick answer but is it the correct one?  Night guards come in various designs but the conclusion that placing one is correct treatment must be made ONLY after a comprehensive diagnosis. 

You cannot do this in a hygiene chair.  A night guard is appropriate to protect the hard and soft tissues and our dentistry from the damage of nocturnal bruxing.  They can reduce some muscle symptoms if the primary cause is bruxing. But how do you know?  Already the patient has informed you that they have clicking!  STOP! Schedule the patient for a proper examination.

At VieSID we teach the proper components of a comprehensive diagnosis.  Our students understand that all TMD issues are complex, and simple solutions are rarely the correct ones. Inappropriately prescribing a night guard can have iatrogenic consequences in addition to being a costly treatment for our patients

A minimum set of records prior to embarking on prescribing a night guard (or splint) must include these 15 steps:

1. Thorough medical and dental history
2. Recording of the chief complaint
3. Occlusal index
4. Neurological examination
5. Chronic pain assessment
6. Muscle palpation
7. Clinical examination ((periodontal chart, teeth wear, ROM, joint palpation, auscultation, etc)
8. Mounted models in RP
9. Radiographic analysis (MRI, CBCT, Ceph)
10. MRI when indicated
11. Condylography (a critical component for diagnosis and treatment)
12. Photography and documentation
13. Occlusograms
14. Brux checkers
15. Static and dynamic assessment of occlusion

These are the VieSID protocols!  Join us for extensive hands-on training.