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Pain Orthotic
Rationale
A) To remove any tooth-to-tooth contact that may be contributing to head, neck, face and jaw pain or causing crunching or grinding of the teeth
B) To prevent further damage to an existing dysfunctional jaw joint
C) To establish and restore proper maxillo-mandibular vertical dimension as it relates to head and neck posture
D) To provide a postural and muscular environment to maximize the benefits of physical therapy modalities
E) To establish proper jaw-to-jaw relationships prior to initiating orthodontic treatment or jaw surgery
Fabrication
1) Establish and record accurately the existing jaw-to-jaw and tooth-to-tooth relationships
A) Mount case on fully adjustable articulator (models, face bow transfer, centric relation, bite registration)
2) Laboratory fabrication of orthotic
3) Finetuning the orthotic in the patient's mouth
4) Monitoring the effects and refining the orthotic as necessary
Care and Use
The pain orthotic you will be wearing is a delicate and gentle appliance. Special techniques were used to make and adjust it so it will be comfortable to wear. It should be worn 24 hours a day except when brushing your teeth. You can brush the orthotic with toothpaste and soak it in WARM (not hot) water with baking soda to keep it tasting fresh. During this phase of treatment, please remove hard and chewy food from your diet. The key is to relax your jaw muscles so try to avoid foods that require heavy chewing: hard-crusted breads, crispy thin-crusted pizza, steak, popcorn, hard chips, ice, raw vegetables and peanuts. Hamburgers pass with flying colors! Gum chewing is definitely out!
As with anything new, you must give yourself a few days to become accustomed to your orthotic. If you have any untoward experience with the device (increased pain, sore tongue, cheek biting, neck pain, etc.), please call for an appointment. If you smoke, the hard plastic will become stained and it will begin to taste objectionable. If you find yourself clinching your teeth together, try to remember to keep your lips together and your teeth apart. Record any unusual jaw movement or restriction that seems to be created by your pain orthotic (clinching, grinding, protruding jaw while talking or eating). Avoid postural habits that put pressure on your jaw: resting your chin in the palm of your hand, cradling the telephone with your shoulder, violin playing, sleeping on your stomach (try to sleep on your side or back).
Be alert to your head and neck posture when talking on the phone, working at computer terminals or any sit-down related work. It is important to avoid strenuous exercises or lifting heavy objects. The reason -- I would like your jaw, neck and upper body muscles to be pampered and unstrained. If you are currently in an exercise program, please be sure I am aware of it. Most stretching exercises are acceptable, weight lifting is not acceptable. Walking is highly recommended. Lifting even ordinary objects should be monitored -- lifting a 20-pound child, moving furniture, shoveling snow or lifting a 12-pound turkey out of the oven. (Push against a wall and notice your face, jaw, neck and shoulder muscles tighten up.) Washing or painting ceilings, windows or walls-- anything that requires you to look up or down for an extended period of time is very stressful on neck muscles (reading a bulletin board with bifocal glasses, sewing or needlepoint).
Become aware of situations that have a tendency to make you nervous or anxious (noises, the radio, children yelling, work stress, arguments. Mental anxiety will directly affect muscle tension and as a result, you wont get the kind of muscle relaxation we are striving to achieve.
It is important that your body receive proper nourishment. What you eat and how you eat affect the healing process. Vitamin and mineral supplements may be required to aid in the healing process.
Please be aware that fabrication and adjustment of your pain orthotic require extended periods of my time and laboratory expense. If you break or lose your device, there will be a substantial charge for repair or replacement. Please keep a daily log of your progress and experiences. I want you to get better, now! but...
you are in charge of your treatment!