J Chirop Ed. | 2009;21(1): 104.
INTRODUCTION: Symptoms of temporomandibular/craniomandibular disorders (TMD/CMDs) vary but often involve severe pain in the jaw musculature, severe pain or difficulty when opening the mouth and chewing, headaches, and ear pain. In conditions where a chiropractor or dentist has reached a therapeutic impasse with a patient’s TMD/CMD, cotreatment may be indicated. This article presents two case reports demonstrating how cotreatment may proceed initiated by a dental and/or a chiropractic referral.
INTERVENTION: The treatment involved SOT management of the patient’s presentation, while relating to TMJ dysfunction, was focused on whole body dynamics and function. The treatment with these two patients had similar aspects in that they both presented with sacroiliac joint hypermobility syndrome (category two), cervical intersegmental restricted motion, and needed craniomandibular balancing therapeutic interventions.
RESULTS: The essential findings in both cases showed reduced pain in TMJ function and/or symmetrical joint translation without crepitus. General relaxation in cervicocranial and craniomandibular musculature was noted by the patient, chiropractor and dentist. The focus was having the patient gain independence from chiropractic/dental care with reduced discomfort and increased function.
DISCUSSION: With a subset of patients body distortions ascend from the feet, pelvis, spine, and neck to affect TMJ dynamics affecting dental occlusion, condylar position, and airway space. With another subset of patients patterns of body distortions descend from TMJ dynamics affecting dental occlusion, condylar position, and airway space. A main obstacle for chiropractic/dental cotreatment is the lack of awareness and knowledge of each other’s professional treatment and diagnostic focus as well terminology. Research studies have noted a relationship between ascending and descending relationships associated with CMD/TMD and postural dysfunctions.
CONCLUSION: While these two cases illustrate how the chiropractic and dental fields can work together for successful treatment outcomes, there is a need to determine what subsets of patients may fit this model. (This is an abstract from a conference presentation only and does not represent a full work that has been peer-reviewed and accepted for publication.)