It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



TMJ Disorder -TemporoMandibular Joint Message Board
Post New Thread   Closed Thread
LinkBack Thread Tools
Old 09-02-2003, 06:08 PM   #1
Member
 
Join Date: Aug 2003
Location: Overland Park, Kansas, USA
Posts: 58
kcgirl HB User
Angry CR vs Nm dentistry....this is what a well known dentist e-mailed me?hmmmm

Dear KC,

What is CR dentistry? Centric Relation dentistry (CR) is a position in which the condyle sits in the most orthopedically stable position (usually superiorly-anterior) in the condlyar fossae.
It is the oldest form of establishing stability in large scale dentistry and taught by every dental school in the nation (maybe one or two exceptions). The CR philosophy follows that if the condyle is happy then the muscles will follow in their happiness. NM is basically the opposite and states that once the muscles are happy the condyle will be too. A little more radical in thinking (not saying it's wrong) but I personally don't think the position of a JOINT should be dictated solely by musculature. JMHO though.


what the heck does all of that mean? Why do dentists feel threatened by Nm dentistry? I am so glad to have this board to aid in eliminating our pain instead of arguing who's theory is better.
I have consulted a few times through e-mail with Dr. B and have decided to plan a consult visit to his office. Thanks to all on this site!

 
Old 09-02-2003, 07:01 PM   #2
Senior Member
(male)
 
Join Date: Aug 2001
Location: Edmonton, Alberta,Canada
Posts: 123
J-man HB User
Post

Quote:
The CR philosophy follows that if the condyle is happy then the muscles will follow in their happiness. NM is basically the opposite and states that once the muscles are happy the condyle will be too.
Hi KC,

Personally I'm a little confused as to why we must necessarily choose between the CR approach and the neuromuscular approach. Let's say that a
person has a broken leg and because of their broken leg they are forced to walk on their feet in such a way that this causes blisters on their feet....These blisters then cause the person to walk in a funny way, so that the healing of their leg is slowed down. Now what is causing the 'problem' here, the broken leg or the blister ? Well both problems are causing the other problem.

In a similar way I think that misplaced discs cause muscles to go into spasm....but if those discs are ever to become -un-mis-placed (excuse my English), then at some point the spasm must be broken. Neuromuscular dentistry assumes that breaking the muscle spasm will allow the disc to slowly return to its proper place (together with ongoing splint adjustments). CR dentistry is just taking it from the other direction ---> putting the discs into place which then relieves the muscle spasm. So both approaches achieve the same final goal...happy muscles and happy joints, but just come at it from different directions.

Maybe I'm missing some key info relevant to the process, but it seems like the 2 'camps' need not be at odds with one another.

Take care,

John


 
Sponsors Lightbulb
   
Old 09-02-2003, 07:12 PM   #3
Senior Member
(male)
 
Join Date: Aug 2001
Location: Edmonton, Alberta,Canada
Posts: 123
J-man HB User
Post



I reread the good Doc's message and I guess he/she is not necessarily disgreeing with the idea that helping muscles helps joints, but is saying that helping muscles won't always be enough to put the joint into position, since there are other 'players' involved in the Tmj system as well (eg ligaments etc). In reality, I think the CR approach is partly a neuromuscular approach ( and vice-versa) because when it comes to muscles and joints ....'you can't treat one without helping the other'. For example, as you start putting the joint into a more proper position, using the CR approach, this starts to relax the muscles....which makes it that much easier to get the joints into the correct position.

I guess my feeling is why put down one approach or the other, when both seem to be tied together.

Have a great day :-)

John


 
Old 09-03-2003, 06:24 AM   #4
Senior Veteran
 
Join Date: Oct 2002
Location: Alabama
Posts: 1,021
Cymy Sue HB User
Post

John,

I think "your" theory or thoughts about treatment comes very close to the ideal therapy.

I've never seen anyone who used centric relation theories totally as an approach to treatment.

I started using splints over 25 years ago. I questioned one member recently because CR had been mentioned several times and I had never heard it mentioned by a Provider. The member explained that it was used many, many years ago. There may be some Dentists or Ortho's who use this method only, but I don't think it's as prominent as we are hearing from some other groups.

If you read the posts of those of us who are being helped and getting better, our Providers use multiple theories and principles in treating TMJD and splint design.

Dr. Pete Dawson still has a teaching center and may very well teach CR as the only method. I don't know. I have not seen anyone who has been to his teaching facility.

My Dentist is not an NM nor a CR. He's just a Dentist who uses everything he can learn ,in regard to TMJD and he helps people. And, he does not make it his business to say anything about the methods others use or how they treat their patients. I think it's called Professional Courtesy.

Maybe it's the other way around. Maybe NM's feel threatened that there are regular Dentists, Ortho's and other Specialists who are treating and helping people using many different theories including neuromuscular and their fees are much less.

I made a post the other day that Dr. Bernard Jankelson is given credit for developing Neuromuscular Denistry Concepts, over 40 years ago.

LVI has been open since 1995, 8 years. I would imagine a few Dentist have picked up on this concept and incoorporated it into their practice prior to 1995. Mine did.

Cymy Sue

 
Old 09-03-2003, 06:39 AM   #5
Veteran
 
Join Date: Sep 2002
Location: Kaysville, Utah USA
Posts: 350
GenDen HB User
Post

J-Man,
My TMJD specialist approaches my treatment by getting the condyles in the right position, then working to relax the muscles. I asked him about the neuromuscular approach and he explained it exactly as you so eloquently stated. He said he had no argument with the neuromuscular approach; they both get at the same result in a different way. He felt that his approach was a little more direct and predictable and he personally liked to use it better.
I personally don't think it serves any good purpose to argue over which is better. I am pretty pragmatic. Whatever works.


 
Old 09-03-2003, 06:54 AM   #6
Member
 
Join Date: Aug 2003
Location: Overland Park, Kansas, USA
Posts: 58
kcgirl HB User
Post

Hey guys...I have been trying to get as much information as possible to help me make a decision on treatment. It is so darn confusing and I agree that both ways make sense. But how to choose one that is best for you personally is quite scary. Not only is it emotionally scary, not knowing if you are making the right choice....but also financially. I feel for everyone on this board...TMJ is horrific and has caused us a lot of pain...I wish there was a miracle cure. You're all in my thoughts and I hope you all find treatment and have pain-free days very soon.

 
Old 09-03-2003, 06:59 AM   #7
Senior Veteran
 
Join Date: Apr 2003
Posts: 730
DianeTMJ HB User
Post

Good morning -
KCgirl, I think Cymy Sue sized it up pretty good. A Dentist/Dr who is really determined to help their patients are going to incorporate many different techniques, educate themselves so they can truly help those in pain. I think that is what I so appreciate about my dentist, he is far beyond a NM, taking on several approaches to assist his patients. It is a shame that we all get caught up in this bad guy/good guy stuff, western -vs- eastern fight. Why can't they all just appreciate the fact that they are all "hopefully" trying to get to the same bottom line... helping their TMD patients, with great success.
Diane

 
Old 09-03-2003, 11:43 AM   #8
Senior Member
(male)
 
Join Date: Aug 2001
Location: Edmonton, Alberta,Canada
Posts: 123
J-man HB User
Post

Quote:
Originally posted by Cymy Sue:
John,

I think "your" theory or thoughts about treatment comes very close to the ideal therapy.

I've never seen anyone who used centric relation theories totally as an approach to treatment.

I started using splints over 25 years ago. I questioned one member recently because CR had been mentioned several times and I had never heard it mentioned by a Provider. The member explained that it was used many, many years ago. There may be some Dentists or Ortho's who use this method only, but I don't think it's as prominent as we are hearing from some other groups.

If you read the posts of those of us who are being helped and getting better, our Providers use multiple theories and principles in treating TMJD and splint design.

Dr. Pete Dawson still has a teaching center and may very well teach CR as the only method. I don't know. I have not seen anyone who has been to his teaching facility.

My Dentist is not an NM nor a CR. He's just a Dentist who uses everything he can learn ,in regard to TMJD and he helps people. And, he does not make it his business to say anything about the methods others use or how they treat their patients. I think it's called Professional Courtesy.

Maybe it's the other way around. Maybe NM's feel threatened that there are regular Dentists, Ortho's and other Specialists who are treating and helping people using many different theories including neuromuscular and their fees are much less.

I made a post the other day that Dr. Bernard Jankelson is given credit for developing Neuromuscular Denistry Concepts, over 40 years ago.

LVI has been open since 1995, 8 years. I would imagine a few Dentist have picked up on this concept and incoorporated it into their practice prior to 1995. Mine did.

Cymy Sue
Hi Cymy Sue,

I think as you and other people have said, there are good and bad dentists of all stripes, and the best are often those who borrow from all the Tmj approaches.

I'm very thankful that both you and I have been blessed with dentists who are compassionate, and dedicated to seeing patients become well. My dentist has now given me close to 20 free adjustments. What a great guy !! I hope that everyone on this forum will be able to experience this type of caring, professional dentist.

God bless all of you guys today :-)
John


 
Closed Thread

Similar Threads
Thread Thread Starter Board Replies Last Post
Bioesthetic Dentistry - is this a sham? amarula Dental Health 3 05-21-2009 08:01 AM
Fear of the Dentist Foxpawz57 Dental Health 6 06-07-2007 09:24 AM
Cosmetic Dentistry s.g. Dental Health 5 01-27-2006 06:35 PM
Mercury Free Dentistry rhody Dental Health 32 10-25-2005 09:13 PM
overtreatment in dentistry Robert81 Dental Health 1 10-05-2005 05:45 AM




Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off




Sign Up Today!

Ask our community of thousands of members your health questions, and learn from others experiences. Join the conversation!

I want my free account

All times are GMT -7. The time now is 02:45 PM.



Site owned and operated by HealthBoards.comô
Terms of Use © 1998-2014 HealthBoards.comô All rights reserved.
Do not copy or redistribute in any form!