The clear aligners that we use are from the ‘Spark’ company; an offshoot of the original metal braces company called ‘Ormco.’ When the Invisalign® patent expired some years ago, the Spark company figured out a way to use softer, gentler aligners to move the teeth. Once the majority of the movement has been accomplished, they would then use stiffer aligners to refine the case.  This has become a major advancement in the field of orthodontics. The gentler aligners mean less discomfort to the patient and less trauma to the teeth. In almost all cases that we see, the teeth need to be taller to support the TM joints so softer aligners mean less stress to the teeth as they erupt taller. This means higher success in lifting the teeth and a better end result for your TM joints!

The technology of digital scanners has a two-fold benefit to both the patient and the doctor. In lieu of using the old-fashioned putty impressions to make an orthodontic appliance, a digital scanner can not only make the process more comfortable, but it is by far more accurate and easier to send to the lab for manufacturing. No longer is an impression being shipped via snail mail; it is sent instantly through the computer to the lab, and they can print a plastic model of the teeth right away. This makes it safer as well, no more saliva or blood being shipped in the mail. (Even though everything was carefully disinfected, this is a huge improvement in the handling of dental cases.) The lab technicians are also safer because they digitally print the model of the teeth and no longer need to handle putty that is potentially infected.

A very new technology that will show up soon enough is the ability to use an app on your phone to digitally scan the progression of your orthodontic case. It already works and soon enough you will see it everywhere. Technology is great!

The post Hi-Tech: No More Putty or Metal Brackets for Finishing Cases first appeared on Sleep & TMJ Therapy.

Diagnosis of the problem is paramount. A really well-done MRI is critical in determining the path of treatment, and many times getting good imaging is quite difficult. So here is the first ‘delay’ in fixing the problem, getting an appointment for a well done and well-read MRI. It can take several weeks to get that appointment and quite honestly some people just do not want to wait. I can’t blame them either. Let’s get it done now!

The next delay is just getting an appointment at the office to discuss all the issues. This is where we look at the bone from the CBCT X-ray and the soft tissue from the MRI. In most cases, people want their insurance to pay at least something and that in turn creates the next delay. Next on our list is the fact that with TMJ appliances, they are custom-made. This takes time. They are not something sitting on the shelf, ready to put in the mouth. It takes weeks to make them since they are custom made for each person.

Now let’s get to the next big delay. You have to wear the devices for 12-18 months to give the discs a chance to move back into the proper position. That’s right folks, it takes that long, especially if the discs have been displaced for several years. The discs don’t just fall back into place instantly. It will take time and patience. Of course, some are not willing to devote such time (and patience) to their health, so they do not do anything. That is OK as not everyone is experiencing the same level of pain or discomfort. When it gets really bad, the patient will pursue treatment but generally now the problem is harder to fix, costs more, and takes more time. This is like most things in life.

Finally, the biggest time consumer of all – finishing after the discs are back in place. In most cases, orthodontic work is needed to grow the teeth taller to protect and support the TM joints (the jaw joints). Orthodontics can take 1 ½ -3 years, easily! So here you are, having spent all this time on appliances only to realize it’s going to take another couple of years. You are basically dedicating up to 4-5 years of your life toward fixing a TMJ problem. This is why we always tell our patients phase one is appliance therapy and phase two is finishing. Thus, the question has been answered. Now you know why TMJ treatment can take so long!

The post The Case of: “Why Does This Take So Long?” first appeared on Sleep & TMJ Therapy.