Hello fellow Dentists! This video demonstrates the specific Range of Motion and Muscle Palpation Exam we do at our office. This exam is a very important part of our diagnostic process along with a postural exam, occlusal exam, CBCT, joint palpation and sonography, and a thorough history. I have linked the PDF for the exam form below. I have also included tips/tricks for the muscle palpation exam as well as which muscles are most often problematic.
I believe that the muscle palpation exam is vital not only for patients to know that some muscles may be dysfunctional, but ALSO for documentation and diagnoses of Subclinical TMJD. Subclinical TMJD is when there are muscles that are painful to palpation but the patient doesn't have constant pain (i.e. regular headaches, neck pain, jaw pain, etc) and/or when there is painless clicking/popping in the the TMJ. Subclinical TMJD can rear its ugly head after routine dental procedures. This means that after a filling or crown, suddenly jaw pain or painful clicking or locking of the jaw can manifest and the patient believes this was caused by the dental procedure; in actuality, this patient likely had Subclinical TMJD that became acute when a dental procedure was done. If we can educate our patients as to what Subclinical TMJD is and get them into a good nightguard made with an Aqualizer bite, there's a high chance we can avoid this turning into acute TMJD! This is a huge benefit for our patients!
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ROM and Muscle Palpation Exam Form:
[ Ссылка ]
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Normal Range of Motion Measurements:
- Interincisal opening: 45-50 mm
- Remember to take deep bites and open bites into consideration and add & subtract accordingly!
- Lateral movements: 10-12 mm
- As simple as these measurements are, they tell us a lot about the dynamics and health of the TMJs.
- Any compromised vertical opening - less than 35 mm - can indicate a displaced articular disk
- Any compromised unilateral movement can indicate an issue in the contralateral joint.
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Tips/Tricks:
- When palpating the Lateral Pterygoid, use your pinky finger.
- When palpating the Deep Masseter, use your pointer and middle fingers on one hand and brace the outside of the cheek with the other hand.
- When palpating the Temporalis Tendon Insertion, use your pointer finger to travel up the anterior border of the ramus to the coronoid process.
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Information About Specific Muscles:
- The Temporalis is a key player in clenching and grinding and is often times tight and sore in our patients, particularly the anterior fibers. The Temporalis muscle being dysfunctional can lead to tension headaches.
- The Masseter muscle is one of the biggest muscles of mastication and is also often times tender or tight.
- The Posterior Digastric muscle is typically tender or painful in patients with forward head posture.
- The Lateral Pterygoid is a KEY player in muscle and joint dysfunction. This is often times the most painful upon palpation and can take a long time - months - to calm down!
- The Temporalis Tendon Insertion is also a hot spot and is quite tender to palpation.
- The Suboccipital muscles are utilized a lot in patients with forward head posture. This area is often one where headaches originate for our patients.
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Other links:
WEBSITE: [ Ссылка ]
FACEBOOK: [ Ссылка ]
INSTAGRAM: [ Ссылка ]
TWITTER: [ Ссылка ]
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Bensound
[ Ссылка ]
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#tmj #tmjd #musclesofmastication #headaches #neckpain #earpain #jawpain
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This channel is all about TMJ disorders - what they are, how they manifest, what to do about them and how they relate to other issues that may be going unnoticed in the body such as tongue tie, sleep apnea, ADHD, and more! I will also be posting about being a dentist and a working mommy to two wonderful children. Thank you and I hope you enjoy my videos!
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