PT to Dentist Referral

PT to Dentist Referral
May 19th, 2017 | Resource Links | Comments Off on PT to Dentist Referral

PT to Dentist Referral

PT to Dentist Referral

First and foremost, many patients demonstrating symptoms of R TMCC patterning will NOT need dental intervention! But it is helpful to know how to recognize those who will. We hope this stepwise chart will aid in decision making.

STEP 1: LOCATION OF SYMPTOMS FROM HISTORY

  • Headache – almost always!
  • Neck pain – possibly. Depends on chronicity.
  • Hx of fracturing back teeth without apparent reason
  • Hx of multiple other dental interventions
  • Hx of unrelenting pain regardless of working with excellent therapist

STEP 2: OBJECTIVE FINDINGS FROM CLINICAL EVALUATION

  • Narrow infrasternal angle – this necessitates use of accessory breathing via neck
  • Bite distortions: Anterior open bite/open posterior bite/cross-bite
  • Tongue tie, V-shaped palates, maxillary cant
  • Negative L ADT test on first visit!

STEP 3: CONFIRM USING TESTING IN VARYING POSITIONS:

After brachial chain intervention resulting in bilateral 90 degrees HG-IR, refer to dentist if any of the following other limitations persist:

  • L HG-HAbD
  • limitation in cervical lordosis
  • limitation in cervical-axial rotation
  • Limitation in mid-cervical lateral flexion
  • Or, patient can maintain BC and TMCC neutrality but symptoms persist

STEP 4: SETTING UP YOUR DENTIST FOR MANAGING EXPECTATIONS

Alert your dentist to have his cell phone handy, when you are seeing patients; this open line of communication is critical. Taking the following photos will help your dentist to prepare any complications that need to be discovered prior to treatment planning:

  • Full face, resting.
  • Profile face, relaxed.
  • Zoomed mouth baring teeth.
  • Zoomed mouth, side view of teeth.
  • Upper and lower arches.
  • Open mouth with tongue to roof of mouth.

**Try taking these both with and without the flash**

STEP 5: SETTING PATIENT UP FOR MANAGING EXPECTATIONS

When referring, you may be asked: “can’t my regular dentist make a bite guard for me?” There are several easy answer options:

  • “If this issue were simply a dental issue, I have no doubt that would work.”
  • “There are dental specialists who can make a bite guard that manage both your clenching/bruxism/TMJ problem/airway issue as well as how your head and neck need to move on your body.”

Patients will sometimes ask this difficult question: “Shouldn’t my dentist have caught on to this?”

  • answer: “you see a general dentist? This is something recognized and treated by a dental bite specialist.”

Other information is very helpful, regarding the business relationship with the dental office: for example,

  • “Dr C’s office is fee for service, and the initial visit is $.”
  • “Dr X will likely want to see a copy of your dental x-rays, along with these photos, prior to scheduling your initial visit.”

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