Dogma in dentistry

Wheaton cosmetic dentist Bryan Bauer

Dental dogma

There is a shift to treating TMD in terms of psychological factors and pain physiology.

Occlusal role

Long believed to be dominant cause now gradually being completely debunked. Information, reassurance, analgesics for pain relief, and jaw exercises will help majority of TMD patients.
Placebo splint covering only hard palate is largely as effective as occlusal splint. Proposed mechanisms for effects of intraoral appliances (excluding debunked occlusal)

  1. Occlusal disengagement
  2. Neurophysiological effect on masticatory system
  3. Change of vertical
  4. Change of caput-fossa relation
  5. Cognitive awareness of harmful behaviors
  6. Stress absorber
  7. Placebo effect

Treatment recommendations

  1. Conservative, reversible, and evidence based therapeutic modalities (not occlusal adjustments)
  2. Home care program

 

J Prosthodont Res. 2009 Jan Critical review of some dogmas in prosthodontics. Carlsson

Acta Odontol Scand. 2010 Nov Some dogmas related to prosthodontics, temporomandibular disorders and occlusion. Carlsson

Denture Dogma

Some interesting facts about dentures10-20% of denture wearers are dissatisfied no matter how denture fabricated.the doctors assessment of the quality of denture supporting tissues are poor predictors of future patient satisfaction of mandibular prosthesis. ( In other words one can not predict who will and who will not be happy other than to say x% will be unhappy)

creation of a good patient/doctor relationship is more important than than a technically perfect denture in terms of patient satisfaction (how truthful are the people answering these questions???  even on a blind form that the doctor will never see I imagine that we are hesitant to be too harsh with a doctor we like and are more likely to be harsh with someone we don’t.  Maybe that is the point, if so that is common sense.)

20 year follow up of dentures shows no difference in use face-bow or not

Canine-guided liked by patients better and reported kept mandibular denture in better

lingualized occlusion and anatomical perceived as better than zero degree

alginate in standard tray is creates as good of final results as any other technique

J Prosthodont Res. 2009 Jan Critical review of some dogmas in prosthodontics. Carlsson GE1.