Episode 4: Interview with Prof. Jeffrey P. Okeson - This is on TMJ, ortho and occlusion. The importance of orthopedic stability when changing the occlusion.
Proper interview starts at 3.30!
https://www.youtube.com/watch?v=nTrIHZWSHGMEven though this is about the debate surrounding ortho causing TMJ, I find it EVEN MORE relevant to us given that that surgery dramatically and suddenly changes the occlusion. This is something I'm really worried about with surgery. I know that A&G address this, but I don't know if others do.
His point is that the joints and occlusion need to be in harmony. In a different video somewhere he talk about it being like a 3-legged chair - with the two joints on one end and the teeth on the other - if one is off balance, everything is off balance.
Some points for those who don't watch:
*Aesthetics are important but a more important factor is function, you can have good aesthetics while having having poor function. That poor function goes a lifetime and sometimes a lifetime of misery.
*Every patient deserves orthopedic stability.
*If an orthodontist builds an occlusion in a very unstable orthopedic position that patient has a greater risk factor for developing TMJ disorders.
*For us to assume orthodontist could not cause problems is pretty naive.
*More risk in adults than adolescents/children.
*When orthodontists are trained to do things well there is no risk factor. But we have to worry about the ortho who is not thinking about joint position.
