Informed Consent for the Treatment of Temporomandibular Joint Disorder (TMD), Occlusal Muscle Dysfunction (OMD) and Bruxism
The temporomandibular joint (TMJ) is the name of the joint located on either side of your head, just in front of your ears. These joints connect your mandible (jawbone) to your temporal bone (skull). The TMJ, which can rotate and move forward, backward and side to side, is considered one of the most complex joints in the body. This joint, in combination with other muscles and ligaments, lets you chew, swallow, speak and yawn. When you have a problem with the muscle, bone or other tissue in the area in and around the TMJ, you may have a temporomandibular joint disorder (TMD), or Occlusal Muscle Dysfunction (OMD).
Signs or symptoms of TMD/OMD include pain and tenderness in or around the ear, the jaw joint, or the muscles of the jaw, face or temples. Other symptoms are problems opening or closing your mouth, and a clicking, popping, crunching or grinding noise when you chew, yawn or open your mouth. TMD/OMD may be linked with neck pain and headaches.
In most cases, TMD/OMD is caused by a combination of factors like jaw injuries and joint disease, such as arthritis. A poorly balanced bite or multiple missing teeth can add strain to muscles and joints as well. It is believed that bruxism (tooth clenching or grinding) and head or neck muscle tension may make TMD symptoms worse. Stress is also a possible aggravating factor, as is fingernail biting and pen or pencil biting.
TMD, OMD and Bruxism are muscle and joint conditions managed most effectively by removable dental appliance therapy. This treatment may be done in conjunction with massage therapy, medication and chiropractic care or physiotherapy. It is important to note that no therapy works 100% of the time. Intra-oral appliances (appliances that sit on the teeth and occasionally on the adjacent gum tissue) work by relaxing the muscles associated with opening and closing our jaws and subsequently reducing inflammation in and around the joint capsules of the mandible. As with any medical therapy, successful treatment of TMD / OMD and bruxism cannot be guaranteed. Success depends on many things. The most important component of success is patient compliance. By signing this document you hereby agree to follow the instruction and advice given to you in detail. Failure to do so may well result in a poor clinical outcome.
In order to properly adjust the occlusion (bite pattern) on the removable TMD/OMD/Bruxism appliance, several appointments may be required. The need for bite adjustments on the appliance occurs when muscle and joint inflammation subsides. Bite adjustments are billed as they are required and as such are not part of the estimated fee for services. Bite adjustment for TMD/OMD/Bruxism it is not possible to predict how many bite adjustments will be required prior to starting treatment.
It is not unusual during the course of appliance therapy for TMD/OMD that the muscles and/or joints associated with opening and closing your jaws may become painful. Keeping scheduled follow-up appointments and following post-insertion instructions will minimize the amount and duration of discomfort that can arise from treatment.
It is normal as muscles relax and joint inflammation decreases that a person may feel that their bite is no longer stable. Often this is a result of a previously unidentified bite discrepancy masked by inflammation. This bite discrepancy may require adjustment to ensure that a stable post-treatment bite is achieved.
By signing that form I consent that the procedure, the risks of no treatment, and possible side effects of treatment have been explained to me.