DentaltownUK April 2017 - 57

Physiotherapy

exercise and manual therapy. In addition
he advocates that physiotherapists and
dentists should work alongside each other.
[8,9,10]
4) There are also many studies which
highlight when physiotherapy is used with
splint therapy the outcomes are better than
with splint alone or physiotherapy alone.
However it should also be noted that there
are also many studies that suggest splint
therapy is better than physiotherapy. I
think a lot more research needs to be done
in this area to reach any conclusions. In my
experience using both produces the best
outcomes. [11, 12, 13]
5) A group of internationally recognised
scientists, with expertise in epidemiology,
pain mechanisms, TMJD diagnostics,
functional genomics, statistical genetics,
bioinformatics, and biostatistics, in
collaboration with a highly recognized
Data Coordinating Center (Battelle
Memorial Institute) and the National
Institutes of Dental and Craniofacial
Research initiated a 7-year prospective
cohort study titled: Orofacial Pain
Prospective Risk Evaluation and
Assessment Study (OPPERA). The
primary goal of the OPPERA study was to
identify the psychological and physiological
risk factors, clinical characteristics and
associated genetic mechanisms that
influence the development of TMD as well
as characterising the biological pathways
through which these genetic variations
causally influence TMD risk.
They found that about 4% of subjects
developed TMJ each year, and that, of the
202 factors considered, several of these factors
had a significant impact on the risk of
developing TMD. They found that general
health factors made the largest contribution
to your risk, followed by psychological factors
and characteristics of your head, neck, and
mouth. Several genetic factors were also
linked to developing TMJD, but future

research is needed to determine their
contribution. Another insight of the
OPPERA study is that TMJD isn't uniform
for all people. There are many potential
profiles of TMJ sufferers, and because of this,
there are many TMJD treatments that can be
employed to achieve optimal results that are
also non-invasive and reversible. [14]

Figure 1: diagram of
the findings from
the OPPERA study.

How Do I Assess Craniomandibular,
Craniofacial and Craniocervical
Disorders?
My initial assessment usually lasts 90
minutes. This is because I create a timeline of
the patient's full medical history from when
they were a child to the present day as well as
the present complaints and patterns of
symptoms they are experiencing. I then go on
to carry out an objective assessment which
consists of an extra oral examination, an
intraoral examination, palpation, conduction
tests of the cranial nerves, neurodynamic
testing, lymphatic system evaluation,
biomechanics of the TMJ, accessory
movements of the TMJ, cranium, cervical
and shoulder evaluation. This gives me a full
picture of the patients craniomandibular,
craniofacial and craniocervical status. I
always make sure that the patient is under the
care of a dentist or a maxillofacial surgeon to
make sure they are receiving treatment from
both aspects.
dentaltownuk.com \\ APRIL 2017

57
http://www.dentaltownuk.com
Table of Contents for the Digital Edition of DentaltownUK April 2017
