T-Scan & DTR
T-Scan is a computerised bite force measuring device which is used to detect bite anomalies and interferences in smooth jaw movement that cannot be detected any other way. The pressure on individual teeth is displayed on the computer screen in graphical and easy to understand format.
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This device gives so much more information than the articulating (carbon) paper as the marks shown by the articulating paper only show contacts, not the order or the intensity of those contacts.
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This means that a tooth that feels uncomfortable but shows no apparent cause and is receiving more force than the other teeth during chewing can be identified and the force reduced by adjusting the tooth shape in conjunction with the T-Scan data.
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T-Scan can also be used to treat patients suffering from chronic muscle pain due to clenching and grinding but as not all bite classifications can be treated this would be subject to examination.
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We have now implemented Bioresearch EMG (Electromyography). EMG measures muscle response or electrical activity in response to a nerve's stimulation of the muscle and this will be synchronised with the T-Scan results to show muscle activity with respect to jaw movements. The combination of these two technologies simultaneously enable us to offer DTR (Disclusion Time Reduction) treatment.
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DTR (Disclusion Time Reduction)
In an ideal bite the patients overbite (meaning the vertical overlap of their front teeth and canines) will guide the lower jaw position when chewing to permit the back teeth to come apart quickly. The time it takes for the back teeth to come apart in these side to side movements is called the Disclusion Time. Ideally, this should take around 0.5 seconds or less and this can be measured accurately with the T-Scan.
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Unfortunately, most of us are not in possession of a bite that has developed a short Disclusion Time by itself but due to the adaptability of the human body most of us tolerate this and the resulting occasional headaches, stiff necks and shoulders are accepted as being under stress especially if it is only occasional and easily treated with painkillers or massage.
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There are a small but significant number of people who do not adapt well or who used to adapt but no longer can. Often, over decades, they have developed a grinding (bruxing) habit and have been made various plastic mouthguards or nightguards that for many reasons have stopped being effective or because they break quickly when they used to last longer. These patients have, over time, developed very strong and hyperactive jaw muscles. The jaw muscles are able to exert forces much stronger than they need to be, which are in excess of the strength of the teeth or restorative dentistry in their mouths and which can lead to fractured teeth, fillings or crowns, failed implants and excessive tooth wear but also the development of regular headaches or migraines.
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These patients will often consult their GP, be referred to the Neurologist who will find nothing adverse and then to Physiotherapists or Acupuncturists when the problem is actually coming from their teeth. The dentist is the last professional to be consulted when in fact the dental practice should have been the first port of call.
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That said, not all dentists can diagnose and treat this condition. The vast majority of dentists do not possess computerised bite analysis technology (T-Scan) and are using articulating paper to diagnose and treat problematic teeth or jaw issues. Articulating paper will only show contacts but not the timing or pressure of that contact. Studies show that dentists attempting to assess bite pressure using articulating paper alone got it right 12% of the time.
TReatment
Firstly, your real-time chewing muscle activity and the dynamic movements of your bite and jaw are digitally analysed by T-Scan and Electromyography (EMG). These are then matched and mapped out onto a computer. Any overly engaging areas in your bite and jaw movements that are linked to excessive muscle strain are identified.
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Following computer-guided recommendations and a clinical analysis by your dentist, customized, minimal adjustments are made to very specific areas on your teeth. This can be in the form of adding composite to a heavily worn canine or minimal removal (less than 1 mm) of tooth substance.
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Finally, measurements will then be retaken as per the initial stage to see if the adjustments have reduced the strain on your chewing muscles or further refinements need to be made. These can be seen and measured with the EMG but you may start to notice a small reduction in tension in the muscles in your head and neck. In addition the changes to your bite should make it feel more even or comfortable.
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How long are the appointments and how many are required?
The first appointment will last 90 minutes and will aim to produce a shortened Disclusion Time of around 0.5 seconds removing the parts of the teeth remaining in contact when sliding to the side or forwards. This is important because the back teeth (premolars and molars) are hard wired anatomically to the brain and to the chewing muscles and removing prolonged contacts allows the muscles to start to relax.
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Why can't this be finished in 1 visit?
It will have taken decades in many instances to build up these pathologically worn teeth and hyperactive muscles and we are trying to reverse the problem. It is not feasible to expect this to be fixed in 1 visit as the teeth will have been compressed into the jaw bone and the muscles will be shortened and also in spasm. With the first reduction in Disclusion Time the teeth will rebound and the muscles start to relax resulting in a new bite. This is the reason symptoms improve initially and then return and patients are asked to return for a second visit for 1 hour after 7 days. After this another appointment is arranged for 30 days later unless symptoms return in which case the patient will be seen earlier. Most patients will require 4-7 visits and yearly checks to ensure a short Disclusion Time is achieved and maintained. It is possible to achieve 80-85% reduction in symptoms which is usually enough to achieve a comfortable bite and reduced or even eliminated head and neck tension. A 100% improvement cannot be guaranteed.
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What does the treatment cost?
A course of treatment takes around 4-5 appointments and costs around £2000 - £2500 on average and can be paid for on a pay as you go basis at £450 per hour.
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After treatment
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After DTR Therapy, you are likely to detect a change to your bite, which is now likely to feel comfortable but different. Most patients are able to quickly acclimatise and adapt to this as their normal and healthier bite. You may also notice a reduction in facial muscle tension.
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If you would like to find out if this treatment might be appropriate for you there is a downloadable form below at the bottom of the page.
Download the form to the left to describe your symptoms and send it with a photo of both sides of your mouth with your back teeth together, and lips retracted. This is a very important step for patients traveling from long distances.
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Please send these to info@blissdental.co.uk