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Why You Should be Working with Patients on Appliance Therapy: Part One

Why You Should be Working with Patients on Appliance Therapy: Part One

8/25/2016 8:35:23 AM   |   Comments: 0   |   Views: 96


Dr. Lee Brady

   by Dr. Lee Ann Brady

    Appliance therapy is the ultimate case acceptance tool you should be utilizing
    in your office. The benefits of this approach can be seen in many
    different patients, from TMD and restorative to orthodontic patients with
    muscle-based or joint-based pain.


   Increasing patient awareness and ownership is the primary goal. Though
   there is a clinical side to appliance therapy, here I will be focusing on
   the importance of the behavioral side.


Demonstrating the potential benefits a patient can experience is one way that you can develop their nterest in appliance therapy. Patients with pain from issues such as muscle tension, chronic headaches, or broken teeth can first experience the benefits of an appliance with an anterior deprogrammer (lucia jig) in the office.


The focus for you should be on creating a positive relationship between the patient and the idea of appliance therapy. A couple methods for doing this are:

  1. Explain the findings of the muscle and joint exam.
  2. Explain the relationship between these findings and their pain.
  3. Describe an anterior-only device and its uses.
  4. Invite them to check in with their pain, whether it be headaches or facial muscle tension/tightness.
  5. Fabricate the deprogrammer.
  6. While they wait, have them relax, read, or play on their cell phone.

When utilizing these steps, you might find something that has amazed me in my own practice: Patients can be incredibly perceptive.

If you emphasize the patient’s impression of differences from using an anterior-only device, you enable them to come to their own understanding of the value of appliance therapy.


Many patient’s perceive a difference, even slight and connect their muscle activity with the device.


If the patient felts no difference or worse, then what do you do?


Take this as a learning opportunity. You’ve now eliminated one potential problem (the issue is not related to their occlusion or parafunction). It could also be possible that the pain’s chronicity requires more time to sense a difference or that a different appliance would be more effective.


Read more of Dr. Brady’s top clinical posts like her Guide to Ovate Pontics or Eliminate Black Triangles from Anterior Veneers.

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