Dr. Colin Lathrop discusses DTR and its impact on his busy practice
Dr. Pam Cain describes her own symptom improvements after undergoing DTR treatment
“A big note of thanks to Dr Robert Kerstein for the in-office training experience with DTR. Our training day was packed full of information and instruction. His guiding teaching mannerisms allowed me and my team to continue to expand our knowledge and training with the T Scan and begin to implement and understand the addition of the EMG unit. I don’t believe there is a better way to learn and understand the system than to have the expert standing next to you pointing out some of the subtle nuances on the recordings and then helping you clinically apply what you are seeing. While our 5 patients were all different, the similarities of each case allowed for a continuation of the learning experience. We all feel better prepared now to integrate this into our office and begin to better help our patients in the healing process of long-term headaches and muscle tension. This was by far one of the best investments in clinical education I have made in 30 years, and this is just the beginning of the learning process as we were able to video the day to enable us to go back and review the material.”
“Earlier this month I had the privilege of having Dr. Robert Kerstein in my office for a super exciting full day of DTR hands on training. The day was a professional revolution for me. It is not very often that I go to a seminar or hands on training, which I do in abundance, and end up with the feeling that I am hundred times more knowledgeable.
I attended so many seminars in the past about occlusion, facial pain, occlusal splints and bruxism, and I can honestly say that I always ended up more confused than before going in, and more disappointed that my best shot to help my patients who presented with TMD and facial pain, was to give them an occlusal splint and rely on their compliance. The bigger disappointment though was the helpless feeling that came when these orthotics failed to help, and the patients still ended up living with chronic pain. Even when I referred my patients to the TMJ specialists, most of my patients ended up without pain relief, and very frequently, had permanent unwanted changes of their bite.
Until I learned about DTR, the area of occlusion and bruxism was the most frustrating to me and I was desperate to learn something that I could apply, a method that made sense to me, which was personalized to every patient’s needs and physiology. The DTR office training did just that for me!
First of all, Dr. Kerstein is one of the most detail-oriented teachers I have had. His passion about teaching DTR was infectious, and his detailed step-by-step teaching method gave me the confidence that after one-day and 7 patients only, I can truly offer my TMD patients some long-term relief. The T-Scan and DTR training has also opened a door that allows me to be a much better dentist, and allows my practice to stand out as a top-notch, high quality practice.
In my training day, I had a variety of patients’ cases. Two of my patients ended up not being candidates for DTR, but even that was a great learning opportunity as Dr. Kerstein explained why they were not DTR candidates and what other treatment options were available. I also had a patient who needed elongation of his canine to be able to do DTR on him, and that was a wonderful experience as well. During all of it, Dr. Kerstein was walking me through the steps, pointing things out on the T-Scan and the EMG tracings, pointing out which contacts on the teeth to treat (and those to not treat), and giving me tips on how to deal with different clinical situations.
It’s very fair to say that without the DTR training at the office, I would have never had that much clarity about the functional occlusion, and I would have definitely not being able to enjoy having measurable results with the EMG. But most importantly, I would not have been able to feel the immediate gratification from the of the instantaneous relief that patients experienced after DTR.
Having gone through the DTR training with Dr. Kerstein was one of the best decisions I have made, and one of the best investments in myself I have made, to become a better and smarter clinician, who can benefit from the technology of this century, and make a difference in patients’ lives. I cannot say enough good things about my experience and cannot thank Dr. Kerstein enough for an amazing memorable day!”
-Dr. Ghina Morad
“How many times in our lives can we say that we have spent time with world’s expert in a certain area of dentistry? And that same expert be warm, caring, insightful, and hardworking? I had this type of experience with Dr. Kerstein in my office for DTR training. Now, as a dental nerd, I love occlusal concepts. It’s an area that I’ve grown into over the last decade. I met my match with Dr. Kerstein. Once I picked up Dr. Kerstein from the airport for dinner, we didn’t stop talking about occlusion. I’m talking 4 hours of occlusion discussion over drinks. Our next day consisted of 6 patients using T-scan and EMGs. Dr. Kerstein treated my patients as if they were his own. He cared. We worked nonstop through our 6 patients. My highly trained team respected his time with them as well.
The 1-on-1 training helped me with both common sense principles as well as interpretation of my existing T-scan data more accurately and quickly. Dr. Kerstein asked the right questions to my patients that helped clarify their needs. His common sense approach to T-Scan-guided occlusal adjustments techniques, as well as his patient management during and post treatment were insightful. Dr. Kerstein trained me on understanding the “WHY” on the T-scan data and how to transfer the information to the patient’s clinical needs. He showed me the reasons that longer disclusion times are problematic and how to approach different scenarios. I learned things that could only be learned by having him by my side. My experience ended with a drive back to the airport deconstructing our day.
I appreciate Dr. Kerstein’s approachable personality, breadth and depth of knowledge, and support in growing the occlusal concepts. I now can say that I worked with the world’s expert in occlusal technology. Wouldn’t you want that same learning experience?”
—Dr. Eric S. Johnson
“It isn’t often that you meet someone who truly has only helping others in mind. However, this has been my experience with both Dr. Robert Kerstein and Dr. Ben Sutter. Drs. Kerstein and Sutter have dedicated their lives to helping the dentists and future dentists of the world learn a technique, Disclusion Timing Reduction (DTR), which can dramatically change the lives of patients. Their commitment to the dentists they teach is remarkable—both doctors have made themselves available for phone calls and texts for answers to questions and clarification on how to incorporate this treatment into daily dental practice. I am grateful to these two for helping me accomplish my heart’s desire of helping my patients live a life without pain. Learning DTR has aided in nearly every aspect of my dental practice and I cannot recommend these doctors or this technique more highly.”
—Dr. Christina Mason
“Having Dr. Kerstein in the office for the hands on DTR training was revolutionary! All the information and technique learned can be applied in our practice in a routine daily basis. Dr. K delivered an amazing day of training for all involved: myself, the team members, and the patients. Patient response to DTR treatment was very positive immediately after treatment rendered. We know now the answers to some of the common troubles we see in our practices on a daily basis but did not know the cause or how to handle them. DRT is a MUST for every one practicing complete dentistry care. It will change the way you see and handle occlusal related issues in your practice.”
—Dr. J. Olavo Queiroz, DDS
Dr. Kerstein and Dr. Nicholson
“I first met Dr. Kerstein in Seattle at the DTR summit earlier this year in January. Over a 2 day period, I received a basic working knowledge of the T-Scan and DTR treatment from his lectures and Dr. Sutter’s lectures. I was able to take the knowledge I received there and bring that back to my practice and started performing DTR therapy on a couple of patients. While I understood the concepts fairly well, I could tell I still had a lot to learn with the T-Scan and BioPak and needed help to expand my knowledge.
Enter in Dr. Kerstein! He came to my office in June for a 1 day one on one training with live patients. We saw 4 patients that day and with his help were able to make some nice changes on all 4 patients. In that one day, I was able to learn so much more with the T-Scan and became so much more efficient with the occlusal adjustments.
Dr. Kerstein has worked so long and hard trying to get the T-Scan and DTR treatment into the mainstream and his passion for his work shows during the in-office training. It is very clear that he genuinely wants the doctor to learn as much as possible so he or she can effectively render treatment to this particular patient base and relieve the symptoms of so many patients who are suffering. Without the in-office training I don’t believe you can understand and render the treatment as effectively as you can with it. It is so worth the investment!
Thank you so much Dr. Kerstein for all your help!!!”
—Dr. Brandon Nicholson, DDS
Kinston Dental Associates
A Trudenta Trained Doctor Learning DTR Therapy
“I recently had Dr Robert Kerstein in my office for a Level, 2 DTR in-office personalized 1-on-1 training. We utilized DTR ( with the ICAGD coronoplasty) on five patients over an eight- hour period. It was absolutely amazing the amount of information Dr Kerstein was able to transfer to me while I was providing treatment. Each patient had different data that we worked through in detail, to get the results we wanted.
This experience was invaluable, and you cannot get this level of understanding any other way.
Dr. Kerstein’s knowledge of the subject, obviously, is unmatched and he is ‘The Man’ when it comes to one-on-one training. My team members were impressed with his patient skills and how he conveyed information to both us as dental professionals and my patients.
For those of you who are Trudenta trained, this DTR training with Dr. Kerstein is what you must have if you truly want success. The T-Scan is a wonderful piece of equipment, but you need the training Dr Kerstein provides to thoroughly understand and utilize it… and get the results!!
Learning DTR has truly opened my mind and eyes as to what the T-Scan with EMG (focusing on excursions between C-D) is really capable of instead of (rather than focusing on A-B closure). If you want to get to the root of the patient’s symptomatic problems, and eliminate their symptoms, discover excessive excursions.
Honestly, Trudenta doctors need Dr. Kerstein’s input and training to provide vastly more optimal and efficient care for headache and migraine sufferers that it is just plain missing in Trudenta’s training currently. I encourage all Trudenta doctors to:
- TAKE THE TWO DAY DTR SEMINAR with Drs. Kerstein/ Sutter…An absolutely mind blowing experience, changes everything!
- CONTACT DR. KERSTEIN and schedule a day of one-on-one, in office, hands on, incredible learning experience
If you’ve invested in T-Scan technology, congratulations! Now, I encourage you to really learn how to use it. Dr. Kerstein’s training and DTR is one of my best investments ever.
Thank you Dr. Kerstein!”
—H. Scott Stewart DDS, NMD
Kyle Benton DDS speaks candidly about his DTR in office training he has experienced with Dr Robert Kerstein. Kyle has the unique perspective of being a dentist and being treated with DTR for his TMD symptomology.
“I want to take a minute to express my gratitude for Dr. Kerstein coming to my office this past December (2016) to teach me hands on the principles of Disclusion Time Reduction (DTR). My background in DTR was an introductory 2-day course in Florida, as well as my using the T-Scan technology for about a year.
My first three training patients I had already attempted to perform DTR on, and was working with Dr. Kerstein to assist me in finishing the cases. I was blown away by how much information was right before my eyes inside the T-Scan data, but that I had not interpreted it completely. I also found that my DTR corrections were not as defined, or as precise as they should have been, until I was overseen by Dr Kerstein, chairside. The final 2 patients of my training were initial adjustment DTR patients (first treatment visit). With my new and deeper understanding of DTR, these 2 cases were refined more effectively in 1 hour, than were my initial DTR patients that I had worked on several times prior to Dr Kerstein’s visit, but had not completed.
I am pleased with the insights and experience I gleaned from working with Dr. Kerstein, in-office. Although I performed some DTR on patients prior to Dr. Kerstein coming to my office, I know now that the DTR I can perform as a result of working 1-on-1 with Dr Kerstein, is going to be much more effective.”
—Nathan Pfister DDS
Dr. Goldstein and Dr. Kerstein
“Dear Dr. Kerstein,
Thank you for coming out to my office and spending the day advancing my abilities with the BioPak and T-Scan. As you know, ever since I attended my first presentation given by you in December, 2014, I have been excited about using this technology to treat my wife, assistant and patients who are suffering from Occluso-muscle pain (frequently misnomered “TMD” or “TMJ”). I spent from 1993 through 2011 attending and training at the Dawson Institute, LVI and TruDenta in their theories of occlusion and how it relates to these types of patients. I had very little success in relieving their symptoms and became very frustrated. Then I attended your lecture in 2014. I already had the T-Scan in the office and so, when I got back, I treated my first patient, a 47 year-old female with severe daily migraines for over 2 decades. After the first visit performing DTR her migraines stopped. I saw her 4 more times to refine her occlusion because her initial maximum opening was only 21 millimeters. She also had a pop in the left joint upon opening that you could hear several feet away. By the last appointment she had a 48 millimeter opening and neither she nor I could aurally detect the “pop”. She has remained migraine-free since that first DTR visit.
I continued to treat this type of patient using the knowledge I gained from your presentation and others given by you and I finally purchased BioResearch’s JVA and EMG. I worked with this equipment for a few months to get used to it and then brought you out to my office for a full day of treating patients. That was the smartest move I have made in a very long time. While I had the concepts down pretty well, my execution of the treatment was tedious and time-consuming. I also was not using the synchronized EMG’s to full advantage. After spending the day with you, I now treat with confidence and know I am not over-treating. I also have reduced the amount of time performing the DTR from 90 minutes a visit to 40 minutes which is economically advantageous to my practice, but also it does not wear the patient’s muscles down as severely and I am getting more accurate scans throughout the treatments, as well.
You also were wonderful to observe in how you interviewed the patient and brought home to them how bad their existence was with the conventional treatments they had tried. I have since then received several testimonials back from these patients about how we changed their lives so significantly for the better. They are now spokespersons for my practice and my capabilities to help patients with their painful symptoms. They all say they cannot thank me enough, and I must parrot them in saying the same to you!
Thank you for your dedication to this marvelous treatment technique and thank you for being such a wonderful teacher. Everything you said and demonstrated was easy to understand and perform. I consider you one of the very best instructors I have ever encountered in my life!”
—Jeffrey N. Goldstein, D.M.D.
“Having Dr. Robert Kerstein out to our practice for in-office, 1-on-1 DTR clinical training was amazing and extremely beneficial to both myself and my dad, as well as our assisting staff. He spent time with me via e mail before he came for his visit on what we needed to have ready, and what to expect for his visit. Although his visit was short, only a day, it was full with patients and clinical cases. We made the most of the time he was here, to make sure all our questions were answered and that we fully understood the intricacies of the DTR procedure. He answered us in a helpful manner (other specialist/experts may treat a question as dumb and demean the question, but not Dr. Kerstein), being very friendly and respectful, while treating us as equals in front of our patients. On the more difficult cases, Dr Kerstein explained the case complexities to the patients (and to us) so everyone together could understand what the specific treatment challenges per patient were. He also encouraged video recording the session so we could review the training day later to reinforce what we and our staff had learned.
Dr. Kerstein spent a lot of time explaining the key features of the T-Scan synchronized with the Electromyograph (EMG), as well as how to read and interpret their output data, most of which despite our having company training, we were not overly familiar with. He also assisted us with remedying the common use problems and data errors that may occur chairside when using these occlusal technologies. And he checked and adjusted our user Settings to make sure the T-Scan/EMG worked optimally when performing DTR treatment.
Dr. Kerstein watched us taking T-Scans and coached us to improve our recording technique. This helped us learn how to obtain high quality recordings. He also coached the patients along with us, to instruct them how to firmly bite into the sensor before making proper excursive movements. Then he helped us to read the T-Scan/EMG video information correctly, prior to making the DTR occlusal corrections.
Reading the DTR chapter in the T-Scan Handbook of Research helped prepare us for where to adjust a patient’s teeth. But having Dr. Kerstein guiding our adjustments intraorally, and confirming the areas that needed adjustments on actual patients, was an immense help in understanding how to properly perform DTR. He pointed out exactly where the teeth should be contacting and where they should not contact. This taught how to adjust the problematic contacts to receive the best occlusal adjustment end results. Then obviously afterwards, seeing the improvement of the patient’s bite while they noticed the immediate lessening of symptoms was rewarding and encouraging for treating other symptomatic patients in the future.
My dad felt the skills we learned from Dr Kerstein’s visit were about how to use the EMG bridged to T-Scan to treat the occlusion to quiet the muscle activity. He also realized that the T-Scan has many features that we were not using, that after learning how to employ them, improved our data markedly. Things like adjusting individual tooth size and setting up an accurate dental arch in the software were skills we did not gain until he was in the operatory with us.
We also learned that the most important factors in DTR treatment are the lateral excursion adjustments instead of focusing on closure and balance corrections. And, that it is important at the beginning of DTR treatment to be definitive with the first few series of adjustments, so we would not have to keep adjusting the teeth in the same locations repeatedly. His guiding us to understand what specific contacts to adjust, and how to make definitive DTR corrections, made us both much more efficient by the end of the training. Using a medium coarse diamond helped with that (followed by definitive surface polishing), as well as having chairside adjustment instructions from patient to patient.”
—Jeremy Frith, DDS and Michael Frith, DDS
“Dear Dr. Kerstein,
I am Dr. Jeffrey Goldstein’s assistant.
I had to send you this email because I thought your visit to our office was incredibly valuable. My doctor has me doing the EMG-synched T-Scans and so he has trained me very well in the technical aspects of performing them. What your visit did for me was to greatly enhance my ability to effectively communicate to our patients the importance of correcting the occlusion to reduce/eliminate their symptoms and future damage to their joints and teeth.
You were so great at explaining everything. It was easy to understand and remember why we are doing the treatment steps that we do. The benefit of that is now I can easily communicate to our patients what you taught us. You see, they don’t ask the doctor their questions. Mostly, they wait until he steps out the room and bombard me with them. You gave me such a clear picture of what is going on that I am able to answer their questions in layman’s terms that they grasp immediately. That is something the doctor has trouble doing. He typically talks like a dentist!
Thank you so much for the wonderful day you gave us. The doctor and I already are seeing the benefits of your visit in case acceptance and efficiency in treatment visits. You are AWESOME!”
—Lisa M. Snyder, EFDA
I want to thank you for visiting our office and sharing your knowledge and enthusiasm about using T-scan and EMG together to reduce Disclusion Time effectively. Previously, I had taken two lecture courses on the T-Scan technology, but did not have a thorough appreciation about the application of the T-Scan and EMG in the treatment of muscular TMD problems. However, after your visit, I learned how to effectively ask patients about their symptoms and to diagnose a simple DTR case versus a complex DTR patient. Your hands-on approach, where you oversaw my making intraoral occlusal adjustments based on the preoperative T-Scan/Bio EMG DTR data, showed me how exactly and precisely the corrective adjustments can be made. The patients treated during your visit expressed immediate relief from their symptoms. The next day, they could not even put into words how much better they felt. I would recommend an in-office visit by Dr. Kerstein if you are interested in learning how to properly implement the T-Scan and BioEMG technologies to eliminate patient facial pain muscular conditions.”
—Dr. Gary Sasaki
Drs. Sasaki with Dr Kerstein together observing the force and timing elements changing during a patient occlusal function T-Scan/BioEMG recording.
“Digital technological advancements in dentistry have sculpted my practice and our ability to deliver predictable treatments to a variety of advanced dental conditions. In my opinion, no matter if it’s digital implant treatment planning, guided surgery, intra-oral scanning and CAD/CAM restorations, digital occlusal analysis with the T-Scan technology has become a vital component of the success of our patient treatment.
I recently became aware of the power of this occlusal technology when combined and synchronized with Electromyography, to accurately analyze and treat a myriad of Occlusomuscular disorders. However powerful the technology, clinical experience in its proper use is needed to guide this sophisticated, detailed occlusal treatment known as Disclusion Time Reduction (DTR). There is no substitute for the expertise that Robert Kerstein has amassed over his career with treating myogenous TMD conditions. I consider myself fortunate that Robert was willing to visit my office and give me “one-on-one” supervision, as I performed DTR treatment on my patients with his chairside T-Scan analysis and clinical adjustment guidance. It really taught me how to properly perform DTR adjustments, as well as how to read the T Scan/BioEMG changes that reflect treatment correctness had been obtained.
Everyone benefited from Robert’s visit, from the staff to the patients and ultimately, my ability to interpret the software and perform the DTR procedure. Robert’s visit helped us truly embrace the power of the technology and the effects of the treatment was palpable, as my staff and I witnessed patient’s years of symptoms melt away during the treatment. It would definitely serve any clinician’s patients, team, and the clinician’s own T-Scan user knowledge and chairside clinical implementation skill level, to have Dr Kerstein work in your practice 1-on-1, live with patients.”
—Dr. James Oshetski,
DABOI/ID, FAAID, DICOI, FAGD
“I want to thank you for coming to our office to share your knowledge of the T-scan-EMG link and DTR. I thought I had a fairly good understanding of the T-Scan but you taught us a whole different level of understanding and application.
From reading your book, I also thought I had a good take on DTR, but having you there looking over my shoulder at the scans and the patient’s teeth was invaluable. Your instructions to the patient on how to close properly and how to go into lateral was also incredibly valuable. So many times I have deleted scans because I just couldn’t seem to get the patient to understand what we were trying to do.
You also showed us how to make sense out of scans that I thought were worthless, yet you were able to show where there was good information. I am just so glad we had a camera filming the whole day so I can go back and review all the ideas you shared with me.
It was a great day and it energized the me and the staff. I can’t recommend your teaching highly enough, and I would strongly recommend any interested T-Scan user to have you come to their practice to learn proper T-Scan use and understanding with this type of individualized 1-on-1 T-Scan training. I believe what I learned this week will be a huge benefit to my many of my pain patients.”
—Allen Sprinkle, DDS
“The day that Dr. Kerstein spent in our office was invaluable to us, as he gave us a new set of eyes to understand the dimension of timing, and force in occlusal contact. The privilege of having him in the office has given us a new level of confidence in treating unbalanced occlusion, pain patients, and avoid costly remakes from understanding the dynamics of a bite better. His textbook, the Handbook of Research on Computerized Occlusal Analysis Technology, has ushered in a new era of dentistry that opens up possibilities and new avenues of treatment that were not available before the invention of the TScan.”
—Dr. Ratna Indah
Sunnyvale, CA Testimonial
“I want to thank Dr. Kerstein for coming to San Francisco for in office one-on-one training. It was a great pleasure to get to know Robert as a person who is so passionate about educating other colleagues and helping patients.
Initially I was introduced to T-Scan about 2 years ago when this technology was used on me. After Disclusion Time Reduction procedure I stopped clenching. That’s when I made up my mind and bought T-Scan for our practice.
After reading Dr. Kerstein’s book on digital occlusion I decided to take my knowledge to the next level by inviting Dr. Kerstein to my office. One of my patients was my wife; she was a grinder with severe muscular tension post ortho treatment in her youth. She tried every type of night guard, but the tension never went away. Dr. Kerstein personally worked on my wife, and now three weeks later she is practically asymptomatic and does not need to wear a night guard.
Seeing immediate clinical results of DTR, I am excited to incorporate this procedure in my practice moving forward. I am hoping that in the near future DTR will be widely accepted in dentistry as a necessary procedure to improve the quality of life for our patients.”
—Alex Pastel, DDS
Dr. Kerstein pointing out to Dr Jim Abraham of Park City Dental Spa, the correct contacts to treat based upon recorded T-Scan/EMG data
I have been working with head and neck pain patients for over thirty years and have incorporated a number of different approaches in that time. As a graduate of a school where centric relation was gospel it was a major league change to incorporate aspects of neuromuscular dentistry and jaw positioning into my practice. But I learned how critical jaw position and muscle activity were to pain patients.
In doing so the T Scan became an integral part of my practice a number of years ago; because the idea of being able to accurately and precisely measure and record force in the mouth and evaluate its effects on muscle activity made complete sense to me. So we incorporated muscle therapy as part of what we do to help our pain patients. When I was first exposed to DTR (disclusion time reduction), it was a clear and logical next step to understanding how to precisely evaluate the effects of force on muscle activity.
Due to our years old pain management protocols, our team already understood how changing force and muscle activity changes pain. Now the incorporation of the EMG (electromyograph) and it’s real time linkage to the T Scan enabled us to precisely link these two critical pain factors. Our time with Dr Kerstein reinforced what we knew, significantly improved our techniques in some areas, and introduced whole new ways to evaluate and treat causative pain factors.
It was an exciting, exhausting, and thrilling day. I cannot recommend strongly enough that anyone interested in occlusion and/or pain spend time with Dr. Robert Kerstein.”
Peter R. Barnett, DMD
Star Ranch Dental; Plano, TX