“What a fabulous weekend we had learning the ins and outs of Disclusion Time Reduction (DTR) and some advanced T-Scan work. Absolutely mind boggling information and yes, some old mind sets where challenged and myths busted.
T-Scan has been around for a long time, and Dr. Kerstein has been a voice in the wilderness, writing and submitting papers to all of the dental publications possible, but he is a scientist and he won’t be on the cover of Dental Economics. He has measurable outcomes to show, and with the addition of a reliable EMG unit that synchronizes with the T-SCAN recording, you can actually see, in real time, what those muscles are doing when you have unwanted tooth contact. BOOM! Anyone who has worked with bites and occlusion for any length of time will tell you that most headache and TMD pain is a muscle issue, not a joint issue. We just needed the marriage of those two technologies to begin to see this.
Let me begin by listing some of the dental myths that Dr. Kerstein’s work has disproven.
1. The occlusion DOES have much to do with headache, TMD and migraines. But the reason we never got that part figured out was that we didn’t have a reliable way to MEASURE the occlusion, to measure the timing or the forces of occluding and discluding. We didn’t realize the limitations of articulating film or paper. A good analogy would be like trying to restore decay without x-rays- you would find some issues, but miss many as well and begin to wonder about dentistry and if it works!
2. Measuring the bite with T-Scan has been demonstrated by Dr. Kerstein, Dr. Sutter, Dr. Nick Yiannos, Dr. Scott Green and others to show that the most important aspect of a therapeutic intervention for sensitive teeth, abfractions, gingival recession and TMD/headache is not having simultaneous occlusal contact that is evenly distributed, but establishing a DISCLUDING pattern where there is almost no molar or bicuspid tooth contact during that motion. And it is a lot harder to get that and to confirm it.
3. There is a particular set of symptoms that typify the occlusal muscle hyperfuction that gets misdiagnosed as TMD, TMJ, Migraine, Trigeminal neuralgia, cluster headache and so on. Once you begin to see the innervation of the Trigeminal Motor Nucleus and all the muscles that may be involved, it becomes easier to see the connection with tinnitus, vertigo, all sorts of head pain, eye pressure, earache, plus the TMD issues we are referring to. Muscle spasm causes pain, whether it is in the back, the shoulder or the head, period. I know that I will never dismiss someone’s symptoms about their head pain again- the old eyes have been opened.
Fifteen dentists were here this weekend, and fifteen new converts have been found. It is compelling and painfully evident that a new way of approaching this issue is at hand. Dr. Kerstein uses no splints in the majority of his cases and this treatment works hand in hand with any occlusal theory- CR, CO or NM. (Dr. Ben Sutter is a fellow at LVI and has significant experience in neuromuscular treatment AND TRU-Denta!)
There will be more workshops and this was the absolute first DTR Summit, and it provided a good mix of theory and hands on practice– there are tons of people who would love to get rid of their headaches and TMD issues. Stay tuned!
Many thanks to Drs. Kerstein and Sutter, Nate Krey from Bioresearch, Clancy Scott from Tekscan, and the dentists who will become some of the clinicians to take this out to the dental world- You will be hearing more about this, and it is an exciting time to know there is a better way of handling people’s problems with head pain.”
—Dr. Rick Coker, DDS, FACE
Director, Academy of Comprehensive Esthetics