Bicuspids and joint disorders
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The controversy concerning whether or not extraction of bicuspids for orthodontic purposes causes temporomandibular joint disorders (TMD) has been argued for over 20 years. It began in the late 1980s after litigation on behalf of TMD patients claiming that the cause of their problems was orthodontic extractions (McNamarra, 1997). The question is still being debated, although there seems little evidence that removal of teeth actually causes TMD. Orthodontists remove teeth in cases of overcrowding to allow normal occlusion of the upper and lower jaws and normal jaw and tooth development. This is still done in some cases, although orthodontists now rely more on repositioning of teeth through the use of braces and orthodontic appliances. Those opposed to bicuspid extraction argue tooth overcrowding in the upper jaw (maxilla) is due to a small upper arch, and removing teeth will only make it smaller, making proper occlusion even more difficult (Chan, 2002). The temporomandibular joint connects the lower jaw, known as the mandible, to the temporal bone of the skull (Chan, TMJ/Myofacial 2002). The two bones are separated by a disc of articular cartilage, and the head of the mandibular bone fits into a concavity in the temporal bone called the genoid fossa. The joint also contains muscles, soft tissue and ligaments. Both temporomandibular joints (TMJ) (right and left) move together as the jaw
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uth opened and closed (Chan, TMJ/Myofacial, 2002).
Symptoms of TMD: Symptoms of TMD are numerous, and include jaw pain, facial pain, back and neck pain, headaches, an uncomfortable bite, sensitive teeth, jaw locking open or closed, sinus symptoms, dizziness, visual disturbances, hearing disturbances, tingling in the hands and fingers, and insomnia (Chan, What is, 2002). There are many other symptoms, and this large variety of symptoms, many of which occur in other disorders, often makes TMJ difficult to diagnose. The NIH Technology Assessment Conference Statement concluded that, "there are significant problems with present diagnostic classifications of TMD because these classifications appear to be based on signs and symptoms rather than on etiology... scientifically based guidelines for diagnosis...are still unavailable" (Chan, What is, 2002).
Diagnosis of TMD: TMJ is usually diagnosed by dental professionals on the basis of several criteria: range of motion of jaw; sounds in TMJ joints; teeth and jaw joint examinations; symptom records; injuries; oral habits; and previous medical and dental histories.
Choices of Orthodontic Treatments - Whether or not to Extract Bicuspids
Patients with tooth overcrowding problems in
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Some common words found in the essay are:
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Approximate Word count = 2585
Approximate Pages = 10 (250 words per page)
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