Four Pillars of Dental Orthopedics:
The four pillars of dental orthopedics are the primary areas of medical dysfunction that suggests the likelihood of the existence of a dental orthopedic issue. They are:
- Chronic pain
- Sensory Integration issues
- Immune dysfunction (issues with inflammation, autoimmunity or depressed immunity)
- Movement disorder (including TMJ and muscle tonicity)
Best dental and medical practice standards:
The presence of any one of these conditions in the medical history of a patient should raise the suspicion of the existance of a significant dental orthopedic dysfunction. Even more suggestive is if a patient has a history of very high medical utilization- a situation that has been shown in many studies to correlate highly with jaw orthopedic dysfunction.
When one of the four pillars of dental orthopedics is present, a comprehensive medical history is indicated with the knowledge and understanding of how an dental orthopedic defect impacts one over their lifetime. In addition, a thorough dental orthopedic exam is indicated. The medical history is necessary to determine whether or not comprehensive dental orthopedic repositioning is indicated. This is currently not being done in most cases of sleep apnea (only PM repositioning).