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Medical Forum / General / Dentistry / September 2005

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NTI cost

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letsconnect - 13 Sep 2005 16:05 GMT
There has been a previous thread discussing how much the NTI device
retails for to the patient (anything from $200-$800), but how much is
the actual cost (to the dentist)?
carabelli - 13 Sep 2005 16:09 GMT
> There has been a previous thread discussing how much the NTI device
> retails for to the patient (anything from $200-$800), but how much is
> the actual cost (to the dentist)?

Nowadays around $420,000.00, but a little higher on the coasts.

carabelli
Amatus Cremona - 13 Sep 2005 16:31 GMT
>but how much is
> the actual cost (to the dentist)?

Counting the time required to research it, study it, learn it properly,
practice doing it until proficient, buying the material, buying the matrix
and paying for copyright, plus office time, about $400 each.  Add in the
time spent going to school to get a diploma so one can legally place these
devices, and the time spent building the practice to the point where the
dentist is earning more than Burger King wages, then the cost of each one
would be 3-4 times higher.

Amatus

/

>> There has been a previous thread discussing how much the NTI device
>> retails for to the patient (anything from $200-$800), but how much is
[quoted text clipped - 3 lines]
>
> carabelli
letsconnect - 13 Sep 2005 16:49 GMT
I was asking because I wanted to recommend it to a dentist who's
interested in TMJ, but he's worried that it's too expensive. I doubt
he'd be interested if the cost to the dentist is $400 per device.
Amatus Cremona - 13 Sep 2005 16:56 GMT
>I was asking because I wanted to recommend it to a dentist who's
> interested in TMJ, but he's worried that it's too expensive. I doubt
> he'd be interested if the cost to the dentist is $400 per device.

The matrix is far cheaper than the lab bill to have a "Horseshoe" made.
However, one needs to consider taking enough time to learn to do it
properly.  The final cost per unit has to include time spent learning to do
it, just like implants, RCT, surgery, etc.

Signature

/

Amatus

/

>I was asking because I wanted to recommend it to a dentist who's
> interested in TMJ, but he's worried that it's too expensive. I doubt
> he'd be interested if the cost to the dentist is $400 per device.
Minnie - 20 Sep 2005 00:53 GMT
>The final cost per unit has to include time spent learning to do
>it, just like implants, RCT, surgery, etc.
    ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^

Just like surgery?
Learning to place an nti is like learning surgery?

You should practically give it away!

WHy? because as a group you CAUSE "TMJ",TMD".

HOW? by applying abnormal amounts and directions of
force for abnormal periods of time to a fragile
joint.  You are the bulls in the temporomandibular
china shop!

*******
letsconnect2 - 20 Sep 2005 01:17 GMT
>WHy? because as a group you CAUSE "TMJ",TMD".
>
[quoted text clipped - 4 lines]
>
>*******

Hm? I was under the impression that TMJ/TMD was stress-related? What's the
story? (I haven't followed previous discussions on this topic, so forgive me
for my ignorance)
Minnie - 20 Sep 2005 02:39 GMT
>>WHy? because as a group you CAUSE "TMJ",TMD".
>>
[quoted text clipped - 6 lines]
>
>Hm? I was under the impression that TMJ/TMD was stress-related?

Alright.
"tmd" is stress related:
The "MECHANICAL STRESS", the TRAUMA of dental procedures,
esp time consuming molar jobs or rct dam, for instance,
disrupts the functioning of the delicate temporomandibular
joint.  -> "TMD"

Reread the above HOW.

My point is that for this reason nti should practically be
given away! like breath mints on the way out of a restaurant!
or AT THE VERY MOST, closer to its original price to the
wearer, $125.
Tim Dixon - 20 Sep 2005 02:44 GMT
>>>WHy? because as a group you CAUSE "TMJ",TMD".
>>>
[quoted text clipped - 20 lines]
> or AT THE VERY MOST, closer to its original price to the
> wearer, $125.

Oh pleeeeeeeeeeeeeeeeeeeeeeeeze.
Minnie - 20 Sep 2005 05:09 GMT
>>>>WHy? because as a group you CAUSE "TMJ",TMD".
>>>>
[quoted text clipped - 22 lines]
>
>Oh pleeeeeeeeeeeeeeeeeeeeeeeeze.

What's wrong with it?
Tim Dixon - 20 Sep 2005 13:16 GMT
>>>>>WHy? because as a group you CAUSE "TMJ",TMD".
>>>>>
[quoted text clipped - 24 lines]
>
> What's wrong with it?

Ok, define what "tmd" is.
W_B - 20 Sep 2005 15:32 GMT
>> What's wrong with it?
>
>Ok, define what "tmd" is.

Trancend Mental Dentication ?
--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
Tim Dixon - 20 Sep 2005 15:44 GMT
>>> What's wrong with it?
>>
>>Ok, define what "tmd" is.
>
> Trancend Mental Dentication ?

Thats about as close as one could get I think.
Stovepipe - 23 Sep 2005 04:41 GMT
> >> What's wrong with it?
> >  
[quoted text clipped - 6 lines]
> Take out the G'RBAGE
> wubbabubbazG@RBAGEyahoo.com

Actually, that's not bad..... I have some-a those kind-a patients

SP
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Minnie - 20 Sep 2005 18:23 GMT
>>>>>>WHy? because as a group you CAUSE "TMJ",TMD".
>>>>>>
[quoted text clipped - 26 lines]
>
>Ok, define what "tmd" is.

You're asking me to answer something I already wrote.
uh.. that would be in the "disrupted function of temporomandibular
joint" line, above, if you re-read what I wrote.
Even better than giving the definition, I give the cause.
Steven Fawks - 20 Sep 2005 20:26 GMT
You gave one example of something that makes
'TMD' symptoms worse.  Not the cause.

;-)
Fawks

>>Ok, define what "tmd" is.

> Even better than giving the definition, I give the cause.
letsconnect - 21 Sep 2005 20:11 GMT
> You gave one example of something that makes
> 'TMD' symptoms worse.  Not the cause.

What is the cause? Bruxism?
W_B - 20 Sep 2005 02:54 GMT
>My point is that for this reason nti should practically be
>given away! like breath mints on the way out of a restaurant!
>or AT THE VERY MOST, closer to its original price to the
>wearer, $125.

When you get your dental degree you can decide what to charge.

--
W_B

wubbabubbazG@RBAGEyahoo.com
Take out the G'RBAGE
Flap - 20 Sep 2005 03:26 GMT
>My point is that for this reason nti should practically be
>given away! like breath mints on the way out of a restaurant!
>or AT THE VERY MOST, closer to its original price to the
>wearer, $125.

When you get your dental degree you can decide what to charge.

--
W_B

Flap's Reply:

And establish your own business/practice.

Flap

http://flapsblog.com
Minnie - 20 Sep 2005 05:09 GMT
>When you get your dental degree you can decide what to charge.
>
[quoted text clipped - 4 lines]
>
>And establish your own business/practice.

Fawks has it right.
Tim Dixon - 20 Sep 2005 13:17 GMT
>>When you get your dental degree you can decide what to charge.
>>
[quoted text clipped - 6 lines]
>
> Fawks has it right.

Fawks has what right?
Steven Fawks - 20 Sep 2005 14:08 GMT
I think that is in reference to my widespread, low-fee (sometimes
just thrown in with a treatment plan) use of NTI's.

If I can get a clencher (undergoing treatment for other procedures)
to wear an NTI, everything is going to be smoother.  I have fewer
phone calls for post-op pain, fewer temporaries knocked off, more
patients that think I'm pretty damn good, etc.

I'd rather do 100 NTI's a year for $150 than 10 for $400.  If a dentist
is in a position where they can do 100 for $400 though, I'm not going
to complain.  It is a very valuable device.

Fawks

>>Fawks has it right.
>
> Fawks has what right?
Tim Dixon - 20 Sep 2005 14:17 GMT
Thats what I thought you would say and I think you have it figured out as
well as anybody that the NTI has more value to both doctor and patient than
the dollar cost.  It all comes down to the individual practice doesn't it?
Example, if all you see are migraine patients then the price is really based
on what the medical insurance will pay.  I believe the national average
right now for a chairside NTI  is around 450$  And in the end, it's still
your license that is on the line.

> I think that is in reference to my widespread, low-fee (sometimes
> just thrown in with a treatment plan) use of NTI's.
[quoted text clipped - 13 lines]
>>
>> Fawks has what right?
Minnie - 20 Sep 2005 18:23 GMT
>Example, if all you see are migraine patients then the price is really based
>on what the medical insurance will pay.  I believe the national average
>right now for a chairside NTI  is around 450$  And in the end, it's still
>your license that is on the line.              ^^^^^^^^^^^^^^^^^^^^^^^^^
^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^

What does this last part mean?  Lose license how?
Lose license for charging less than a set price?
Then price set by whom?  

>> I think that is in reference to my widespread, low-fee (sometimes
>> just thrown in with a treatment plan) use of NTI's.
[quoted text clipped - 13 lines]
>>>
>>> Fawks has what right?
Tim Dixon - 20 Sep 2005 22:30 GMT
>>Example, if all you see are migraine patients then the price is really
>>based
[quoted text clipped - 6 lines]
> Lose license for charging less than a set price?
> Then price set by whom?

No one said anything about losing a license, you are out of context and
putting words in my mouth.
Minnie - 20 Sep 2005 22:40 GMT
>>>Example, if all you see are migraine patients then the price is really
>>>based
[quoted text clipped - 9 lines]
>No one said anything about losing a license, you are out of context and
>putting words in my mouth.

Okay, then what does "in the end, it's still your license that is on
the line" mean?
Tim Dixon - 20 Sep 2005 23:07 GMT
>>>>Example, if all you see are migraine patients then the price is really
>>>>based
[quoted text clipped - 13 lines]
> Okay, then what does "in the end, it's still your license that is on
> the line" mean?

It means just what it says.  Believe me, SWF knows what I meant even if you
don't, and thats all that matters.
Minnie - 20 Sep 2005 23:53 GMT
>>>>>Example, if all you see are migraine patients then the price is really
>>>>>based
[quoted text clipped - 16 lines]
>It means just what it says.  Believe me, SWF knows what I meant even if you
>don't, and thats all that matters.

Oh yeah, I get it.  Does not bother me. Not at all.  
Stovepipe - 23 Sep 2005 04:41 GMT
> What does this last part mean?  Lose license how?
> Lose license for charging less than a set price?
> Then price set by whom?  

In our own case, it's the price that has been figured by the CPA. Some
treatments chez-nous are more $$$ than chez our neighbors, but most are
less. It really depends on what the practice does to earn its living.

SP
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Stovepipe - 23 Sep 2005 04:41 GMT
> I think that is in reference to my widespread, low-fee (sometimes
> just thrown in with a treatment plan) use of NTI's.
[quoted text clipped - 9 lines]
>
> Fawks

I see nothing wrong with this position EXCEPT:

Do the patients really APPRECIATE a device so inexpensive?

Will they therefore not just let it fall by the wayside after a few
months?

Do insurance companies treat the NTI at that price as a real treatment
or a gimmick and refuse to pay?

If _I_ were a moderately motivated patient, I might not want to tough
out the adaptation period if I knew that I only paid 150$ for it. If I
paid 300$ for it, the motivation would be higher, I'm sure.

As it is, we have a sliding scale of payment, and often the payments are
in installments with post dated cheques. I'm not sitting at the front
desk very often, but even so, I have yet to hear a patient who has
learned to wear the NTI properly complain about its price. OTOH, we
don't ever charge over 350$, and that is for someone who comes in
specifically for that and needs nothing else.

JMO
SP
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Minnie - 20 Sep 2005 18:23 GMT
>> Fawks has it right.
>
>Fawks has what right?

Fawks has it right, and SP, if you read the thread.
Tim Dixon - 20 Sep 2005 22:32 GMT
>>> Fawks has it right.
>>
>>Fawks has what right?
>
> Fawks has it right, and SP, if you read the thread.

Ask Fawks and SP how many medically dx migraine patients they see and how
much they bill insurance.
Minnie - 20 Sep 2005 22:42 GMT
>>>> Fawks has it right.
>>>
[quoted text clipped - 4 lines]
>Ask Fawks and SP how many medically dx migraine patients they see and how
>much they bill insurance.

So?  
Tim Dixon - 20 Sep 2005 23:09 GMT
>>>>> Fawks has it right.
>>>>
[quoted text clipped - 6 lines]
>
> So?

So ask them.
Minnie - 20 Sep 2005 23:59 GMT
>>>>>> Fawks has it right.
>>>>>
[quoted text clipped - 8 lines]
>
>So ask them.

What an @-hole!
It's none of my business.
For all I know, none.  You don't know either.
Tim Dixon - 21 Sep 2005 00:30 GMT
>>>>>>> Fawks has it right.
>>>>>>
[quoted text clipped - 13 lines]
> It's none of my business.
> For all I know, none.  You don't know either.

No i don't know, but it's not 15 bucks.  It will be based on what the
insurance company will pay if it's billed to medical as it should be.  But
it's not 15 bucks.  Get it????????????
Steven Fawks - 21 Sep 2005 15:36 GMT
> Ask Fawks and SP how many medically dx migraine patients they see and how
> much they bill insurance.

I have seen quite a few, but I *DO NOT* want to develop a practice
where I would see several each day!

Some migraine patients are easy to treat and receptive to the NTI
therapy.  Others argue, quote their physician, their neurologist,
their spouse, their friend, stuff they found on the web, and are
just PITA's.  "Their migraines are different"  "I need to get a shot
when they hit me"

The thought that they are doing this to themselves is too frightening
to consider and a little piece of plastic is way too simple for the
complexities of their condition.

$1,000 would not be enough for some of these.

JME,
Fawks
Tim Dixon - 21 Sep 2005 15:46 GMT
>> Ask Fawks and SP how many medically dx migraine patients they see and how
>> much they bill insurance.
[quoted text clipped - 16 lines]
> JME,
> Fawks

Thanx for the honest answer and opinion Steve.  I didn't expect anything
less from you.

TD
Stovepipe - 23 Sep 2005 04:41 GMT
> >>> Fawks has it right.
> >>
[quoted text clipped - 4 lines]
> Ask Fawks and SP how many medically dx migraine patients they see and how
> much they bill insurance.

As of today, 22 Sept 2005, 20h30 (PM) I've seen exactly... none. It is
all the more frustrating in that I personally went to see each Mad Dog
that shared the waiting room with me (before they retired) and I told
them about the treatment and how it could help. I did not get ONE
reference.

.... Gang of immature children.....

It _IS_ part of our Medical/Dental Questoinnaire though. And I _do_
insist on palpating the patients' head/neck/shoulder muscles the first
time I see them.

Not many believe me, and I just say: 'Very Well: when you're tired of
enduring that pain and stiffness, we'll talk again.'

Don't forget I'm in the poor end of Quebec..... This is the land of:
don't put off 'till tomorrow what you can put off 'till only the
specialist can fix it...

SP
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Minnie - 20 Sep 2005 05:09 GMT
>When you get your dental degree you can decide what to charge.
>--
[quoted text clipped - 7 lines]
>
>http://flapsblog.com

No thanks. Common sense is enough.
Let's face it. Fitting an nti is not brain surgery or even
implant surgery.  It's a low cost/unit little plastic taco
that one can learn to fit via cd.
Gouging people for this kind of therapuetic device is
egregious.
Tim Dixon - 20 Sep 2005 13:16 GMT
>>When you get your dental degree you can decide what to charge.
>>--
[quoted text clipped - 14 lines]
> Gouging people for this kind of therapuetic device is
> egregious.

Really, what CD would that be?
W_B - 20 Sep 2005 15:33 GMT
> It's a low cost/unit little plastic taco
>> that one can learn to fit via cd.
>> Gouging people for this kind of therapuetic device is
>> egregious.
>
>Really, what CD would that be?

Dark Side of the Moon.
--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
Tim Dixon - 20 Sep 2005 15:48 GMT
>> It's a low cost/unit little plastic taco
>>> that one can learn to fit via cd.
[quoted text clipped - 4 lines]
>
> Dark Side of the Moon.

BRAIN DAMAGE

The lunatic is on the grass
The lunatic is on the grass
Remembering games and daisy chains and laughs
Got to keep the loonies on the path

The lunatic is in the hall
The lunatics are in my hall
The paper holds their folded faces to the floor
And every day the paper boy brings more

And if the dam breaks open many years too soon
And if there is no room upon the hill
And if your head explodes with dark forbodings too
I'll see you on the dark side of the moon

The lunatic is in my head
The lunatic is in my head
You raise the blade, you make the change
you re-arrange me 'till I'm sane

You lock the door
And throw away the key
There's someone in my head but it's not me

And if the cloud bursts, thunder in your ear
You shout and no one seems to hear
And if the band you're in starts playing different tunes
I'll see you on the dark side of the moon.
W_B - 20 Sep 2005 15:57 GMT
>>> It's a low cost/unit little plastic taco
>>>> that one can learn to fit via cd.

>>>Really, what CD would that be?
>>
[quoted text clipped - 3 lines]
>
>The lunatic is on the grass

Poor Sid.
--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
Stovepipe - 23 Sep 2005 04:41 GMT
> BRAIN DAMAGE
>
> The lunatic is on the grass
> The lunatic is on the grass
> Remembering games and daisy chains and laughs
> Got to keep the loonies on the path

Well FU*K all that, we gotta get on with THIS....

SP
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Minnie - 20 Sep 2005 05:09 GMT
>>My point is that for this reason nti should practically be
>>given away! like breath mints on the way out of a restaurant!
>>or AT THE VERY MOST, closer to its original price to the
>>wearer, $125.
>
>When you get your dental degree you can decide what to charge.

I don't have to have a dental degree to have an opinion.

>--
>W_B
[quoted text clipped - 6 lines]
>
>http://flapsblog.com
W_B - 20 Sep 2005 15:47 GMT
>>When you get your dental degree you can decide what to charge.
>
>I don't have to have a dental degree to have an opinion.
>
>>--
>>W_B

Opinions are like a**holes
--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
Steven Fawks - 20 Sep 2005 17:20 GMT
Everybody has one?  You appreciate your own but
think others stink?  Dan probably has more options.

Fawks

> Opinions are like a**holes
> --
>
> W_B
> Take out the G'RBAGE
> wubbabubbazG@RBAGEyahoo.com
Stovepipe - 23 Sep 2005 04:41 GMT
> >>When you get your dental degree you can decide what to charge.
> >
[quoted text clipped - 5 lines]
> Opinions are like a**holes
> --

.... One day, all of the parts of the body were discussing who should be
boss.

The eyes said that since with out him, the body could not see, he should
be boss.

The legs said that since without him, the body could not move forward,
he should be boss.

The brain, of course tried to dazzle them with his elegant logic, and
terminated three hours later, saying that therefore, he should be boss.

The stomach, the intestines, the heart, the feet; all the important
parts stated their cases.

- Then the a.shole applied for the job. -

The other parts of the body almost killed them selves laughing- so much
so that the a.shole became mad and closed up.

After a few days, the brain went foggy, the eyes crossed, the leggs
wobbled, and all the other parts started to go awray.

After a couple more days of this, the other parts relented and
pronounced that the a.shole could be boss.

-What does this mean?-

That one does not have to be smart, clear- and far-sighted, strong,
fast, or any of a million other attributes to be boss.

-One just has to be an a.shole._

S
P
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Amatus Cremona - 20 Sep 2005 11:40 GMT
> Reread the above HOW.

Do you have internet access under your bridge?

Signature

/

Amatus

/

>
>>>WHy? because as a group you CAUSE "TMJ",TMD".
[quoted text clipped - 21 lines]
> or AT THE VERY MOST, closer to its original price to the
> wearer, $125.
Minnie - 20 Sep 2005 18:23 GMT
>Do you have internet access under your bridge?

Do you?

>>WHy? because as a group you CAUSE "TMJ",TMD".

>>HOW? by applying abnormal amounts and directions of
>>force for abnormal periods of time to a fragile
>>joint. You are bulls in the temporomandibular china shop!
W_B - 20 Sep 2005 19:19 GMT
>>Do you have internet access under your bridge?
>
>Do you?

Only on the lower right 3-unit.
--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
letsconnect2 - 20 Sep 2005 12:15 GMT
>>>WHy? because as a group you CAUSE "TMJ",TMD".
>>>
[quoted text clipped - 8 lines]
>disrupts the functioning of the delicate temporomandibular
>joint.  -> "TMD"

So you're saying that TMJ is caused by keeping your mouth open during dental
procedures, rather than as a result of (oftentimes stress-induced) clenching
or grinding? I would have thought that, unless you suffer with TMJ symptoms
anyway, you'd recover pretty quickly after RCT? Or are you saying RCT
actually causes *permanent* TMJ??

*confused*
Tim Dixon - 20 Sep 2005 13:18 GMT
>>>>WHy? because as a group you CAUSE "TMJ",TMD".
>>>>
[quoted text clipped - 19 lines]
>
> *confused*

So then what is TMJ?
Steven Fawks - 20 Sep 2005 14:20 GMT
Seems like that's what is being implied.  Dental treatment is
'no big deal' for 'normal' patients.  Patients who have joint
issues can have significant pain after a long appointment.

The dental treatment does not cause the condition, but it can
cause symptoms to go from 'mild & sub clinical' to 'it hurts
bad'.

It's easy to see how these patients sometimes do not understand
their condition.  They cruise along for months without significant
pain that they attribute to their TMJ's.  Sit in a dental chair for
an hour getting a few fillings, crown, or root canal, and can
hardly open their jaw the next morning.  For them, dental treatment
seems to be the cause of their pain.

JMO,
Fawks

> So you're saying that TMJ is caused by keeping your mouth open during dental
> procedures, rather than as a result of (oftentimes stress-induced) clenching
[quoted text clipped - 3 lines]
>
> *confused*
Minnie - 20 Sep 2005 18:24 GMT
>>>>WHy? because as a group you CAUSE "TMJ",TMD".
>>>>
[quoted text clipped - 11 lines]
>So you're saying that TMJ is caused by keeping your mouth open during dental
>procedures,

no. not just keeping mouth open, but force.

>rather than as a result of (oftentimes stress-induced) clenching
>or grinding?

the mechanical disruption is primary, the other symptoms you describe
are secondary - are symptoms of mechanical disruption.

>I would have thought that, unless you suffer with TMJ symptoms
>anyway, you'd recover pretty quickly after RCT?

No. I don't think so. Not necessarily.

>Or are you saying RCT
>actually causes *permanent* TMJ??

No. a procedure such as rct CAN cause tmj

>*confused*

I'm still saying what I already said:

>HOW? by applying abnormal amounts and directions of
>force for abnormal periods of time to a fragile
>joint.

>The "MECHANICAL STRESS", the TRAUMA of dental procedures,
>esp time consuming molar jobs or rct dam, for instance,
>disrupts the functioning of the delicate temporomandibular
>joint.  -> "TMD"

And for this reason, they will do better in the long run
to not gouge, for the $12 therapuetic device.
And as someone else mentioned, it could end up in wal-mart.
Amatus Cremona - 20 Sep 2005 18:25 GMT
> No. a procedure such as rct CAN cause tmj

Llort, inversion syndrome

Signature

/

Amatus

/

>
>>>>>WHy? because as a group you CAUSE "TMJ",TMD".
[quoted text clipped - 48 lines]
> to not gouge, for the $12 therapuetic device.
> And as someone else mentioned, it could end up in wal-mart.
W_B - 20 Sep 2005 19:25 GMT
>>So you're saying that TMJ is caused by keeping your mouth open during dental
>>procedures,
>
>no. not just keeping mouth open, but force.

What force ?

>>rather than as a result of (oftentimes stress-induced) clenching
>>or grinding?
>
>the mechanical disruption is primary, the other symptoms you describe
>are secondary - are symptoms of mechanical disruption.

Untrue.

>>I would have thought that, unless you suffer with TMJ symptoms
>>anyway, you'd recover pretty quickly after RCT?
>
>No. I don't think so. Not necessarily.

False.

>>Or are you saying RCT
>>actually causes *permanent* TMJ??
>
>No. a procedure such as rct CAN cause tmj

Again, untrue.

>>*confused*
>
[quoted text clipped - 3 lines]
>>force for abnormal periods of time to a fragile
>>joint.

Ahh Ha, now you have hit the nail.
You have stumbled upon the definition of parafunction.

>>The "MECHANICAL STRESS", the TRAUMA of dental procedures,
>>esp time consuming molar jobs or rct dam, for instance,
[quoted text clipped - 4 lines]
>to not gouge, for the $12 therapuetic device.
>And as someone else mentioned, it could end up in wal-mart.

It's not $12.

Just for the sake of argument:

Materials........$30
Knowing where and when to place materials
....................$200 - 500

It's about diagnosis.

--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
Minnie - 20 Sep 2005 20:13 GMT
>>>So you're saying that TMJ is caused by keeping your mouth open during dental
>>>procedures,
>>
>>no. not just keeping mouth open, but force.
>>
>What force ?

Unusual amounts and directions of force for an unusual
duration of time *applied by the operator during a procedure.*
disrupts the structure of the temporomandibular joint on either side
which results in "parafunction".

>>>rather than as a result of (oftentimes stress-induced) clenching
>>>or grinding?
[quoted text clipped - 3 lines]
>
>Untrue.

True.  (I'm right ;)

>>>I would have thought that, unless you suffer with TMJ symptoms
>>>anyway, you'd recover pretty quickly after RCT?
>>
>>No. I don't think so. Not necessarily.
>>
>False.

Not False.

>>>Or are you saying RCT
>>>actually causes *permanent* TMJ??
>>
>>No. a procedure such as rct CAN cause tmj
>>
>Again, untrue.

True.  

>>>*confused*
>>
[quoted text clipped - 6 lines]
>Ahh Ha, now you have hit the nail.
>You have stumbled upon the definition of parafunction.

Parafunction is caused by:
>>>The "MECHANICAL STRESS", the TRAUMA of dental procedures,
>>>esp time consuming molar jobs or rct dam, for instance,
[quoted text clipped - 12 lines]
>Knowing where and when to place materials
>....................$200 - 500

In the UK they know for $15.
Jim knows for free during a seminar.
Some dentists know for no charge, or break even
w/the idea that the device protects their work,
makes their job easier and creates priceless good will.
Charging $750, IN MY OPINION is egregious particularly
since as a class dentists cause tmd.  Sure, I know -
a person can charge what he wants.  People can also
choose where to go.

>It's about diagnosis.

tmd is easy to diagnose.
nti is a simple device.

>--
>
>W_B
>Take out the G'RBAGE
>wubbabubbazG@RBAGEyahoo.com
W_B - 20 Sep 2005 21:17 GMT
>>>>So you're saying that TMJ is caused by keeping your mouth open during dental
>>>>procedures,
[quoted text clipped - 7 lines]
>disrupts the structure of the temporomandibular joint on either side
>which results in "parafunction".

Assumes facts not in evidence, onset of parafunction is
idiopathic.

>>>>rather than as a result of (oftentimes stress-induced) clenching
>>>>or grinding?
[quoted text clipped - 5 lines]
>
>True.  (I'm right ;)

Sorry, you are wrong.

>>>>I would have thought that, unless you suffer with TMJ symptoms
>>>>anyway, you'd recover pretty quickly after RCT?
[quoted text clipped - 4 lines]
>
>Not False.

Yep, false.

>>>>Or are you saying RCT
>>>>actually causes *permanent* TMJ??
[quoted text clipped - 4 lines]
>
>True.  

Absolutely not.

>>>>*confused*
>>>
[quoted text clipped - 32 lines]
>Charging $750, IN MY OPINION is egregious particularly
>since as a class dentists cause tmd.

Again, parafuntion is idiopathic.
Your opinion stinks just like that other thang.

>  Sure, I know -
>a person can charge what he wants.  People can also
>choose where to go.

Greed is wanting something for nothing.
Get yourself to the UK, and see how you fare there.

>>It's about diagnosis.
>
>tmd is easy to diagnose.

No it actually is not.

>nti is a simple device.

NTI is a very well though out and designed device.
It took years to develop.

Elegant ? Maybe. Simple ? Not a chance.
--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
Minnie - 20 Sep 2005 22:03 GMT
>>Unusual amounts and directions of force for an unusual
>>duration of time *applied by the operator during a procedure.*
[quoted text clipped - 3 lines]
>Assumes facts not in evidence, onset of parafunction is
>idiopathic.

I don't believe parafunction is idiopathic since I have just
laid out a logical explanation of the cause.

>>True.  (I'm right ;)
>>
>Sorry, you are wrong.

right.

>>>>>Or are you saying RCT
>>>>>actually causes *permanent* TMJ??
[quoted text clipped - 6 lines]
>
>Absolutely not.

It is so.

>>>>>*confused*
>>>>
[quoted text clipped - 34 lines]
>
>Again, parafuntion is idiopathic.

No. Mechanical origin as already explained.

>Your opinion stinks just like that other thang.

Same to you.

>>  Sure, I know -
>>a person can charge what he wants.  People can also
>>choose where to go.
>
>Greed is wanting something for nothing.
>Get yourself to the UK, and see how you fare there.

In the UK some people got their ntis for $15
Some dentists here charge little for an nti.
How does it follow that I should go to the UK???

>>>It's about diagnosis.
>>
>>tmd is easy to diagnose.
>
>No it actually is not.

Not hard to recognize.

>>nti is a simple device.
>>
>NTI is a very well though out and designed device.
>It took years to develop.
>
>Elegant ? Maybe. Simple ? Not a chance.

Ask Jim Boyd if the device is simple.

>W_B
>Take out the G'RBAGE
>wubbabubbazG@RBAGEyahoo.com
W_B - 20 Sep 2005 22:05 GMT
>>>Unusual amounts and directions of force for an unusual
>>>duration of time *applied by the operator during a procedure.*
[quoted text clipped - 6 lines]
>I don't believe parafunction is idiopathic since I have just
>laid out a logical explanation of the cause.

Ignores years of scientific research, cause of parafunction
is unknown.

Even small children clench/grind in their sleep.
How do you explain that ?

--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
Minnie - 20 Sep 2005 22:35 GMT
>>>>Unusual amounts and directions of force for an unusual
>>>>duration of time *applied by the operator during a procedure.*
[quoted text clipped - 9 lines]
>Ignores years of scientific research, cause of parafunction
>is unknown.

Not to me.

>Even small children clench/grind in their sleep.
>How do you explain that ?

Depends.
I've never seen evidence of this.  Mostly, but not only
women, beginning around thirties, I thought.

>--
>
>W_B
>Take out the G'RBAGE
>wubbabubbazG@RBAGEyahoo.com
Amatus Cremona - 20 Sep 2005 22:50 GMT
>Ignores years of scientific research, cause of parafunction
>is unknown.
>
> Not to me.

Llort eht deef  ton od esealp.

Signature

/

Amatus

/

>
>>>>>Unusual amounts and directions of force for an unusual
[quoted text clipped - 25 lines]
>>Take out the G'RBAGE
>>wubbabubbazG@RBAGEyahoo.com
W_B - 21 Sep 2005 15:44 GMT
>>Ignores years of scientific research, cause of parafunction
>>is unknown.
>>
>> Not to me.
>
>Llort eht deef  ton od esealp.

Done.
--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
Stovepipe - 23 Sep 2005 04:41 GMT
> >Ignores years of scientific research, cause of parafunction
> >is unknown.
> >
> > Not to me.
>
> Llort eht deef  ton od esealp.

.pots ll'I ,KO

SP
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Tim Dixon - 20 Sep 2005 23:09 GMT
>>>>>Unusual amounts and directions of force for an unusual
>>>>>duration of time *applied by the operator during a procedure.*
[quoted text clipped - 18 lines]
> I've never seen evidence of this.  Mostly, but not only
> women, beginning around thirties, I thought.

Thats the problem, you thought.
W_B - 21 Sep 2005 15:45 GMT
>> Depends.
>> I've never seen evidence of this.  Mostly, but not only
>> women, beginning around thirties, I thought.
>
>Thats the problem, you thought.

Tried to think is probably closer to the mark.
--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
Tim Dixon - 21 Sep 2005 15:50 GMT
>>> Depends.
>>> I've never seen evidence of this.  Mostly, but not only
[quoted text clipped - 6 lines]
>
> W_B

Yeah I think you are correct.
W_B - 21 Sep 2005 15:43 GMT
>>Even small children clench/grind in their sleep.
>>How do you explain that ?
>
>Depends.
>I've never seen evidence of this.  Mostly, but not only
>women, beginning around thirties, I thought.

That's what you get for thinking.

Though it is debatable that you think at all.
--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
Stovepipe - 23 Sep 2005 04:41 GMT
> >>>>Unusual amounts and directions of force for an unusual
> >>>>duration of time *applied by the operator during a procedure.*
[quoted text clipped - 11 lines]
>
> Not to me.

Then, Min, a Nobel Prize in Physiology and Medicine awaits you.

> >Even small children clench/grind in their sleep.
> >How do you explain that ?
>
> Depends.
> I've never seen evidence of this.  Mostly, but not only
> women, beginning around thirties, I thought.

What?!?!?!?! Min!!!!!!!: you must treat clenching and grinding from
about TWELVE years old up to and through adulthood. Thirty years old is
oodles of time to have damaged teeth/joints/muscles.

SP
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Amatus Cremona - 20 Sep 2005 22:43 GMT
> I don't believe parafunction is idiopathic since I have just
> laid out a logical explanation of the cause.

Llort  --  just ask Leonardo Di Vinci

Signature

/

Amatus

/

>
>>>Unusual amounts and directions of force for an unusual
[quoted text clipped - 103 lines]
>>Take out the G'RBAGE
>>wubbabubbazG@RBAGEyahoo.com
Amatus Cremona - 20 Sep 2005 21:22 GMT
> Unusual amounts and directions of force for an unusual
> duration of time *applied by the operator during a procedure.*
> disrupts the structure of the temporomandibular joint on either side
> which results in "parafunction".

Llort  --  in reverse proportion

Signature

/

Amatus

/

>
>>>>So you're saying that TMJ is caused by keeping your mouth open during
[quoted text clipped - 87 lines]
>>Take out the G'RBAGE
>>wubbabubbazG@RBAGEyahoo.com
W_B - 20 Sep 2005 22:07 GMT
>Charging $750, IN MY OPINION is egregious

My fee is $250.

--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
Minnie - 20 Sep 2005 22:42 GMT
>>Charging $750, IN MY OPINION is egregious
>
>My fee is $250.

I know.  I read that before.

>--
>
>W_B
>Take out the G'RBAGE
>wubbabubbazG@RBAGEyahoo.com
Stovepipe - 23 Sep 2005 04:41 GMT
> >Charging $750, IN MY OPINION is egregious
>
> My fee is $250.

And you undoubtedly collect it 'egregious-ly', I sure...

SP
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Stovepipe - 23 Sep 2005 04:41 GMT
W_B writed furst:

> >What force ?
>
> Unusual amounts and directions of force for an unusual
> duration of time *applied by the operator during a procedure.*
> disrupts the structure of the temporomandibular joint on either side
> which results in "parafunction"

No, Min: you would not let the dentist injure you like that. You are not
sleeping during these procedures.

SP
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Minnie - 20 Sep 2005 21:23 GMT
>>>So you're saying that TMJ is caused by keeping your mouth open during dental
>>>procedures,
>>
>>no. not just keeping mouth open, but force.
>>
>What force ?

To be more specific, jamming the mandible backward and/or
laterally disrupt, where normally FORWARD (mandible
forward on the person) and chin staying on the midline are
better.
W_B - 20 Sep 2005 21:35 GMT
>>>>So you're saying that TMJ is caused by keeping your mouth open during dental
>>>>procedures,
[quoted text clipped - 7 lines]
>forward on the person) and chin staying on the midline are
>better.

What the heck are you talking about ?

What you describe sounds like a boxing match.
--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
Minnie - 20 Sep 2005 22:35 GMT
>>>>>So you're saying that TMJ is caused by keeping your mouth open during dental
>>>>>procedures,
[quoted text clipped - 11 lines]
>
>What you describe sounds like a boxing match.

Whats so unclear?
mandible:
lateral, backward movement - avoid
non-lateral, forward movement - good

Anyway, no doubt boxing matches have resulted in tmd too,
or...maybe not since they wear those arches to stabilize.

>W_B
>Take out the G'RBAGE
>wubbabubbazG@RBAGEyahoo.com
Tim Dixon - 20 Sep 2005 23:13 GMT
>>>>>>So you're saying that TMJ is caused by keeping your mouth open during
>>>>>>dental
[quoted text clipped - 20 lines]
> Anyway, no doubt boxing matches have resulted in tmd too,
> or...maybe not since they wear those arches to stabilize.

No such thing as tmd.  Sorry.  Find one dentist in this group that claims
tmd exists and i'll eat my hat if you find one.  If you do find one lets
have him/her explain exactly what it is since you can't.  It ain't gonna
happen sister.
Amatus Cremona - 20 Sep 2005 23:18 GMT
> No such thing as tmd.  Sorry.  Find one dentist in this group that claims
> tmd exists and I'll eat my hat if you find one.  If you do find one lets
> have him/her explain exactly what it is since you can't.  It isn't gonna
> happen sister.

I know what TMD is.

TMD = Tim M. Dixon

I never could figure out what the "M" stood for.

Signature

/

Amatus

/

>
>>>>>>>So you're saying that TMJ is caused by keeping your mouth open during
[quoted text clipped - 26 lines]
> have him/her explain exactly what it is since you can't.  It ain't gonna
> happen sister.
Tim Dixon - 20 Sep 2005 23:21 GMT
>> No such thing as tmd.  Sorry.  Find one dentist in this group that claims
>> tmd exists and I'll eat my hat if you find one.  If you do find one lets
[quoted text clipped - 6 lines]
>
> I never could figure out what the "M" stood for.

Very good.. but even I don't know what the "M" stands for.
W_B - 21 Sep 2005 15:46 GMT
>> No such thing as tmd.  Sorry.  Find one dentist in this group that claims
>> tmd exists and I'll eat my hat if you find one.  If you do find one lets
[quoted text clipped - 6 lines]
>
>I never could figure out what the "M" stood for.

'Mighty'

--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
Tim Dixon - 21 Sep 2005 15:51 GMT
>>> No such thing as tmd.  Sorry.  Find one dentist in this group that
>>> claims
[quoted text clipped - 9 lines]
>
> 'Mighty'

hahaha thats pretty good, but unfortunately my middle initial is just a
simple "G"
Amatus Cremona - 21 Sep 2005 16:00 GMT
>TMD = Tim M. Dixon
>
>I never could figure out what the "M" stood for.
>
> 'Mighty'

Actually  --  TMD  =  Ti M Dixon

Signature

/

Amatus

/

>
>>>> No such thing as tmd.  Sorry.  Find one dentist in this group that
[quoted text clipped - 15 lines]
> hahaha thats pretty good, but unfortunately my middle initial is just a
> simple "G"
Tim Dixon - 21 Sep 2005 16:06 GMT
>>TMD = Tim M. Dixon
>>
[quoted text clipped - 3 lines]
>
> Actually  --  TMD  =  Ti M Dixon

Hey thats pretty good.
W_B - 21 Sep 2005 17:53 GMT
>>>TMD = Tim M. Dixon
>>>
[quoted text clipped - 4 lines]
>hahaha thats pretty good, but unfortunately my middle initial is just a
>simple "G"

G = Goodman !
--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
Stovepipe - 23 Sep 2005 04:41 GMT
> >>> No such thing as tmd.  Sorry.  Find one dentist in this group that
> >>> claims
[quoted text clipped - 12 lines]
> hahaha thats pretty good, but unfortunately my middle initial is just a
> simple "G"

That's a pity:

'Come-on without....
Come-on within...
You've not seen nothin' like the
MIGHTY Tim...'    ;-)
SP
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Tim Dixon - 23 Sep 2005 05:07 GMT
>> >>> No such thing as tmd.  Sorry.  Find one dentist in this group that
>> >>> claims
[quoted text clipped - 22 lines]
> MIGHTY Tim...'    ;-)
> SP

Hey I love that song, of course I love all Dylan songs..
Stovepipe - 23 Sep 2005 05:37 GMT
> >> hahaha thats pretty good, but unfortunately my middle initial is just a
> >> simple "G"
[quoted text clipped - 8 lines]
>
> Hey I love that song, of course I love all Dylan songs..

I prefer the Manfred Mann version, myself...

SP
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Amatus Cremona - 21 Sep 2005 15:58 GMT
>TMD = Tim M. Dixon
>
>I never could figure out what the "M" stood for.
>
> 'Mighty'

Magnificent !

Signature

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>
>>> No such thing as tmd.  Sorry.  Find one dentist in this group that
[quoted text clipped - 16 lines]
> Take out the G'RBAGE
> wubbabubbazG@RBAGEyahoo.com
Tim Dixon - 21 Sep 2005 16:07 GMT
>>TMD = Tim M. Dixon
>>
[quoted text clipped - 3 lines]
>
> Magnificent !

Now the Mrs. might say that ;-)
W_B - 21 Sep 2005 15:41 GMT
>>What the heck are you talking about ?
>>
[quoted text clipped - 3 lines]
>mandible:
>lateral, backward movement - avoid

So, don't chew, right ?
Dumb.

>non-lateral, forward movement - good

Even dumber.

>Anyway, no doubt boxing matches have resulted in tmd too,
>or...maybe not since they wear those arches to stabilize.

Since you know so little about this subject, I refuse to
enter into a war of words with an unarmed opponent.

--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
Amatus Cremona - 21 Sep 2005 15:57 GMT
> Since you know so little about this subject, I refuse to
> enter into a war of words with an unarmed opponent.

West Marine stocks lots of the supplies you would need.

Signature

/

Amatus

/

>
>>>What the heck are you talking about ?
[quoted text clipped - 23 lines]
> Take out the G'RBAGE
> wubbabubbazG@RBAGEyahoo.com
W_B - 21 Sep 2005 17:55 GMT
>> Since you know so little about this subject, I refuse to
>> enter into a war of words with an unarmed opponent.
>
>West Marine stocks lots of the supplies you would need.

Indeed.

It appears that my immediate need would be a 'hook-out' <g>
--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
Minnie - 21 Sep 2005 18:45 GMT
>>>What the heck are you talking about ?
>>>
[quoted text clipped - 10 lines]
>>
>Even dumber.

You have missed the point.
What I am referring to here, what we were discussing,
is the *force applied by the operator during a dental procedure*.

>>So you're saying that TMJ is caused by keeping your mouth open during dental
>>>procedures,
>>
>>no. not just keeping mouth open, but force.
>>
>What force ?

>-Unusual amounts and directions of force for an unusual
>-duration of time *applied by the operator during a procedure.*

Hardly relates to chewing, now does it?
Or maybe I am mistaken and they have meals and rct simultaneously
time at your place?
W_B - 22 Sep 2005 04:31 GMT
>>So, don't chew, right ?
>>Dumb.
[quoted text clipped - 6 lines]
>What I am referring to here, what we were discussing,
>is the *force applied by the operator during a dental procedure*.

It is you that have missed the point.

What is the force applied to the mandible by a 245 @ 200k+ rpm
while preparing #20 for a DO ?

Gorilla-fist dentists are a rare species.

--
W_B

wubbabubbazG@RBAGEyahoo.com
Take out the G'RBAGE
Minnie - 22 Sep 2005 17:56 GMT
>What is the force applied to the mandible by a 245 @ 200k+ rpm
>while preparing #20 for a DO ?

Why?
At x lbs of pressre in y direction for z time
the garage door gets unhinged?  not necessary.
Knowing which directions to avoid is useful! as I already
mentioned, that is something I suppose is taught in
dental college, I'm surprised if it is not.

C'mon. Let's face it. It is so obvious that during big time
consuming dental procedures, and when using a dam
there is tremendous strain on the joint.  It's undeniable,
it is far outside the normal use of the "tm system".
"Parafunction" is simply the bodies attempt, via musculature
to correct the disrupted "disc assembly", the unhinged
garage door.  The "tm system" is particularly susceptible because it
is a fragile complex system, a fragile, complex "closed system"
I would call it.

The side by side graphic says a lot.
I'm not so sure it's *only a psa block* paralyzing the ipsilateral
LP that is causing an imalance in opening efforts.

http://www.nti-tss.com/TM-Animated-Tuorial/Unilater-LP-activity.html

>Gorilla-fist dentists are a rare species.

Apes in lab coats?
Some have lighter hands, some have heavy hands.

>--
>W_B
>
>wubbabubbazG@RBAGEyahoo.com
>Take out the G'RBAGE
carabelli - 23 Sep 2005 01:17 GMT
>>What is the force applied to the mandible by a 245 @ 200k+ rpm
>>while preparing #20 for a DO ?
[quoted text clipped - 15 lines]
> is a fragile complex system, a fragile, complex "closed system"
> I would call it.

Nope, parafunction is when the masticatory system goes into overdrive
without masticating.  Period

Acute trauma can occur when access is needed for dental procedures.  If the
existing TMJ anatomy is already stressed from previous parafunction the
patient is more likely to have problems from acute trauma.  And acute trauma
from any source can disrupt TMJ function, however I am not aware of trauma
inducing parafunctional activity.  If you are, please provide us with some
peer reviewed evidence.

You are totally off base.  Are you a dentist?  How long have you been
practicing?

carabelli
letsconnect - 23 Sep 2005 01:29 GMT
> Nope, parafunction is when the masticatory system goes into overdrive
> without masticating.  Period
[quoted text clipped - 5 lines]
> inducing parafunctional activity.  If you are, please provide us with some
> peer reviewed evidence.

That's the way I understood it as well.

What's the actual cause of parafunction, though?
carabelli - 23 Sep 2005 03:46 GMT
>> Nope, parafunction is when the masticatory system goes into overdrive
>> without masticating.  Period
[quoted text clipped - 13 lines]
>
> What's the actual cause of parafunction, though?

1. without reference to evidence based research - this is a response for
*some* when mental stress is added to the equation.
2. Why this is the response - I don't have a clue.  For some people playing
with a string of beads, etc will provide a physical activity that alleviates
to some extent the mental stress that (acknowledged or not) exists.  For
some reason unknown to me, unusual and/or certainly unnecessary physical
activity (clenching) is an involuntary response to stress levels that  may
affect one individual and may not affect the next.

3. If you do not exercise on a regular basis you should.  Why, because I
said so.  If that doesn't make sense - go back to # 1

carabelli
Stovepipe - 23 Sep 2005 22:55 GMT
> 1. without reference to evidence based research - this is a response for
> *some* when mental stress is added to the equation.
[quoted text clipped - 4 lines]
> activity (clenching) is an involuntary response to stress levels that  may
> affect one individual and may not affect the next.

Ain't that the truuuth: When I'm takin' out a tooth on a medically
compromized elder lady, and I DON'T wanna see it break, and she's waited
until there's no lingual left on the tooth, and so I have to force the
beaks WAY subgingival to find something to grab onto, and I only have 20
minutes to do this,,,, I catch myself CLENCHIN' my teeth real good...
and then I berate myself for concentratin' on my clenching instead of
the tooth, and then I refocus on the tooth, and this goes round and
round a few times....

... And if that happens more'n once a week, I've got my NIGHTTIME NTI in
place, and I'm bitin' on it but good....

.... and I don't care if they can't understand what I'm sayin'....

... And if they ask why, I tell them that over your'n, in the US of A,
people TAKE CARE of their teeth and they don't wait till the last minute
to get a tooth out if that's what is necessary. And I tell them that I
know dentists who charge what the xray says the tooth is: simple or
complex compared with the bone, even if the dentist was able to take it
out as a simple extraction.

.... And I tell them I want them to heal up and come back to get the
rest of the mouth looked at because I don't want them having problems
with their teeth as well as their heart.... or they can go get treated
in a hospital milieu where all bets are covered.... and so is the $$$$
thay they will pay....

.... and THEN, and ONLY then, do I take out my NTI.

.... and I take off my helmet and my seatbelt,  

... and my O2 mask....

Because if the tooth breaks, it is NOT my fault, and they will have to
come back some other time....

.... and have to stop their Coumadin AGAIN.....

.... and meanwhile my staff steal my Big Mac Trio lunch and my extra
Mountain Dew...

.... and the petty cash money...

... and I stare thoughtfully into the distant sky....

.... and CLENCH summore....

<....the Pipe bursts out crying into his iBook....>

<.... and the sparks start flyin'.....>

HAVE A FRIGGIN' NICE DAY!!!!!!!!!     :-/

SP
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Amatus Cremona - 23 Sep 2005 23:39 GMT
>.... and have to stop their Coumadin AGAIN.....

You stop anticoagulant therapy?

Amatus

>> 1. without reference to evidence based research - this is a response for
>> *some* when mental stress is added to the equation.
[quoted text clipped - 59 lines]
>
>SP

..

Amatus

.
Stovepipe - 24 Sep 2005 04:04 GMT
First, the Pipe whined:

> >.... and have to stop their Coumadin AGAIN.....
>
> You stop anticoagulant therapy?
>
>  Amatus

For extractions, I ask that the Mad Dogs do, yes. I ask them to bring
the patient into a clotting in 10-15 minutes range. That usually means
reducing and not eliminating the dose. I don't usually touch it for
anything else. If all they're taking is aspirin, I don't stop that.
Usually put Surgicel in the alveolus, and send them to the waiting room
biting on a wet tea bag and with an ice pack on and off for thirty
minutes.

They resume normal medication the next morning.

Of course, this has to be tempered with the clinical situation. If the
teeth are fairly mobile, periodontally involved, I may not touch the
Coumadin at _all_.

Are you telling me you _don't_ ever turn off the Coumadin for
extractions?

SP
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Take out the TRASH to reply

Amatus Cremona - 24 Sep 2005 05:18 GMT
>Are you telling me you _don't_ ever turn off the Coumadin for
>extractions?

Normally I do not stop the medication if they can clot at all.  Rather
than ask the physician to stop the medication I prefer to ask for a
bleeding time test.   I would prefer the socket bleeds for an extra 45
minutes over the patient having a stroke.

Amatus

>First, the Pipe whined:
>> >
[quoted text clipped - 22 lines]
>
>SP

..

Amatus

.
Stovepipe - 24 Sep 2005 07:42 GMT
> >Are you telling me you _don't_ ever turn off the Coumadin for
> >extractions?
[quoted text clipped - 5 lines]
>
>  Amatus

OK, I can accept that. Where do you get your bleeding time? Or do you do
it yourself wit