Episode #253: Better Understanding of Appliance Therapy with Dr. Michelle Lee - a podcast by ACT Dental

Dr. Michelle Lee delivers a presentation on an array of temporomandibular disorders (TMD), the problems they cause for Dr. Lee’s patients, and how different appliances can offer therapeutic solutions.
Different facial muscles are affected by TMD and that in turn causes breathing problems, general and localized pain, and issues with biting and chewing. This is both therapeutic and diagnostic, and we need to treat it as such. The “why” of TMD treatment includes understanding and prioritizing muscle comfort, occlusion stability, and a free airway.Anterior (muscle) deprogrammers are a diagnostic tool and they can help correct some bite problems. Dr. Lee explains some of the risks involved with anterior only therapy and reviews the functions (and key symptoms) of the muscles of the face: the temporalis, the masseter, the digastric muscles, and the plerygoid muscles.
Dr. Lee describes a patient named Emmy who suffered from a lot of pain in her back and neck, problems with posture, and mouth breathing. The science behind mouth breathing and how it can negatively affect facial development and healthy sleep are truly connected.Bite splints should fit properly or patients will play with them too much. A high resolution pulse oximeter can also be used to check for sleep apnea problems.
She also shares a personal story of her six-year-old son, Nathan, and how his deep bite and tongue tie affected his sleep breathing and general development—UARS (Upper Airway Resistance Syndrome).Pankey’s Cross of Dentistry:
Know YourselfKnow Your Patient
Know Your WorkApply Your Knowledge
Main Takeaways:You can use Appliance Therapy before, during, and after treatment. (3:30)
We need to understand the muscles, the joint, occlusion, and the airway. (9:30)“For every 10 degree change in the angle of disclusion, there is a 30% change in the force applied.” (32:32)
“We can be the change we want to see in the world [through our dentistry].” (43:45)
“TMD and UARS are more linked than we previously thought.” (54:14).Quotes:
“I’ve been able to stand on the shoulders of giants at the institute.” — Michelle“Do the clench test if you want to determine if your patient has a high anterior only risk.” — Michelle
“The timing of the sound of clicks can give us a better understanding of occlusions.” – Michelle“In the war between muscle and teeth, muscle always wins.” – Michelle.
“Mouth breathing is not a developmentally good thing.” – Michelle.“I know there’s a big pause in our lives, but we can sharpen our skills.” – Michelle.
“Start with a little bit of ramp and move up...that’s why it’s called therapy.” – Michelle.Snippets:
How Michelle got into dentistry. (2:00 – 3:30)Michelle’s philosophy. (5:00 – 6:00)
Why we use TMD appliances in the first place. (8:20–9:40)Emmy’s case study. (44:30 – 46:30)
Michelle’s son Nathan and his UARS. (51:40 –53:30)Bio of Speaker:
Dr. Michelle Lee is very proud to provide all aspects of comprehensive dentistry which includes Restorative, Cosmetic, TMD, and Sleep Apnea treatment to the Fleetwood and Berks county areas. Dr. Lee is a graduate of the University of Pennsylvania School of Dental Medicine with a one year post graduate General Practice Residency Program at the Abington Memorial Hospital.Dr. Lee continues to be a life long learner herself and constantly keeps herself abreast of dental advancements by committing to hundreds of hours of advanced dental education. She is an active member of the Pankey Institute, American Academy of Cosmetic Dentistry (AACD), and American Equilibration Society (AES), and other courses for advanced education.
Dr. Lee has advanced knowledge and training in the TMJ, Disorders of the TMJ (TMD), bite disorders, and Sleep Apnea. She continues to expand her knowledge in this field because she feels passionate about Dentistry based on the relationship of the Jaw Joint, Muscles, and Occlusion (teeth). She approaches dentistry with precision, accuracy,...

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