Dr. Roubal's Omaha, Nebraska blog

Omaha, Nebraska

Monday, April 12, 2010

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posted by edanjou at 2:14 PM

Commitment to wear appliance

I just counseled a young patient not to start treatment unless she was willing to wear an oral appliance during her school time (all day). She was concerned that someone may see her appliance and make fun of her. This was a teen who is missing some school already because of her headaches, but still had enough concern about peer pressure that she didn't know if she could commit to full time wear. I suggested we not start treatment until she was sure and pledged to wear it, or wait until school was over for the summer to start treatment. I am not sure want she will decide.

Yours for better health, Dr. Roubal

posted by Dr. Roubal at 12:09 PM

What is lock jaw?

I had a sixteen year old female in this past week who had a "locked jaw." Based on her lower jaw range of motion, she actually did not have a locked jaw, but rather was experiencing a displaced disc with reduction. This means she could "wiggle" her jaw and it would "pop" and then she could open her jaw. She had a lot of other symptoms of dysfunction and pain which I feel very strongly that I could have likely reversed since she is so young. Funny thing, the mother called and cancelled a later appointment since I didn't "unlock" her daughter's jaw on the initial visit. I really learned something because of that. Even though I though they had really understood my explanation and reasoning, obviously I didn't do good enough. Sad. they are going to go to a chiropractor for treatment that will not be successful long term as the bite relationship is very seriously "off!" Staying this way could result in permanent jaw joint damage. Hopefully, they will call back and be treated properly.

Yours for better health, Dr. Roubal

posted by Dr. Roubal at 12:00 PM

Pain came back until orthotic was placed

I had a women this month come in wondering if our treatment was helping or was she somehow better coincidentally. She had original symptoms of headaches, neck pain, and jaw pain that appeared after she had two crown preparations done earlier at another dental office. After a few failed attempts to get the pain/dysfunction problems taken care of, the treating dentist referred the patient to my office. She originally rated her pain at a "9" on a 0-10 scale; "10" being the worst pain you can imagine.

After about 45 days, she rated her pain at a "1" and on discussion she confessed the level was nearer zero. She had a non-removable orthotic placed because she required a non-intererence to speech appliance. I also discovered she had sleep apnea which was also treated concurrently.

Anyways, she decided she wanted the "fixed" orthotic removed as she had trouble believing the "piece of plastic: could deliver such a "miracle" of pain relief to her. We removed it. After three days, she called and low and behold, all of her pain and dysfunction was coming back! I could not see her for an additional two days. She was very happy to get back the orthotic. In fact, I saw her later the same day and she was already reporting feeling much better. Properly positioned orthotics can be amazing in times of pain improvement.

Yours for better health, Dr. Roubal

posted by Dr. Roubal at 11:50 AM

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