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Pediatric TMJ pain is misunderstood.

Especially certain conditions like Juvenile Idiopathic Arthritis (JIA)

In today's More Than Teeth🦷, we'll look at it briefly and give you the confidence to start screening for it in your practice today!

In Today’s Edition:

• Physiotherapy in Managing Juvenile Idiopathic Arthritis

• Turn Cost Questions into Patient Conversions

• Industry Events

• [Video] Juvenile Idiopathic Arthritis

7-minute read👇

Clinical Corner

🥼Use the clinical corner as your secret weapon to impress your colleagues and patients!

Key Takeaways🔑

The Power of Physiotherapy in Managing JIA-Related Orofacial Symptoms

Introduction

Juvenile Idiopathic Arthritis (JIA) is a chronic condition that can severely impact children’s and adolescents’ lives, leading to pain, inflammation, and functional limitations. One area often affected is the temporomandibular joint (TMJ), causing significant orofacial discomfort and dysfunction. Recent studies highlight the potential of physiotherapy and home exercises to alleviate these symptoms. Let’s explore how these treatments can benefit patients with JIA and TMJ involvement.

Understanding JIA and Orofacial Manifestations

JIA affects 15-150 per 100,000 children globally, manifesting as joint pain, inflammation, and reduced quality of life. The TMJ is frequently involved, leading to orofacial symptoms, dental deformities, and functional impairments. Comprehensive management typically involves a multidisciplinary team, including pediatric rheumatologists, maxillofacial surgeons, orthodontists, and physiotherapists.

Key Study Insights

A proof-of-concept study involving 12 patients with JIA and TMJ involvement explored the effects of an eight-week physiotherapy and home-exercise program on orofacial symptoms.

Significant Findings:

• Pain Reduction: Before treatment, 66.7% of patients reported daily pain. Post-treatment, only 8.3% experienced such frequent pain. 

• Improved Function: Mandibular function improved notably in maximal mouth opening capacity, laterotrusion, and protrusion during and after treatment.

Physiotherapy and Home Exercises

The study’s physiotherapy regimen included manual soft tissue/stretching, strengthening of orofacial muscles, and guided active TMJ mobilization. Home exercises focused on facial muscle relaxation, TMJ mobilization, and jaw movements.

Compliance and Effectiveness:

• High Compliance: 73.5% of patients fully adhered to the prescribed exercises, enhancing the treatment’s effectiveness.

• Sustained Benefits: Improvements in pain and function persisted beyond the treatment period, indicating lasting benefits.

Practical Applications for Dental Sleep Professionals

Implementing Physiotherapy in Practice

1. Assessment and Planning:

• Evaluate orofacial symptoms and TMJ involvement through standardized clinical examinations and patient questionnaires.

• Develop a tailored physiotherapy plan focusing on specific orofacial dysfunctions.

2. Treatment Protocol:

• Weekly physiotherapy sessions combined with prescribed home exercises can yield significant improvements.

• Common interventions include soft tissue treatment, muscle strengthening, and guided active TMJ mobilization.

3. Patient Compliance:

• High compliance with home exercises was observed, indicating that well-structured programs and clear instructions can lead to better patient outcomes.

• Regular follow-ups and reassessments ensure adherence and track progress.

Screening for Orofacial Manifestations in JIA

A standardized clinical examination is essential for detecting TMJ involvement in JIA patients. A consensus-based, short clinical examination protocol offers a quick and effective screening method. This protocol includes six key items:

1. Clinician-assessed pain location

2. TMJ pain on palpation (open and closed mouth)

3. Mandibular deviation at maximal mouth opening (≥ 3 mm)

4. Maximal unassisted mouth opening capacity

5. Frontal facial symmetry

6. Facial profile

This examination takes less than three minutes to complete and provides valuable information about orofacial symptoms, TMJ dysfunction, and dentofacial deformity. Incorporating this screening protocol into routine assessments can help identify JIA-related TMJ issues early, allowing for timely intervention and better management of the condition.

Case Study: Real-World Impact

Consider a mid-sized dental practice that integrated a structured physiotherapy program for JIA patients with TMJ issues. Over an eight-week period, patients reported reduced pain and improved jaw function, aligning with the study’s findings. This real-world application underscores the practical benefits and feasibility of incorporating physiotherapy into dental sleep medicine practices.

Conclusion

Physiotherapy presents a viable, non-invasive option for managing JIA-related orofacial symptoms. Dental sleep professionals should consider integrating orofacial physiotherapy into their treatment protocols to enhance patient outcomes.

Takeaways for Practice:

• Assess JIA patients for TMJ involvement and consider physiotherapy as a complementary treatment.

• Develop individualized physiotherapy and home exercise plans.

• Monitor patient compliance and progress through regular follow-ups.

Vassis, S., Resnick, C.M., Nørgaard, M. et al. Impact of physiotherapy on orofacial manifestations of juvenile idiopathic arthritis. Pediatr Rheumatol 21, 116 (2023). https://doi.org/10.1186/s12969-023-00900-0

Business of Sleep

📈Better businesses = more lives saved!

The Price Conundrum: Turning Cost Questions into Patient Conversions

In the bustling world of dental sleep practices, there's a dreaded question that often sends shivers down the spines of front desk teams: “How much does it cost?” This question, while seemingly straightforward, carries a weight of assumptions and potential pitfalls. But what if we told you that instead of fearing this inquiry, you could leverage it to enhance your practice’s efficiency, patient satisfaction, and ultimately, your bottom line?

Welcome to the Business of Sleep section of the More Than Teeth newsletter, where we delve into strategies that transform routine challenges into powerful opportunities. Today, we’ll explore how to handle pricing questions with finesse, backed by data and successful practices that ensure you turn curious callers into committed patients.

Understanding the Patient's Perspective

First, let’s step into the shoes of your patients. Dental visits can be intimidating. Patients feel vulnerable, both physically and financially. Studies show that 36% of individuals experience dental anxiety, with 12% facing extreme fear. Imagine the added stress when they're unsure about costs and worry about affording necessary care. Addressing this anxiety head-on by discussing pricing transparently can build trust and ease concerns.

Rethink the "Shopper" Mentality

Consider two callers: Patient A, who asks about same-day crowns and books immediately, and Patient B, who asks about the cost first. It's easy to label Patient B as a "shopper" and assume they're difficult or unwilling to pay. But this assumption can be costly.

The reality is, you don’t know their story until you engage them. They might be more ready for treatment than you think but are simply cautious about their finances – a reasonable and relatable stance.

Mastering the Art of the Pricing Conversation

The challenge isn’t the question itself, but how it’s handled. Research shows that the way a call handler responds to pricing inquiries can make or break the patient’s decision to book an appointment. Here’s a structured approach to mastering this art:

• Redirect with Confidence

  Start by redirecting the question. If a patient asks about the price right away, respond with, “Great question! While I’m checking on that for you, may I ask you a few questions?” This allows you to gather essential information and build rapport before circling back to their query.

• Build Rapport

  Engage the caller with open-ended questions that show genuine interest in their needs. Questions like “What’s bringing you in today?” or “How long have you been experiencing this issue?” help you understand their situation better and build a connection.

• Educate Before Estimating

  Explain why precise pricing can only be given after an exam. For instance, you might say, “To give you an accurate cost, our doctor needs to determine the specific treatment you need, which we can do during an exam.” This shifts the focus from a transactional interaction to a consultative one.

• Leverage Financing Options

  Discuss financing options early in the conversation. Many patients fear large, upfront payments but are relieved to learn about installment plans. Familiarize your team with the details of financing options like CareCredit or in-house plans, and rehearse these conversations to ensure comfort and clarity.

• Data-Driven Results: Transforming Calls into Appointments

  Implementing these strategies can significantly impact your practice. According to recent studies, practices that train their staff to handle pricing questions effectively see a 20-30% increase in appointment bookings. Moreover, patients who feel their financial concerns are understood and addressed are more likely to follow through with treatment plans.

Action Steps for Dental Sleep Professionals

To transform your practice’s approach to pricing questions, follow these actionable steps:

• Train Your Team

  Regularly train and role-play with your front desk team on handling pricing inquiries. Provide scripts and scenarios to build their confidence.

• Implement Call Protocols

  Establish clear protocols for redirecting pricing questions, building rapport, and discussing financing. Ensure consistency across all patient interactions.

• Monitor and Adjust

  Track the outcomes of calls involving pricing questions. Use this data to refine your approach and provide ongoing training based on real-world results.

• Promote Transparency

  Consider providing general pricing ranges on your website to set expectations and ease the initial anxiety of potential patients.

Looking Forward: The Future of Patient Engagement

The dental industry needs to keep changing, emphasizing honesty, understanding, and putting patients first. By getting better at discussing prices, dental sleep experts can improve their businesses and make patients happier and healthier. This smart and active approach is essential for success in a competitive market.

Previous Editions

👉 Treatment of snoring with positional therapy

👉 Exploring CBCT in with Sleep-Disordered Breathing

Something Sweet

🍭Stuff so sweet you might get a cavity..

Industry Events

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Miscellaneous

😅P.S. … I forgot something

Physiotherapy and home exercises can work wonders for children with JIA and TMJ—reducing pain and boosting jaw function. Dive into the latest insights to see how these treatments make a lasting difference!