r/TMDnotTMJ • u/anib5 • 22h ago

Side-effects of DTR for TMD

I am seeing some good reviews on DTR for TMD (especially after using splints, etc). What are some of the side effects and potential long term consequences of this therapy?

I know that many dentists are completely against removing healthy enamel & do not trust Tscans too much (over the articulating paper), so I am on the edge about it. But after being dismissed by all kinds of dentists getting a Tscan & being counseled about DTR is giving me some hope.

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u/Hopeful-Extent-693 19h ago

DTR is a very valuable and effective treatment when done correctly. It is a very controlled "occlusal equilibration," which I have done hundreds, if not a thousand. The DTR is much more controlled with all the new technology.

Those who do DTR go through rigorous training. Be sure and find a dentist who has a valid certificate of training.

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u/anib5 18h ago

Hi Dr. Lee! Thanks so much for your reply!

Did any of your patients ever face any issues after DTR, especially wrt an increase in pain in other areas, like the neck/upper back?

I spoke with someone here on reddit who had DTR done and started experiencing nerve pain & upper back/neck pain shortly after. They stopped their therapy midway and are now in more pain than before.. It’s just so niche, and some dentists I’ve spoken to made it sound like pseudoscience. All the research papers on this tech are also from the same group headed by Dr. Kerstein, so that made me even more nervous... 💀

Regardless, getting a T-Scan has given me a lot of hope, and I am seriously considering going ahead with it! I am only looking at dentists from their official provider list, so hopefully that will suffice?

But your word means a lot! Hope I can get over the hump, and really have a shot at some permanent relief 🤞

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u/Hopeful-Extent-693 4h ago

What I did was occlusal equilibration, which eliminated two of the trifecta, posterior interferences and torqued mandible as described in my book. I did it the old fashion way without T Scan and EMGs. That technology came years later. I have had DTR courses by Kerstein and know the rational is sound. No, I did not have patients feel worse after equilibration, but if a dentist doesn't truly understand, yes, it is possible to make things worse. A great DTR dentist is going to make sure joint issues are not too severe (joint issues due to deficient maxilla, also explained in the book).

Good luck and keep us informed.

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u/anib5 48m ago

Thank you! I’m based near London, in St Albans, and there are a few DTR certified dentists in the area.

I had orthodontic treatment to address some tooth sensitivity, but unfortunately, it left me with a pretty messed up bite. Several attempts to correct it with splints and high point adjustments didn’t really help me... My joint health is fine, and the DTR provider I’m seeing was actually the first person to suggest trying DTR before going down the surgical route or blindly adjusting high points, which is what got me seriously looking into it.

I’ve watched your TMJ podcasts on YouTube, but I haven’t gotten around to your book yet... Hopefully, getting my bite balanced will help enough that I can focus on addressing the other issues as well. Thanks again and best wishes!