1.

Describe the signs and/or symptoms that made you decide on the patient selection explain

possible correlation (2 Points):

- The signs and symptoms that made me decide to do a TMD assessment on this patient

are that they expressed having discomfort while chewing hard foods, Jaw fatigues from

having it open for a while, and they notice daytime clenching when they are feeling

stressed. All of these factors lead to TmJ discomfort, furthermore resulting in TMD.

2. Describe the intra and/or extraoral signs presented by your patient that may be related to

TMD (Include photos if possible - 2 Points)

- The extraoral sign the patient presented with was bilateral clicking and popping of the

TMJ, associated with crepitus when opening and closing the jaw slowly. In the

radiographs, the patient presented with widening of the PDL which is due to the

clenching and grinding the patient has noticed at night time.

3. Upon completion of your assessment, what information and recommendation were provided

to your patient (2 Points)?

- I asked the patient if they knew that they clenched and grinded at night they answered

yes, due to waking up with sore muscles when opening their mouth and sore teeth

where they have clenched the hardest/longest at night time. The patient also expressed

that they like to chew a lot of gum when they are stressed to help them from clenching

during the day, as of late it has become a habit since they are a new dental hygiene

student wrapping up their first semester. It was recommended for the patient to see their

dentist for further evaluation, and for a night guard. Another recommendation to the
 patient was to avoid chewing gum as it can further damage the TMJ, when misuse or

overuse of the joint becomes habitual, this can cause further wear to the joint.

4. How did you proceed with the dental hygiene services for this patient provide an approach

and rationale (2 points)?

- I had a bite block ready for the patient, however, the child bite block felt too bulky for the

patient and decided to proceed treatment without out since the patient stated they felt

most comfortable without it. While scaling, I did have the patient relax their jaw and close

down a bit so that they are more comfortable and their jaw does not fatigue. During the

appointment, I asked the patient if they were comfortable and if at any given moment

they felt discomfort to let me know. I also gave the patient breaks to close down their jaw

completely to rest the muscles and TMJ.

Part C

Using professional literature (Journals), research an article that relates with the case assessed,

and provide the following: What are the correlations with the case? What are the possible

outcomes if there is no professional interference? What are the expected outcomes with

professional interference? (3 points).

In this study by P.Roda, Bag n, et al. looked into the parafunctional habits of people and

how it affects the TMJ. In this study, it was said they looked into another study where they saw
that people who chewed gum excessively for more than 4 hours manifested signs of ear pain for

those individuals. They consider chewing gum jaw play since it was not a function of need like

chewing for food consumption but due to habit. They found that chewing gum contributed to

pain and joint sounds. This study correlates to my patient's case because they like to chew gum

a lot. When asked how much gum they chew they said about every day and mostly in class,

which they have class 4 times a week from 8 am to 4 pm on average. This study also relates to

my patient since they expirience symptoms described in the study from people who chew gum

more than 4 hours, My patient as well expiriences ear pain and fatigued muscles after chewing

gum for an entire day. Possible outcomes for this patient, if there is no education or professional

interference, is that they would further damage the temporomandibular joints causing further

wear and develop more severe popping and clicking due to chewing gum everyday and due to

nocturnal parafuntional habits. With professional interference and with some education I had

given to the patient on the day of their appointment the expected outcome is that they will now

go forth with the new knowledge given to them and avoid chewing gum. A recommendation

given to them was to direct the stress elsewhere instead of chewing gum as a way of releasing

stress through chewing they could possibly use a stress ball to direct that need of relieving

tension that way. It is also expected for the patient to visit their dentist and seek the treatment

they may need for their TMD, including a night guard for the clenching and grinding they

experience at night.

Poveda Roda, R., Bag n, J., D az Fern ndez, J., Hern ndez Baz n, S., & Jim nez Soriano, Y.

(2007). Review of temporomandibular joint pathology: Part I: Classification, epidemiology

and risk factors. M d c a O a , Pa aOa YC a B ca (I ), 12(4), 292-298.

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Total points awarded: