CLAYTON CHAN DDS - Philosophy

PHILOSOPHY AND APPROACH

"Defining and Refining the Field of Dentistry"

Dr. Chan's approach to treating each of his patient's is one of interest, care and desire to understand each persons dental concerns. He recognizes that proper jaw posture as it relates to the cranium and the teeth relate to the surrounding musculature, ligaments and joints. A healthy balance of these structures is crucial for optimal function, stability and comfort.

His systematic and methodical approach in discovering the underlying cause (etiology) of each patient's complaint is critical to his success. Attention to details and his willingness to take the time to understand the problem results in a timely and effective resolution.

His dentistry is a subtle blend of dental laboratory technology background with an overlay of traditional gnathologic teachings and experience that inspires the precision detailing required in many of his cases. The neuromuscular occlusal principles as it relates to the mandibular cervical postural system is the overlaying perspective that brings it all together, making the application of these core dental principles logical and practical to his dentistry.

He takes a "logical makes sense" approach to his treatment in which the layman can understand these simple, yet profound concepts to attain an optimal result.

A Comprehensive Understanding

It is apparent after a more thorough understanding, diagnosis and evaluation by the dentist that musculoskeletal, postural, emotional, biochemical and/ or functional issues may be part of the suffering patients complaints. Many of the symptoms that accompany these problems continue to challenge the great minds of the dental profession who may not be aware that the numerous signs and symptoms which are presented go beyond the occlusal perspective of how teeth articulate and where the centricity of condyle to glenoid fossa relationship exists.

• A Thorough Objective and Measured Evaluation is done to determine the optimal maxillo-mandibular relationship in all “six dimensions”. Advanced telemetric and EMG computerized scanning and recordings are used to assess an optimal starting position "PHYSIOLOGICALLY", without manual intervention.

• A Physiologic Jaw Relationship of the upper and lower arches must first be established and stabilized prior to any extensive restorative dentistry and confirmed via EMG (electromyography), CMS (computerized mandibular scanning), ESG (electrosonography), and radiographic imaging (digital tomography) studies.

Phase I - Diagnostic Therapy

Orthopedic alignment and stabilization of the upper and lower arches is usually first required to establish a stable relation before a permanent solution is determined.

Removable Anatomical Orthosis:

A removable orthosis ("orthotic" = custom designed anatomical lower appliance) is worn 24/7 prior to any restorative dentistry.

The anatomical orthosis is scientifically designed and adjusted by the doctor to meet the proprioceptive demands for patient comfort. Dr. Chan routinely will spend his time refining the appliance to make sure it is comfortable and properly functioning to achieve the desired result for his patients using computerized technology.

Objective measurements using CMS and EMG along with TENs is usually implemented to confirm that the appliance is properly adjusted to the patients masticatory muscles, free of torque and strain.

If the symptoms reoccur after the orthotic is removed as a test for structural and muscle stability, a second phase of treatment will be necessary to complete the case.

It’s the terminal contacts ("the Bite") that hold the head and neck posture stable. Proprioception plays a great part in how the lower jaw responds and relates to the cranium. Establishing a precise end point of all the teeth within the spatial boundaries of the oral environment is critical to meet the demands of the central nervous system. Dr. Chan is a firm believe in the following:

Teeth Dominate
Muscles Accommodate
Joints Accommodate

It is the constant accommodation of muscles and the wearing down jaw joints and ligaments that comprise dental health and comfort. Healthy supporting teeth are often the missing component that are necessary to support the lower jaw to the cranium for proper neck and shoulder balance.

A lower anatomical orthosis that is precisely fined tuned (vertical, lateral and antero-posterior) is often the answer to most muscle related jaw problems, since most of the occlusal pathology starts with under developed vertical height of the posterior teeth and crowding of the anterior teeth.

Semi-Fixed Anatomical Orthosis:

In particular cases where space is a limitation a fixed orthosis can be designed to be worn as a semi-permanent appliance placed over the teeth to hold the bite. (The patient cannot remove it out of the mouth except with the help of the dentist).

The lower fixed orthosis is first waxed to models replicating the idealized lower teeth, after the bite relationship has been determined. A rubbery matrix mold is shaped over the waxed model to create the matrix. Temporary tooth colored material is injected into the matrix and placed over the teeth which will hold the bite/jaw at the neuromuscular position.

The rubbery matrix is removed from the mouth, leaving in the mouth the hardened tooth colored semi-permanent "fixed anatomical orthosis".

Phase II - Finishing Treatment

A consultation appoint will be set up for the patient to discuss various treatment options for the second phase of treatment. The second phase of treatment will require one of the following procedures: