Digging Deeper into the Treatment of TMJ

Half a year ago, I discovered a painful popping and clicking as I opened and closed my mouth, followed by ringing in the ears. A visit to my doctor, my orthodontist, and Google have shown me that I have a condition called TMJ, AKA TMD, AKA temporomandibular joint disorder. In simplest terms, it's the dysfunction between the muscles that move the jaw and the joints that connect the mandible to the skull.

Over the course of the school year, my research has brought me to scholarly articles on the disorder, as well of its common origin and the best treatment options.

At this point it is unclear to me whether or not TMJ is caused by orthodontic braces or is even connected to orthodontic treatment. I am also on the hunt for successful non-surgical remedies, but there isn't much luck narrowing that down, either. I feel that finding a solid fix for TMJ will be very helpful in finding more answers to my essential question: What is the most important factor an orthodontist must consider when treating a patient?

Blog 11: Holiday Project Update

1. It is important to consistently work on your senior project, whether it is break or we are in school. What did you do over the break with your senior project?

The break gave me a chance to do more research on my topic, as well as look further into orthodontics as a career. Sadly, I was very limited on my research sources because my primary database -- ProQuest -- has been down for a while.

2. What was the most important thing you learned from what you did, and why? What was the source of what you learned?

My work over the break has taught me that I need a new approach with my research. The source of this knowledge was my previous research and similar results coming up when I looked for new articles. I know there is more fresh research available, but I just need the right keywords to find them.

3. If you were going to do a 10 question interview on questions related to answers for your EQ, who would you talk to and why?

I think I might ask an orthodontist other than my current mentor in order to gain a different perspective on orthodontics and my essential question. My final answers will be more complete after speaking with multiple practicing professionals in the field.

2014 in Perspective: A Review of Findings

About four months. That's how long I have been researching for my senior project topic. The question I have been trying to answer is, What is the most important factor an orthodontist must consider when treating a patient?

Perhaps my research was merely focused on just one answer, but I find that appliances play a large role in orthodontic treatment. Appliances used by practicing orthodontists include braces, headgear, palatal expanders, and retainers. As I have mentioned in previous posts, such appliances will correct bites and tooth alignment, or do all sorts of other miraculous things to get treatment done. (Proper planning and judgement is necessary to get the right appliance into a patient's mouth, of course, so it isn't as if the orthodontist is being forgotten.)

Basically, orthodontic appliances ARE the treatment and it would be very hard to get much of anything done without them. Combined with an orthodontist's experience and knowledge, appliances are powerful.

I hope that the new year brings forth many other revelations that will help me with my senior project. Happy 2015.

EQ

1. I reviewed the rule of three for writing an EQ.

2. Review the following EQs and tell us if each meets the rule of three and why they do or don't.

a) What is the most important factor in healthy weight loss?

The wording is clear, it provides a framework for studies and research, and the question is not a list of facts. However, this EQ does not completely follow the rule of three; the student should be more specific about the means by which a person would be losing weight. The most important factor could be different for daily exercise 

b) What is most important to securing a conviction in a criminal investigation?

This EQ does follow the rule of three; it  specific, allows the student to argue for his position, and is not a yes/no question.

c) What is most important in creating a hairstyle that best satisfies a customer?

 This EQ does not follow the rule of three. The question is too broad.

d) How can an anesthesiologist best treat chronic pain?

This EQ does not follow the rule of three. While the question mentions specific elements such as anesthesiologist and chronic pain, it seems too broad. At the same time it seems like the question limits research to just treatment options for chronic pain (which could be caused by a number of conditions).

3. Working EQ: What is the most important factor an orthodontist must consider when        
    treating a patient?

Blog 8: Research and Working EQ

1. My working Essential Question is as follows:

What is the most important thing an orthodontist must consider so they can help a patient?

2.  After being a patient at my orthodontist's office and volunteering there, I have come up with an answer to my question:

Patients need to understand which treatment options are available to them.

Staff should make patients feel at home and comfortable. 

3. So far, my most important sources that have helped me develop these answers to my Essential Question are experience as a patient and research articles from the ProQuest databases. My experience has shown me that patients that are treated kindly and like family are more likely to return for visits, trust their orthodontist more, and are more willing to keep up their treatment (rubber bands, retainers, avoiding hard/sticky foods..). My research on ProQuest so far consists of many studies on customer satisfaction and how being informed and totally included in the decision making process leaves the patient more content after their treatment is completed.

4. My mentor is Dr. Dan Banh DDS and I do my mentorship at his clinic, Banh Smiles. Right now, what I do at Dr. Banh's office is shadow and observe the staff. This relates to my Essential Question because without actually stepping into an orthodontics office, I cannot fully understand the treatment process, let alone what an orthodontist needs to consider for treatment.

Blog 5 - Mentorship Reflection

• Describe your experience in how you found your mentorship? If you haven't found one yet, describe your experience so far in the search of a mentor.

I found my mentorship just by going to my regular orthodontist. After much thought, I decided on orthodontics as my topic and visited Dr. Banh's office to ask him to be my mentor. The reason I chose Dr. Banh as my mentor is because I was very satisfied with the results of my treatment and the way he and the staff treat the patients. Since Dr. Banh already teaches regularly at USC's school of dentistry, he was more than happy to mentor me and teach me about the field of orthodontics.

• Research question: What has been your most important article you have read so far and why?

So far, the most important thing I have read was chapter one of Orthodontics: Current Principles and Techniques, titled "The Decision-making Process in Orthodontics." This chapter includes the basics of what an orthodontist should look for in order to diagnose a patient, as well as guidelines for treating a patient. I feel that these two things are crucial to know since they are pretty much the center of an orthodontist's job.

Class Trip to the Library

On Friday, August 29th, my house walked over to Cal Poly's library. We were led by our teacher to a computer lab type room and watched a presentation from one of Cal Poly's librarians about research and using some of the resources available to us through the Cal Poly library's website. From that presentation, I learned to use the ProQuest databases. I really like using ProQuest because there are so many online articles on my topic to choose from, so I have plenty of research options. On the other hand, I have to be sure to narrow my search because I would otherwise be stuck scrolling through hundreds of unwanted ads for orthodontic clinics that opened around ten years ago.

Some of the many results from ProQuest with the keyword "Orthodontics"

In addition to finding out about using the online databases, I had the opportunity to find books for my research on orthodontics for my senior project. I found seven books that piqued my interest, but I was only able to check out five thanks to the library's check-out limit. I checked out the following books:

• An Introduction to Dental Terminology
• Oral Health, Dentistry, and the American Public
• Removable Orthodontic Appliances
• Dental Anatomy and Occlusion
• Orthodontics: Current Principles and Techniques

The five books that I checked out from the Cal Poly library

I spent a good chunk of my Friday looking at these books and they are so interesting. The most interesting part is the pictures. One book has thousands of pictures with cases and diagrams and graphs. There was one case (pictured below) of a woman with bimaxillary protrusion, meaning the woman's teeth on her maxilla and mandible (upper and lower jaw) were excessively protruding forward. Her treatment included having her premolars removed and undergoing an augmentation genioplasty (chin augmentation).

I find it amazing that people can change their appearance with the removal of some teeth and surgery. Even the use of orthodontic appliances like braces and headgear yield impressive results. These books and their content have served to fuel my passion for the medical field and orthodontics. It's all just so fascinating.

A case shown in Orthodontics: Current Principles and Techniques

Examples of appliances for orthodontic treatment from Removable Orthodontic Appliances

Anatomy of the oral cavity

Blog 3: Topic Choice and Working EQ

1. The topic I have chosen for my senior project is orthodontics.
2. What is the most important thing an orthodontist must consider so they can help a patient?

Blog 1: 2-Hour Presentations

From the 21st through the 29th of May, I have had the privilege of watching senior presentations. Admittedly, not all of them were spectacular, but I learned plenty from each and every one of them. I am thankful to have gotten the opportunity to see the fruits of their labor.

1.  What presentations did you see?

• "Social Work for Abused Children" by Debora Martinez
• "Teaching Elementary" by Regina Rizo
• "Criminology" by Analysa Gallegos
• "Neonatal Nursing Intensive Care" by Michelle Ortega
• "Pediatric Dentistry" by Nitjasin QP
• "EMT (First Aid)" by Jeremy Ethridge
• "Personality Disorders" by Kimberly Gallardo
• "Microbiology" by Vanessa Machuca
• "Angioplasty" by Angel Arredondo
• "Homelessness" by Bradley Yamashita
• "Medical Missionary" by RJ Baron
• "Linguistics" by Lara McConnaughey
• "Hip Hop Dance Choreography" by Mark Patena
• "Internal Medicine" by Alfonso Esquivel
• "Automotive Repair" by Junior Rico
• "Structural Engineering" by Wesley Wu

2. What questions do you have that haven't been answered about the senior project? This can be about the senior project in general, any components or about a presentation topic you saw or what they said.

One thing I feel was not answered about each topic is how much time people in that field spend working. Of course, senior project is not about careers and is about specific topics but I feel the career aspect is also important since we have to do mentorship and learn about working with said topics first-hand.

I also would have liked to know how linguistics is applied in the world outside of learning. Is it simply translation or studying the acquisition of new, second languages?

What components led up to the final presentation, aside from the interview with a mentor? Are there a lot of small components, or are they difficult and spaced apart?

3. What has the most important part of the senior project based on what you are seeing in the 2-hour presentations?

I believe mentorship is the most important part of senior project. Without any mentorship, there is little opportunity for in-depth experience and learning from an expert. Research can only teach a person so much about a topic in comparison to interaction with a person who can answer all of your questions and teach you what you need to know and more. However, I do think research is equally important. Research is where solid facts and figures come from. Research can also be used as a guide and reference for almost anything you need to know for this project.

4. What topic are you considering doing and why?

I am considering doing my senior project on obstetrics, which is "the branch of medicine and surgery concerned with childbirth and the care of women giving birth." I would like to do this topic because obstetrics has always piqued my interest and I would like to make a career out of it in the future.

5. What are you doing for your summer mentorship?

For my summer internship, I plan to shadow and do volunteer work at USC Medical Center with an obstetrician. It will most likely involve learning about how regular appointments are conducted and procedures in the event of labor.