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Generally, when a person comes in like that, first of all we refer them for imaging,
MRI and maybe CT so that we can be sure there are no other lesions there that are contributing
to that pain, no hidden neo plastic lesions,
that sort of thing. So a prosthodontist can do that under Medicare,
and so straight away we’ve got a radiologist involved.
Radiologists are one of the hidden heroes behind the scenes that look at things.
We often use physio therapists and if the patient doesn’t have a physio therapist
but has a chiropractor or an osteopath, I’m quite happy for them to go and see them,
I'll have a discussion with them on what we need to do and where we are going and it
might be quite instructive for them to find that there is this other aspect to the pain
that they have been trouble treating. We’ve had to send some people to a psychologist.
Now the problem with mentioning psychologist, is that often people think “I’m going
to the psychologist cos he thinks I’m MAD”, and in fact that’s entirely the wrong attitude,
the reason why we are sending you to a psychologist is that they are a person who is really equipped
to help you manage things like stress and areas of your work where you need some high
powered concentration. Cos that’s the other aspect of TMD pain:
it's not necessarily stress, it might just be that you really need to concentrate
*** whatever you are doing. Driving in Sydney traffic is a classic example.
Some people find it stressful and some people just concentrate hard.
And some people take both, you know.
So it's an interesting thing to have explain to a patient,
“Well we really think you need to go to a psychologist to handle this part of your
life” and patients don’t expect that.
So patients are a bit confronted by that fact that they are getting that information from
a prosthodontist when they would expect to get it from their HR rep at work or HR consult
or their doctor. They need to understand that we are doing
that because a psychologist is the best person to work on that aspect of their problem.
I think that really is the point