Everyday Oral Surgery: Surgeons Talking Shop

Pearls for Diagnosing and Treating TMD Patients from the Creator of TMJ Concepts Custom Joints, Dr. Louis Mercuri

September 15, 2021 Grant Stucki - oral and maxillofacial surgeon Episode 69
Everyday Oral Surgery: Surgeons Talking Shop
Pearls for Diagnosing and Treating TMD Patients from the Creator of TMJ Concepts Custom Joints, Dr. Louis Mercuri
Show Notes

The etiology, diagnosis, and treatment of temporomandibular joint (TMJ) and orofacial pain disorders are frequently challenging, and misdiagnosis and multiple failed treatments are common in this patient population. Today, we are joined by Dr. Louis Mercuri, an experienced oral maxillofacial surgeon, Clinical Consultant for TMJ Concepts, and Visiting Professor at Rush University Medical Center in Chicago, who has practiced in the state of Illinois for many years. Over his career, Dr. Mercuri has obtained research funding, published extensively, and been invited to lecture locally, nationally, and internationally on subjects related to the diagnosis and non-surgical and surgical management of temporomandibular joint disorders (TMD). In this episode, Dr. Mercuri shares some pearls for diagnosing and treating TMD patients, including the tricks and techniques he uses during examination to determine if the condition is intra-articular or extra-articular, how he communicates with unhappy TMD patients, and what resources he provides them with, plus so much more. This is a fascinating and informative conversation about TMD with a foremost expert on the subject, so make sure not to miss it!


Key Points From This Episode:

  • Learn about Dr. Mercuri’s dental and surgical training and his current practice setup.
  • Advice for young surgeons who are interested in doing TMJ surgery: learn from others.
  • Complications he has observed in TMD patients, many of which start with misdiagnosis.
  • Diagnosis is key, as is knowing the difference between intra-articular and extra-articular conditions and what operation is required to treat it.
  • Tricks Dr. Mercuri’s uses during examination to determine if TMD is intra- or extra-articular.
  • Why some patients don’t respond to botox and others only feel relief for a few months.
  • Why Dr. Mercuri says you should never operate for pain or promise 100 percent pain relief.
  • The ‘bio-psycho-social’ etiology of TMD and the role that para-functional habits play.
  • What Dr. Mercuri means when he says a well-informed patient is a partner in treatment.
  • The benefits of what he calls a ‘hands in the pocket’ diagnosis.
  • Indications for a total joint replacement, including dysfunction and degenerate changes.
  • Learn more about the custom joint that Dr. Mercuri developed and its benefits.
  • The importance of the social aspect of communicating with an unhappy TMD patient.
  • The resources that Dr. Mercuri provides for TMD patients to take home with them.
  • With the right patient, the right time, and the right equipment, you’ll get a good result!
  • What Dr. Mercuri recommends for the oral surgeon who needs a good counterpart to help with non-surgical procedures.
  • The important distinction that he makes between dentists, oral surgeons, and ‘pain doctors’.
  • Useful medications that Dr. Mercuri prescribes diagnostically, like a low-dose of Elavil.
  • Advice for younger surgeons looking to treat TMD patients: keep up with the literature!


Links Mentioned in Today’s Episode:

Dr. Louis Mercuri Email — 

TMJ Concepts — https://www.tmjconcepts.com/

Rush University Medical Center — https://www.rush.edu/

OMSNIC — https://www.omsnic.com/

Dr. Grant Stucki Email — [email protected]

Dr. Grant Stucki Phone — 720 441 6059