What is '1 session (deviation correction)' in custom TMJ balancing therapy?

TMJ balance medicine treats systemic conditions by working toward the jaw joint’s ideal point of balance. Let us explain how “custom” treatment is carried out, and what the basic unit of treatment — “1 session” — actually is.

It is one of the things we explain most often to patients at the TMJ Balance Medicine clinic of Sandol Korean Medicine Clinic in Sejong.

The basic difference between the standard and custom appliances is easier to follow if you first read [The intraoral balancing appliance, explained].

Standard vs custom: what is different

The standard appliance is a ready-made intraoral balancing appliance, produced in a range of sizes through various standardisation steps. The custom appliance, by contrast, is made at every visit: the left–right height difference of the jaw joint is measured, and an impression putty is shaped precisely to that correction value.

A standard appliance only sets a “guide with some play,” keeping the jaw joint moving within an ideal range. The custom appliance, because it is measured precisely and then built to that value, is made to fix the teeth and jaw completely, with no play. When you swallow and exercise the whole body with the teeth and jaw fixed in this way, the effect of correcting the entire neural axis through the myodural bridge is greatly increased.

What it means for a “deviation” to occur

While you swallow and power-walk with the teeth and jaw completely fixed, each joint and the nervous system across the whole body adapt quickly to the jaw-joint value just corrected. This adaptation usually ends within about two minutes, and within ten minutes at the most. The state in which adaptation has finished is described as “a deviation has occurred.”

Once a deviation occurs, a new correction value is measured and a new appliance is made to match it. Carrying out this one corrective step to the correction value is counted as “1 session,” also called “deviation correction.”

In more severe cases the deviation appears sooner

The more severe the condition, the faster deviations appear in the early stage of treatment. In some cases a new deviation occurs within about ten seconds of finding the left–right correction value. When the deviation appears within two minutes, a new one arises before the putty custom appliance can even be finished, so depending on the situation a session is sometimes carried out with the measurement alone, without making the putty.

Early visits are mostly handled with the measurement alone, but in most cases the putty is made, followed by about two minutes of power-walking and then a test for a deviation. If a deviation has occurred, a new correction value is measured and the custom putty is made again; if not, power-walking continues while waiting for a deviation to appear.

As sessions accumulate, the deviation time lengthens

The deviation time that appears quickly in the early stage of custom treatment gradually lengthens as the number of sessions increases. Even after the deviation time has lengthened, however, it can shorten again if, during treatment, you become overtired, accumulate a lack of sleep, or your body changes through a cold, the flu or an accident.

How many sessions in a day

The more often deviation correction is done, the more the treatment effect is reinforced, and it can range from 1 up to 10 times per visit. In general, patients admitted for custom treatment at our clinic receive an average of 6 sessions of deviation correction a day, while outpatients receive between 4 and 8 sessions a day. Because deviation correction also takes the patient’s condition into account, the daily average for inpatients is usually set at 6 but adjusted between 4 and 10 depending on the situation. In addition, deviation correction is sometimes carried out for two or three patients at the same time slot, so it is best to know this before you come in.

Reactions during recovery

As the whole body adapts through deviation correction, you may feel flu-like aches, or feel that an area that was already troublesome has become worse. This is not a worsening, however; it is better understood as a reaction that surfaces on the way toward recovery. This is covered in detail in [The four deviation reactions during treatment].

How long 1 session takes

The time a single session takes — including measuring the deviation, making the putty to the correction value, and re-measuring after power-walking — is usually about 5 to 10 minutes. If you receive 4 sessions of custom treatment a day as an outpatient, then including the custom treatment together with acupuncture, Chuna therapy and physical therapy, you can expect the whole treatment to take around one hour and twenty minutes.