Dr. Shapira's Chicago Headache Blog

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Sunday, June 27, 2010


NEUROMUSCULAR DENTISTRY is an exciting field not only about teeth, jaws and jaw joints but intimately involved with neurology, orthopedics, rehabilitative medicine, physiatry otolaryngology and osteopathic medicine. Patients who can benefit from Neuromuscular Dentistry cover almost every field of medicine.

Headaches are especially well suited to treatment by Neuromuscular Dental proceedures. A wide varienty of headaches may respond well to the first step of Neuromuscular Dental treatment, the Neuromuscular Diagnostic Orthotic. Patients with Classical Migraine, Atypical Migraine, Opthalmic Migraines, and Chronic Daily Migraine all frequently respond well to Neuromuscular Dental Treatment due to the connections to the Trigeminal Nervous System. Almost 100% of all types of Migraines are in full or in part mediated by the Trigeminal Nervous System and are therefore amenable to treatment with a Neuromuscular Dental Orthotic. A Neuromuscular Dental Orthotic is designed to decrease pathologic accomadation of the trigeminal neuromuscular system to decrease nociceptive input to the central nervous system. This nociceptive input is actually the bodies attempt to correct physical malalignment of the masticatory system. This results not only in central nervous system overload of the trigeminal system but also to repetitive strain injuries to the piostural muscles of the head and neck.

Muscle Spasm Headaches, Tension-Type Headaches, Chronic Daily Headaches, Cervically referred headaches (cervicalgia), Muscle Tension Headaches and headaches secondary to Myofascial Pain and Dysfunction Synrome are all examples of repetitive muscle strain disorders that result in headaches that are always upsetting and often disabling but fortunately these headaches almost always respond to Neuromuscular Dentistry. The Neuromuscular Dental treatment always begins by using an Ultra-Low Frequency TENS (transcutaneous electrical neurostimulation) to relax the muscles by utilizing anti -dromic impulses and by pumping waste products out of the muscles and allowing nutrients in to allow the natural (holistic) relaxation of the muscles. Once a TENS treatment has created a healthier state in the muscles and nervous tissues a diagnostic testing work-up utilizing EMG (electromyography) and MKG or CMS (madibular kinesiograph or computerized mandibular scan) is utilized to identify the ideal mandibular (lower jaw) position for healthy functioning of the cervical and jaw musculature and healthy postural position. This correction is achieve with a Diagnostic Neuromuscular Orthotic.


The changes are not magical but often they seem that way to patients who have suffered from years of chronic pain and dysfunction. "Suffer No More: Dealing with the Great Imposter"
http://www.sleepandhealth.com/story/suffer-no-more-dealing-great-impostor is an excellent article in Sleep and Health Journal that explains a few of the consequences of TMJ disorders and compromisd Neuromuscular functioning. There is anthother article http://www.sleepandhealth.com/neuromuscular-dentistry in Sleep and Health Journal that explains the scientific basis of Neuromuscular Dentistry.

The Diagnostic Orthotic of Neuromuscular Dentistry corrects the underlying pathology that has created muscle pathology and neuromuscular nociception. When the underlying pathology is eliminated the body "naturally heals" itself. The return to healthy homeostasis is a basic premise of Neuromuscular Dentistry as originally described by Dr Barney Jankelson. Dr "J" as he was affectionally known was a prosthodontist who drastically change the field of entistry by using healthy physiology as a basis for treatment instead of the outdated mechanistic theory of centric relation. Centric Relation actually has over 26 different definitions as old theory was adapted to new scientific facts and measurements. The definition of Centric Relation has little to do with healthy physiology and a lot to do with transferring information to an articulator for labratory procedures.

Orthopedic corrections of forward head position thru Neuromuscular Dentistry is n incredibly complex physiologic process that ocurs quickly after placing a neuromuscular diagnostic orthotic. The Quadrant Theorem of Guzay explains much of the complex changes that occur. The size of the airway also has a lot to do with correction of forward neck posture. Patients with compromised airways assume a forward neck posture with rotation of the atlas/ occipital and axis to maintain an open airway. It is this complex relationship that led the NHLBI (NTIONAL HEART LUNG AND BLOOD INSTITUTE) to release the report "CARDIOVASCULAR AND SLEEP RELATED CONSEQUENCES OF TEMPOROMANDIBULAR DISORDERS".

Chronic muscle pain, Fibromyalgia, Myofascial Pain and Dysfunction and numerous other chronic muscle problems relate to sleep disorders as outlined in that report.

ENT symptoms including Ear Aches, Otalgia, Eustacian Tube Dysfunction, stuffy ears, clicking and popping noises in the ears, dizziness and equilibrium problems are frequently secondary to these muscle problems. These problems are also closely related to abnormal jaw function and neuromuscular dental disorders.

Sleep disorders and Neuromuscular Dentistry are intimately related and are a major cause of morning headaches.

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posted by Dr Shapira at 2:31 PM

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