This website is all about utilizing neuromuscular dentistry to treat and prevent migraines and tension type headaches.
I invite you to roam the site and follow the links to learn how the teeth, jaws and jaw muscles along with the trigeminal nerve are partially or completely connected to chronic pain. Neuromuscular dentistry can help a wide variety of chronic pains, treat sleep apnea and snoring, possibly alleviate sympoms of movement disorders including Parkinson's.
Visit Sleep and Health Journal (http://www.sleepandhealth.com/neuromuscular-dentistry) for my detailed article on Neuromuscular Dentistry that was first published by the American Equilibration Society and the republished in ICCMO's annual anthology of Neuromuscular Dentistry.
Learn why TMJ disorders are called The Great Imposter in another Sleep and Health Journal article. http://www.sleepandhealth.com/story/suffer-no-more-dealing-great-impostor
Wednesday, December 29, 2010
Tuesday, December 28, 2010
Oral Appliances for treating Parkinson's and other movement disorders
The utilization of using Neuromuscular orthotics to treat or eliminate migraines, tension-type headaches and chronic sinus and facial pain is well established. The correction of postural distortion is also well documentd however the treatment of movement disorders has been primarily anectdotal.
That is beginning to change, the correction of oral and pharyngeal reflexes combined into neuromuscular orthotics allows treatment of more complex disorders.
The OSB, or Oral Systemic Balance appliances promoted by Dr Farand Robson are focused into these reflexes. The work of Brendan C Stack DDS MS, Dr John Beck MD and others in treating Parkinsons is exciting new work. The Academy of Craniofacial Pain is a diamond sponsor of this event.
There are two clips on the Parkinson's Resoure organization website dealing with TMJ and Parkinson's and the group has a meeting in January 2011. http://www.parkinsonsresource.org/press/latest-news/item/11-temporomandibular-joint-disorder-and-parkinson’s-breakthrough
Treatment of TMJ disorders (TMD) can have tremendous effects on posture throughout the body. Posturology is a new field of study and TM Joints, jaw position are only two of many factors affecting total posture.
The brain is are central computer, the effect of jaw problems is to create anI/O error or an input /output error. If bad information is fed into the CNS than bad information comes out.
The Natioonal Heart Lung and Blood Institute has excellent information on TMJ disorders and Sleep Apnea at http://www.nhlbi.nih.gov/meetings/workshops/tmj_wksp.pdf in a report CARDIOVASCULAR AND SLEEP-RELATED CONSEQUENCES OF TEMPOROMANDIBULAR DISORDERS NHLBI WORKSHOP
That is beginning to change, the correction of oral and pharyngeal reflexes combined into neuromuscular orthotics allows treatment of more complex disorders.
The OSB, or Oral Systemic Balance appliances promoted by Dr Farand Robson are focused into these reflexes. The work of Brendan C Stack DDS MS, Dr John Beck MD and others in treating Parkinsons is exciting new work. The Academy of Craniofacial Pain is a diamond sponsor of this event.
There are two clips on the Parkinson's Resoure organization website dealing with TMJ and Parkinson's and the group has a meeting in January 2011. http://www.parkinsonsresource.org/press/latest-news/item/11-temporomandibular-joint-disorder-and-parkinson’s-breakthrough
Treatment of TMJ disorders (TMD) can have tremendous effects on posture throughout the body. Posturology is a new field of study and TM Joints, jaw position are only two of many factors affecting total posture.
The brain is are central computer, the effect of jaw problems is to create anI/O error or an input /output error. If bad information is fed into the CNS than bad information comes out.
The Natioonal Heart Lung and Blood Institute has excellent information on TMJ disorders and Sleep Apnea at http://www.nhlbi.nih.gov/meetings/workshops/tmj_wksp.pdf in a report CARDIOVASCULAR AND SLEEP-RELATED CONSEQUENCES OF TEMPOROMANDIBULAR DISORDERS NHLBI WORKSHOP
Sunday, December 12, 2010
TENSION-TYPE HEADACHES AND MIGRAINES OFTEN HAVE COMMON CO-MORBIDITIES OF TEMPOROMANDIBULAR DISORDERS, MYOFASCIAL PAIN AND FORWARD HEAD POSITION
A new article "Pure tension-type headache versus tension-type headache in the migraineur." in Curr Pain Headache Rep. 201:465-9.0 Dec;14(6) (PubMed abstract below) looks at primary headache disorders. What is most interesting is that they state that differential diagnosis is made difficult to the frequent presence of co-morbidities including temporomandibular disorders and myofascial pain.
I wish the authors could realize that what they classify as co-morbidities are actually underlying triggers and causes of both migraines and tension-type headaches. When they assume that these headaches are primary they miss the opportunity to actually treat and prevent them from occuring. The authors go on to state "chronification, particularly of migraine, leads to a decrease in the associated symptoms of migraine, such as nausea, photophobia, and phonophobia, so that these headaches more closely resemble tension-type headache" and missing the fact that central sensitiztion and chronicity is due to not treating the primary trigeminal nerve problem that is secondary to repetitive motion injuries from underlying dysfunction that leads to myofascial pain disorders.
There is a musclar component as well as a neurogenic/vascular component to all headaches. The real issue is the elimination of the conditions that trigger tension-type headaches, migraines and TMJ (TMD) disorders. Neuromuscular dentistry is extremely effective in preventing and eliminating tension-type headaches and migraines because it eliminates the repetitive strain injuries by idealizing the physiologic status of the entire trigeminal nervous system that is responsible in whole or in part for almost all migraines and tension-type headaches as well as other head, neck and facial pain.
Curr Pain Headache Rep. 201:465-9.0 Dec;14(6)
Pure tension-type headache versus tension-type headache in the migraineur.
Blumenfeld A, Schim J, Brower J.
The Headache Center of Southern California, 320 Santa Fe Drive, Encinitas, CA 92024, USA. blumenfeld@neurocenter.com
Abstract
Primary headache disorders include tension-type headache and migraine. These headache types can be differentiated based on strict clinical definitions that depend on the patient's signs and symptoms. However, some of the clinical features can overlap, and in addition, the same comorbid conditions can occur in both headache types. Distinction between these headache types on occasion can be difficult due to comorbid conditions such as temporomandibular joint disorders and myofascial pain with forward head posturing, which may be present in both headache disorders, and thus result in similar features in both conditions. Furthermore, chronification, particularly of migraine, leads to a decrease in the associated symptoms of migraine, such as nausea, photophobia, and phonophobia, so that these headaches more closely resemble tension-type headache. Finally, in some patients, both tension-type headache and migraine may occur at different times.
PMID: 20878271 [PubMed - in process]
I wish the authors could realize that what they classify as co-morbidities are actually underlying triggers and causes of both migraines and tension-type headaches. When they assume that these headaches are primary they miss the opportunity to actually treat and prevent them from occuring. The authors go on to state "chronification, particularly of migraine, leads to a decrease in the associated symptoms of migraine, such as nausea, photophobia, and phonophobia, so that these headaches more closely resemble tension-type headache" and missing the fact that central sensitiztion and chronicity is due to not treating the primary trigeminal nerve problem that is secondary to repetitive motion injuries from underlying dysfunction that leads to myofascial pain disorders.
There is a musclar component as well as a neurogenic/vascular component to all headaches. The real issue is the elimination of the conditions that trigger tension-type headaches, migraines and TMJ (TMD) disorders. Neuromuscular dentistry is extremely effective in preventing and eliminating tension-type headaches and migraines because it eliminates the repetitive strain injuries by idealizing the physiologic status of the entire trigeminal nervous system that is responsible in whole or in part for almost all migraines and tension-type headaches as well as other head, neck and facial pain.
Curr Pain Headache Rep. 201:465-9.0 Dec;14(6)
Pure tension-type headache versus tension-type headache in the migraineur.
Blumenfeld A, Schim J, Brower J.
The Headache Center of Southern California, 320 Santa Fe Drive, Encinitas, CA 92024, USA. blumenfeld@neurocenter.com
Abstract
Primary headache disorders include tension-type headache and migraine. These headache types can be differentiated based on strict clinical definitions that depend on the patient's signs and symptoms. However, some of the clinical features can overlap, and in addition, the same comorbid conditions can occur in both headache types. Distinction between these headache types on occasion can be difficult due to comorbid conditions such as temporomandibular joint disorders and myofascial pain with forward head posturing, which may be present in both headache disorders, and thus result in similar features in both conditions. Furthermore, chronification, particularly of migraine, leads to a decrease in the associated symptoms of migraine, such as nausea, photophobia, and phonophobia, so that these headaches more closely resemble tension-type headache. Finally, in some patients, both tension-type headache and migraine may occur at different times.
PMID: 20878271 [PubMed - in process]
Sunday, December 5, 2010
TMJ disorders and Neck Pain are closely linked. New study shows mechanical and kinematic movement of neck is altered by neck pain.
A recent article (Arch Phys Med Rehabil. 2010 Dec;91(12):1884-90.) showed changes in neck function when pain was present. Neck pain is one of the most frequently helped conditions during neuromuscular treatment of TMD disorders. If treating the pain can return normal function this would be an incredible finding.
The article concludes "Velocity and smoothness of cervical motion were more restricted in patients with chronic neck pain than found previously. Unlike range of motion and other static measurements, these dynamic variables reflect functional cervical motion and therefore contribute to a better understanding of the impairment associated with neck pain. Because the ability to move quickly in response to external stimuli is a commonly occurring phenomenon, this deficit is highly relevant to clinical assessment and management."
The unanswered question is whether the limitation and pain have a common orgin or if the pain is the cause of the changes noted. If the pain alone causes these changes than more debilitating problems would occur over time. An interesting follow-up study would be to examine changes after treatment of pain.
The PPM, Pure Power Mouthguard has been shown to increse flexibility and balance in athletes. A Rutger's study confirmed this. I have frequently seen normalization in pain and function in patients treated with neuromuscular orthotics but these are subjective improvements. This "virtual reality assesment" may be a more objective method to measure improvement in neck function following rehabilatative medicine, physical therapy, chiropractic or osteopathic adjustments and TMD treatment.
Arch Phys Med Rehabil. 2010 Dec;91(12):1884-90.
The effect of neck pain on cervical kinematics, as assessed in a virtual environment.
Bahat HS, Weiss PL, Laufer Y.
Department of Physical Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel.
Abstract
Sarig Bahat H, Weiss PL, Laufer Y. The effect of neck pain on cervical kinematics, as assessed in a virtual environment.
OBJECTIVE: To compare cervical kinematics during functional motion in patients with neck pain and in asymptomatic participants using a novel virtual reality assessment.
DESIGN: Clinical comparative trial.
SETTING: Participants were recruited from university staff and students, and from a local physical therapy clinic.
PARTICIPANTS: Patients with chronic neck pain (n=25) and asymptomatic participants (n=42).
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: Kinematic measures (response time, peak and mean velocity, number of velocity peaks, time to peak velocity percentage) were sampled while participants were engaged in the virtual game. Group and motion direction differences were assessed with a 2-way repeated-measures analysis of variance, Tukey-Kramer testing, and contrast analysis when relevant.
RESULTS: Participants with neck pain had lower peak and mean velocities than the asymptomatic participants (P<.0001). They also demonstrated a greater number of velocity peaks, indicating impaired motion smoothness (P=.0036). No significant group differences were found for response time or for time to peak velocity percentage. Cervical rotations were significantly faster and smoother than flexion and extension movements (P<.05). The overall impairment percentage in velocity and smoothness of cervical motion in patients with neck pain ranged from 22% to 44% compared with asymptomatic participants.
CONCLUSIONS: Velocity and smoothness of cervical motion were more restricted in patients with chronic neck pain than found previously. Unlike range of motion and other static measurements, these dynamic variables reflect functional cervical motion and therefore contribute to a better understanding of the impairment associated with neck pain. Because the ability to move quickly in response to external stimuli is a commonly occurring phenomenon, this deficit is highly relevant to clinical assessment and management.
Copyright © 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
PMID: 21112430 [PubMed - in process]
The article concludes "Velocity and smoothness of cervical motion were more restricted in patients with chronic neck pain than found previously. Unlike range of motion and other static measurements, these dynamic variables reflect functional cervical motion and therefore contribute to a better understanding of the impairment associated with neck pain. Because the ability to move quickly in response to external stimuli is a commonly occurring phenomenon, this deficit is highly relevant to clinical assessment and management."
The unanswered question is whether the limitation and pain have a common orgin or if the pain is the cause of the changes noted. If the pain alone causes these changes than more debilitating problems would occur over time. An interesting follow-up study would be to examine changes after treatment of pain.
The PPM, Pure Power Mouthguard has been shown to increse flexibility and balance in athletes. A Rutger's study confirmed this. I have frequently seen normalization in pain and function in patients treated with neuromuscular orthotics but these are subjective improvements. This "virtual reality assesment" may be a more objective method to measure improvement in neck function following rehabilatative medicine, physical therapy, chiropractic or osteopathic adjustments and TMD treatment.
Arch Phys Med Rehabil. 2010 Dec;91(12):1884-90.
The effect of neck pain on cervical kinematics, as assessed in a virtual environment.
Bahat HS, Weiss PL, Laufer Y.
Department of Physical Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel.
Abstract
Sarig Bahat H, Weiss PL, Laufer Y. The effect of neck pain on cervical kinematics, as assessed in a virtual environment.
OBJECTIVE: To compare cervical kinematics during functional motion in patients with neck pain and in asymptomatic participants using a novel virtual reality assessment.
DESIGN: Clinical comparative trial.
SETTING: Participants were recruited from university staff and students, and from a local physical therapy clinic.
PARTICIPANTS: Patients with chronic neck pain (n=25) and asymptomatic participants (n=42).
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: Kinematic measures (response time, peak and mean velocity, number of velocity peaks, time to peak velocity percentage) were sampled while participants were engaged in the virtual game. Group and motion direction differences were assessed with a 2-way repeated-measures analysis of variance, Tukey-Kramer testing, and contrast analysis when relevant.
RESULTS: Participants with neck pain had lower peak and mean velocities than the asymptomatic participants (P<.0001). They also demonstrated a greater number of velocity peaks, indicating impaired motion smoothness (P=.0036). No significant group differences were found for response time or for time to peak velocity percentage. Cervical rotations were significantly faster and smoother than flexion and extension movements (P<.05). The overall impairment percentage in velocity and smoothness of cervical motion in patients with neck pain ranged from 22% to 44% compared with asymptomatic participants.
CONCLUSIONS: Velocity and smoothness of cervical motion were more restricted in patients with chronic neck pain than found previously. Unlike range of motion and other static measurements, these dynamic variables reflect functional cervical motion and therefore contribute to a better understanding of the impairment associated with neck pain. Because the ability to move quickly in response to external stimuli is a commonly occurring phenomenon, this deficit is highly relevant to clinical assessment and management.
Copyright © 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
PMID: 21112430 [PubMed - in process]
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