Neuromuscular Dentistry and ICCMO: Barny Jankelson the Founder of Neuromuscular Dentistry founded ICCMO with the other great names of Neuromuscular Dentistry.

Neuromuscular Dentistry is one of the most powerful tools for treating TMJ, TMD and other CranioMandibular disorders tied to Chronic Headaches and Migraines.  If you are lookng for a Neuromuscular Dentist your first resource should be ICCMO, The International College of CranioMandibular Orthopedics.

The website of ICCMO has a "find a neuromuscular dentist" tab in the patients area.  I strongly reccomend that if you are looking for a Neuromuscular Dentist that you begin at the ICCMO website.  http://occlusiontmjauthority.com

Learn how neuromuscular dnetistry can treat a wide variety of TMJ disorders at the ICCMO site.

VASCULAR HEADACHES AND TMJ DISORDERS; VASCULAR CHANGES IN MIGRAINE MEDIATED BY THE TRIGEMINAL NERVE.

This article on Migraine discusses a physiologic basis for migraine.   While it does not mention TMJ, Neuromuscular Dentistry or the trigeminal nerve .  The control of blood flow to the anterior two thirds of the meninges of the brain is controlled by the trigeminal nerve.  This is the nerve that neuromuscular dentistry is primarily concerned with.  By correction of masicatory physiology we effect the vascular vessels involved in migraine.



Evidence for a vascular factor in migraine.
Asghar MS, Hansen AE, Amin FM, van der Geest RJ, Koning PV, Larsson HB, Olesen J, Ashina M.

Danish Headache Center and Department of Neurology, Glostrup Hospital, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
Abstract
OBJECTIVE: It has been suggested that migraine is caused by neural dysfunction without involvement of vasodilatation. Because dismissal of vascular mechanisms seemed premature, we examined diameter of extra- and intracranial vessels in migraine without aura patients.

METHODS: A novel high-resolution direct magnetic resonance angiography imaging technique was used to measure arterial circumference of the extracranial middle meningeal artery (MMA) and the intracranial middle cerebral artery (MCA). Data were obtained at baseline, during migraine attack, and after treatment with the migraine abortive drug sumatriptan (a 5-hydroxytryptamine agonist).

RESULTS: We found dilatation of both MMA and MCA during migraine attack (p = 0.001). Sumatriptan administration caused amelioration of headache (p < 0.001) and contraction of MMA (p < 0.001), but MCA remained unchanged (p = 0.16). Exploratory analysis revealed that in migraine attacks with half-sided headache, there was only dilatation on the headache side of MMA of 12.49% (95% confidence interval [CI], 4.16-20.83%) and of MCA of 12.88% (95% CI, 3.49-22.27%) and no dilatation on the nonheadache side of MMA (95% CI, -4.27 to 11.53%) and MCA (95% CI, -6.7 to 14.28%). In double-sided headache we found bilateral vasodilatation of both MMA and MCA (p < 0.001).

INTERPRETATION: These data show that migraine without aura is associated with dilatation of extra- and intracerebral arteries and that the headache location is associated with the location of the vasodilatation. Furthermore, contraction of extracerebral and not intracerebral arteries is associated with amelioration of headache. Collectively, these data suggest that vasodilatation and perivascular release of vasoactive substances is an integral mechanism of migraine pathophysiology. ANN NEUROL 2011.

Copyright © 2010 American Neurological Association.

What is Neuromuscular Dentistry? How do I Find a Neuromuscular Dentist

WHAT IS NEUROMUSCULAR DENTISTRY?

If you are looking for a Neuromuscular Dentist dedicaed to the art and science of the field I strongly suggest a member of the International College of CranioMandibular Orthopedics (ICCMO) at their website
http://occlusiontmjauthority.com. That site has an extensive educational area for patients that is continually being updated.

My description of What is Neuromuscular Dentistry that was originally written for the American Equilibration Society and republished in the ICCMO anthology and by Sleep and Health Journal is considered one of the most succint and easy to understand descrptions of the basic principles of Neuromuscular Dentistry.  http://www.sleepandhealth.com/neuromuscular-dentistry

Neuromuscular Dentistry or NMD is a field of medicine and dentistry based on the work of Barney Jakelson.  There are many greats in the field including Norman Thomas BDS, PhD, Barry Cooper, Jim Geary and Barney Jankelson's son Bob Jankelson who wrote the tesxtbook on Neuromuscular Dentistry.  The International College of CranioMandibular Orthopedics is the organization devoted to the field of Neuromuscular Dentistry and is universalIy acknowledged as the primary organization representing Neuromuscular Dentistry.  There is an American Section of ICCMO representing Neuromuscular Dentists in North America, There is a South American ICCMO based in Argentina, There are large ICCMO chapters in Japa, Germany and a newly organized group in Russia. I have personally been working in the field of Neuromuscular Dentistry for over 35 years.been working in the field of Neuromuscular Dentistry for 35 years.

Dr Janet Travell famed for her work with Myofascial Pain and Dysfunction described in detail in her textbook the mechanism of trigger points, taut bands and myofascial pain.  She lectured at meetings in conjunction with ICCMO and much of her work is directly related to Neuromuscular Dentistry.  Her descriptions of how trigger points form is directly addressed by Neuromuscular Dentistry.


Neuromuscular Dentistry is the most physiological based approach to dentistry and treatment of TMJ disorders, TMD, Migraines, and  headaches.  There is more to Neuromuscular Dentistry than teeth, bones and joints which is where most of dentistry focuses.  Neuromuscular Dentistry looks at the entire nervous system including the parasympathetic and sympathetic portins of the autonomic nervous system and closely looks at physiological aspects of the somatic nervous system.  The stomatognathic must look beyond the jaws and teeth and look at how this interacts with the entire body.

Posture is a primary function of the masticatory system that is ignored by most of dentistry.  Airway maintenance is another  primary function of the the masticatory apparatus and associated systems. The Quadrant Theorem of Guzay explains from a mechanical engineering view how the TMJoint and head posture and the Atlas and Axis vertebrae interact.

Neuromuscular Dentistry utilizes objective data to measure how function and physiology work together.  Neuromuscular Dentistry utolizes EMG to measure muscle physiology and function (dysfunction).  The use of Ultra Low Frequency TENS in Neuromuscular Dentistry to create relax musculature was not discovered by Dr Barney Jankelson but was found during basic science research.  The genius of Dr Jankelson was utilizing it to relax the trigeminally innervated muscles that move the jaws.

The utilization of the Mandibular Kinesiograph now called computerized Mandibular Scans allow careful evaluation of jaw function is three dimensions in real time or in slow motion.  There are two companies that make equipment for Neuromuscular Dentists, Myotronics the company founded by Barney Jnkelson and BioResearch who also manufactures equipment for Neuromuscular Dentists.

http://www.sleepandhealth.com/neuromuscular-dentistry

Chicago area patients should visit my www.thinkbetterlife.com for more information

The Las Vegas Institute (LVI)  utilizes Neuromuscular Dentistry as the basis for its educational programs. I strongly suggest finding LVI dentists who are also members of ICCMO.   It is important to understand that not all LVI dentists are Neuromuscular Dentists.

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Chicago Migraine Treatment Center: A Better Approach To The Treatment and Prevention of Migraine

There are numerous medical headache clinics in Chicago.  Diamond Headache Clinic, Robbins Headache Clinic, and the University of Chicago are among the best.  All of them utilize  the  typical medical approach to treatment of migraines and headaches of medications to alter the central nervous system.

There is another way to alter brain chemistry and that is to change the input to the central nervous system.  Changing neuro input changes the ratio of neurotransmitters at various synapses and changes brain chemistry.

The most Holistic approach to correcting brain chemistry is changing neural input to the brain.  This has no toxicities or medication side effects.  Neuromuscular Dentistry offers patients with chronic migraines new hope.

The first step in treatment is a consultation and work-up followed ay a diagnostic neuromuscular orthotic.  Patients frequently report 50-90% improvement after 1 week in the orthotic.  No pain, no meds.  There is additional improvement over time.

Additional procedures such as sphenopalatine Ganglion Blocks, Greater Occipital Nerve blocks are also both diagnostic and increase efficacy of treatment.

Treatment is only continued when patients respond.  The majority of patients show vast improvement.

The only way to find out if this healthy alternative is idel for you is to have the diagnostic orthotic made but it is possible to utilize an Aqualizer as a "Bandaid Appliance" for a short time to feel the effects prior to starting treatment.

My favorite patients are the chronic migraine patients because we know if we can relieve their pain at the first visit we can vastly improve or eliminate their pain.  It is always easier to understand a problem you can see.  Episodic migraine is actually harder to understand in a single visit than is chronic daily pain.

If you ae tired of living with Migraine Pain contact the office and we will begin the process of pain elimination.

TMJ, TMD: Patient Friendly Video Explains TMJ, TMD, Posture, NUCCA, Atlas-Orthogano, Sleep Apnea and Snoring

My friend Curtis does an excellent job of explaining TMJ Disorders or TMD and how they are addressed with Neuromuscular Dentistry.  I like to always refer to the Neuromuscular Orthotic as a Diagnostic Neuromuscular Orthotic because we use it not just to help in the diagnosis of a patients but to evaluate the new diagnostic position and the effect it has on body posture.

I am into fascinated with the  science of TMJ, TMD and MPD and the postural effects of changing the bite.  Curtis does fabulous job in explaining difficult concepts in a simple easy to understand and entertaining format.  I enjoy watching his video every time I play it.  There is an amazing body of evidence and science into his postural discussion that includes the work of Nobel Prize winning Sherrington and the work of Tallgren.
As a Regent and Secretary of ICCMO I am currently having the pleasure of reviewing his excellent mastership thesis of ICCMO

View his you tube video @

https://www.youtube.com/watch?v=oAdKVu6vS20 

Migraine: New Article in Cephalgia: Targeting pericranial nerve branches to treat migraine: Current approaches and perspectives.

This new article in Cephalgia (PubMed Abstract below) discusses evidence that interventions targeting peripheral Nerves are useful.

This is not new information to anyone who has experienced relief and elimination of Migraines from occipital Nerve Blocks or SphenoPalatine Ganglion Nerve Blocks.  Both of these nerve blocks can be safely and efficiently used to decrease, treat and eliminate migraines.

The Sphenopalatine ganglion block is easy for patients to self administer at home to prevent migraines.

Neuromuscular Dentistry has shown thousands and thousands of patients that correction of craniomandibular problems can decrease and eliminate migraines by changing the input into the Trigeminal Nervous System.  All headaches and migraines are mediated in part of fully by the Trigeminal Nerve and the TrigeminoVascular System.

There is a massive amount of input into the Trigeminal Nervous system from proprioception that passes thru the mesencephalic nucleus.  The mesencephalic nucleus is very specialbecause it does not contain chemical synapses.  The neurons are electrically coupled unlike other central nevous system (CNS) ganglia.  The mesencephalic nucleus is the only CNS Ganglia to contain cell bodies of a primary afferent nerve.  The Trigeminal Ganglion is the primary sensory nucleus of the Trigeminal Nerve.

Trigeminal Neuralgia is sometimes treated by destroying parts of the Trigeminal Ganglion with thermocoagulation or injection of glycerol.

Another well known procedure for preventing and treating migraines is osteopathic and chiropractic treatment.  Especially effective are upper cervical chiropractic techniques used by NUCCA and Atlas-Orthoganol Chiropracters.

A very dfferent type of perpheral stimulation of the Trigeminal Nerve can decrease migraine.  Humans smell Menthol with their Trigeminal Nerve. The use of topical menthol is an effective topical pain treatment but smelling of menthol and activation of the Trigeminal Nerve may account for much of this action.    Activation of the antitussive effects of menthol  "occur secondary to the activation of TRPM8+/TRPV1− nasal trigeminal afferent neurons."  (http://jap.physiology.org/content/115/2/268).
These effects were the reason cigarrette companies added menthol .

The trigeminal system is unique in its ability to smell and taste Menthol in a different manner than olfactory nerve (smell) , chord tympani of facial nerve (taste), posterior third of tongue tastefrom Glossopharyngeal nerve.
Smells and taste are frequently associate with migraines as percipitating factors, Auras and can be used in a preentive manner.

Cephalalgia. 2015 Mar 3. pii: 0333102415573511. [Epub ahead of print]

Targeting pericranial nerve branches to treat migraine: Current approaches and perspectives.

Ambrosini A1, D'Alessio C2, Magis D3, Schoenen J3.

Author information

Abstract

BACKGROUND: 

Migraine is a highly prevalent neurological disorders and a major individual and societal burden. Migraine is not curable at the present time, but it is amenable to acute symptomatic and preventive pharmacotherapies.

SUMMARY: 

Since the latter are frequently unsatisfactory, other treatment strategies have been used or are being explored. In particular, interventions targeting pericranial nerves are now part of the migraine armamentarium. We will critically review some of them, such as invasive and noninvasive neurostimulation, therapeutic blocks and surgical decompressions.

CONCLUSIONS: 

Although current knowledge on migraine pathophysiology suggests a central nervous system dysfunction, there is some evidence that interventions targeting peripheral nerves are able to modulate neuronal circuits involved in pain control and that they could be useful in some selected patients. Larger, well-designed and comparative trials are needed to appraise the respective advantages, disadvantages and indications of most interventions discussed here.

© International Headache Society 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Neuroscience. 2011 Aug 25;189:377-83. doi: 10.1016/j.neuroscience.2011.04.065. Epub 2011 May 7.

Perception of specific trigeminal chemosensory agonists.

Frasnelli J1, Albrecht J, Bryant B, Lundström JN.

Author information

Abstract

The intranasal trigeminal system is a third chemical sense in addition to olfaction and gustation. As opposed to smell and taste, we still lack knowledge on the relationship between receptor binding and perception for the trigeminal system. We therefore investigated the sensitivity of the intranasal trigeminal system towards agonists of the trigeminal receptors TRPM8 and TRPA1 by assessing subjects' ability to identify which nostril has been stimulated in a monorhinal stimulation design. We summed the number of correct identifications resulting in a lateralization score. Stimuli were menthol (activating TRPM8 receptors), eucalyptol (TRPM8), mustard oil (TRPA1) and two mixtures thereof (menthol/eucalyptol and menthol/mustard oil). In addition, we examined the relationship between intensity and lateralization scores and investigated whether intensity evaluation and lateralization scores of the mixtures show additive effects. All stimuli were correctly lateralized significantly above chance. Across subjects the lateralization scores for single compounds activating the same receptor showed a stronger correlation than stimuli activating different receptors. Although single compounds were isointense, the mixture of menthol and eucalyptol (activating only TRPM8) was perceived as weaker and was lateralized less accurately than the mixture of menthol and mustard oil (activating both TRPM8 and TRPA1) suggesting suppression effects in the former mixture. In conclusion, sensitivity of different subpopulations of trigeminal sensory neurons seems to be related, but only to a certain degree. The large coherence in sensitivity between various intranasal trigeminal stimuli suggests that measuring sensitivity to one single trigeminal chemical stimulus may be sufficient to generally assess the trigeminal system's chemosensitivity. Further, for stimuli activating the same receptor a mixture suppression effect appears to occur similar to that observed in the other chemosensory systems.

Copyright © 2011 IBRO. Published by Elsevier Ltd. All rights reserved.

Highland Park Dentist is New Chair of The American Alliance of TMD Organizations. New Highland Park Office Focuses on TMJ Disorders, Sleep Apnea, Snoring, Chronic Daily Headaches and Migraines

The Alliance of TMD Organizations' mission is to support and protect the rights and freedom of patients and their doctors. A grave new threat is now looming that may have very negative effects on patients and doctors.

The American Alliance of TMD held its annual meeting on February 26-27 at the Chicago Marriott. Long Time Highland Park resident Ira L Shapira became the new Chair of the TMD Alliance.

The Alliance (http://www.tmdalliance.org/index.html) is dedicated to protecting the rights of TMD patients to receive the care they need. According to Dr Shapira there is a grave new threat has arisen that may effect both the patients rights and ability to have their care reimbursed by insurance. The threat is from a new board claiming the right to grant specialty outside the auspices of the American Dental Association which is and always has represented the dental profession and public safety.

The American Dental Association is the voice of organized dentistry and Specialty recognition in the U.S. The American Dental Association has recognized several dental specialties including: American Board of Dental Public Health, American Board of Endodontics, American Board of Oral and Maxillofacial Pathology, American Board of Oral and Maxillofacial Radiology, American Board of Oral and Maxillofacial Surgery, American Board of Orthodontics, American Board of Pediatric Dentistry, and American Board of Periodontology.

A new group, the American Board of Dental Specialties (ABDS) is acting outside of organized dentistry to create and grant specialty status to groups that have either not met the ADA standards for specialty or had their application rejected by the Ameican Dental Association.

The following Dental Specialty Boards have been granted recognition by the ABDS:

American Board of Oral Implantology. Implant Dentistry; this so called specialty is already well represented by both The American Board of Oral and Maxillofacial Surgery & The American Board of Periodontology.

American Board of Orofacial Pain. This group has been repeatedly denied specialty by the American Dental Association for multiple reasons. There have been other groups who have also been denied specialty in the TMD field by the American Dental Association. All Diplomats of the ABOP will become instant (just add water) specialists. Many of these doctors have previously been involved in questionable groups that unfairly (and possibly fraudulently) deny patients legitimate insurance claims. Specialty Status, however dubious will embolden them to unfairly attempt to restrict medical benefits to patients. This group actually discounts the effect of dentistry and occlusion on oral facial pain. The promote utilizing drugs and psychotherapy to treat TMJ disorders.

Two additional boards seeking specialty are:
American Dental Board of Anesthesiology
American Board of Oral Medicine.

The TMD Alliance and it's individual members have multiple other concerns over any specialty designation in TMD or Oral Facial Pain.

Dr Shapira could not comment further on specifics of the problems associated with this group but the Alliance of TMD Organizations has long been opposed to specialty. Dr Shapira believes this specialty will hurt patients, TMD practitioners as well as the entire dental profession.

The so called specialties being created will need to be approved by each and every state dental board across the country. Dr Shapira urges the ADA and all of its constituents to do all it can to protect the American Public from this dangerous development. State Dental Boards across the country need to reject these questionable new specialties to protect the public until they have been properly vetted. The ADA should consider taking a strong stance in this issue before it is too late.

When the American Dental Association creates a new specialty it Grandfathers in doctors working within the specialty as specialists. The DANGER WITH SELF-DECLARED SPECIALTIES IS ONLY MEMBERS OF A SELECT GROUP ARE ADMITTED AND THEN THAT GROUP IS IN CHARGE OF WHO CAN LATER BECOME A SPECIALIST. The ABOP has been restrictive in the past in who could become members.

THIS IS A REAL DANGER TO THE AMERICAN PUBLIC AND SHOULD BE DISCUSSED IN AN OPEN FORUM.

The Alliance of TMD Organizations includes the following organizations:

American Academy of Craniofacial Pain
(Previously American Academy of Head, Neck and Facial Pain

American Equilibration Society
(The first organization dedicated to TMJ disorders)

International Association of Physiologic Aesthetics
(previously International Association of Comprehensive Esthetics)

International College of Cranio-Mandibular Orthopedics
(The original Neuromuscular dental group)

International Association for Orthodontics

Sacro Occipital Technique Organization-USA
(The only Chiropractic group in the Alliance)

Tennessee CRANIO

The following organizations have lapsed membership in the Alliance but Dr Shapira hopes to bring them back to full membership status:

American Academy of Pain Management
American College of Prosthodontics

Treatment of TMJ and Sleep Disorders has been a consuming passion for Dr Shapira for 35 years who is a Fellow of the International College of CranioMandibular Orthopedics as well as Secretary and the representative from ICCMO to the TMD Alliance along with Dr Barry Cooper, who is Past President of ICCMO, A Life Member of the AES and one of the founding members of the Alliance and past chair. Dr Cooper has an impressive history in the TMD field.
http://www.tmjtmd.com/curriculum-vitae2.html

As a Diplomat of the American Academy of Pain Management and a long time member of both the American Equilibration Society and the Academy of CranioFacial Pain, and a previous member of the IACA Dr Shapira is well versed in all of the pholosophies of each group. As a member Dr Shapira urges the ADA, the Illinois State Dental Society and the Chicago Dental Society to see these pseudo-specialties as a threat to the profession and the public.

Dr Shapira is a founding member of The American Academy of Dental Sleep Medicine (formerly the Sleep Disorder Dental Society), a Diplomate of the American Board of Dental Sleep Medicine and a founding and charter member of DOSA, The Dental Organization for Sleep Apnea. The AADSM should, in Dr Shapira's opinion, join the TMD Alliance this year.

Dr Shapira is the Dental Editor of Sleep and Health Journal.

Dr Shapira did research on the similarities in jaw position in sleep apnea and TMJ patients in the 1980's as a visiting assistant professor at Rush Medical School where he worked with Rosalind Cartwright PhD who is primarily responsible for the entire field of Dental Sleep Medicine. He also studied with Dr Barney Jankelson who created the initial concepts that neuromuscular dentistry still uses today and created a company Myotronics that is the leading manufacturer of instrumentation used by Neuromuscular Dentistry.
His research showed that TMJ and Sleep Apnea patients had very similar jaw postures.

Dr Shapira has maintained a general dental practice with a special emphasis on sleep and pain in Gurnee, Il and has recently started Chicagoland Dental Sleep Medicine Associates in Highland Park. More information on Sleep, TMJ and Headache Treatment can be found on his websites.

http://www.thinkbetterlife.com (Highland Park office)

http://www.delanydentalcare.com (Gurnee Office)

http://www.ihateheadaches.org

http://www.chicagoland.ihatecpap.com.

http://www.Sleepandhealth.com

Dr Ira L Shapira is an author and section editor of Sleep and Health Journal, President of I HATE CPAP LLC, President Dato-TECH, President of Sleep Well Illinois,
 Dr Shapira also holds several patents on methods and devices for the prophylactic minimally invasive early removal of wisdom teeth and collection of bone marrow and stem cells. He is currently working with Dr Tom Diekwisch at the University of Illinois and Baylor University to prove these stem cells can change peoples lives for the better. Dr Shapira is a licensed general dentist in Illinois and Wisconsin.
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