Showing posts with label chronic daily headaches neuromuscular dentistry. Show all posts
Showing posts with label chronic daily headaches neuromuscular dentistry. Show all posts

Sunday, November 20, 2011

Chronic Daily Headache: Neurological Sciences Study Showed 17 of 20 Patients Required Neurmuscular Orthotic

A neuromuscular orthotic is used to correct occlusal discrepancies that can cause chronic daily headaches, migraines and tension-type headaches.The current study (abstract below) showed that 85% of patients with chronic daily headache has significant discrepancies between their occlusion and their ideal neuromuscular position.

The majority of dentists treating TMJ disorders and chronic head and neck pain are lost when it comes to establishing the neuromuscular position. The neuromuscular rest position and occlusion can only be determined after uilizing ultra-low frequency TENS to relax muscles and deprogram the occlusion.

I prefer the term Diagnostin Neuromuscular Orthotic because even though Neuromuscular Dentistry is extremely effective it is imprortant to establish success prior to long term restoration. The diagnostic orthotic is used to find this three dimensional relaxed position.

I see chronic headache and TMJ disorder patients on a long distance basis. The first series of appointments are to establish improved posture and a functionally correted Diagnostic Neuromuscular Orthotic.

I will have my out of town patients arrive on Sunday and then see them Monday AM for diagnostic evaluation, radiographs, impressions and examination. I then deliver the Diagnostic Orthotic Monday afternoon. It is adjusted Tuesday AM and PM and on Wednesday morning. This protocol allows me to send patients home after a short series of appointments with a functionally corrected neuromuscular diagnostic orthotic. I frequently will also do trigger point injections, SPG blocks and other physical therapy modalities.

I insist I receive a complete history and conduct a phone interview prior to giving the patient an appointment. This is essntial to be able to rapidly help patients get relief from chronic daily headaches, migraines and head and neck pain.
Neurol Sci. 2011 May;32 Suppl 1:S161-4.

Chronic daily headache: suggestion for the neuromuscular oral therapy.

Source

Fondazione IRCCS CĂ  Granda, Dipartimento di Scienze Chirurgiche Ricostruttive e Diagnostiche Sezione di Odontostomatologia, UniversitĂ  degli Studi di Milano, Via della Commenda 10, 10122 Milan, Italy.

Abstract

Tweny patients (M: 4, F: 16, mean age 37 ± 11 years) with diagnosis of chronic daily headache (CDH), after drug withdrawal, were under electromyography, kinesiography and masticatory muscle deprogramming by TENS to identify the physiological rest position of the mandible. Our purpose was to clarify a possible role of the neuromuscular stomatognathic system. Examinations showed that 17 patients needed a neuromuscular orthosis, an occlusal device, to provisionally correct the detected discrepancies of jaw position. Of those, the 10 patients who showed an occlusal sagittal discrepancy higher than 2 mm and/or a lateral deviation higher than 0.4 mm, associated with more than three parafunctional activities, had a meaningful decrease on frequency/intensity of migraine crisis and/or of days of headache. VAS pain score during crisis decreased from 9.0 ± 0.9 to 4.9 ± 2.7; frequency of crisis were from 20.7 ± 5.2 to 9.5 ± 7.7. Baseline pain were from 5.3 ± 1.2 to 3.0 ± 1.3. Satisfying clinical results can be reached combining behavioural education and neuromuscular orthosis. This can be very helpful in patients who show significant discrepancy of jaw position that only TENS deprogramming can reveal and kinesiography can detect with such accuracy.

PMID:
21533736
[PubMed - indexed for MEDLINE]

Friday, May 21, 2010

Prevention of Migraines: Press Release reprint

It is widely accepted that almost all headaches wether classified as vascular, neurogenic , hormonal or muscular in orgins are caused primarily by the Trigeminal Nervous system. While there are many drugs that can be utilized in the treatment of migraines and other headaches one of the best diagnostic proceures may not only clarify why the headaches occur but eliminate, decrease and/or prevent them entirely without the use of dangerous and/or adicting meication.

Neuromuscular Dentistry May Be The Best Migraine Prevention Available For Many Patients. I HATE HEADACHES website provides extensive information on Neuromuscular Dentistry.

The Trigeminal Nerve is so closely tied to headaches that prevention of noxious input can be a permanent cure for many patients. Patients who are tired of their lives being controlled or ruined by headaches should approach treatment cautiously. Initial treatment of headaches should always be preceded by a consultation appointmet with an experienced Neuromuscular Dentist. Patients should expect to spend at least an hour at this initial visit to determine if they are apprpriate canidates for a diagnostic appointment.

Dr Ira L Shapira in Gurnee, Illinois has 30 years experience in utilizing Neuromuscular Dentistry to elimnate, prevent and treat migraines and othe chronic headaches. He will usually spend 60-90 minutes with patients at the initia consultation and will then prescribe a diagnostic appointment appropriate for the patients specific disorders. Patients with more complex problems and longer history of pain are usually given a more comprehensive assessment.

During the consultation it is frequently possible to turn off a head or neck pain in just a few seconds by deactivating myofascial trigger points. Dr Shapira, a Diplomate of the American Academy of Pain Manage explains that he can sometimes see amazing transformations in patients as they realize that finally some knows how to turn off their pain. "I recently saw a patient who accompanied her husband to my office for treatment of his sleep apnea. I noticed that "M" was holding her right temple and asked if she was having headache which she confirmed. I asked if I could try to "turn it off" and she agreed to let me attempt to relieve it. we spent less than five minutes deactivating trigger points and she was "pain free". She then told me she had had a continuos headache for over 50 years which her husband, a retired physcian, confirmed. A appointment was made to deliver her husbands snoring and sleep apnea appliance and to do a consultation and begine treatment the following week. At the next a diagnostic evaluation was done and a diagnostic neuromuscular orthotic was deliverd to "M". One week later M and her husband returned and she reported being headache free and sleeping much better because we had eliminated her husbands snoring s well. M has now been reconstructed to this Neuromuscular Position and remains headache free. She loves to tell stories about how her children and grandaughter are constantly asking if she still doesn't have a headache. She also feels she has never looked as good as she does now since the dental reconstruction."

The use of a diagnostic orthotic is n essential element of both diagnosis and treatment of headache patients. It allows for the corrction of the jaw joints, jaw muscles and most importantly the correction of the input to the Trigeminal Nervous system. It allows the patient to understand and evaluate treatment prior to making any irreversible change. Neuromuscular Dentistry is extremely conservative in it avoids the risk of making problems worse by making permanent bite changes as an initial treatment. If patients decide to make permanent changes they have multiple treatment choices but most importantly they have "test driven" their new bite and know the effects before embarking on the second phase of treatment. The diagnostic orthotic patient is essential to determine treatment direction and to protect the patient.

Centric Relation dentistry is another approach to treating patients. Dr Shapira was both a patient and practitiner of CR dentistry before becoming a strong advocate for the Neuromuscular Approach. "The problem with centric relation treatment" in Dr Shapira's opinion "is that permanent changes are made early in treatment and if a patient becomes worse instead of better ther treatment is not reversible. Centric Relation is determined by the dentist manipulating the patients mandible to position utilizing the dentist's muscles but Neuromuscular Dentistry on the other hand utilizes the patients own muscles to guide treatment. Removal of underlying pathology lets the body heal" according to Dr Shapira, "and then we just have to adjust the diagnostic orthotic to match the healthier position that naturally occurs."

Dr Shapira has created two excellent website to help patients find answers to difficult medical problems:

http://www.ihateheadaches.org for headache and migraine disorders

http://www.ihatecpap.com for patients with sleep apnea and snoring and who want a comfortable alternative to CPAP

There are two excellent articles that should be read by anyone suffering from chronic headaches, Migraines or TMJ disorders published in Sleep and Health Journal:

http://www.sleepandhealth.com/story/suffer-no-more-dealing-great-impostor

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

The first article "SUFFER NO MORE: DEALING WITH THE GREAT IMPOSTER" discusses patients symptoms and stories and the second discusses Dr Shapira's explanation of the science of Neuromuscular Dentistry.

Dr Shapira can be contacted for treatment of headaches, sleep apnea, and TMJ disorders at his Delany Dental Care practice where he also practices general dentistry with his partner Dr Mark Amidei.http://www.delanydentalcare.com