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Olinm 06-09-2012 12:49 AM

Stabilizing following disaster....
Hi all, I had a dental disaster with a dentist several years ago involving splint therapy. I was in PT for a long time to correct skeletal imbalances the device had caused. PT ultimately had to be discontinued since it was damaging and caused more issues. I felt like I had been hit by a bus the day following PT. I've since learned that I have ligament laxity - hypermobility syndrome, possible Ehlers Danlos. So I would assume there was never a place for me to stabilize. PT just shuffled me around stabilizing nowhere causing more pain. I would walk out and my head would be spinning. So I stopped and began treatment with a NM dentist and this was also unsuccessful. I had the same response with increased skeletal distortions. Apparently, I'm Gumby. I realize I now have a great deal of cranial distortion complicated by the treatments. One tmj is higher than the other, one more prominent, one cheekbone up and one down. I'm unable to swallow well, can't breathe, SI joint out. back teeth don't meet at all, have a jaw cant and crossbite and virtually no occlusion to speak of, losing lower arch. I was also born with an underdeveloped jaw and everything that goes along with that. I need the stability EVERYWHERE. I've recently tried passive Feldenchrist but it bulks up one side of the body due to the imbalance. All the weight is to one side so one hip is muscular and the other is atrophied due to compensations. So, I'm back to the balancing act. I could try a flat plane splint along with cranial work to try to balance but I have to be careful because I go into rotation when we begin adjusting. It's been suggested that I try palate expansion (ALF) but I'm very cautious because of my history. Interestingly, when I was previously in PT I wore a flat plan splint very briefly and my body was holding all of the adjustments my PT made. My dentist couldn't make the connection and it was unfortunately discontinued. So, I realize the jaw/occlusion was never stable but by adding dental support the body stabilizes. Don't know if I'm missing something. I'm beyond frustrated but need to do something. I'd appreciate any comments from anyone who can understand this thread. ;-0

judye 06-09-2012 09:16 AM

Re: Stabilizing following disaster....
Hi Olinm,

I'm so sorry to hear what you've been going through - wow, you've really been through the ringer! Sounds like a pretty complex situation that would require an amazingly competent NM dentist that is working closely with a team of others professionals, such as PT and chiro so that they can all be comunicating closely to figure out and treat your issues in conjunction.

I am not an expert and I really don't know anything about hypermobility syndrome but I want to share the little that I can in the hopes that it might be helpful. One thing I've learned is that issues in the jaw often goes hand in hand with misalignment in the body. I believe this misalignment can exacerbate pain issues and the misalignment in the jaw - working together to form a nasty vicious circle. As a result, I think they both need to be treated simultaneously by professionals why are extemely experienced and consulting with each other.

My NM dentist works very closely with a chiropractor who also specializes in TMJ issues. When my splint therapy didn't seem to be relieving symptoms at first, he sent me immediately to work with this chiro. My body wasn't straight at all - hips twisted and one lower than the other, one shoulder much higher than the other. You could tell just by looking at me. At first my body kept slipping back into its original misalignment, but as splint therapy proceeded and I had the chiro straightening me many times over several months, I finally held. I still need to go back from time to time as I'm now in braces and the changes in my jaw are still affecting my body. I also needed an atlas adjustment to finally get straight. It was very twisted, as it is for many folks with TMJD. My NM dentist felt that straightening my atlas was key in treating my jaw issues.

I'm wondering if this type of treatment, done by a really well-trained, well-reputed NM dentist/chiro team would help you as you mentioned that your body was holding the changes your PT made for a while. I'm also wondering if the changes in the body need to be accompanied by changes in the jaw to be permanent.

Did you see a physio that specializes in TMJ/orofacial issues or one that understood hypermobility syndrome or both? I went to a regular physio and didn't get any help whatsoever but once I went to one that specialized in TMJ, she was really helpful. I have central sensitization so it's so easy for my pain to be exacerbated by treatments - I really needed a PT (and chiro) who fully understood the nature of this so that they didn't cause me more pain with their treatments. I imagine you might need that as well with your hypermobility syndrome.

Well I really hope you get some relief soon. It's a long, strange and difficult road but don't give up. Keep trying until you find relief. I was mired in pain with so many dentists and professionals who were not helping, causing more pain and drying up my wallet. Finally, I did a ton of research to find the best NM dentist in my area with tons of experience and post-grad work under his belt and I'm now on the road to recovery.

Hoping you find relief soon! Best of luck :)

Olinm 06-09-2012 05:40 PM

Re: Stabilizing following disaster....
Thank you so much for your insightful reply! Our stories are incredibly similar. I had previously been in treatment with a top NM DDS co-treating with a SOT chiro. Unfortunately, I only met with the chiro during the orthotic adjustments (8 week intervals) There was also a lack of communication and coordination between the DDS and chiro and my adjustments never held leading to even more physical distortions. I also question the NM equipment i.e. jaw tracking in order to find the "perfect bite." Did your DDS use this? In my situation the new jaw position was probably too abrupt and with my structural instabilities I was unable to adapt. I remember my chin deviating to the side with the orthotic causing a large muscle knot. I realize there are DDS's who recognize the relationship between jaw and body who co-treat with chiros. I don't believe them to be NM DDS's since they don't utilize jaw tracking or TENS. Am I correct? I've been told that if you have ascending skeletal issues NM will not be successful. I also present with twisted and rotated hips as well as shoulder imbalances and central sensitization (I've not heard it referred to in this manner) Did you have these issues before you began treatment or did the imbalances present as you were working through to correction? I don't want to bombard you with questions but how did your problems initially present and what physical medicine professionals have you worked with? My occlusion has always been unstable since I don't maintain a solid skeletal foundation. My current skeletal issues are largely due to the first dental orthotic. The learning curve is great and it's a long, strange and difficult road to recovery. I'm glad you responded to my post, you really made my day.

judye 06-10-2012 10:17 AM

Re: Stabilizing following disaster....
"The learning curve is great and it's a long, strange and difficult road to recovery" -

It certainly is...I've never heard someone sum up my own experience of this journey quite so eloquently! I'm very happy to connect with you - it really helps to talk with someone who really understands this bizarro journey and can also help fill in the gaps. There's so little information out there for us. I've found this to be one of the very best ways to learn!

So here's a little more of my story to answer some of your question. Yes, I did have the twisted and rotated hips, as well as the imbalanced shoulders, before the TMJD really flared up. I basically was having issues with headaches only and then some dental work seemed to set off the full-blown TMJ picture. I had a root canal (tricky one, curvy root) not done by a specialist and then botched. Infection and another root canal followed. I can't be sure but it may have been the duration my mouth was pried open for that was the trigger - I've read that this is common. I was one of the most severe cases my specialist had seen, with all the TMJ symptoms except ear popping/clicking and fullness. I also had extreme tinnitus, hyperacusis and light sensitivity. Wore sunglasses inside for a time - that was a hard fashion move to pull off! I had to leave work and was marooned in bed for a very long time. It took me a long time to get diagnosed with TMJ (MS was the first dx - I think due to the headaches and the tingling neuralgia) and once I did, I tried a year following the protocol of a traditional NM dentist to the tee. His night guard for bruxism made things worse. He said that there was nothing structurally wrong with me - that it was only muscular and that the only thing he had left for me was botox, which I declined. This was one of the best traditional NM dentists in my city, a big city at that.

Thank goodnesss I found my way to a great NM dentist. I really researched a ton before I decided on one. (He was a NM dentist who co-treated with a chiro by the way...I've also heard of some NM dentists who co-treat closely with chiro's and physio's - I imagine this may be helpful for you) The moment I met him, he could see the bite issue. I have a jaw that is too low and too far back (and trapped there by the front teeth), my top teeth didn't touch the bottom. With no resting place for my jaw over years, it got totally stressed out and the muscles formed knots, trigger points, cementing a constellation of pain in place.

When I went into phase one, functional splint, my dentist (we don't use the term DDS here in Canada - I'm not familiar with it anyways) did use tensing at first and a jaw tracking device to find an initial starting positing for my splint. This may have happened a second time, but overall he tracked my mouth himself and adjusted the orthotic continually and repeatedly until we found comfort. I saw him as soon as things felt uncomfortable and he adjusted the splint accordingly. There was no limit to the visits - my jaw seemed to dictate the frequency and he used his own expertise to find the optimal position after the initial splint was made. I saw my chiro weekly for the first few difficult months of the splint. Things actually got worse before they got better for me. The first 5 months of splint therapy was awful. Many people give up because of this - I'm so glad I hung in there because finally after 5 months I felt relief I hadn't had in years and after almost a year in the splint I was nearly pain free. I guess it's tricky because sometimes people who've been given a splint unnecessarily or by a dentist who botched it up, or have complications outside TMJD, need to stop therapy. Others struggling in spllint therapy are just going through the necessary ills and need to hang in there. Apparently 2/3 of the jaw repositioning for the entire treatment (phase 1 and 2) happen in splint therapy - the first 4-6 months can be quite rough for many.

During this time, I also saw an amazing physio, naturopath, acupuncuncturist (for lock jaw) and I also bought a low frequency at home tensing unit to relax my muscles. I found that until I saw practitioners who specialized in TMJ, nothing helped (tried regular physio, massage, acupuncture and it didn't do anything but create more pain). I also could only work with practitioners who understand central sensitization and would work carefully, slowly, lightly. It was amazingly hard to find them - most people just couldn't understand and caused me more pain! You probably get what this is like...I was pretty close to giving up but I'm lucky to have good support so those around me have kept me going when I didn't have it in me.

I'm now into my second month of functional orthodontics and the pain is still quite low. There are some small up and downs, but overall quite manageable. My NM dentist sees me very frequently - once or twice a week during the first month! I just needed adjustments that often! My top teeth are moving faster than the bottom. He has created build-ups (also known as incisor blocks) behind my top front teeth which are supposed to do two things - hold the bottom jaw forward, in place, and also keep the jaw in a position that is pain free as the molars are no longer touching. He has recreated the build-ups once already to ensure the bite is still good. There are still pieces of the orthotic (build-ups) left on the two back molars and my bottom canines.

Well sorry for the lengthy post - and this is the abridged version!

What makes me hopeful about your situation is that you had some positive results, albeit briefly - "previously in PT I wore a flat plan splint very briefly and my body was holding all of the adjustments my PT made" - I wonder if you will have success working very closely with an amazing NM dentist co-treating closely with physio and chiro. I think it would be important that they really understand the full complexity/complication of your hypermobility syndrome (and possibly Ehlers-Danlos) and feel they can treat carefully and succesfully, keeping this into account. Like me, I think you need a caring dentist who doesn't put a limit on visits - complicated cases often require more. My guess is that you would also benefit from weekly chiro/physio visits during splint therapy.

Well - just some thoughts. Hope you find some of this helpful...I really hope you can finally find relief as i have!

MissyJ 06-10-2012 08:48 PM

Re: Stabilizing following disaster....
I know what you're talking about! My whole body alignment is so wrong. Loss of lordosis, tilting head, and imbalanced shoulders and hips. I also have a BIG problem with my C2. I get it adjusted by the chiropractor, but when I go back to him a week or two later, it's popped out again! I've been going to him for about three months already, but it just won't stay. Very frustrating!

I'm 6 weeks in my orthotic now, and things seem to be going up and down and I really can't tell if I'm improving or not.

Anyway, what I really wanted to ask you was about the atlas adjustment that you had. Might be useful for Olinm as well.

- Did you only need one atlas adjustment or did you have to go back a few times?
- When did you get the atlas adjustment done? (Which month into your splint therapy?)
- Do you think the atlas adjustment was necessary for the success of your splint therapy?

Thank you. Your replies to other members here are always so insightful.

judye 06-10-2012 10:39 PM

Re: Stabilizing following disaster....
Hia Missy,

I'm happy to share any information I can - especially with such a kind and helpful contributor such as yourself :) I've been helped by some wonderful folks on this site. This forum is such a great way for us to share info, support each other and try to figure out this crazy condition!

Gosh I wonder how many more people have this similar TMJ body profile. I can't help but wonder if the effect of the body distortion might be similar to that of trigger points, working as a whole system to keep the TMJD locked in place.

I was quite wary of getting my atlas adjusted. With my central sensitization, even light chiropractic adjustments seemed to set off pretty serious pain for me. Even though I don't like x-rays, I felt it was too big a risk to take without knowing if my atlas seriously needed adjustment. Once I saw that it was very twisted up, I decided to go ahead with it. It only required a very light touch to perform and my nm dentist mentioned that recent research was finding this adjustment to be necessary in the treatment of many TMJD cases. The adjustment happened 3 months into phase one - which was very rough for me for the first 4-5 months, as you may know from some of my posts.

I had a pretty scary reaction to the adjustment actually. A few hours afterward, I suddenly felt very off-balance, slightly dizzy and basically lost in space. Walking was weird, driving out of the question - it felt really awful. This intense part lasted about a week or so. It improved by about 50% in two weeks, after a month, it was mostly gone and completely resolved by 6-8 weeks. My chiro said he'd never had a patient react this way and wasn't sure what was happening. I guess it makes some sense as the part of the brain that regulates balance is the cerebellum, which is found right on top of the spinal cord - not far from the atlas. I don't want this to scare you - it is a very rare reaction apparently and I am very sensitive to any changes in body parts that relate to my TMJD.

You know it's hard for me to say if the atlas adjustment was necessary to my success in splint therapy - my nm dentist would probably say it played an important role. The big turnaround for me started about 4-6 weeks after the adjustment, so that looks favorable. However, this was also aaround the 5 month mark in splint therapy and difficult cases usually start to find relief between 4-6 months. I wish I could give you a more definitive answer. I guess I think that if you are experiencing severe symptoms (like I was) and splint therapy isn't improving your condition, it's really worth getting the scan to see if your atlas is twisted. It's a big decision and everyone needs to work out for themselves whether it's worth the risk. I guess if I could go back in time, I'd still choose to do the adjustment despite the terrible side effects as it seems likely it could have been a key step in my recovery. Perhaps though, I might wait until the 6 month mark and do it then if I hadn't started to see significant improvement.

Wanted to mention to you that my chiropractic adjustments didn't hold either - for at least 3 months. I think that maintaining good posture between adjustments is one of the keys here (besides possibly atlas adjustment), so if you can try to be really vigilant throughout the day, it might help. Watch out for places where you zone out, like the TV and the computer. I put a reminder bell on my cell phone and had it gong every half an hour to remind me to straighten up! I also got fit for a pillow that was posture-supportive and a knee bolster for sleeping so I could stay straight at night and prevent turning on my side, which was painful.

Well I'm pulling you for Missy. It's easy to get down when you are in pain, but try not to let yourself forget that ups and downs are normal in splint therapy and that you are likely experiencing good pains...the pain of healing. As often as possible, imagine yourself recovering completely and your jaw moving with ease into a healthy, pain-free position. I have to say I really admire the spirit of open investigation and warmth that you take to the recovery process.

Please let me know how you make out with chiro and splint therapy and never hesitate to contact me if you have any questions for someone who's made it through to the other side :)

Olinm 06-11-2012 01:31 PM

Re: Stabilizing following disaster....
Hi ....and that was also my "abridged" version!
You were very fortunate to have found a caring dentist. You've always had underlying issues and you gradually reached a tipping point. I had underlying issues but was “pushed” to the tipping point. Have you ever wondered why these skeletal shifts happen in such a small group of people and not the majority? I’ve heard many times that people who have lost and not replaced missing teeth, dysfunctional bites etc. somehow adapt and never have problems. (The Hobo story that dentists love to tell) It could be connective tissue, hormonal shifts or possibly just an isolated weakness in one SI joint or shoulder that doesn’t properly support the unit as a whole. ?? Just wondering if anyone had any further insight. For me, everything refers to one SI joint. It's like I have a loose connection from the jaw / C-spine to the SI joint. Strange. In my situation hypermobility was first mentioned by my doc just a few weeks ago.

When I removed my NM orthotic several months ago not surprisingly everything collapsed from lack of occlusal support. My back molars no longer touch and I had an open bite before so only a few unbalanced teeth currently touch. A complete skeletal shift has ensued. My face has now changed dramatically as the cheeks are sunken, increased pelvic tilt. I believe a stabilizing device will be immensely helpful along with cranial/PT. I’ve always been told I need to work through the pain with an orthotic (as you did) but in my case I think I need to discontinue treatment when I feel the pain. I need an amazing group of people who are able to help but this is proving to be quite difficult. There’s also a reluctance to take on the more challenging cases and previously failed cases due to the liability that’s associated with them. Not to forget the folks who don't believe these things could possibly happen. I feel as though I’m fighting bears everyday. I also wear eyeshades and earplugs and am not able to go to restaurants since the music often times is very loud and the clatter of silverware echoing throughout can be very disturbing. I don't need to wear sunglasses at home.......yet!

I also have the lordosis issue as well as head tilt and C1-C2 always out of place to the maximum. Hmmm, I believe my first C-1 adjustment was made before the measurements were taken for the NM orthotic and then every time I went for adjustments thereafter (usually around 6 weeks or so) My adjustments never held throughout the entire process and I was told the jaw was never in proper position. Yet again, maybe some people are never in place. ?? I didn't have many problems with the adjustments but I was a bit dizzy afterwards but it resolved very quickly. Even when PT moves C1 manually I feel the same way for awhile, a bit uncomfortable but not really a problem. . Hang in there, things will improve!

judye 06-12-2012 04:48 PM

Re: Stabilizing following disaster....
Hi again Olinm,

Boy I do remember the days, not that long ago, when I couldn’t go out in public due to the light and noise sensitivity, when talking, laughing and eating hurt – TMJD can be a really life disturbing experience. Not bad if you are a deaf, anti-social, anorexic mole however. I had to work long and hard to find the right people to help me… I know you’ve already worked long and hard but I think if you keep going, you can too.

I hear what you are saying about how hard it is to find good specialists, especially if you have other health complications. I know it’s hard but I want to encourage you to keep trying until you do find the right help. I believe there are still some good docs out there and if you found one, perhaps you could select the other members of the care team yourself and get them to work together to help you. It’s not an easy task for you to accomplish but I think it may be necessary for you and I believe it’s possible. Hopefully you don’t have to pay for the conferring time, but even if you did – if it led to health success, it’d be worth it. If you are too unwell to do the work in finding the specialists, perhaps a support person (or people) can help you do the research/interviewing, etc... Just an idea.

The more postings of yours I read, the more questions I have about your situation! Now, I really don’t want to bombard you… if you don’t have the interest or energy, please don’t feel compelled to answer them – I won’t mind. On the other hand, if you would like to explore your situation by sharing online with myself and others, I’m curious to find out more about your situation.

The first thing I’m wondering is if you’ve got a definite diagnosis on the hypermobility syndrome front. What are the specific symptoms that point in this direction? You mentioned ligament laxity as one. You also mention skeletal imbalance and distortion – can you specifically describe to me what that means in your situation? How don’t you “maintain a solid skeletal foundation”? Was the ligament laxity/skeletal distortion an issue for you always or only after the splint-therapy disaster? Who mentioned the Ehlers Danlos as a possibility? What symptoms do you have that point in that direction? If you haven’t got definitive diagnoses for these, is it possible either get one or rule it out with certainty? I think that it would be really helpful to know if you have these conditions so healthcare providers can treat you with this in mind. If not, you may wind up in more unnecessary pain and with more unsuccessful treatments. I’d hate to see that.

Why was your second neuromuscular treatment unsuccessful? Was this the dentist who did the jaw tracking and saw you every 8 weeks? Did he jaw track at every adjustment? I feel sceptical about this heavy reliance on this machine and the infrequency of adjustments for someone in your situation. You said that after you removed your orthotic several months ago, everything collapsed from lack of collusal support. Was this a repositional orthotic and was there supposed to be a phase two treatment? In my limited understanding, if the orthotic is providing support and nothing is done to move your bite into a permanently supportive position afterward, things will naturally fall back away. Why did this happen?

You mentioned that you were told that if you have ascending skeletal issues, NM dentistry will be unsuccessful. Pardon my ignorance here but what do you mean by ascending skeletal issues and who told you this?

Today I went to see my doctor of naturopathic/Chinese medicine and we were discussing when to start my trigger point therapy. I have some pretty serious trigger points but my central sensitization is still strong enough that trigger point therapy may be too painful for me as yet. While we were talking, the discussion moved to prolotherapy and I thought of you. I don’t know if you’ve heard of this type of therapy but it might be helpful. It’s almost like the opposite of trigger point therapy. With trigger point therapy, a needle is injected (like acupuncture, either dry or with procaine/B12) into the middle of the muscle knot to loosen it up in order to eventually disband the knot. With prolotherapy, there is a needle injection of sugar water (sometimes with procaine/B12 to help kill pain & promote healing) into the weak ligament or tendon in order to strengthen it, increasing blood supply so that it can repair itself and reattach to bone. I asked my doc if it could help with ligament laxity and hypermobility syndrome and he gave me a pretty positive response that it could. Perhaps something to look into if you did try nm treatment again – or maybe even worth trying on its own. I wonder if you repaired and strengthened ligaments before and during treatment if you’d have a better chance of success.

Well I really hope you can find some answers someday soon – in the meantime, continue the quest. We’re pulling for you!

Olinm 06-14-2012 09:51 PM

Re: Stabilizing following disaster....
Hi Thank you for thinking of me regarding the information your naturopath so kindly gave to you. I'm aware of prolotherapy and this may be a viable option for me at a later date. To answer your questions, I was given a diagnosis of hypermobility by my Internist but it's also been noted in the past by other practitioners. Imaging is also useful in shedding some light on the situation. I could opt to undergo genetic testing but the majority of the genes responsible for these conditions have yet to be identified and there is a tremendous degree of overlap and fine distinctions between the known types. Essentially, my joints are hypermobile and this can be seen very clearly so I'm uncertain what benefit this would produce. I would think you would have some of the same issues due to the skeletal distortions you describe. This is not a typical presentation. I would believe you've been told by practitioners that your dental issues were in no way related to your uneven shoulders/pelvic tilt. Am I correct? It's likely I've always had the tilted shoulders and rotated pelvis however they were subtle observations and I never focused on them and was never in PT prior to my current situation. Throughout my life, I've had issues with occlusal/TMJ joint instability but never made the connection or understood the impact it may have on someone with underlying issues. In the past a simple crown would often times set off immediate cervical pain but it would quickly resolve. I would suspect the root cause of these complex cases are not necessarily dental in nature and unfortunately most dentists are not educated beyond their narrow scope and often times cause more harm than good.

In my opinion, the NM treatment was not successful since we didn't have a clear understanding of my structural issues. In addition, my treatment was not well coordinated and the appropriate PT never delivered. Cases like ours require the utmost attention. Yes, I would have eventually moved into Phase II involving orthodontia following the repositioning orthotic (like you) but I never reached that point. I had to discontinue my treatment due to increased skeletal misalignments (as you had) that were actually increasing and not decreasing. I still have my doubts about jaw tracking. Did your dentist use tracking equipment and, if not, how did he track or monitor your progress? My dentist checked a few times during the treatment period but it remained unchanged. Also, how often did he speak with your PT to make sure you were on track? I know many dentists speak before or after every visit. I hope I'm not bombarding you with questions but in your opinion, what is it that defines NM dentistry? So many dentists within this realm are so vastly different. Also, how did your dentist find "your correct bite" ? To answer your question about "ascending issues" I apologize, I was actually incorrect. I was told that NM dentistry will NOT be helpful with ascending issues WITHOUT physical/manual medicine involved. Essentially, you will need to work the body into proper alignment during your dental treatments. I would be interested in learning if you had issues in the past or if you thought they could have possibly been age related or possessed a hormonally related component. There are not many people who present like we do and it's important that we continue to learn from each other. :-)

judye 06-16-2012 12:13 PM

Re: Stabilizing following disaster....
Hi again Olinm!

Actually once I found very good practitioners, they were ones that did see the connection between shoulder, hips and jaws. When my splint therapy wasn't providing results, my nm dentist sent me to a chiropractor to see what was up with my body and my atlas. The PT I found wasn't referred to me by the nm dentist. I asked her why only the traditional nm dentists refer to PTs (rarely the modern nm ones seem to) and she said that it was because the traditionalists think the muscles are the cause and the dentists don't. I think a good nm dentist will understand that there is always muscle involvement and I've heard of some from people on this site that co-treat with PTs. Interestingly, my own nm dentist had severe TMJ years ago that he treated himself and during his treatment he saw PT, and massage therapists for trigger point release. However, he doesn't co-treat with anyone other than chiro.

I'm really sorry to hear that your nm treatment didn't work out. More and more I think that understanding the definitive cause of one's TMJD is absolutely prerequisite to getting proper treatment. Severe cases like ours definitely need to be coordinated with other specialists like chiro, pt as the body is one system working together - a constellation of sorts - move one thing and all the rest is affected.

My nm dentist worked closely with the chiro and I often visited the chiro immediately before seeing the dentist for splint fitting/adjustments to make sure my body was straight, in alignment, before adjusting the jaw. This makes a lot of sense to me. He did use the tracking equipment at the beginning to find the optimal position and he may have used it once or twice again during treatment. I also believe he used his own expertise and feedback from me on what felt right as guidance in the orthotic adjustment. I could see him as soon as the orthotic felt like it needed adjustment; this helped minimize pain and get me to the optimal position faster. I went in a lot but still feel I needed to go even more. I would have had way less pain in the process if I had!

You ask a really interesting question: what defines nm dentistry? This would be an interesting post on its own as I'm so interested in what others think about this. I posted on this recently so I may use some of that post here. I apologize in advance for the lengthy response but it requires a lengthy discussion!

To sum it up what I’ve learned through my own research and asking “cheeky” questions to healthcare professionals, I’ve learned that the traditional nm dentists believe that the ONLY causes of TMJD include joint and muscle issues. The modern ones include issues such as malocclusion as possible causes. This is rarely spoken of and why depending on which kind of dentist you see, your treatment will be vastly different. I’ll use my experience as an example. I spent an extra year in pain because I started off with a traditional NM dentist and spent a ton of money on treatments (least invasive/safest first) and nightguards that only worsened my situation. Because the cause of my TMJ was a bite issue, and traditional NM dentists refuse to acknowledge this as a real issue, he was no help. He was one of the finest in my city (a big one at that) and he claimed there was absolutely nothing left for me to try, save botox, which I wasn’t willing to try as it is no long term solution and has many complications. I had no idea that there were other types of dentists offering other types of treatments. My desperation finally drove me to research the most highly reputed NM dentist I could. Once found, he saw my bite issue immediately. Finally understanding and observing the definitive cause of my TMJD, I went into reposition splint/orthodontics. I’m one year into treatment and almost pain free for the first time in years.

Now, on the other hand, if someone with a muscle-based issue (say they were a stress clencher with no bite problems) went to modern NM dentist and was mis-treated by being fit with a repositional splint (maybe the dentist is incompetent or looking for $), this person would spend tons of money on the wrong treatment and possibly end up in more pain and/or a bad bite.

People need to know about this confusing divide so that they can try to find the right treatment to fit their specific cause of TMJD.

That said, the treatment protocol varies quite a bit among the modern nm dentists as well– there are no standard practices in place. I believe that this is because the old boys club (traditionalists) still ultimately own and control the playing field. Until the modern treatments are recognized as valid, there can be no formal best practices and people like us desperately seek out the best practices by researching people’s experiences on forums such as these.

Why are the traditionalists so adamantly opposed to the modern nm dentists? I’ve given this some thought and I have a few ideas. By the way, the divide I speak of is very contentious and dentists tend to avoid direct discussion about it. I asked a traditional NM dentist about functional orthodontics and he said something along the lines that The National Health Institute (NHI) doesn’t approve of contest and unproven treatments. But can we really trust the National Institute of Health? Do they only have our best interest at heart? I did some investigating to get some clarity for myself before moving forward with modern treatments and discovered some interesting things.

The NIH been telling us for years (and still claim) that aspartame is safe (although it’s been proven otherwise). If you follow this NIH advice, you risk getting sick from carcinogenic sweeteners! There is a clear conflict of interest here as the NIH government scientists and officials are in the pockets of the food & drug companies whose studies they are conducting. It’s hard for me to trust the NIH when they take large “consulting fees” from such companies – the NIH will have a vested interest in those studies being successful. Using corporate and federal records, the Los Angeles Times, exposed hundreds of NIH officials who took “consulting fees” from drug companies. The drug companies are also making a lot of money off of those whose TMJD remains untreated as they stay in pain and require drugs if no successful treatment is found. This represents a conflict of interest as government scientists are taking in huge consulting fees from the very drug companies getting rich off our pain and suffering. This state of affairs is apparently not uncommon. My husband was reading the biography of a prominent AIDS researcher who claims that there are 3 or 4 possible research areas that could very likely lead to a cure but they are not being pursued because, with drugs, people can live a full life span with AIDS and there is so much money to be made off these drugs. How sad for the folks in Africa who can’t access them. How sad for the folks here that they have to live a drug-addled existence rather than be cured.

Also, significant institutional change is very threatening to the establishment in question (traditional side) and takes time to implement. Imagine once the traditionalists finally include such issues as malocclusion as possible causes of TMJD, they will need to change undergraduate dental curriculum and reeducate the professors, every nm dentist will be required to do more post-graduate work to keep up with changes, they will have to buy expensive new equipment...the list goes on. I believe it’s only a matter of time until the modern NM treatments are accepted as status quo but until then, we remain in a state of confusion and often without coverage for the treatments we need. And NM dentistry remains undefined, leaving people like us to fend for ourselves.

I’m interested to hear your thoughts on all this and anyone else who cares to chime in.

To answer your last question about whether or not there could be an age-related or hormone-related component, well that’s another interesting question! I’m not really sure. I’m curious to hear your thoughts about this possibility as I’ve never really considered it before.

Hope you have a lovely weekend – without too much discomfort!

Olinm 06-17-2012 10:06 PM

Re: Stabilizing following disaster....
I’m very well aware of the many issues surrounding treatment and I couldn’t agree with you more. The average and non-suspecting patient has no idea what lies below the surface. Human suffering created by others is a tremendous business and there is great resistance to change for the reasons you have so well stated. There are options but you need to search and reach for them. I also recognize the contention between the two camps. Traditional dentists are protecting “their turf” and have in the past sought legal action against the NM practitioners claiming a misguided philosophy. As you had so well stated it would change the entire paradigm in the way dentistry is practiced around the world. Actually, from my understanding “traditional dentistry” focuses entirely on teeth. These dentists are usually Pankey trained and believe that teeth are a separate entity. NM Dentists focus on muscles and occlusion yet they are also acutely aware of the “body as a unit” and have awareness of the skeletal discrepancies individuals like us present with. On the flip side, I’ve also been told that NM represents just 1% of practicing dentists and is considered to be antiquated. In what way I don’t know. To further confuse, there are “degrees” within both camps so it’s very difficult to find the proper philosophy or strategy that works best for you. Like snowflakes, no two are alike so possibly titles are unimportant. It’s critical to find a dentist who is kind, forward thinking, exceptionally rational and not motivated by the $. A rare gem. I just don’t have the answers and often times luck must be on your side. As an example, I presented several years ago with a facial skeletal discrepancy and my original “traditional docs” recommended orthognathic surgery. Fortunately, it was never done. Fast forward several years as I continue to peel away the layers of the onion I’ve learned I’m hypermobile. This affects the integrity of the pelvis to a great degree in addition to my other joints. My pelvic instability is not subjective as it can be clearly seen on MRI. A relationship also exists between the pelvis and the jaw. Without addressing these issues in tandem the orthognathic surgery would have been an incredible disaster as the sole focus would have been on the correction of the jaw/teeth relationship forgetting that the body is an attachment. Following these major surgeries many complex patients are often times left in chronic pain and are ultimately abandoned by their providers and/or referred to psychiatry. This is truly a crime. In manyinstances they really don’t know how to “fix you.” It’s very much a mathematical equation. In realizing this everything from that point forward is experimental. There are too many variations and presentations and “standard level of care” has never been established for very good reason.

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