Dr Shapira is the founder of I HATE HEADACHES LLC and Dr Kevin Ladesic was the first dentists in Wisconsin asked to become a part of the website http://www.ihateheadaches.org a website dedicated to Neuromuscular Dental treatment and prevention of headaches including Migraines, Episodic Tension Type Headaches, Chronic Daily Headaches, Sinus Headaches, Occipital Headaches, Parietal Headaches, Retro-orbital Headaches and all headaches related to the Trigeminal nerve.
Dr Ladesic is also a member of http://www.ihatecpap.com another website started by Dr Shapira, a pioneer in Dental Sleep Medicine. Patients can see Dr Kevin Ladesic in his West Salem dental office.
"Kevin is one of a small select group of dentists that I would trust to treat my family or me" according to Dr Shapira, a Gurnee Illinois dentist. Not only because of his extensive knowledge and training but because he is a good person at heart. When treating chronic pain who you are can be as important as what you know. "I am sure that Kevin cares about each of his patients. I saw his caring attitude over the years when we worked together closely.
It has been estimated that as many as 30-48 million Americans have chronic headache or migraine. Approximately one in six Americans suffer from headaches. They are divided into two groups Primary and Secondary Headaches. The Primary group accounts for more than 90% of all headaches and include tension headaches or muscular contraction headaches, vascular or migraine headaches, and cluster headaches.
It is these primary headaches sufferers that neuromuscular dentistry can help. Recent studies in Cephalgia estimate that a large percentage of these patients have overlapping disorders and that treatment of the patients TMD disorder can have positive effects on eliminating the problems. A study in Cephalalgia. (2008 Aug;28(8):832-
A second paper published in Cranio (2009 Apr;27(2):101-
The article also reported clinically significant reduction or resolution of tension-type headaches. The new website http://www.ihateheadaches.org concentrates on how neuromuscular dentistry can be used to reduce or eliminate tension-type headaches and migraines. A recent article on Neuromuscular Dentistry in the American Equilibration Society publication "Contact" was reprinted in Sleep and Health Journal and can be found at http://www.sleepandhealth.com/
Two articles published in Cranio by Shimshak et al showed that there was a 200-300% increase in medical costs in all medical field in patients carrying a diagnosis of a TMJ disorder. This should be considered especially important as we try to control expansion of medical costs. A study in Cephalgia (2009 Apr 30.) "Application of ICHD-II criteria for headaches in a TMJ and orofacial pain clinic." found that ". In 502 temporomandibular disorder and orofacial pain patients, 246 patients (49%) were diagnosed with tension-type headache (TTH), followed by migraine without aura (14.5%), probable migraine (12.9%), migraine with aura (7%), probable TTH (4.8%) and cluster headache (0.2%). " It also found that "Of the headache patients, 81.1% presented with masseter muscle pain and 47.8% with temporal muscle pain." They concluded by suggesting that these muscle pains " may be an inducing factor of primary headache."
The Trigeminal nerve is what TMJ,TMD, tension-type headaches (previously chronic daily headaches) and migraines have in common. The trigeminal nerve is implicated in most migraines because it controls the blood flow to the anterior two-thirds of the brain thru the meninges. The Trigeminal nerve is also called the Dentists nerve because it supplies nerves to the jaws, jaw joints, jaw muscles, the tongue, the lining of the sinuses (ie sinus pain or headache), the tensor of the eardrum and the muscle that controls the soft palate and eustacian tube. TMJ disorders are sometimes called The Great Imposter (http://www.sleepandhealth.com/
A new article in Medical Hypothesis (Med Hypotheses. 2009 Sep 16) "Migraine, neuropathic pain and nociceptive pain: Towards a unifying concept." presents the case for a unifying theory of the three commonest pain syndromes affecting humans, migraine, neuropathic pain and nociceptive pain. They address the issue that the two theories of migraine pain, central mediation vs periferal and suggest they share the same pathophysiology. This is exactly what neuromuscular dentistry proponents have taught for years.
The authors conclude "At the end, we suggest that fundamentally all the three pain syndromes referred to in the article share a common pathophysiological mechanism, namely peripheral pain perception, peripheral sensitization at dorsal root ganglion or its intracranial counterpart (like trigeminal ganglion) and central sensitization at the spinal cord (dorsal horn for somatic pain), brain stem nuclei and thalamus before final pain perception at the sensory cortical matrix." The problems of TMJ disorders (TMD) are often related to central sensitization of the trigeminal nerve secondary to nociception (painful impulses received by the brain) from peripheral problems.
Neuromuscular dentistry can effect over 50% of the nervous input to the brain in a positive way to reduce nociceptive input from peripheral nerves and thereby prevent both the neuropathic pain and central sensitization. There is a second theory that migraines are caused primarily thru vascular rather than neurogenic means. This would also be explained by the Medical Hypothesis article"Migraine, neuropathic pain and nociceptive pain" as the trigeminal nerve controls the blood flow to the brain and both central and periferal influences could cause pathological blood flow leading to migraine or other intracranial vascular disorders. Neuromuscular dentistry would still be suited to treating the vascular headaches thru correction of trigeminal nerve regulation.
There is a large overlap between TMJ symptoms and symptoms associated with sleep apnea. Morning headaches in particular are nearly always related to either sleep disorders or TMJ disorders. Sleep bruxism and sleep clenching are considered to be sleep disorders primarily that negatively effect the TM Joint and trigeminal nerve controlled muscles.
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Dr Ira L Shapira is an author and section editor of Sleep and Health Journal, President of I HATE CPAP LLC, President Dato-TECH, He has recently formed Chicagoland Dental Sleep Medicine Associates. He is a Regent of ICCMO and its representative to the TMD Alliance, He was a founding and certified member of the Sleep Disorder Dental Society which became the American Academy of Dental Sleep Medicine, A founding member of DOSA the Dental Organization for Sleep Apnea. He is a Diplomate of the American Board of Dental Sleep Medicine, A Diplomat of the American Academy of Pain Management, a graduate of LVI. He is a former assistant professor at Rush Medical School's Sleep Service where he worked with Dr Rosalind Cartwright who is a founder of Sleep Medicine and Dental Sleep Medicine. Dr Shapira is a consultant to numerous sleep centers and teaches courses in Dental Sleep Medicine in his office to doctors from around the U.S. He is the Founder of I HATE CPAP LLC and http://www.ihatecpap.com