M was at her husbands consultation and Dr Shapira noticed she held her temple during the appointment and asked if she had a headache. She did, and he used a simple technique to relieve her pain. This was a first for M who had never experienced this in 50 years of living with chronic headache pain. Neuromuscular Dentistry was discussed briefly at that visit and at the second visit her husband received his oral appliance to eliminate his sleep apnea and snoring and M began her Neuromuscular Dentistry treatment.
M recieved a Diagnostic Neuromuscular Orthotic that day and except for one day has been headache free since that time. M does report that when she is sick she may get a headache but it is different than the headaches she lived with for most of her life.
What is Neuromuscular Dentistry and what is a Diagnostic Neuromuscular Orthotic and how does it work?
An article that Dr Shapira was asked to write for the American Equilibration Society is one of the best explanations available online and has been reprinted in Sleep and Health Journal. http://www.sleepandhealth.com/
In the most simple terms the way Neuromuscular Dentistry works is change input and output from our brains and central nervous system to Muscles, Joints, and nervous system end organs in the Trigeminal Nervous System. Our brains are similar to computers. GARBAGE IN- GARBAGE OUT explains in computer lingo how bad input leads to bad output. The brain is basically a biological computer and GARBAGE IN- GARBAGE OUT holds true when it comes to our brains.
Input to the brain comes from two sources, input from the spinal column which accounts for 20% of the total input to the brain and input from 12 pairs of Cranial nerves that accounts for 80% of brain input. The Cranial nerves are responsible for sight, smell, taste, vision, hearing, proprioception and control of the autonomic nervous system.
The TRIGEMINAL NERVE accounts for approximately 70% of the input to the brain from the Cranial Nerves or more than half of total brain input. The Trigeminal Nerve is also known as the Dentist's Nerve. It goes to the Teeth, Jaw Joints, Jaw Muscles, the Periodontal Ligaments of the teeth, the muscle that tenses the Eardrum, the muscle that opens and closes the eustacian tubes, the innervates the lining of the sinuses and nasal mucosa. It also controls the blood flow to the anterior 2/3 of the meninges of the brain. When we smell menthol that is another trigeminal nerve function which may be why Vicks Vapo rub works for many pains.
The TRIGEMINAL NERVE also has a enormous autonomic component and is a chief cause of CENTRAL SENSITIZATION. Central Sensitization is a primary aspect of most headaches and migraines, facial pains, fibromyalgia and almost all other chronic pain syndromes.
GARBAGE IN - GARBAGE OUT takes on new meaning when we are talking about the majority of input to the brain. Neuromuscular Dentistry turns bad data our brain recieves into good data. Central Sensitization can turn good input into bad output. Examples are Hypersthesia where there is an over-reaction to pain stimuli and Allodynia where non-painful input is received as Nociceptive of Pain inpulses. The Trigeminal Nerve is also vital for controlling respiration and airway patency. The National Heart Lung and Blood Institue issued a report "CARDIOVASCULAR AND SLEEP RELATED CONSEQUENCES OF TEMPOROMANDIBULAR DISORDERS" which is available at http://www.nhlbi.nih.gov/
Dr Shapira created http://www.ihateheadaches.org to help patients understand Headaches, Migraines and how Neuromuscular Dentistry is an essential and vital treatment resource.
Why do patients suffer for years if there is a treatment that can so drastically improve their lives?
Do problems addressed Neuromuscular Dentistry actually affect health and medical costs?
Cranio, The Journal for CranioMandibular Practice published two articles that answer that question. The studies by Shimshak et al showed that patients with TMJ disorders had a 300% increase in medical utilization in all fields of medicine except obstetrics. In other words, aside from not getting pregnant these patients utilize three times the average in medical expenses.
The NHLBI report discusses how respiratory disorders related to TMJ disorders can effect many body systems. Dental Sleep Medicine is an extremely effective approach to treating sleep apnea. It is more effective overall than surgery. CPAP is still considered the Gold Standard of treatment for Sleep Apnea but has horrendous issues with patients compliance.
That means it works well if used but most patients do not use it. A recent study showed that 60% of patients did not use CPAP. One study cited at the Trucking and Sleep Apnea conference presented by the American Sleep Apnea Association showed only 5% of truckers using their CPAP. Patients prefer oral appliances to CPAP when offered a choice but most patients are never given a choice. That would be understandable if CPAP compliance wasn't an issue. Studies of patients who do use their CPAP show that they average only 4-5 hours a night of use not 7-7 1/2 that is ideal.
Patients with untreated sleep apnea have up to a six-fold increase of risk of heart attacks and strokes which usually occur in the early morning hours when most CPAP users have already stopped utilizing their CPAP.
Dr Shapira created the website I HATE CPAP! to hellp the majority of patients who could not tolerate treatment with CPAP. Thousands and Thousands of patients visit this website every single month which leads them to appropriate and scientifically supported treatment.
Treatment and prevention sleep apnea with oral appliaces is now well accepted but is still fighting for its proper place in medicine. In a few years oral applliances will probably account for a vast majority of treatment of mild to moderate sleep apnea.
Morning headaches have two primary causes, TMJ disorders and Sleep Apnea. The NHLBI says Sleep Apnea is a TMJ disorder. There is an FDA approved appliance for preventing Migraines the the NTI-TSS appliance.
The Aqualizer appliance, invented by Dr Martin Lerman is an a simple inexpensive appliance that can produce incredible success but does not offer permanent correction.
It was used to keep M free of pain between her first and second appointment.
Neuromuscular Dental treatment starts with a Diagnostic Orthotic. When treatment effectiveness is assured patients can proceed with long term phase 2 treatment of a permanent removable orthotic, orthodontic correction of Neuromuscular Reconstruction. Patient M chose reconstruction which not only eliminated her headaches but also gave her a beautiful new smile.
The Aqualizer and NTI-TSS are excellent tools but they do not provide definitive treatment.
Dr Shapira's Team can make arrangements for patients from outside of the Chicago area
to have an intensive course of treatment if Dr Shapira accepts them as patients.
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I HATE CPAP! LLC provides information on Sleep Apnea, Dental Sleep Medicine and alternative to CPAP for patients who are CPAP intolerant. The website http://www.ihatecpap.com has valuable information on treating sleep apnea utilizing oral appliances.
I Hate Headaches supplies information on Neuromuscular Dentistry on its website http://www.ihateheadaches.org
Dr Shapira maintains a general dental practice in Gurnee, Illinois and is president of Chicagoland Dental Sleep Medicine Associates. http://www.chicagoland.ihatecpap.com/