Copyright Information Page

This document is a free sample with limited content. It includes:

- Chapters 1 to 4 of Part 1 by Marecello Leonard Mazza PhD

- Chapter 6 of Part 2 by Dr. Jeffrey Brown DDS MBA

Copyright © 2017 by New European Bio-Mechanical DystoniaAssociation. All rights reserved worldwide. No part of thispublication may be replicated, redistributed, or given away inany form without the prior written consent of theauthor/publisher or the terms relayed herein.

New European AssociationBio-Mechanical DystoniaEmail: biomechanical-dystonia@neweuropean.netWeb: www.biomechanical-dystonia.net

Dr. Jeffrey Brown DDS MBASleep & TMJ Therapy2841 Hartland Road, Suite 301, Falls Church, VA 22043, USAWeb: www.sleepandtmjtherapy.com

Index

About this Book1. Why?2. How?3. Disclaimer4. The Bio-Mechanical Dystonia Association

Part I: Causes1. Introduction2. What is Dystonia?3. A Bio-Mechanical Approach to the Human Body4. Bio-Mechanics of Dystonia5. The Neurological Consequences6. Neurologists: Killing the Messenger7. Displaced TMJ Disks - By Dr.J. Brown8. The Dental Connection9. Can you Trust your Dentist?

Part II: Treatment1. A Protocol for the Treatment of Dystonia2. Principles of Splint Therapy and the TMJ3. Postural Alignment and the Molar Lever4. Cranial Derangement and the ALF5. Phase 16. Phase 27. Phase 3

Part III: Case Studies and Personal StoriesPart IV: Questions & AnswersPart V: Resources and Bibliography

Page 1

About this Book“Science is the belief in the ignorance of experts”

By Nobel Prize winner Richard Feynman

Page 2

Chapter1Why do we Write this Book?

In 2013 life was great. I was a 43 year old athlete. I could run

10 km and swim 1 km four or five times every week. Life was

great. Roberto, my son, was eleven years old and was a

healthy, fun, intelligent and loving presence in a happy family.

Nancy and I were in love and life was fantastic... Then

suddenly, my life changed. . My name is Marcello.

One day, out of the blue, I decided to get rid of some gold

inlays and amalgam fillings that I had in several teeth since I

was 18 years old. The reason was purely (and in a very stupid

way) aesthetic: I did not like having that much metal in my

mouth. Unconsciously, I had subscribed to the goal of having a

“Colgate white”, Hollywood smile. I also was keen on getting

rid of the risk of mercury based fillings in my teeth.

Page 3

It was the biggest mistake of my life.

Within 24 hours of that dental treatment, I woke up as twisted

and dystonic as Stephen Hawking. I was tormented with

involuntary, asymmetric muscle spasms that twisted my spine

and mandible. Life would never be the same again.

Page 4

In a matter of days, a horrible series of events torqued my

entire body. The mandible moved massively towards the left

and got jammed into the skull pressing against the left ear. The

whole spine twisted -a true postural collapse. The rib cage

deformed, the pelvis tilt asymmetrically, one leg became

shorter than the other, the eyes twisted within the eye sockets

and the spinal chord within the neck became compressed to

the point that you can appreciate in the image above.

Needles to say, I had to stop working. I was disabled. And I

had to start looking for medical advise. In the following two

years, I visited the best medical professionals, professors and

self proclaimed experts in Europe.

Page 5

The Nuerologists that I consulted diagnosed me with Cervical

Dystonia with degenerative affection of neck vertebres C5-C6-

C7. In their opinion there was no cure and the only possible

treatment to manage the symptoms consisted of Botox

injections in the neck every 3 months to weaken the pulling

muscles. Eventually, treatment would be given with systemic

anti-epileptic drugs if the situation evolved unfavorably towards

Generalized Dystonia.

The Maxilofacial Surgeons that I consulted insisted that the

only possible treatment consisted in surgically removing part of

the mandible and surgically changing the inclination and

rotation of the maxilla to realign the plane of dental occlusion

with the axis of the skull.

Many Dentists and self proclaimed experts in Dental

Occlusion and Cranio-Facial Pain insisted that there was no

cure and that the neurological symptoms were not related to

dental occlusion. Most of them were completely ignorant of the

symptoms and characteristics of Cervical Dystonia. Many went

as far as displaying great personal and epistemic arrogance

and ignorance by declaring that it was a psychological issue.

Page 6

Nevertheless, it was evident from the very beginning that the

Dystonic Symptoms were related to dental occlusion: I had a

set of two orthodontic clear retainers that reproduced the

dental occlusion I had before the negligent dental treatment

broke havoc with my body neurological system. They were

manufactured at the end of an orthodontic treatment that

endured 10 years before.

When I slept with the clear retainers, all the symptoms of

Dystonia went into remission and, within the first few weeks

after the iatrogenic (iatrogenic is a great term -it means

Page 7

damage cause by a doctor) dental trauma, even disappeared

completely.

Closing the mandible with the clear retainers in place caused

the Atlas (the first cervical vertebra – C1) and the Axis (second

cervical vertebra - C2) and pelvis to move and re-align

themselves with the skull and spine with loud “pop” sounds.

Finding a Solution

Since the medical experts could not help, I had to do my own

homework. I had no choice: I had to support a family, an

eleven year old son and even an ex-wife. The only path offered

by neurologist meant that I had to get used to being disabled,

in pain, unemployed, broke, and addicted to a wide list of

prescription drugs for the rest of my life as I watched my body

degenerate.

I had to find a solution. There was no other choice.

Since none of the best European experts in dental occlusion

and dentists were able to stabilize my dental occlusion, I

resorted to building my own dental splints. Below you can find

the very first dental splint that I ever made.

Page 8

In my case, the elimination of all non-vertical contacts by a

dentist with a drill resulted in a collapsed occlusion (picture on

the left) that triggered dystonic symptoms. The use of a dental

splint to reestablish diagonal, lateral and torque contacts

between the dental arches (picture on the right) resulted in

discontinuance of all dystonic symptoms.

Based on my experience that is how I decided to create a team

of patients, medical professionals and researchers to try an

experimental treatment based on Bio-Mechanics to treat and

cure Dystonia.

And that is also why I will write this book using mainly the

pronoun “we.” It truly has been a team effort.

We started writing a blog ( www.biomechanical-dystonia.net )

about the journey and research and experimental treatment

Page 9

that we were carrying out. Today, only three years later, more

than 70 thousand patients suffering from Dystonia from over

150 countries read the blog. 500 patients have joined a private

Facebook group where they exchange information, comment

on progress and setbacks, ask questions and get answers

about the implementation of the Protocol for the Bio-Mechanical Treatment of Dystonia that we have developed.

We will describe the Protocol in Part 2 of this book.

We have set up a non-profit organization: the New European

Bio Mechanical Dystonia Association. This book has been

funded by the Bio-Mechanical Dystonia Association.

And... the million dollar question? Am I “cured?”

I can tell you that neurological symptoms like brain fog,

involuntary muscle spasms, twisting of the spine and pain are

a long forgotten distant memory.

I lead a very active, happy and productive professional and

personal life. My job takes me travelling around 3 continents

more than 160 days every year. I do not use any Botox or

prescription drug of any kind. I have not been able to go back

to running -which was my great passion and hobby- because

Page 10

my spine is not sufficiently stable. Instead, I HAVE to do an

hour every day of exercise: yoga, or stretching, or low impact

and high lung capacity sports as roller-blading and swimming.

An excellent physiotherapist takes care of straightening my

body every month. I have to sleep with a dental appliance

every night. I will probably have to do it for the rest of my life.

To me, that means being “cured.”

The picture above shows the effect that 6 months of bio-

mechanical treatment had on my body.

I want to stress that we do not claim to have found a “cure” for

Dystonia. We absolutely do NOT claim that we can “heal”

Dystonia, Parkinson and Tourette’s syndromes. We have just

observed empirically that the application of the Bio-

Page 11

Mechanical Protocol that we describe in this book results in amajor improvement of the quality of life – and often full

discontinuance of neurological symptoms – for the patients

who applied it.

At the end of Part 1 of this book, we will come back to what

“curing Dystonia” really means. First it is necessary to explain

a few concepts of our bio-mechanical approach.

An Experimental Treatment Based on Bio-Mechanics

The line of research that this book follows is based on the

belief that:

The cause of Dystonia is strictly related to the bio-mechanical derangement of the cervical spine, TMJand cranial bones driven by the weight of the skullthat sinks, falls, leans and gets twisted as it lacksproper support in the dental arches

Page 12

According to this approach, the skeletal, neurological, chemical

postural, muscular and psychological symptoms that are

described by the academic, medical and scientific literature are

consequences of the effort produced by the body to adjust to

this mechanical derangement and the mechanical twisting

strain on the brain stem and paresthesia of the trigeminal

nerve caused by the sinking skull.

As a consequence, we wish to document in this book an

experimental treatment directed at curing Dystonia (as

opposed to merely covering the symptoms with proscription

drugs and making the disease chronic) starting from:

Page 13

Reestablishing sound support and alignment of theskull on the cervical spine, dental arches andTemporo-Mandibular Joints (TMJ)

What is Dystonia?

If you are not familiar with what Dystonia is, don’t be surprised.

Many medical professionals -including the overwhelming

majority of dentists- have never heard the word Dystonia.

What most patients (and sadly a great number of medical

professionals) fail to realize is that the word “Dystonia” does

not identify a specific, well-defined disease (like HIV infection,

pneumonia or any other disease with a known pathogenic, with

a well-defined cause and measurable treatment). The word

“Dystonia” is just a description of symptoms.

Dystonia is not a disease. The word “Dystonia” is only a

description of a very wide range of symptoms and literally

means “dysfunctional muscle tone.”

In the picture below, you will find a graphical description of

some of the most extreme cases of Dystonia.

Page 14

As a description, the word “Dystonia” is as vague a medical

definition as the word “overweight.” For example: “Cervical

Dystonia” means dysfunctional muscle tone in the cervical

spine; “Oromandibular Dystonia” means dysfunctional muscle

Page 15

tone in the mouth and mandible; “Torsion Dystonia” means

dysfunctional muscle tone that causes torsion of the spine. And

so on and so forth...

It should come as no surprise, given this broad descriptive

definition, that people diagnosed with Dystonia may actually be

suffering from a very extensive range of symptoms, conditions,

injuries and diseases that may or may not be related.

Some patients sharing the same or similar symptoms may not

be diagnosed with Dystonia. Some alternative and

complementary diagnoses include: scoliosis, Tempo-

mandibular Joint Dysfunction (TMD), postural collapse and

bruxism. In addition, various neuro-muscular, orthopedic, and

rheumatologic conditions can cause symptoms similar to those

associated with Dystonia.

There is no black-or-white, definitive test to determine if

somebody has Dystonia.

An it should not come as a surprise, given this broad

descriptive definition, that academic and clinical medical

research has failed to find a specific cause and a specific cure

for Dystonia.

Page 16

Mainstream academic and clinical Neurology definesDystonia as a neurological disorder with physicalmovement consequences

From a Bio-Mechanical approach, Dystonia is acollection of physical injuries, derangement andimpairments that produce neurologicalconsequences

We approach dystonic symptoms as the consequence of an

impairment of the ability of the neck to support the skull due to

mechanical derangement and injury. We maintain that a

combination of physical injuries and derangement in the lower

cranial and upper cervical area can cause neurological

dystonic symptoms.

Page 17

In a sense, it could be compared to a massive injury of the

knee such as triple broken ligaments and deranged knee-

cap…. except the injury is at the level of the upper cervical and

lower cranial areas (TMJ, dental occlusion, cranial base, Atlas,

Axis, Occiput and Sphenoid bone).

Is this a New “Revolutionary” Approach?

The answer to this question is a clear, resounding, loud and

schocking “NO.”

The bio-mechanical approach has been researched and

developed for decades with proven scientific results on

thousands of patients. These patients are real people: you

can talk and chat with them in any of the dozens of online

Page 18

groups of patients suffering from Dystonia undergoing bio-

mechanical treatments.

The protocol we describe in this book does not invent anything

new. It is the result of extensive study and integration of

decades of previous research, experiments and practice of

medical professionals, professors, dentists, orthodontists,

technicians and practitioners such as: Dr. Gelb (father and

son), Dr. Gerber, Dr. Bennet, Dr. Stacks, Dr. Brown, Dr. Mew

(father and son), Starecta, Dr. Lee, Dr. Nordstrom, Dr. Sims.

Moreover, the correlation between some sort of dental trauma

and the onset of Dystonia (specially Cervical Dystonia) has

been reported in scientific research papers for decades.

If you run a search with the text “peripherally induced

secondary Dystonia originated by dental trauma” on Google

Academics, you will find 668 peer reviewed academic research

papers. Yet, the overwhelming majority of dentists have no

knowledge that dental procedures can be the cause that

triggers the onset of Dystonia.

Page 19

The dental connection with dystonic symptoms is awell established scientific fact

In Part 5 of this book (Bibliography and Resources) you will

find many relevant peer reviewed scientific research papers

describing dystonic symptoms arising within hours of dental

procedures.

A complete bibliography of the relevant research papers is

published in Part 5 of this book. We have included over 100

peer reviewed academic research papers, case studies and

FDA approved clinical trials that deal with the biomechanics of

neurological movement disorders.

Page 20

Anyone who is active in the multiple online support groups for

Dystonia patients knows that the overwhelming majority of

patients suffering from dystonic symptoms have endured major

dental works such as extractions, equilbration, orthodontics,

rapid palatal expansion, head gear, orthognathic surgery or

implants.

Yet, the major organizations and foundations who grant

millions of US$ for Dystonia research have never funded any

study on this correlation. On the other hand, millions of US$

are spent researching genetic correlation with very

unimpressive results.

The Bio-Electrical/Chemical approach of mainstream academic

Neurology can not explain this connection.

In one of the next chapters of this book we will analyze the

effectiveness, desirability and side effects of the treatments of

Dystonia offered by neurologists. At this stage, it is sufficient

to understand that prescribed mainstream treatments include:

Botox injections to inhibit muscle activity; drugs that change

the chemistry of the brain and Deep Brain Stimulation surgery

to implant electrodes in the brain to produce balanced

electrical currents.

Page 21

The cause of the supposed misfiring of the basal ganglia is not

understood by academic and clinical neurology. Research

deals with possible genetic correlations with very limited

practical results.

The effectiveness of all these bio-chemical/electrical

treatments is limited (some sources that we will analyze in the

next chapters put it at 30%) and the side effects are massive

and crippling for patients.

Moreover, these bio-chemical/electrical treatments do not even

try to cure Dystonia: their goal is to cover and manage the

symptoms.

The bio-mechanical approach is not mainstream because of

the way medical academia organizes research and teaching in

separate systems.

From a bio-mechanical point of view, the causes andtreatment of Dystonia sit between Traumatology,Dentistry, TMD, Orthopedics, Physiotherapy andNeurology

Page 22

It is not mainstream because there is no money and incentive

from pharmaceutical laboratories to fund bio-mechanic clinical

studies and research.

Even though the bio-mechanical and the bio-chemical

approaches stem from opposite principles, it is important to

understand that:

Bio-mechanical and bio-chemical/electricaltreatments are compatible and complement oneanother.

It is possible to carry out splint therapy while receiving Botox

injections, Deep Brain Stimulation surgery and any drug

treatment prescribed by a neurologist. On the other hand, often

and in many cases, a bio-mechanical treatment results in

discontinuance of neurological symptoms and makes it

unnecessary to endure the massive side effects of prescription

drugs, Botox and brain surgery.

A bio-mechanical treatment of Dystonia can be long but

remarkably inexpensive and effective. And it can improve the

quality of life of patients to the point that they do not need

Page 23

lifelong drug treatments and can live a normal active, working

and family life.

We can conclude this chapter with a message to some of the

most important readers of this book: patients, dentist and

neurologists.

Dystonia sits between Traumatology, Dentistry, TMD,Orthopedics and Neurology

Physical injuries of the upper cervical, lower cranialarea can produce dystonic symptoms

Negligent dental work can cause Dystonia

Page 24

Chapter 2How do we Write this Book?

We wrote this book to be useful for both sufferers from

Dystonia and medical professionals treating neurological

movement disorders.

You will find that this book shatters a significant number of

beliefs, principles and practices that are mainstream in

dentistry, orthodontics, orthopedics and neurology. We will

demonstrate how traditional clinical medicine has had little to

offer in the way of understanding, treating and improving the

quality of life of patients suffering from neurological movement

disorders. Indeed, too often we see that mainstream teachings

of dental schools are the original cause of neurological

movement disorders.

This is not an academic research paper. It is written to inform.

We voluntarily chose to use a language that can be understood

Page 25

by the “average Joe” in order to be able to reach as wide an

audience as possible.

The intention of this book is to allow patients suffering from

Dystonia to build a cooperative relation with the team of

medical professionals that helps them, from a position of

understanding, knowledge and empowerment.

We will show that the patient suffering form dystonic symptoms

needs to adopt a cooperative approach with a team that

includes an excellent dentist, a neurologist, an osteopath, a

physiotherapist and a dental laboratory trained in the bio-

mechanical protocol.

In Part 1 of this book we will analyze the causes and skeletal-

structural-neurological correlations of neurological movement

disorders from a bio-mechanical point of view.

In part 2 of this book we will outline a bio-mechanical protocol

that we have developed for the treatment of Dystonia.

This Protocol does not invent anything new. It is the result of

extensive study and integration of decades of previous

research, experiments and practice of medical professionals,

professors, dentists, orthodontists, technicians and

Page 26

practitioners such as: Dr. Gelb (father and son), Dr. Gerber, Dr.

Bennet, Dr. Stacks, Dr. Brown, Dr. Mew (father and son),

Starecta, Dr. Lee, Dr. Nordstrom and Dr. Sims.

This protocol has shown to be effective also for the treatment

of other occlusion related movement disorders, with varying

levels of neurological symptoms (from postural collapse driven

by a sinking skull to Parkinson’s, Generalized Dystonia,

Oromandibular Dystonia and Tourette’s).

We do not claim to have found a cure. We have just observed

empirically that the application of this protocol results in a

major improvement of the quality of life – and often

discontinuance of neurological symptoms – for the patients

who have applied it.

In Part 3 of this book we will show through the words of

patients and medical professionals that a bio-mechanical

treatment can bring about better results with less side effects

than most mainstream drug-based treatments prescribed by

clinical and academic neurology for a large number of patients

and conditions.

Page 27

Part 4 will be dedicated to reporting on case studies and

patient testimonials.

This is not an academic research paper. Nevertheless, this

book is based on a strictly scientific approach stemming from 4

decades of research, clinical trials, case studies and peer

reviewed academic research papers.

Within Part 5 of this book, the reader can find a very

comprehensive list of the relevant case studies, FDA approved

clinical trials, peer reviewed academic research paper, online

patient groups, resources and videos.

Page 28

Chapter 3Disclaimer

This book is not intended as a substitute for the medical advice

of physicians. The reader should regularly consult a physician

in matters relating to his/her health and particularly with

respect to any symptoms that may require diagnosis or

medical attention.

We do not promote a “do it yourself” approach to the treatment

of Dystonia. We strongly believe that the patient suffering form

Dystonia needs to adopt a cooperative approach with a team

that includes an excellent dentist, a neurologist, an osteopath,

a physiotherapist and a dental laboratory trained in the bio-

mechanical protocol.

Moreover, we believe it necessary to get advise, guidance and

support from the multiple online communities of patients,

Page 29

dentists, neurologists, physiotherapist and osteopaths who are

applying bio-mechanical treatments for Dystonia.

The intention of this book is to allow patients suffering from

Dystonia to build a cooperative relation with the team of

medical professionals that helps them, from a position of

understanding, knowledge and empowerment.

Page 30

Chapter 4Bio-Mechanical DystoniaNon-Profit Association

This research behind this book has been funded by the New

European Bio-Mechanical Dystonia Association, a non-profit

organization dedicated to the research, development and

implementation of bio-mechanical treatments for neurological

movement disorders.

The activities and goals of the New European Bio-Mechanical

Dystonia Association include:

Page 31

1. Raising public awareness about bio-mechanicaltreatments of neurological movement disorders.

2. Providing access to treatment, information andappliances for bio-mechanical treatments, specially tothose patients who do not have access to it due tofinancial or geographic reasons.

3. Promoting and funding research and publication ofrelevant articles and books.

4. Producing and funding videos and practical how-to guidesfor patients and medical professionals.

5. Training medical professionals.

6. Organizing and running informal online medical trials ofspecific treatment protocols.

7. Managing, moderating and funding online communities,forums and blogs.

8. Researching and publishing correlation statistics aboutdental/occlusion related bio-mechanical impairments anddiseases.

9. Raising awareness among dentists and the general publicabout the consequences of dangerous/negligent dentaltreatments.

10. Organizing and participating in seminars, courses andcongresses.

Page 32

Part I: Causes“Look well to the spine for the Cause of Disease.“

By Hippocrates

Page 33

This free sample of the Book only includes Chapter 6 of Part 1

Displaced TMJ Disks

By Dr. Jeffrey Brown DDS MBA

To get more information or buy the whole book, please visit our

blog or become a member of the Bio-Mechanical Dystonia

Association

New European AssociationBio-Mechanical DystoniaEmail: biomechanical-dystonia@neweuropean.netWeb: www.biomechanical-dystonia.net

Dr. Jeffrey Brown DDS MBASleep & TMJ Therapy2841 Hartland Road, Suite 301, Falls Church, VA 22043, USAWeb: www.sleepandtmjtherapy.com

Page 34

Chapter6Displaced TMJ Disks

By Dr. J. Brown

When you go to your so-called ‘TMJ Specialist’, it is critical that

certain protocols are honored. And one of those protocols is to

take an MRI of the temporo-mandibular jaw joints (TMJ) in

order to know what you are dealing with.

As someone who exclusively treats TMJ disorders, I have

found it necessary to understand what is going on with the

articular discs BEFORE the patient begins any treatment,

otherwise you are just shooting in the dark.

The reason for this is that in a fair number of patients that I

meet, the discs are already perforated or torn and there is no

amount of therapy that will fix this problem other than doing the

surgery needed to repair or remove the damaged discs.

Page 35

Laterally Displaced TMJ Disk

The image above is a very typical Magnetic Resonance

Imaging scan (MRI) of the TMJ. The top of the jaw bone -

called condyle- is the large whitish thing in the middle of this

image (circle by a white line). The laterally displaced disc is the

black piece hanging off to the left side (circled by a red line).

This is a textbook image of a laterally displaced articular disc.

Page 36

Medially Displaced TMJ Disk

Below is an image of a very medially or inwardly displaced disc.

In both cases, the disc should be almost exactly on top of the

jaw bone, but instead it is pushed off to the side.

In the case of the medial displacement, this is very difficult to

work with because quite often that little disc is tightly ‘jammed’

into the dense tissue in that area and can easily ‘pinch’ nerves

and blood vessels – this is where all the pain comes from.

Page 37

Perforated TMJ Disks

Below is an example of what a perforated disc looks like. As

you can readily see, the condyle (jaw bone) has ground

through the disc and now the condyle is grinding bone on bone

within the socket. This can be not only extremely damaging to

the joint and the condyle, but also very painful as well. This is a

case where surgery is definitely indicated.

This is why the MRI is so critical- why go through all that

appliance treatment if all along you needed surgery anyway?

Page 38

Anteriorly Displaced TMJ Disk

Below, we have the imagery that demonstrates anterior

displacement of the articular disc. This is by far the most

common type of displacement and should be noted that this is

also the easiest type of displacement to correct.

Generally, by wearing a bite splint that takes the pressure off of

the joint region, the discs will self-correct and go back into

proper position if given the chance.

Our appliances are designed to provide freedom of movement

so that the discs can move around enough so that they can

return to proper position over time.

Page 39

How Did the Disk Get Displaced?

One of the most common questions the patients askwhen they discover is: How did this happen?

My response is that the slipped discs are usually caused by

some form of trauma- and that includes birth trauma in many

cases. When a baby is born, and especially if some form of

forceps were used- this is extremely traumatic and it will distort

the skull, twist the cranial bones, and can easily cause the

discs to literally ‘pop’ out of the joints. Years later this will

manifest with the various symptoms that I will describe shortly.

The other question that is often asked of me is: Whydidn’t my doctor/dentist/health care professional tellme about this a long time ago?

Well folks, that’s a great question, and the answer is that none

of this is taught in dental school or medical school. The very

few dentists out there who exclusively treat TMJ disorders

learned through the very few programs out there that teach the

basics, and then there are those like myself who learned by

Page 40

being the apprentice of someone like Dr. Brendan Stack,

arguably the father of TMJ therapy!

Symptoms Associated with Displaced Disks

Now let’s go through some of the obvious symptoms that are

associated with displaced articular discs:

Jaw clicking and or popping are amongst the mostobvious

Headaches and migraines Blepharospasm- lots of eye blinking Brain fog Sleep problems- this may tie into sleep apnea Neck and back pain Comorbidities of TMJ disorder include: Tourette’s,

Parkinson’s, essential tremors, Dystonia, TardiveDyskinesia

Otalgia- Ear Pain Tinnitus- Ringing or buzzing in the ears Inability to open your mouth wide Jaw Pain Jaw clenching/grinding Deviation on opening your mouth

This is why when your doctor examines you for TMJ disorder,

not only must he/she order a well done MRI, but he/she must

also do a thorough exam of the head and neck region.

Page 41

The MRI is sometimes not conclusive due to the patient

moving too much or there might be too much inflammation to

read the images, so treatment might have to be based on

symptoms alone.

Another major facet of diagnosis is the ability of the doctor to

both palpate distorted cranial bones and to see them as well

on the x-ray images. The reason for this is that if the cranial

bones are distorted, oftentimes this means that the joints are

distorted, and therefore the condyles are no longer seated into

level joints – this alone will wreak havoc with the discs as you

can well imagine!

Just think of it like trying to put two new tires on the front of

your car and ignoring that the front end alignment is way off-

your ride will be shaky in no time- just like the jaw bones are

jumping around in those twisted sockets- it simply doesn’t work!

And now just to throw a wrench into the whole thing, taking a

good MRI requires some skill and training. In most cases, I

have had to reject MRI’s done from other imaging centers,

other than the one that I know and approve of.

Page 42

And then we have the issue of reading the actual films, and

that takes some skill as well. Personally, I use Novant imaging

because they have a dedicated Tesla coil just for TMJ imaging.

My other advantage is that the former director of NIH radiology

reads for me- you can’t beat that kind of service! But even

within this group of radiologists that I work with , there is only

the one guy that I trust to read my images- his work is

exemplary- and I have found the other doctors in the same

group sometimes not as capable. So as you can see, it takes a

lot of training and a great radiologist to get good reports on the

MRI images. Even then, I sometimes question the reading of

the MRI- only because all I do is look at these things all day

long!

Admittedly, the field of TMJ and displaced discs is sorely

lacking in consistency and training. There are many doctors

out there who tout themselves as ‘experts’ in the field- hence

my sarcastic statement at the beginning of this chapter. In truth,

there is no specialty at all in TMJ disorders. There are also no

standards that a patient can count on when they see a TMJ

practitioner.

Page 43

For these reasons, many patients end up confused and even

scared as they hop around from one doctor to another. Until

such time as the schools, the dental societies, the ADA, etc.

get some cohesiveness going, patients will be at a loss for

direction.

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Part II: Treatment“As to methods there may be a million and thensome, but principles are few. The man who graspsprinciples can successfully select his own methods.The man who tries methods, ignoring principles, issure to have trouble.”

By Ralph Waldo Emerson

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Part III: CaseStudies and

Patient Stories“To study the phenomena of disease without booksis to sail an uncharted sea, while to study bookswithout patients is not to go to sea at all.“

ByWilliam Osler

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Part IV: Questionsand Answers“To be able to ask a question clearly is two-thirds ofthe way to getting it answered.”

By John Ruskin

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Part V: Resourcesand Bibliography

““Be sceptical, ask questions, demand proof.Demand evidence. Don't take anything for granted.But here's the thing: When you get proof, you needto accept the proof. And we're not that good atdoing that.”

By Michael Specter

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