Myofascial Pain Treatment Methods
The basic premise of neuromuscular dentistry is that healthy physiologic muscle function is basic to all of dentistry and medicine. A corollary to this is: Doctors do not heal their patients but rather they remove the impediments to healing and the body heals itself.
Neuromuscular dentistry is one of the most exciting fields of dentistry. The history of dental treatment has always been mechanical and primarily involved in repairing disease. This changed in 1934 when Dr. Costen, an otolaryngologist, in St Louis , Missouri described a series of problems in denture patients that eventually grew to become know as TMD or TMJ disorders. True to the mechanical background of dentists, they treated these problems as mechanical problems. Dr. Barney Jankelson, a board-certified prosthodontist changed all that. He realized that mechanics were important in treatment of these painful conditions, the underlying muscle physiology was most important. Dr. Jankelson (or Dr J) as his friends called him developed methods of relaxing muscles and measuring physiologic parameters . His work was done in Seattle, Washington now known world-wide as the birthplace of Neuromuscular dentistry.
Due to the Knowledge of Dr. J. and many other great innovators, neuromuscular dentistry became the prominent treatment for TMJ problems.
There was a split in dentistry with many dentists clinging to their outdated mechanical views. These dentists still believe that the jaw joint or the temporomandibular joint is the most important aspect of treatment . They consider themselves to be Centric Relation dentists. Centric relation is the description of a joint position. The fallacy of this belief is reflected in the fact that the definition of centric relation continuously changes, and there are over 20 different definitions. The main belief of this group is that the muscles of the treating dentist’s hands know better where the patients jaw should function than the patient’s own relaxed healthy muscles.
There are other greats in Neuromuscular Dentistry.
Dr. Jim Garry was a pedodontist who described how airway and facial development affected the normal formation of the jaws and face. He was a great advocate of breastfeeding, and his work has changed the lives of tens of thousands of children.
Dr. Norman Thomas is an anatomist, physiologist and dentist who understood the science behind neuromuscular dentistry and how it related to total body health and posture. He is the brilliant man that still enables clinicians to integrate their clinical skills with the underlying basic science. He continues to do some of the most important work in all of dentistry at the Las Vegas Institute (LVI).
Robert Jankelson, Barney’s son, carried on his father’s work and wrote the first textbook on neuromuscular dentistry.
Janet Travell is one of the all time medical greats and is known for her textbook Myofascial Pain and Dysfunction: A Trigger Point Manual. She was President Kennedy’s personal physician. He had severe chronic pain and walked with a limp and cane due to war injuries. Dr. Travell changed his life by letting him live without severe pain.
Jackie Kennedy built the Rose Garden at the White House in her honor because Dr. Travell loved Roses.
I am Dr. Ira Shapira and I was fortunate to be students of these greats of neuromuscular dentistry. I have been practicing the art and science of neuromuscular dentistry for over 25 years . My partner Dr. Mark Amidei, has been with me for over 16 years and also practices using neuromuscular dentistry.
The Las Vegas Institute, considered the premier learning institute, was founded by Dr. Bill Dickerson. His background was from the Centric Relation mechanical school of thought but 10 years ago he had the great courage to abandon the outdated ideas and teach cosmetic reconstruction using neuromuscular ideals. Thousands of dentists around the world are now embracing the science of neuromuscular dentistry. Bill is one of the great men in cosmetic dentistry but he will be best remembered for his work in making neuromuscular dentistry available to the world.
Traditional dentistry operates under the assumption that your jaw’s acquired position is its optimum position. Neuromuscular dentistry, on the other hand is focused on finding the ideal position or range of positions for ideal health. This optimum position for your jaw is the basis for future work.
Our goal is not just to treat a single tooth to solve the problem. Instead, we examine the entire neuromuscular and anatomical system of the head and neck in order to treat the whole patient, alleviating pain throughout the mouth and body.
We strive to treat the whole problem and give our patients a higher quality of life by aligning your jaw in the most comfortable position possible. Posture throughout the body is affected by the jaw and jaw function. The lower jaw acts like a counter balance for the skull as it sits atop of the spine much like the weights that are used in a doctors scale. You set the 50 and the 10 pound weights and the when you get the 1 pound weight perfectly adjusted the scale rests perfectly centered. If you move that weight even slightly in either direction the scale does not go slightly out of balance but rather it goes clunk. That is the effect disruptions in jaw function has on the entire body’s postural balance. I tell my patients, You’ve been clunked.
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