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TMJ Problems:
Many people know that their head hurts. They reach for asprin, Advil, Tylenol or any one or more of a plethora of pain medicatons in the market. They may go from doctor to docor seeking reief. We term this pattern, the medical merry-go-round. They are usually told there is nothing wrong with them after extensive and exhaustive conventional medical tests. Often they are tod they will have to live with their pain. Often, these folks are at the end of their ropes emotionally.
What follows is an attempt to explain a fantastic physiologic process. The "neuromuscular technique" works from approximatly 80% of head pain sufferers. Dr. Meyer has used this technology for 22+ years and is one of the most experienced in the country. Please be sure to read the testimonials at the end of the section for some "real life" experiences.
The jaw joints are a unique set of joints. They are designed to function in a smooth and harmonious manner. Every person has a range of adaptability or tolerance for all areas of their body. The jaw joints and associated structures, when subjected to forces outside the range of adaptability are said to be in dysfunction when functioning with those forces. This dysfunction causes and exquisite irritation of the Trigeminal Nerve. This nerve and associated structures to often become painful as a signal that something is amiss. Sometimes the dysfunction is as simple as a non-painful deviation of the jaw during opening or closing and at other times it can manifest as severe debilitating headaches. Then, the unsuspecting sufferer climbs aboard the medical merry-go-round. They search for answers by going from doctor to doctor, often specialists. Usually they get several rounds of various brain scans, physical exams, blood tests and medication to manage the pain. When those don’t work out after a suitable trial period, they are recommended to a psychologist or a pain management specialist. Alas there is little relief. There are two very damaging, non-pain manifestations. Both are quite insidious. (See Bites or Occlusion)
Our approach to the problem begins with a diagnosis based on history, physical examination and objective biomedical tests. We employ radiographs of the teeth, jaws and jaw joints, additionally the advanced biomedical tests mentined above are Electromyography* (EMG); to ascertain the status of the muscles of the jaws while at rest and also in function. Transcutaneous Electric Nerve Stimulation* (TNS) is used to relax the muscles and Computerized Mandibular Scans* (CMS); are used to track the movement of the jaws through time and space. Add to this; diagnostic models and photographs and you have rounded out the basic diagnostic tools necessary to make the initial treatment decisions. (*Instrumentation manufactured by Myotronics-Noromed, Inc. Tukwila, Washington)
 
This booklet is very informative. Pease call the office and one can be sent on to you. The picture on the right shows a woman having data taken.
Note the obvious differences in the "activity" of one side to the other. This is seen in the images both above these lines.
The above shows a "real time" power clench. Little activity is dysfunction.
Here you can see in the above image to the left, the black dot and the bulk of the vertical lines are not at all coincident.
Here, in this picture, you can see the black dot and the oblique vertical lines are co-incident. This bite system is near perfect.
Once the data is gathered it is analyzed by Dr. Meyer and a plan is designed. This may be a decision to gather additional information based on the outcome of diagnostic block injections or to order a special bone scan (i.e. Cavitat tm). Again after these tests are completed a consultation is scheduled to fully review the tests and the next step(s) in care. This might include a precision oral orthosis, specific care to the teeth, a nighttime bite guard, physical medicine modalities or even surgery. There are also times when combinations of the above might be used to solve ones problems.
Most often (approximately 80%) a precision orthosis is fabricated. It is made out of a clear vinyl that is low in toxicity. The top of the appliance is carved to look like teeth, function like teeth and be your new teeth. The orthosis is worn for twenty- four hours a day except to brush your teeth and clean the appliance. You are then appointed either for a review of the test results or to begin the treatment process. If you begin the process now or later the following occurs. After two weeks from the diagnostic appointment, you return for the fitting of the appliance. This is usually a fairly straightforward process. There are times that a bit more adjusting must be done to the appliance to give you comfort but it is not too long. Our goal at the appointment is to fit the appliance, make it as comfortable as possible, instruct you on its care and most importantly see to it that it is what was ordered. This is confirmed by using the diagnostic computer. We can check it against what had been saved from the prior appointment and verify we have what we want.
You are then sent on and we see you in a week for follow-up. We do this because the introduction of the orthosis to your system can be quite a shift and we want to be able to see any positive benefits or negative occurrences as soon as possible. After this visit, that usually is a short one, you are then appointed for one month. Here the appliance is checked for form and fit and comfort. You grade yourself on the Kinnie-Funt TMD scorecard. This same process is followed at the next few appointments. Here we are just monitoring what your body is doing. There are times now and then that during this period of time we will recommend some type of bodywork. This can be massage therapy, chiropractic or osteopathic care. Remember your system was suffering and ailing. As you return to more normalcy different issues will arise and we want to be ready for you when they do.
At the end of 3-6 months of visits you are then put back on the K6I for a “check-out” session. Here you are given the same battery of tests as the first visit. The difference now however is that you are more healthy. We will usually find one of two things happening at this visit. They are: 1) You are stationary on your orthosis (this is our hoped for outcome) or 2) you have made strides in positive change and now need to have the orthosis altered so the muscles can function at an even better position. This will result in either a new orthosis or a “topping” of the existing orthosis. That decision is made at the time the testing is completed. Seldom will you have to return for the “topping” but you may, this is time dependent.
Once we have met the criteria for a successful outcome or have had to accept the limitations of your particular case the next question is what to do next. The options we have available to us are:
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Equilibration or Coronoplasty; this is the reshaping of the biting surface of the tooth be be in better harmony with your special requirement.
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Semi-permanent removable overlay orthosis; this is similar to the appliance you may have had but is made from a more durable material that will not wear down as readily as the vinyl or acrylic one has.
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Fixed Rehabilitation; this is the permanent altering of your teeth by resurfacing them. This will be either with crowns, laminates, or bridges.
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Orthodontics; the moving of your teeth to a more ideal position to fit your specific needs. This works well when your teeth have not been previously treated by a dentist (or only minimally; i.e. large fillings or crowns)
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Oral surgery; in a very small fraction (<1%) of the cases this is needed.
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Combination therapy; any of the above to achieve the desired results.
See Informative approx. 12 min.Video here: Click here.
Gail Johnson
Scottsdale, AZ
Pain Free
It has been a little over two years since I completed my dental program with Dr. Nicholas Meyer. For the most part I am pain free, I have not taken an aspirin or advil in close to a year, I can sleep at night and have even learned how to relax my jaw. Dr. Meyer is honest, ethical and professional. Most importantly what he did for me worked! It has been two years and I cannot remember being in pain. Now that’s what I call a testimonial.
Here’s my story
When I met Dr. Meyer in 1999 I was at the end of my rope. I had tried everything trying to address my TMD. I had spent years and tens of thousands of dollars on dental treatments, untold dental fillings, crowns and crown replacements, night guards, physical facial therapy and massage.
My symptoms included continuous pain in my jaw-not just that dull ache right near the ear lobes that nagged me night and day, but recurring and long lasting muscle spasms on the sides of my face. I had earaches, pulsating headaches and several sensitive teeth a few of which caused searing pain when I bit down. I could not relax my jaw and was continually clenching my teeth. In addition I endured constant neck and shoulder pain and recurring sinus problems.
I had visited several dentists to no avail and I had just cracked my right rear crown for the third time in a year and was facing replacing it again. I could hardly eat or sleep and I was exhausted. I was taking from eight to ten aspirin or advil per day depending on what type of pain I was experiencing. When I came to work each day I immediately went to the coffee machine and got a steaming cup of coffee just so I could place the warmth against my face. Yep I was a complete mess and desperate for relief. It seemed like the pain and problems were now accelerating at a rapid pace.
Thinking back, I am sure that I had TMD since I was in my teens. I probably was not the most coordinated of kids ad I had a few accidents, A fall off a bicycle face first, facial injury incurred as a passenger in a car accident and I had even ran head first into a parked truck while playing hide-n-seek on my 10th birthday. To top that off I had extensive orthodontic treatment including four extractions.
I did quite a bit of research to learn about treatment options. I spent time on the internet, read several books and reference material. I knew I would not consider jaw surgery and I wasn’t to thrilled about filing down my teeth to make my bite better as my last dentist had suggested. I was looking for a complete expert and someone with experience. I was willing to go anywhere to find the right person to resolve my problem even if I had to travel.
I chose Dr. Meyer because he was extremely qualified with numerous degrees and certifications. Lucky for me he was right in my own backyard in Scottsdale, Arizona. I was able to get an appointment fairly quickly and in a few sessions he completed a comprehensive examination, both visually and with a computer program. He determined that my bite was not in the correct position. He spent time with both my husband and myself in his office carefully describing a plan for correction and answering all of our questions. He provided me with references of current and former patients to call. My treatment did not include any surgery, but rather a bite adjustment.
The bite adjustment was done in a series of phases beginning with mouth guard appliances for both my top and bottom teeth that had to be worn 24 hours a day. Within one to two weeks of wearing them my symptoms had disappeared. After six months I had all of my crowns replaced to match my new bite and I no longer needed the appliances. The transition phase was a bit difficult, but Dr. Meyer was patient, persistent and quick with a reassuring hug when needed. He expertly got everything to line up just right
So here I am two years later, I have never needed another adjustment, I am pain free and don’t have any symptoms. It was a challenge to write this because I have forgotten all of the pain and problems I was experiencing when I first met my friend Dr. Nicholas Meyer. I put my trust in his able hands, he changed my life by bringing me relief I so desperately sought. By the way I now just refer to him as “St. Nick!”
I am writing this testimonial to help those who are suffering from Myo facial pain dysfunction (MPD) and TMJ related pain.
For almost two years, I had chronic head, neck shoulder, back, ear, and facial pain. In addition, I had developed an extremely dry and irritated sinus condition. All of my symptoms started when I was doing my normal daily exercise one day in May of 2000. I had no prior symptoms previously and I was a very healthy and active person who thoroughly enjoyed life.
While the pain was just short of being debilitating, it did adversely affect my family, work and social life. I visited numerous doctors during this period, not one of which could offer a diagnosis of my problem and none of which offered any significant relief for my constant pain.
During this period I sought help for my pain from:
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Family Physician 10 times
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3 separate ENTs
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Osteopathic Cranial Pain Management Specialist
2 separate chiropractors
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Arizona spine center
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Neurologist
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Mayo Clinic
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Musculoskeletal and Rehabilitation Specialist
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Physical therapy
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Family dentist
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Orthodontist Massage therapy
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TMJ doctor for a night guard
Around the middle of May, 2001, after a doctor at the Mayo clinic told me,
“There are things in life doctors can fix and there are things that we can’t and your problem we can’t, so you’ll just have to learn to live with it”, I began searching the internet for answers for my pain, since the general medical community had no answers for my condition. I found Dr. Nick Meyer listed on the internet, while searching for head, neck and facial pain symptoms.
I visited Dr. Meyer in May 2001 and was extremely pleased with how interested he was in my condition and in helping me. However, I had never heard of MPD or TMJ before, and to tell you the truth, I was very skeptical that a dentist could solve my pain, when the general medical community couldn’t. I decided to postpone doing the test Dr. Meyer recommended, because I was a skeptic; what a mistake!
For the next 10 months, I spent over $17,000 of my own money on alternative treatments in search for a cure for my chronic pain. During this period, while I had periods of relief from my symptoms, my chronic condition continued and I became depressed and close to being suicidal. Then in March of 2002, out of sheer desperation, I went back to see Dr. Meyer for help.
Dr Meyer conducted approximately four hours of tests and diagnosed my condition as MPD. After two weeks of treatment my pain had improved by 75% and I felt like a miracle had been performed! My family, friends and co-workers immediately saw a difference in me and how I felt. Within a month, I was able to do something I hadn’t done in close to two years; I went golfing! What a miraculous change in such a short period of time; six months ago I was contemplating not being able to live with the pain for the rest of my life, and now, I’m back to appreciating and enjoying life, thanks to Dr. Meyer.
I truly hope the tale of my journey will help others who are presently in pain like I was and who are skeptics because they are skeptics because they are not familiar with MPD/TMJ. MPD and TMJ related pain is misdiagnosed by the general medical community and often not even acknowledged. Dr. Meyer is not only an expert in TMJ/MPD, but he is also a person who cares.
Dr. Meyer, thank you for caring and thank you for allowing me to enjoy life again!
Bill Medora
Scottsdale Arizona
Dr. Meyer has his new Holistic Biological Dentistry Site being developed here. (Click Here)
Dr. Meyer also has his Snoring & Sleep Apnea site here. (Click Here)
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