ELIGIBILITY FOR TMJD TREATMENT

Harry Cooperman DDS
Noboro Miura DDS

Since the National Institute of Dental Research (NIDR) has not come up with any "solutions" (meeting of April-May 1996) concerning TMJD: we (International Academy of Myodontics) cannot wait and have embarked on our global research effort to decipher TMJD.

ELIGIBILITY OF PATIENTS WITH TMJD (USA & JAPAN)

1. TMJD pain patients whom have NEVER been treated by the following procedures:

ROOT CANAL THERAPY

a. Equilibration
b. Bite Correction
c. Maxillary splint therapy
d. Mandibular splint therapy
e. Maxillary and Mandibular splint therapy
f. Selective tooth balancing
g. Night guards
h. Bite plates
i. Orthodontia
j. Tooth extractions
k. Muscle relaxants
l. Eating soft foods
m. Appliances to protect TM joints
n. Tooth up righting
o. Wisdom teeth extractions
p. Any tmj surgery
q. Glenoid fossa surgery
r. Pharmaceutical pain killers
s. Mandibular positioners
t. Hot packs
u, Cold packs
v, Mouth exercises
w. Jaw exercises
x. Hypnosis
y. Relaxing exercises
z, Meditation exercises
2. DIAGNOSIS

The production of painful sensation is the organism's most important means for directing attention to body disharmony. The patients description of the location and the character of the pain is often incalculable value in diagnosis although there are times when deceptively referred pain leads to serious error. Alleviation of pain is often the physician's most significant contribution to the patient's comfort although there are times when premature and over enthusiastic use of analgesics has unfortunate consequences.

In general, painful stimuli are referred to anatomic sites or to a physiologic dysfunction.

A committee selected by the National Institutes of Health (April-May 1996) declared that medical science is so unsure about how to treat TMJD, that this disorder has not been accurately diagnosed or described-- and no one is certain whether it should be treated by physicians or dentists or both.

"We are dealing with problems that have no clear diagnosis" said chairwoman Doctor Judith E.N. Albino of the University of Colorado Health Science Center in Denver (1)

Jaw pain is classified under a general title of tempormandibular disorder (TMJD). This condition can include symptoms ranging from aches in the jaw ears and head, dizziness, pain on chewing, a limited ability to open or close the mouth, clicking or popping sounds, when the jaw is used.

Patients spend a $1 billion a year on medical care and drugs for TMJD according to the National Institute of Dental Research.

Historically, tempormandibular disorders were described by J.B.Costen M.D. (1931) and have been recognized as medical problems and no one is certain of treatment to this date.

Doctors Harry Cooperman (USA) and Noboru Miura (Japan) researchers of the International Academy of Myodontics, have included the symptoms of TMJD in their syndrome of " Uvula Tongue Malposture" (Dictionary of Medical Syndromes, J.B.Lippincott.1991).

Their interest in a group of patients, who suffered persistent or recurrent manifestations such as those in tempormandibular disorders, was aroused by the finding of various degrees of irritation of the covering tissues of the dorsum of the tongue and uvula.

Suspecting that the underlying cause of these irritating phenomena might be postural, they demonstrated; first, that mandibular protrusion, as seen in stone age skulls, was a natural protective mechanism that functioned to preserve head, throat and neck physiology occurring after cuspal erosion of the teeth by attritional occlusion; second, that mandibular retrusion, as observed in their patients. causes the dorsum of the tongue and the uvula to impinge on one another, thereby producing irritation in the manner of overlying toes or similar structures; third, that uvula impingement appreciably narrows respiratory and alimentary pathways in the oropharynx; fourth, that these impingements may produce anatomic and physiologic disturbances including pain, breathing, swallowing, eustachian tube dysfunctions; fifth, that mandibular retrusion in itself, may disturb tempormandibular relationships (TMJ) and tempormandibular disorders (TMJD) as described by others; and sixth. that recognition of the basic anatomy and physiology mal-alignment of the mandible may permit the informed physician and dentist to correct the mal-alignment by mechanical measures.

When the publication of Cooperman et al "Organic Tooth Wear--Overlooked in Anatomy Texts" appeared in Medical Hypotheses adjunctive truths were annexed to present day understandings concerning tempormandibular disorders.

Doctors Cooperman and Miura found the condition of uvula tongue malposture syndrome in most of their patients (3). UTMS is the rubbing together of the uvula against the dorsum of the tongue. The space between the tongue and uvula always surfaces in anatomy texts. Texts consistently depict a space between the uvula and the posterior surface of the tongue. This space was absent in all our treated patients practice and research. Why has this missing natural organic tooth wear never been documented in normal occlusion?

Cooperman and Miura believe this new appreciation, of stone age man's abrasive, sandy. unclean, uncooked. hard to chew, food diet, created the consequent tooth-crown wear.

This missing physiologic tooth attrition via the abrasive primitive diet is the missing link to the diagnosis and effective method of treatment of tempormandibular joint disorders patients.

Cooperman and Miura postulated that as organic tooth-crown wear progressed, in primitive man. the mandible and it's attachments became free of dental `locking'. That,`text-book' interdigitation and occlusion of the teeth restrained any natural movements of the mandible.

The following `on the spot' immediate care and non-invasive routine for stopping painful and non-painful TMJD were simultaneously developed at Kaiser Medical Center, Honolulu, Hawaii and in Tokyo, Japan (1980-1987).

Researched patient complaints of pain and non-pain TMJD were:

Headaches Difficulty Breathing
Tight Chest Chronic Cough
Allergies Sinusitis
Face Pain Jaw Pain
Tongue Pain Snoring
Shortness of Breath Asthma
Sleep Disorders Speech Problems
Emphysema Rapid Breath
Wheezing Inflamed Tongue
Bluish Nails or Lips Echoes of Voice
Bronchitis Bruxism
Dizziness Popping of Ears
Facial Paralysis Numbness of Scalp
Post Nasal Drip TMJD
Tonsillitis Eye Pain
Ear Pain Changes in Pitch of
Voice
Snapping TMJ Tongue Biting
Stuffy Nose Throat Difficult to
Clear
Difficult Open Mouth Excessive Saliva
Stuffiness of Nose Apneas
Running Nose Lung Congestion

PREVIOUS DISAPPOINTING RECOMMENDED TREATMENTS BY MD.&/DDS

Neck Traction Psychiatry
Ultra Sound Neurologists
Blood Studies Urine Testing
Pain Killing Drugs Muscle Relaxants
Sleeping Pills Tooth Removals
Balancing Bite Craniopathy
Bite Raising Oral Nights Guards
TMJD Appliances Bite Correction
Orthodontia T.E.N.S.
Jaw Repositioning Muscle Injections
Dieting Swimming
Exercising Tongue Restriction

Diagnosis and treatments for TMJD patients were made by Marcelo Obando M.D., Chief of Otolaryngology, Kaiser Medical Center, Honolulu, Hawaii in U.S.A. and a parallel M.D. & D.D.S. team in Japan.

All patients were fitted with a pair non-toxic temporary maxillary and mandibular intra-oral "TMJD Wedges" atop their
remaining teeth. None of the research patients were edentulous. The wedges were made of mouth guard material in the HIP/ATTRITIONAL plane of occlusion. The wedges infringed and negated any freeway space, contained no interdigitating occlusion, all theories of previous TMJD therapy were discarded, face-bows for mandibular alignment were never used. TMJD wedges are temporary, non-invasive and reversible in this therapy.

Prior to our TMJD approach all patients reported that they had been told, in one way or another, that, "Nothing further can be done," "Research is being done on your problem." and/or "You simply have to live with it."

However, when these patients (80) were diagnosed and treated with our TMJD Wedges over a five year period, all reported significant improvement of their TMJD complaints. Many of the patients stated "I can breathe better." "I sleep better" "I have more energy". "Most of my problems are gone."

Anatomy and physiology texts describe the gear-like apposition, of adult upper and lower teeth, as normal in growth and development. By-passed by academicians is the attritional wear of teeth that results from man's stone age man's food diet. This tooth attrition, which is not taught as a normal physiologic evolution, has been overlooked. Not recognized is that the presence of this tooth wear is nature's wisdom and protection that functions to prevent future head and neck disorders, preserve oral, pharyngeal and breathing physiology throughout life.

As man removed grit, sand and other abrasive food from his diet, he deprived himself of a natural health aid, i.e..
attritional wear of teeth. In contrast, the unworn teeth, characteristic of present day man, prevent anatomic and physiologic changes that normalize the pathways of breathing, deglutition, voice and other physiology. For these reasons textbook tooth occlusion should be re-evaluated.

The International Academy of Myodontics has adopted nature's attritional occlusion as the natural and normal dental occlusion rather than dentistry's present day concepts.

All dental examinations of IAM commence with the establishment of the HIP/ATTRITIONAL plane of occlusion on patient mounted casts. Dental engineering failures are instantly exposed and diagnosis of dental requirements follow.

NOTE:

Dictionary Definition:

Disorder is: A lack of order or regular arrangement.
Confusion
An upset of health or function
Disarrangement

Disease is: An abnormal condition of an organism
or part, especially as a consequence
of infection, inherent weakness, or
environmental stress, that impairs
normal physiological functioning.
Lack of ease.

Which TMJD are you about to treat?

Disease or Disorder?

If disorder: Dentist may treat.
If disorder: physician should treat.

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