Dentist
Information
Harry Cooperman D.D.S.
Nobora Miura D.D.S.
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 (1996) declared that medical science is so unsure about how to treat MMD 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.
Jaw pain is classified under a general title of MANDIBLE MALPOSTURE DISORDER (MMD). This condition could include symptoms ranging from aches in the jaw ears and head, dizziness, pain at chewing, a limited ability to open or close the mouth, clicking or popping sounds, when the chewing, opening and closing.
Patients spend a $1 billion a year on medical care and drugs for according to the National Institute of Dental Research.
Historically, temporomandibular joint 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 MMD in their syndrome of "
Uvula Tongue Malposture" (UTMS) Medical Dictionary of Syndromes,
J.B.Lippincott.1991.
.
Their interest in a group of patients, who suffered persistent
> or recurrent manifestations such as those in temporomandibular
joint 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 of breathing, swallowing, eustachian tube dysfunctions;
fifth, that mandibular retrusion in itself, may disturb temporomandibular
joint relationships and MANDIBLE MALPOSTURE DISORDERS (MMD) as
described by others; and sixth. that recognition of the basic
anatomy and physiology mal-alignment 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 (1992) adjunctive truths were annexed to present day understandings concerning MMD.
Doctors Cooperman and Miura found the condition UVULA TONGUE MALPOSTURE SYNDROME (UTMS) present in most of their patients. 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.
Absent in all our patients, practice and research, was the attritional wear of the tooth crowns. Why has this natural organic tooth wear not been documented as normal occlusion? Cooperman and Miura believe this new appreciation of the mastication of stone age man's abrasive, sandy. unclean, uncooked. hard to chew, food diet, created consequent tooth crown wear. The tooth wear is the missing link to the diagnosis and effective method of treatment for temporomandibular joint disorders patients.
Speculating as organic tooth crown wear progressed, in primitive man. the lower jaw and attachments became free of dental `locking'. That,`text-book' interdigitation and closure of the teeth restrained any natural movements of the mandible. This, very unfavorable to our treatment of MMD
The following `on the spot' immediate care and non-invasive routine for stopping the pain. and other patient characteristics of MMD, were developed at Kaiser Medical Center, Honolulu, Hawaii and in Tokyo, Japan simultaneously. (1980-1987)
Patient complaints of pain
and non-pain researched MMD were:
Ear Pain
Eye Pain
Bruxism
Allergies
Face Pain
Dizziness
Tonsillitis
Bronchitis
Wheezing
Headaches
Stuffy Nose
Tight Chest
Tongue Pain
Emphysema
Rapid Breath
Tongue Biting
Snapping TMJ
Running Nose
Facial Paralysis
Sleep Disorders
Cough Sinusitis
Post Nasal Drip
Echoes of Voice
Popping of Ears
Excessive Saliva
Jaw Pain Snoring
Inflamed Tongue
Stuffiness of Nose
Numbness of Scalp
Shortness of Breath
Bluish Nails or Lips
Difficult to Swallow
Difficult Open Mouth
Throat Difficult to Clear
ApneasLung Congestion
AsthmaSpeech Problems
AsthmaSpeech Problems
Changes in Pitch of Voice
Difficulty Breathing Chronic
Previous disappointing recommended treatments M.D. & D.D.S. prior to surgery.
Dieting
T.E.N.S.
Exercising
Psychiatry
Swimming
Bite Raising
Ultra Sound
Sleeping Pills
Orthodontia
Craniopathy
Neurologists
Urine Testing
Blood Studies
Neck Traction
Balancing Bite
Bite Correction
TMJ Appliances
Tooth Removals
Muscle Relaxants
Muscle Injections
Jaw Repositioning
Pain Killing Drugs
Tongue Restriction
Oral Nights Guards
Diagnosis and treatments for MMD 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 non-toxic temporary upper and lower intra-oral 'MMD Wedges". None of the research patients were edentulous (wearing complete dentures). The wedges were processed in the hamular-incisal-papilla plane (HIP/ATTRITIONAL) of occlusion. Infringed on the freeway space, contained no interdigitating occlusion nor contained freeway space.
All previus methods to treat MMD were discarded. MMD wedges are prescribed in this non invasive and reversible itherapy.
Prior to our MMD 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 MMD Wedges over a four year period, all reported significant improvement of their MMD 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 is the attritional wear of teeth that resulted from 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 preserve oral, pharyngeal and respiratory physiology throughout life. As man removed grit, sand and other abrasive food from his diet, he deprived himself of a natural. i.e., attritional wear of teeth.
In contrast, the unworn teeth, characteristic of present day man, prevents 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.
Dictionary Definition:
Disorder:
A lack of order or regular arrangement. Confusion / Disarrangement
An upset of health or function
Disease:
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 MMD are you about to treat? disorder ~or~ disease?
If disorder... dentist may treat.
If disease... physician should treat.