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Jaw locks seldom get better on their own. Without treatment, they normally get worse, get more frequent and lead to more damage to the TM Joints. Jaw locks can be closed locks or open locks. This case history is that of a “closed lock” -meaning the jaw is locked when the mouth is closed and the disc is out of place preventing the jaw from opening normally.
This is a medical doctor who figured out how to manipulate the jaw to unlock. But since the jaw alignment was poor, the jaw locks recurred until the jaw would lock every time he closed his mouth. He had tried a mouth guard from one ‘TMJ expert’ for 2 years. He then went through 2 years of orthodontics hoping to resolve the TMJ locks. The teeth were straighter, but the jaw locks never improved. He was unwilling to have jaw surgery since he was managing OK.
When he learned about Physiologic Neuromuscular Dentistry, he looked into that for a solution. He realized that Dr Raman is a recognized TMD expert in his profession. After the optimal jaw alignment was diagnosed through Physiologic Neuromuscular Dentistry protocols, he chose to have Phase 1 PNMD orthotic treatment done. IMMEDIATELY after the orthotic was placed, the jaw locks were resolved! After 20 years of jaw locks, which was not corrected with splint therapy and orthodontic braces, PNMD orthotic corrected the jaw alignment problem and resolved the jaw locks! Headaches and neck pain also resolved.
Angela and her family live in Kenai peninsula, Alaska and have traveled to Kansas City to seek help from Dr Raman. She has been suffering with severe vertigo for about 8 months and more recently extreme ear pain and Migraine.
Initially Angela went to her dentist to have a filling done and left the office that day in extreme pain. It was then determined that this tooth could not be saved and would need to be removed. Angela decided to have both of her lower wisdom teeth removed at the same time along with the lower right molar.
Angela was put under with IV sedation and had all three teeth removed. She was unable to bring her teeth together for about 8 days due to the amount of swelling. Three days later she had a migraine and the severe vertigo started. Angela went to the hospital and was told that she had an anxiety attack. She then decided to see an ENT who ruled out BPPV (Benign Paroxysmal Positional Vertigo). They also did an MRI, CT scan and hearing tests. All of these tests came out negative. The ENT specialist told her that her symptoms had NOTHING to do with TMJ or her teeth loss.
At this point a family friend who is also a dentist was the first one to mention that it could have something to do with her TMJ and recommended that she see a massage therapist. She also had lower back adjustments done by a chiropractor and her symptoms just got worse. Angela then made the decision to see a TMJ doctor in Anchorage who made her a lower acrylic guard to be worn at all times except when eating. The vertigo was so bad that she could barely walk out of his office.
At this point Angela felt stuck. She was unable to eat and could not even get in a car for 3 weeks. She has 2 young children ages 6 and 3 and couldn’t even drive her son to school because of the vertigo. Her anxiety level has been very high trying to deal with all of this and she did not want to spend her life this way. Her husband Jeremy then found Dr Raman on the internet. Once Angela realized that the more she moved her jaw around the worse the vertigo got, Dr Raman’s Physiologic Neuromuscular dentistry approach made a lot of sense.
Once Dr Raman determined that there is a jaw alignment issue, Angela went through a series of diagnostic testing. A detailed consultation was done with Angela and Jeremy and they made the decision to proceed with the phase I treatment option. She was then fitted with a fixed neuromuscular orthotic. Just five days after the orthotic was delivered Angela was doing really good. She said that she had one of the best days that she had in the past 8 months.
Angela said that her vertigo did not spike and she was able to drive. She was enjoying spending time with her family and is excited to keep moving forward.
Does Physiologic Neuromuscular Dentistry (PNMD) seem ‘just too simple’ to resolve debilitating Migraines? Is it too hard to believe that neck pain (after an injury) and back pain (after disc herniation surgery) could ALSO resolve through PNMD? Dana thought that there is no way a ‘dentist’ could help her with Neurologist diagnosed Migraine that was barely controlled with Zomig. Even after a friend that had her Mayo Clinic diagnosed Fibromyalgia resolved through PNMD referred her, it was just too hard to believe! Until she checked it out herself as a ‘last resort’!
Dana suffered with debilitating migraines and severe neck pain for 14 years. At times the pain would get so bad that she would have to go to the hospital and gets shots. She felt as if she had so many lost days in her life. Dana was on several medications to try and control the pain that were prescribed to her by a neurologist and her general practitioner. These medications consisted of Naproxen, Zomig and Phenergan for nausea.
Dana heard about Dr Raman through a friend who had also suffered with TMJ symptoms and was already in treatment with him. She was skeptical at first because she has tried so many other things. At this point she started to feel very depressed and sick almost every day. She thought that she was going to have to live with the pain for the rest of her life and felt like this was her last try at getting help.
Dana came to see Dr Raman initially for a consultation and then went through a series of neuromuscular diagnostic testing. Once the correct jaw alignment was determined she was then fitted with a fixed Physiologic neuromuscular orthotic for 90 days. She first felt the biggest difference in her neck pain and range of motion. She said that she has improved immensely and has no more back spasms, sleeps better, headaches much improved and no more lower back pain.
Dana is now in the Physiologic neuromuscular functional orthodontics phase of her treatment. She now has a lot more energy and even her family sees a difference in her. She is very excited. The best part of this is how it impacted her daughter’s wedding. Dana felt so well that she made all the table decorations and made all the hors d’oeuvres at home by herself over several days. She could not have even imagined being able to do all of that prior to her treatment. That made the wedding very special for the whole family. THAT is the power of PNMD and its impact on families as well as on the guests we help.
Isn’t Vertigo, a medical condition? How can a dentist possibly help vertigo? One of the symptoms of a poor jaw alignment is vertigo. In such cases, PNMD can definitely help.
Unrelenting Vertigo resolved through Physiologic Neuromuscular Fixed Orthotic when medications did not help. AO chiropractic adjustments helped for short periods. Previous Neuromuscular removable or fixed orthotics worsened the vertigo.
Veronica lives in Dubai, United Arab Emirates and traveled to Kansas City to seek treatment from Dr Raman. She has been suffering with severe vertigo as well as neck pain, headaches and shoulder pain for the past 5 yrs. She would always feel off balance. Even raising her arm and picking up light weights would bring on vertigo. Her symptoms first began after having 20 Lumineers done in Lebanon for cosmetic purposes. She had her first “violent vertigo attack” immediately following that.
Veronica sought help from several different doctors including 3 neurologists who were very thorough, had MRI, MRA and CT scans done of her brain and spine. No cause of her vertigo was diagnosed. She then consulted with 5 ENT specialists who ruled out Meniere’s and Benign Positional Vertigo. When medications did not help, she was told by all of these doctors that she would just have to learn to live with it. She then decided to see a Physical therapist, a Chiropractor and an Osteopath. Those treatments actually worsened her symptoms. Her symptoms slightly improved with the Atlas Orthogonist Chiropractor at least for short periods. He is the only one who mentioned that her symptoms may be related to her jaw alignment. Poor jaw alignment affects the AO alignment. So his AO cervical adjustments would not ‘hold’. Much credit should go to this AO chiropractor since he alone pointed Veronica in the right direction when all the medical specialists were telling her that is due to “stress” and “just have to learn to live with vertigo”. So she saw a neuromuscular dentist near her and was treated for 8 months .
Veronica was first given a removable orthotic that she wore at night time only. She was then fitted with a bonded orthotic. The bonded orthotic made her “violently ill” for the 10 days that she had it in her mouth. They decided to discontinue treatment and had the orthotic removed. Several people that Veronica knew kept telling her to go to America for treatment. She did a lot of research on the internet and found Dr. Raman as well as a doctor in California and one in Nevada. After much checking she decided that her best chances for getting better is to be treated by Dr. Raman in Kansas City, Missouri. She saw more examples of difficult cases that he had treated than the other doctors. The only thing he could promise was that he would do his very best to help her.
Veronica was seen on a Wednesday for examination and diagnostic tests. Two days later, her Physiologic Neuromuscular Fixed orthotic was delivered on Friday afternoon. No adjustments were made. Her jaw and rest of the body needed to adjust to the alignment correction of the orthotic.
At her First follow up visit on Monday morning, 2 days post orthotic delivery, Veronica said that she had absolutely no vertigo, no neck/shoulder tightness and has been able to eat just fine. She said that she feels quite relaxed. She was vertigo and shoulder pain free after suffering for 5 years.
It is hard to measure the life impact of this treatment in this woman’s life compared to how it would have been in her family life, social life and general happiness if the unrelenting vertigo had continued. After all neurologists told her to “accept it” and live with. No wonder Veronica believes that it was worth the cost & travel time it took for her PNMD treatment.
10% of all patients that go to an ENT specialist for ear pain, ear congestion etc. have NOTHING wrong with their ears at all, according to ENT specialists. Their pain is from TMD / TMJ disorder.
Unrelenting Ear pain, ringing in ear called tinnitus, jaw pain resolved through Physiologic Neuromuscular Dentistry. Physiologic Neuromuscular Fixed Orthotic resolved these symptoms when pain medications did not help.
Stan was having ear pain and dull jaw pain about a year ago. He went to his primary care doctor who told him that his jaw and face was constantly hurting. The doctor thought it was from clenching. Stan then went to his general dentist who also confirmed that his pain was coming from clenching. A couple of months later he started having ringing and sharp pain in his ear. He decided to see an ENT who examined his ear & throat which were normal. He told him to take over the counter Aleve for 2 weeks but it made no difference in the pain and then he was referred to Dr Raman.
Stan owns a construction company and always felt very fatigued. He also noticed that he could not lift heavy items as easily but just blamed these things on his job and age. Once Dr Raman evaluated Stan and determined that his symptoms were stemming from his poor jaw alignment he was then fitted with a fixed neuromuscular orthotic for 90 days. Within this 90 day period Stan saw an 80% overall improvement with his symptoms.
Stan said that he feels a lot better, not fatigued and that most of his pain has calmed down quite a bit. He can also lift more than he used to and feels more balanced.
If ear pain, ear congestion and ringing in the ear called tinnitus is affecting your life but the ear examination is normal, Physiologic Neuromuscular dentistry may help resolve those problems once and for all. It may also improve your overall balance and lessen fatigue.
Unrelenting headaches and neck pain resolved through Neuromuscular Fixed Orthotic when Topamax, pain management, chiropractic adjustments and pain medications did not help. TMJ splints by ‘specialists’ that estimated the jaw position worsened the headaches.
Carmen had a single crown done 16 years ago and ever since that procedure she has suffered with face pain, head pain then neck pain and shoulder pain later on. She felt as if her jaw joints were dislocated.
Carmen has seen several different doctors over the years from dentists, oral surgeons, rheumatologist to neurologists but no clear diagnosis was ever given. She was told that she was depressed and given Prozac. Based on a panoramic x-ray, she was told that there were no TMJ joint problems and prescribed Topamax and Medrol steroid pills. She has been through Prolotherapy, acupunture, trigger point injections and splint therapy and all were unsuccessful. She even had arthroscopic surgery done on both TM joints and only had 2 days of pain relief from it. The pain has been very intense for the past 10 years.
Carmen is an RN. With the medications, severe pain and disabling fatigue, she felt that it was no longer safe for her to work. She reduced her work load to part time and found even that was too much. So she completely quit the profession she loved, three years ago.
Carmen was then referred to Dr Raman for an evaluation. Following the TMD evaluation he felt confident that he can help her. CT scans and a series of Neuromuscular K7 jaw computer tests were done to determine the correct jaw/neck alignment. Carmen was then fitted with a fixed orthotic to maintain this diagnosed position. After 16 years of suffering, she was already 30-50% pain free after just 1 month. She was also able to go for 5 days without taking any anti-inflammatory medications after being on Naproxen or Mobic daily for 16 years. She was unable to gain weight for years because of the pain. She can eat better now and is happy that she has gained some weight.
To anyone that is dealing with unrelenting headaches, neck pain, ear pain & shoulder pain, Carmen says “Don’t give up. Find the right doctor to help you”.
If regular orthodontists & oral surgeons say that jaw surgery is the ONLY option to correct TMJ pain, joint / ear pain when chewing, DON’T accept that too quickly. NFOO has proven to be an EFFECTIVE and non-surgical resolution of such symptoms many, many times. Here is one case history.
Laramie started having really severe pain when chewing and ear pain when she was in grade school. Her mother thought that she was a finicky eater. But Laramie did not know what it is like to eat without pain in the ears and jaws. Her dentist referred her to an orthodontist even though her teeth looked straight, which is the usual reason for getting braces. After 3 ½ years of braces, she continued to have ear and jaw pain. The pain skyrocketed after her wisdom teeth were removed, which evidently aggravated her existing chronic pain.
Laramie’s mother was alarmed to see her continue to lose weight, down to 100 pounds. She realized that her daughter is not just a finicky eater, but it was painful for her to even chew any food. She only ate what she could swallow without chewing. Laramie was in constant ear pain and jaw pain. She became depressed but did not realize that the pain was causing it.
They consulted with the orthodontist that had previously treated her. He felt that it was beyond orthodontics and referred her to an oral surgeon. The surgeon believed that the only option was jaw surgery. They consulted with another orthodontist who also thought that it was beyond orthodontics at that point.
Traditional orthodontics improves the smile cosmetically by straightening the teeth. 4 out of 5 patients we treat for TMD had previously had traditional orthodontics. So they often have ‘nice smiles’ but their jaws were poorly aligned. Once the optimal bite was diagnosed through advanced Neuromuscular protocols, moving the teeth along with bone support and gum tissue to this position is called Neuromuscular Functional Orthopedics / Orthodontics (NFOO). Objective electronic measurements of jaw / neck muscle activity and CT scans of the TM Joints guide the entire treatment.
THAT is the difference between NFOO and traditional orthodontics.
Laramie remains pain free, happy, able to eat anything she wants to and got married during her treatment. Just because regular orthodontic braces therapy has not worked to correct TMD problems you don’t have to accept surgery as the only other option.
It may be hard to believe. But neuromuscular functional orthodontics / orthopedics (NFOO) can actually solve these problems in most cases without surgery. So if you are tired of the jaw pain and hate taking medications with no end in sight, there is hope.
Watch this video of Laramie, an actual patient who was helped through Neuromuscular orthotic and Neuromuscular Functional Orthopedics / Orthodontics (NFOO). She is pain free and able to chew any food she wants without pain.
It is hard to measure the life impact of this treatment in this young person’s life compared to how it would have been in her social life and general happiness if the unrelenting ear pain and painful chewing had continued. No wonder both Laramie and her mother believe that it was “definitely worth” the cost of NFOO.
Botox - botulinum toxin type A - has been touted for lots of problems that ail us.
It started off being used for facial cosmetics - to ‘relax’ wrinkles such as ‘crow’s feet’ on the side of forehead by paralyzing the tiny muscles under the wrinkles. But more and more uses of this drug is promoted all the time.
Recently there is a big push to use Botox injections in the jaw muscles “to treat TMJ”. Pharamceutical companies are experts in marketing & have the big money to give grants, sponsor research and sponsor speakers to promote its use. I have seen many patients that had this done repeatedly with less and less effectiveness. They are more difficult to treat - not impossible - since these muscles have been damaged. This is not just my opinion based clinical experience. There are scientific studies that prove this. These jaw muscles are NOT like the tiny facial muscles that cause ‘crow’s feet’ wrinkles on the face that are paralyzed by Botox for cosmetic results. The jaw muscles are important functional muscles! Does paralyzing them with a neurotoxin make a lot of sense to anyone?
Why then do doctors do this to treat TMD & patients go through these injections? Are they just looking for a quick fix? Or are these doctors that push this ‘treatment’ for TMD just clueless?
What are your thoughts on Botox for TMD treatment? Any of you have personal experience with Botox for TMD? Are you thrilled with the results?
This is a patient case history to support my call for a truly comprehensive view of the entire musculo-skeletal system - the whole person! The hyper-focused view of a specialist is useful but risks a “tunnel visionâ€.
Moira was fighting severe fatigue for over 8 years. It gradually worsened so much that every 5 days she will “crash†for 2 or 3 days. Her Primary Care Physician (PCP) referred her to an endocrinologist who prescribed hormone supplements for deficient thyroid function.
Few years later, her general dentist noted exposed tooth roots and referred her to a periodontist for gum grafts. The gum tissue receded after bone around the teeth were lost.
The next year, she developed migraines which devolved into a chronic 24/7 migraine for 8 months. One neurologist ordered MRI and diagnosed it as a psychosomatic headache. Lyrica, prescribed by another neurologist, broke the headache but gave her a foggy feeling and weight gain.
In the mean time, her teeth were getting very loose. Her general dentist got concerned and sent her to her periodontist again. He could not see a reason for the looseness and sent her to an orthodontist. He made her a hard plastic mouth guard to prevent further looseness. But Moira could not wear it since it was uncomfortable.
Later, she had ear pain and was referred to an ENT specialist who did not find any problems with the ears.
She consulted with her children’s dentist who referred her to a ‘TMJ dentist’ who made her a soft mouth guard. This one was more comfortable to wear but all of her symptoms – fatigue, headaches, ear pain, neck pain and shoulder pain remained. After all the time and money spent with the various doctors, she had come to a place of acceptance. She will just have to learn to live with these symptoms.
For 18 months one of her colleagues was telling her about our practice & NMD. But Moira did not see any point in going to “another dentist†when she has already seen so many. Finally she saw Michelle’s video. She saw that a common denominator for her symptoms could be a poor jaw- head- neck alignment which can be improved through NMD.
Moira saw that while I am a dentist, our NMD approach takes a comprehensive view of the musculoskeletal postural chain of the entire body. If jaw relation is poor AND it is shown to be the primary source of postural compensation, then correcting that it through NMD would be beneficial. Then the seemingly unrelated symptoms – debilitating fatigue, severe ‘migraine’ headaches, constant neck pain and ear pain would improve as well. While these are “medical symptomsâ€, the postural chain does not care what kind of doctor corrects the imbalances or through what methods.
After a lower fixed Neuromuscular orthotic, Moira started noticing improvement. She had the option to have that orthotic removed, if it did not help her significantly. The fatigue improved almost immediately. So after 90 days she chose NM orthodontics to move her teeth to an optimal position. Within few weeks, ALL of her symptoms have completely resolved. For the last two months, she remains 100% symptom and medication free. We are far from achieving the most optimal end results from my perspective. It will be another 2 years to complete the NM orthodontics. Her progress will be tracked with K7 jaw computer scans to measure her muscles and CT scans to check her TM joints. Moira is fine with that since she has no further
symptoms. She has not had a single “crash” since the beginning of NM orthotic, while the longest she had gone without a “crash” in the last 8 years was only 6 consecutive days.
Does this case illustrate a need for a truly comprehensive view of he entire postural chain? Moira will answer that question with a resounding “YESâ€.
When someone has a tooth – dental – problem or symptom they go to their dentist. If it is more than a routine tooth problem, then she may be referred to a dental specialist. If it is a gum / bone support issue to a periodontist, if is a surgery issue to an oral surgeon, if it is a tooth alignment issue to an orthodontist and so on.
If the same patient has medical symptoms such as headaches, neck pain, ear pain or general fatigue, then she will go to her primary care physician. PCP may, in turn, refer her to a neurologist, orthopedist, ENT or an endocrinologist for these symptoms respectively.
Specialized knowledge in one area is useful. But does it also lead to a “tunnel vision†view? Human body, after all, developed from a single cell. The various parts are very much connected. This is especially true of the musculoskeletal system. A human on two feet is constantly resisting gravitational forces. So any imbalance in one area affects the entire postural chain from feet to head.
It truly is a chain – both in the left/right and front/back planes. The spine with its alternating front to back curves from the head to tail connects these sections and allows flexibility in compensating for the imbalances, especially when the body is in motion. These are the lordotic curves of the cervical and lumbar regions and the kyphotic curves of the thoracic and sacro-coccygeal regions.
This compensating system is challenged even more when walking and running in a gravitational field than when standing still. When DOES this person really gets looked at as a “whole person� Let me share a case history to support my call for a truly comprehensive view of the entire musculo-skeletal system.
