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Metro Christian Living

Metro Christian Living Magazine

June 2013

Dr. Cole Fortenberry Answers Your Questions

There are over 80 million Americans that suffer from chronic temporomandibular joint (TMJ) pain, chronic headaches, and migraines. Many of these conditions have dental force related imbalances that either cause or aggravate these issues. Patients suffering from these symptoms should not only see their physician, but should also consider seeing their dentist.

The most common symptoms of TMJ disorder include headache, face pain, and aches in and around your ear. People with TMJ problems may also experience a sense of dizziness or imbalance and feel like their ears are clogged or ringing.

According to the National Institute of Dental and Craniofacial Research, TMJ disorders are the second most common pain-causing musculoskeletal conditions after chronic low back pain. TMJ disorders affect 5 to 12 percent of the population, and women are twice as likely as men to experience TMJ disorders. Most people who have TMJ problems experience temporary but recurring pain that may go away on its own. However, some cases result in long term problems.

According to the National Headache Foundation, over 45 million Americans suffer from chronic, recurring headaches. About 20 percent of children and adolescents also have significant headaches. And according to the American Migraine Foundation, 36 million Americans (about 12 percent of the population) suffer from migraine headaches. One-in-four households in America have a member with migraines. Migraines are three times more common in women than men, with migraines affecting 30 percent of women over a lifetime.

Many people who suffer from TMJ/Headache problems have spent significant time and money looking for a solution. They have visited multiple health care professionals and tried various medications and therapies without much relief. Now, a new diagnostic and treatment system has been introduced to dental offices called TruDenta. This leading edge technology allows professionals to quickly pinpoint possible problems, that when properly treated can decrease or alleviate pain.

Local dentist Dr. Cole Fortenberry has been implementing the TruDenta system and has experienced great success in helping this group of patients achieve significant pain relief. His Madison dental practice performs a wide variety of dental procedures, but has a special focus on helping people with TMJ dysfunction.

Q: Dr. Fortenberry, when a patient who has suffered from chronic TMJ pain, headaches, or migraines comes to you, what is done initially to determine what could be a factor in their symptoms?

Dr. Fortenberry: Most patients we see have already seen their physician to rule out any life threatening or organic pathologies. Our office uses new technologies to allow us to screen patients using a digital bite force analyzer to measure the different dynamic forces in the mouth (musculature, joints, and teeth) to pinpoint imbalances. This allows us to determine the type of treatment or combination of therapies that might be needed. We also use a computerized tool that measures the cervical range of motion and identifies dysfunction or disability in the muscles of the head and neck. In an in-office screening appointment, we can determine whether the patient’s TMJ pain is related to improper or imbalanced forces.

Q: Does the program involve pain, needles, or drugs? 

Dr. Fortenberry: No, in fact, it’s exactly the opposite. There is no pain whatsoever with our treatments. The TruDenta treatments are conservative and non-invasive, and the program is specifically designed to help decrease pain and reduce the need for medicines. Patients report that the therapies are very relaxing and most begin experiencing pain relief after one or two treatments.

Q: Give us an example of the kinds of treatments you might perform on a chronic TMJ pain sufferer. 

Dr. Fortenberry: Because TMJ dysfunction, headache, and migraine sufferers have many sensitivities that can trigger pain, our treatment plans are designed to be slow, conservative, and effective. We use a combination of FDA approved medical devices to reduce inflammation and restore blood flow in the muscles and TMJ. Additionally we use low-level cold laser therapy to help restore energy at a cellular level. We also use a specially designed mouth orthotic that helps restore normal function in the TMJ, and then selectively correct the bite imbalances with the aid of our digital bite analysis system. The thing that really makes this system unique is the blend of treatments: some that target muscles and nerves—combined with advanced dental treatments targeting TMJ dysfunction and bite imbalance.

Q: What kind of results have you seen? 

Dr. Fortenberry: The results have been amazing. We have treated a number of patients who have been plagued with severe TMJ pain, headaches, and migraines for more than 10 years, robbing them of countless hours of their lives every week. These patients come into my office desperate for help. When you can help take away or reduce their pain in a matter of weeks, it becomes a life-changing experience for that patient. As a healthcare professional, helping my patients become free of pain is the most rewarding part of my practice.

Q: In what other ways can the TruDenta technology and training you have received be used? 

Dr. Fortenberry: The TruDenta system is not only effective on patients with TMJ problems, but also patients who clench or grind their teeth or who have tinnitus (ringing in the ears).

Q: Is treatment affordable? Are there options to pay for it? What about insurance coverage? 

Dr. Fortenberry: We strive to make the cost of care affordable, with treatments ranging from several hundred dollars to several thousand dollars, depending on the number and types of treatments needed. Certain insurance plans cover the treatment, and financing is available.

Q: How can we find out more about the TruDenta system? 

Dr. Fortenberry: Visit www.smile4alifetime.com for more information and to see patient testimonials, or call 601-853-3565 to schedule your consultation in our office.

Dr. Fortenberry is a general dentist that has been in practice in Madison, MS, since 1990. He is a member of the American Dental Association (ADA) and the Mississippi Dental Association (MDA).


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News Coverage
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Assessment & Treatment
  • Assessment Process
  • Treatment Process
  • Only Dental Professionals
  • Assessing DMSD
  • Bite Force Analysis
  • Mandibular Range of Motion
  • Cervical Range of Motion

Only Dental Professionals

In many cases, only dental professionals can help the estimated 80 million Americans suffering from the painful symptoms caused by improper dental forces, called dentomandibular sensorimotor dysfunction (DMSD).

READ MORE "...it is imperative to include the training for orofacial pain, particularly those from temporomandibular joint and musculoligamentous tissues.” JADA Cover Story, 10/2015, Vol. 146, Issue 10, Pg. 721-728

Assessing DMSD

20% of your existing patients suffer from DMSD, as do 20% of all Americans. Your team members quickly assess patients for "red flags" (which indicate DMSD), utilizing TruDenta's patented technologies.

The National Institutes of Health estimate that over 80 million Americans suffer from one or more of the symptoms of DMSD, including:
• Chronic Headache
• Migraine
• Tinnitus
• Vertigo

Bite Force Analysis

TruDenta uses digital force measurement technology, powered by Tekscan®, for evaluating the amount of bite force that is present during closure, at closure, and while chewing. The technology is so advanced that it actually calculates the bite force and motion on a tooth-by-tooth basis. This digital exam literally shows a movie of the bite force in action revealing abnormal forces in the nerves, muscles and ligaments that are often the cause of symptoms.

Bite balance is also calculated to identify potential issues within the overall chewing system. READ MORE

Mandibular Range of Motion

A normal opening for an adult is 53 mm to 57 mm. Limited or restricted range of motion (less than 40 mm) is a reduction in an individual’s ability for normal range of movement. Along with opening movement, an individual should be able to slide their jaw to the left and to the right at least 25 percent of their total mouth opening in a symmetrical fashion.

When restricted movement exists, an imbalance in the system is present, and breakdown of the system is likely to occur. READ MORE

Cervical Range of Motion

The TruDentaROM is a system of hardware and software that digitally measures cervical range of motion (ROM) impairment based upon AMA guidelines. This directly affects the proprioceptive feedback system of the dental occlusion, TMJ, and the muscles of mastication.

ROM impairment is another “red flag” which assists doctors in accurately diagnosing symptoms that are often dental force related. This data enhances medical insurance collections and the collaboration with referring medical doctors. READ MORE

  • Doctor Chair Time
  • Therapeutic Ultrasound
  • Microcurrent Stimulation
  • Low-Level Cold Laser

Less Than One Hour Doctor Chair Time

A typical case requires less than one hour of doctor time in the diagnosis and minor occlusal adjustments during the rehabilitation period.

Treatments are performed by a trained team member once per week, in less than one hour. The most severe cases require 12 treatments. Therapies are spa-like, non-invasive and require no drugs or needles. Most patients report dramatic results after the very fist treatment. Note: The majority of patients utilize an orthotic only during the treatment period, up to a maximum of 12 weeks. READ MORE

Therapeutic Ultrasound

The goal of therapeutic ultrasound treatment is to return circulation to sore, strained muscles through increased blood flow and heat. Another goal is to break up scar tissue and deep adhesions through sound waves.

Therapeutic exposure to ultrasound reduces trigger point sensitivity and has been indicated as a useful clinical tool for managing myofacial pain. Additionally, ultrasound also has been shown to evoke antinociceptive effects on trigger points. READ MORE

Microcurrent Stimulation

Sub-threshold microcurrent stimula¬tion reduces muscle spasm and referral pain through low electrical signal. It also decreases lactic acid build-up and encourages healthy nerve stimulation. In particular, microcurrent electrotherapy has been shown to help increase mouth opening significantly.

• Reduces muscle spasm and referral pain through low electrical signal
• Decreases lactic acid build-up
• Encourages healthy nerve stimulation
• Increases mouth opening significantly

Low-Level Cold Laser

Low level laser/light therapy is one of the most widely used treatments in sports medicine to provide pain relief and rehabilitation of injuries. Over 200 randomized clinical trials have been published on low level laser therapy, half of which are on pain.

Low level laser/light therapy decreases pain and inflammation, accelerates healing of muscle and joint tissue 25 to 35 percent faster than without treatment, and reconnects neurological pathways of nerves to the brain stem, thereby inhibiting pain. READ MORE

Additional Content & Resources
Download this eBook on The Hidden Causes of Head Pain
DRSdoctor training
Download this eBook on The Hidden Causes of Head Pain
Download this eBook on The Hidden Causes of Head Pain
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