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by Sheila Birth, DDS, MS, and Cristi Fletcher, DDS
2014 Dentist Guide
LAURA GIBBS’ PAIN WAS INTENSE.
Her temporomandibular joint disorder (TMJ/D) had left her barely able to carry out routine chores around the house. Some days, the pain kept her in bed all day. She feared that surgery would be the next step. Having worked as a dental hygienist, she had seen the many unwanted after-effects of surgery. When pain management seemed like her only other option, Gibbs became hopeless and depressed. “I asked God to just help me to live with this condition,” Gibbs recalled. “Then my prayers were answered.”Gibbs heard about a new treatment called TruDenta. “I didn’t want to get my hopes up, but it sounded good,” said Gibbs. “I HAD ABSOLUTELY NOTHING TO LOSE, AND I WAS DESPERATE.”
Her husband made an appointment at Birth Fletcher Orthodontics. After being evaluated, they decided to move forward with this seemingly miraculous solution. Gibbs started treatment the very next day. Gradually, she felt better and better. Today, she is a completely different person.
“I’m sleeping better and am able to get out of bed in the morning without a headache, and I have a clear head,” exclaimed Gibbs. “I’m driving again, and am able to get things done around the house without laying down. I am able to take care of my family and do the things we love to do together. I have my life back!”
We know orthodontists as the “braces” doctors. It’s an oversimplification that becomes more arcane by the minute. Orthodontic practices have become more sophisticated and diversified in recent years.
Today’s orthodontists incorporate ground breaking technologies and the wisdom of doctors from many disciplines to address a range of health-related issues that may be rooted in and around the mouth. True, an orthodontist’s bread and butter remains braces, but at Birth Fletcher Orthodontics, new treatments are rofoundly changing lives by eliminating pain from chronic headaches, migraine, TMD, tinnitus (ringing of the ears), vertigo and more.
“There is a way to treat migraines and TMJ/D now that doesn’t involve any drugs or needles, and it works,” said Dr. Sheila Birth. “We’ve treated people who have had migraines for years, and have gotten them off their medication.”
From the start of her career in dentistry, Dr. Birth wanted to be a part of something that delivered consistent and replicable results. Orthodontics provided that. Today with TruDenta, she can make an even bigger impact on patient’s lives.
She and her team can offer a way out of the excruciating pain from migraines and other medical conditions that stem from the jaw joint (temporomandibular joint). This area houses a concentrated network of nerves (close to 50 percent of all your body’s nerves) that control pain signals from the teeth, face, head, and neck, and it’s right next to your brain.
Migraine sufferers may not know the mechanics of their pain, but they certainly know one thing—they want it gone. The National Headache Foundation says about 37 million Americans suffer from migraines. Studies place the loss of productivity from migraines between $5.7 billion to $17.2 billion per year because of missed work. The pain is so debilitating that sufferers go to many lengths to alleviate it—prescription medication, acupuncture, massage, chiropractic adjustments, hypnosis, even Botox— often with fleeting results.
Dr. Birth wanted a more effective treatment for her patients. She’s used to getting teeth straight 100 percent of the time, but noticed that existing approaches for dental force related pain were only about 30 to 40 percent effective. Then, she and her colleagues met a neurologist who teamed with a dentist who told them, “We have a better system.”
“The neurologist that came up with TruDenta thinks outside of the box. Doctors are often taught to tailor treatments around what medicines to prescribe, but the medicine just takes care of the symptom (or pain), not the underlying cause of the problem, which can be dental force related,” explained Dr. Birth.
The treatment is only as effective as the doctor who performs it, and TruDenta practitioners must undergo rigorous training before they can offer the service.
“Acquiring the diagnostic and treatment technologies are fairly expensive, and you have to put in a lot of work,” Dr. Birth stressed. “There’s an extensive time commitment to the education and training. Before you can even take the class, you have to go through a number of seminars and take several tests before taking the final exam.” Their efforts have been worth it.
When Terese Penner came to Dr. Birth, her pain was so severe, it affected her family life. In 2009, Penner sustained trauma in her jaw—an experience that left her with debilitating pain. Every day by late afternoon, Penner’s jaw hurt so badly, she didn’t want to talk and felt “extremely grumpy.”
“My jaw would just ache and the headaches never went away. I was taking at least 1600mg of Motrin, if not more, daily, and that was to just take the edge off. I am a mom to four wonderful kids who weren’t getting the best of their mom,” said Penner.
She sought the care of a TMJ/D specialist who employed similar techniques to TruDenta, but the outcomes were mixed. Her headaches would subside, but within a month, the pain would return.
“I suffered until I went in to see Dr. Birth,” Penner recalled. “I thought if I fixed my teeth with braces, my bite would be better and the pain would stop.”
As soon as Penner recounted her injury and described her symptoms, she could see interest perk up on Dr. Birth’s team’s faces as they realized that she could benefit from TruDenta. “We can treat a lot of people. We complete a series of diagnostic tests to determine if you’re a candidate for the treatment. We do a digital bite force analysis and tooth scan which is very precise and gives us a relative force on each tooth,” said Dr. Birth.
The test analyzes where teeth are hitting, how hard they’re hitting and at what time periods, and if the jaw shifts as you close. If there’s interference either by the shape of the tooth or a tooth being in the wrong position, there may be interferences as you close. It may not be something most people realize on a day-to-day basis, but the tooth scan can pick up on those minute muscle movements.
“If muscles are reacting to a tooth in the wrong position, they get overworked which creates a trigger point. That trigger point, in turn, can cause the headaches, migraine, tinnitus and vertigo in many cases,” Dr. Birth explained.
Dr. Birth looks for specific indicators. When functioning properly, the jaw and its muscles painlessly exert massive forces within your mouth. If the forces that power your jaw are unbalanced or create improper forces, this can be problematic. For example, if your molars take any more than 13 percent of the bite, that raises a red flag. Painless electronic tests can also survey the range of motion of cervical muscles. If a patient’s cervical range of motion (ability to turn and tilt your head) isn’t where it should be, that’s another red flag.
“We don’t treat everybody, but the consultation is free. We can quickly determine if we can help you or not. If you’re a candidate, we can improve your quality of life.”
After learning how TruDenta worked, Penner felt she had found that elusive solution to her pain, though she did not immediately move forward. She didn’t have health insurance at the time. Birth Fletcher set her up with a payment plan that made it possible to proceed with the three month treatment.
“By the third treatment the headaches stopped, and I stopped taking all the pain meds,” said Penner. “I have now completed my 12 treatments, and I have no headaches, my jaw does not ache, and I can laugh with my kids again. The pain is gone and I feel like a new person. I suffered for five years, and in just three months TruDenta healed me.”
Terese Penner’s swift deliverance from a life of pain would not have been possible only a few years ago. Now, with the TruDenta system, available at Birth Fletcher Orthodontics, more people are finding that they don’t have to live with chronic headaches, migraine, clenching and grinding, neck pain or ear pain.
Furthermore, the system is virtually pain free. “Not only is this cutting edge technology that obviously works, the treatments are amazing,” Penner attested. “You feel no pain. It’s like going to the spa every week!”
“We treat many conditions. With this same system, we’ve relieved people of tinnitus (ringing of the ears). We’ve also seen success in treating vertigo,” said Dr. Birth. “We not only do orthodontics, we have a full service commitment to our patients’ overall health.”
That commitment entails providing the most modern innovations to keep patients safe and comfortable. Braces patients, for example, have benefitted from the TruDenta low-level laser therapy, also offered by Birth Fletcher. “Orthodontics never hurt when you’re in the office, but it starts to get sore at home. Orthodontics is more comfortable in our practice because of our low-level laser, which is another type of pain reduction system,” described Dr. Birth.
3D digital imaging is also a valuable new technology Birth Fletcher has adopted for all patients. Jennifer Goodwin, Birth Fletcher’s Regional Manager, said 3D X-rays give the doctors extensive information about what’s happening in a patient’s mouth that older imaging systems do not show. “If someone has an impacted tooth, the 3D X-ray helps us treatment plan to either bring in the impacted tooth or to extract it. It can actually speed up treatment because, early on, the doctors see what they need to see,” said Goodwin.
“I know there are others out there who have given up like I had,” said Laura Gibbs. “There are no words to thank Doctors Birth and Fletcher and Meghan for all they have done for me. They were all so kind and genuinely cared about me getting better so I was able to get back to the things that I loved to do.”
It’s this commitment to service and the most advanced technologies that has earned Birth Fletcher the admiration of their patients. Life changing results don’t hurt either.
Doctors Birth and Fletcher believe that the TruDenta technology has made them better orthodontists, realizing how important the position of each tooth and relative force impacts the overall health of the patient forever. Dr. Birth and Dr. Fletcher have a passion for orthodontics, both are board certified and are committed to continuing education for the best care for their patients.
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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
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
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
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
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
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
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
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 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