Reprinted from a letter by Ira L Shapira DDS, D,ABDSM, FICCMO on the LVI Forum
Important information for patients with CHRONIC DAILY AND TENSION-TYPE HEADACHES, MIGRAINES and/or TM JOINT problems, TMD, TEMPOROMANDIBULAR DISORDERS, AND SINUS or JAW PAIN.
“I have been teaching therapeutic use of the Gag reflex in neuromuscular dentistry for well over 20 years.
The gag reflex is a protective reflex that presents a patient from aspirating vomitus into their lungs which is a fatal (frequently) event.
When the patient gags all of the elevators of the mandibles becoming completely relaxed or atonic (emg value= “0”) and the depressors of the mandibles (supra and infrahyoid maximaly conttract. It frequently is almost magical in how it treats an acute close lock. It is basically applied anatomy/physiology.
This leads to a jaw opening like a snake
(who disarticulates to swallow entire animals) with the mandible bodily moving straight down as opposed to rotation and translation or the mandible. This creates a disengagement of the TM Joint and the anterior-medially displaced disc is now unaffected by the pull of the superior head of the lateral pterygoid muscle. If the elastic tissue of the retrodiscal lamina (RDL) is still intact it will retract the disc.
If the RDL is stretched out (like old underwear with no elastic) than the mandible can be manipulated to recapture displaced disc.
Long term locks cause the loss of anatomical form of the disc so the sooner a lock is resolved the better chance of success.
Migraines are frequently associated with vomiting and patients often report after vomiting the pain ends. For 20 years I have always said that was because of total relaxation of trigeminally innervated muscles that cause referred pain to the head. This was a small part of the truth. The V nerve also controls blood flow in the anterior 2/3 of the Meninges of the brain and migraine is to some extent an input/output error (I/O error) in computer lingo, ie the afferents create brain changes. Garbage in/ Garbage out
The research currently being done at LVI on atlas axis and the odontoid process probably will prove that I have oversimplified the scenario. In order for the mandible to open the posterior cervical muscles also contract simultaneously otherwise the depressors would just pull the head forward. It is quite possible as Norman teaches us that a great deal of the problem in migraine is caused by compresion or torsion of the primitive portion of the brain as passes into the spinal column and the gag reflex may also serve as a reset mechanism for the atlas axis occiput complex.
Natures Nucca or atlas orthogonal adjustment may be a severe gag reflex. An excellent research paper would be displaced (off center) odontoid then gag and place appliance and compare. If you can show high success on icat it is significant even if only successful on a percentage of total patients.
When doing emg’s of V nerve muscles a gag will cause relaxation. It will also frequently correct reverse pulse fron tens.
LVI offers an opportunity to do research projects under the tutalage of Norman Thomas and Sahag.
I strongly suggest everyone who has not taken the Anatomy and Physiology course with r Thomas sign up today. There are probably a dozen research projects on the gag reflexes and their effect on gagging, cerebral blood flow, atlas axis joint.
The woork of Guzay has effectively defined the mandible as the last vertebrae acting as a counterbalance for the skull.
The truth is obvious we just need to identify the puzzle pieces and create a finished picture.
Doing research with Norman is not an exercise to get a certificate or mastership, it is the chance of a lifetime to help define the future not of dentistry but of neurology and medicine.
I have listened to Norm for over 20 years and still have only pieces of the picture and I do not know if anyone exists who can ever replace him. The A-P course is probably the single most important couse to take at LVI
Hope that helps
I will get off my soapbox
Dr Ira L Shapira is the Dental Editor of Sleep and Health Journal, a Diplomate of the American Board of Dental Sleep Medicine, a Charter and Credentialed Member of the Sleep Disorder Dental Society, A Founding Member of DOSA, the Dental Organization for Sleep Apnea, the Secretary, a Fellow and a Regent of ICCMO, the International College of CranioMandibular Orthopedics and the ICCMO representative to the TMD Alliance.
He founded I HATE HEADACHES LLC and the website http://www.ihateheadaches.org a major source of information for patients with chronic headaches and migraines that explains how Neuromuscular Dentistry (NMD) can provide drug free relief of migraines and chronic headaches as well as correction of cervical and postural problems. Dr Shapira also founded I HATE CPAP LLC and http://www.ihatecpap.com the premiere site for information about Sleep Apnea Diagnosis and Treatment and the benefits of Dental Sleep Medicine. Dental Sleep Medicine offers comfortable oral appliance alternatives to CPAP that most patients prefer to CPAP when offered a choice of treatments.
Dr Shapira and his partner Dr Mark Amidei practice at Delany Dental Care Ltd (http://www.delanydentalcare.com) where they treat TM Joint disorders utilizing Neuromuscular Dental Treatments and have a general dentistry practice that emphasizes cosmetic and reconstructive dental therapeutics including implant dentistry. Dr Shapira treats Sleep Apnea and Snoring at Delany Dental Care in Gurnee, Il and at Chicagoland Dental Sleep Medicine Associates with offices in Skokie at American Sleep Medicine, Schaumburg in the dental offices of Dr Alan Acierno, and at Sleep and Behavioral Medicine Institue with offices in Skokie, Bannockburn an Vernon Hills. Dr Shapira is a former Assistant Professor at Rush Medical School where he did research in the relation of jaw position to Sleep Apnea and treated patients with comfortable oral appliances. Dr Shapira continues to teach a course in Dental Sleep Medicine to dentists from across the United States.
LVI, or the Las Vegas Institute is the leading educator in Neuromuscular Dentistry and has recently become LVI Global and is training dentists world-wide in utilization of Neuromuscular Dentistry to cure and/or alleviate chronic headaches, migraines, TM Joint disordrs, TMD or Temporomandibular Dysfunction. LVI is the premiere educational environment for dentists learning Neuromuscular Dentistry
http://www.ihateheadaches.org is working to help bring Neuromuscular Dentistry to its rightful position in medicine.
The National Heart Lung and Blood Institute (NHLBI) of the National Institute of Health (NIH) has published a report titled “CARDIOVASCULAR AND SLEEP RELATED CONSEQUENCES OF TEMPOROMANDIBULAR DISORDERS” that spells out how sleep apnea and TMJ disorders are related. Additional articles in Sleep and Health Journal are listed below:
SUFFER NO MORE: DEALING WITH THE GREAT IMPOSTER
NEUROMUSCULAR DENTISTRY (originally published in the American Equilibration Society magazine)
Oral Appliances vrs CPAP, Shapira
ORAL APPLIANCES VS CPAP – Good news for patients who say “I Hate CPAP”
SLEEP APNEA TREATMENT: ARE DENTAL APPLIANCES MORE SUCCESSFUL THAN SURGERY?
CARDIOVASCULAR AND SLEEP RELATED CONSEQUENCES OF TEMPOROMANDIBULAR DISORDERS