Solution: Blue sapphire orthotic
Background: Jen had been a dental assistant for a number of years. Her teeth were worn down in the back of her mouth, so the dentist at her office offered to fix them. She had a background in dentistry and trusted the dentist, so they decided to alter her posterior chewing teeth. Her dentist tried to increase the vertical dimension of her bite by increasing the size of the rear molars, but Jen didn’t feel right. The dentist made the corrections a few teeth at a time. Finally, after several months, he completed the restoration — all gold and PFM (porcelain fused to metal) crowns. Jen had sixteen new posterior teeth in all.
After just a few days, she realized she couldn’t chew because there was interference with her bite. So she went back to her dentist and asked him to adjust her teeth. The dentist started adjusting one tooth after another, one side after another, upper, lower…trying to “find” the correct bite for her. Doing that by trial and error, as opposed to using modern technology to design a structurally perfect bite, you could definitely lose the vertical height and the occlusal marks that are necessary for teeth to function properly and work together.
After a very short amount of time, Jen started having symptoms of TMJ: clicking; head, neck and shoulder pain; ringing in the ears (tinnitus); grinding and clenching heavily at night, and not being happy with her bite. Overall, she was not happy with the way her mouth felt. She knew that something was wrong, but she couldn’t pinpoint it. She thought maybe this was normal and would go away eventually; that she was just adjusting to her new mouth. Little did she know that this was only the beginning of a long and painful journey for her. Over the course of the next 14 months, she developed severe symptoms of TMJ. She suffered from migraine headaches, neck stiffness, and vertigo. Jen was in desperate need of someone who could relieve this misery.
By the time she came to me, she said, “I don’t care how much it costs or how long it takes, I am just desperate to get out of this pain.” She was literally willing to do anything to relieve the suffering she was experiencing.
Jen was unsatisfied, unhappy, and had no idea how to find a cure. She was living with her very caring and loving boyfriend, who started to do some research online and found out about neuromuscular dentistry. After talking on the phone with different offices, they decided to come and see me for a consultation. After a thorough examination — going over her medical history, under- standing the primary cause of her pain and taking necessary x-rays and photos — I discovered that she was suffering from severe TMJ and a loss of vertical height in her bite.
We hooked her up to the K7 computer and found the exact position of the bite and where it needed to be in order to alleviate the symptoms. Because of all the pain and suffering she had been going through, she had not been able to eat or nourish properly at all. She was on an all-liquid diet at that point because she was physically unable to chew solid food. We needed to do something right away.
Once I had assessed her condition and figured out the proper bite, I decided to make her an orthotic device with a special material called “blue sapphire.” This is a powder that becomes very, very hard when it gets wet. It makes a very accurate bite for the patient by molding it in her mouth at the time of finding the proper physiological bite. The orthotic device was made right then and there for her, instead of sending it to the lab and making her wait (and suffer) for two more weeks. I made the proper adjustments that day and instructed her to wear the device 24/7 and to contact me within 48 hours if she saw any immediate changes.
Jen came back two days later for a follow-up visit. She had a smile on her face that had been absent for the preceding 14 months. She reported that she was much more relaxed and doing better.
We knew we needed to do more accurate adjustments with the orthosis. First, we set her up for about one hour on the TENS unit. The TENS unit is a muscle stimulator used to create a physiologically relaxed state of the muscles of mastication. At this point, we adjusted the orthosis to be more precise and more accurate with her bite. She was instructed to come back in a few days for another adjustment.
After the first week, she told me she felt 50 percent relief from the pain and suffering. She could open her mouth two millimeters more, so she was able to eat soft solid foods again. It was a great improvement in just one week, and she was very happy. Two weeks into treatment, we did one more adjustment and she was feeling a lot better. Her smile was back for good.
She sent me this email:
This is just a note to let you know that I’ve been doing well the last week. In fact, every day I keep improving. And I’ve been able to do more at home without a lot of pain. This is the best I’ve felt in months. Thank you for everything you’ve done for me so far. Things are moving along nicely.
She reported that she was completely symptom-free after a month. We proceeded into the permanent repositioning of the posterior teeth that had been done by her original dentist. We wanted to completely eradicate the pain and soreness and get a good aesthetic result. This case was what my industry calls “iatrogenic dentistry”: a problem caused by a dentist.
Dr. Solomon specializes in Full Mouth Reconstruction and Full Mouth Rehabilitation. With his advanced dental degrees and qualifications, he is able to effectively restore a patient’s entire mouth in only 2 visits. He ensures that the restorations look very natural, while maintaining and if need be, restoring the integrity of the patient’s bite.