Parkinson’s TMJ patients trends

Trends in Parkinsons TMJ patients:

From the moderate sample of Parkinsons TMJ patients that I have seen, there are emerging trends that I think need to be pointed out.  Four of the last six patients have been orthodontically treated four bicuspid extraction cases.  The Parkinsons TMJ patients all had severe jaw alignment defects; some severely retruded, some with excess vertical space between the teeth when the jaw is relaxed (i.e. excess freeway space).  The over riding symptoms have been rigidity and various types of movement disorders, but not necessarily tremors.

Extraction of teeth is almost never good with orthodontic treatment.  It is typically done when an orthodontist erroneously takes no functional records (i.e. only skeletal records=traditional records = ceph, study models, pictures). Orthodontists are not taught much about jaw alignment (jaw orthopedics), hence they treat only to a cosmetic ideal, typically disregarding functional requirements, and causing stressful bites.  This leads to elevated neurological activity, elevated neuropeptides, and ultimate neurological degeneration. It is frightful to think that a significant percentage of extraction cases would turn into Parkinsons TMJ patients since so many people have been treated orthodontically with extractions.

Trends in Parkinsons TMJ patients:

The last new Parkinsons TMJ case I saw this week, was a non-orthodontically treated female with intermittent tremor, right side rigidity, lots of TMJ symptoms, and an occlusion in which her lower jaw was 3 mm left of the upper jaw (congenital defect).  Palpation of her inner ear showed the left TMJ to be severely displaced backwards into her ear space as a result of her bite being shifted 3mm to the left.  The rigidity would be expected on the right side as a result of the jaw shifted to the left (animal studies show that lowering bite on left causes hypertonicity on the right). Treatment will entail jaw repositioning with twin block crozat appliances (phase I) similar to the attached picture.orthopedic appliances for parkinson's patient

With the diagnostic repositioning it is expected that her tremor and rigidity will resolve.  If successfully resolved, she will need to be stabilized in the therapeutic position with a combination of orthodontics and overlay crowns ( to make back teeth taller).

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