Solution: Neuromuscular Full Mouth Reconstruction
Background: Ira came to us a very angry, unhappy man. He was suffering from headaches, migraines, and neck spasms. He was a heavy smoker and used drugs to take his mind off the pain. He came to me for a consultation about his gums. Terrible gingivitis had ravaged his mouth. From the first moment I walked in and saw him fidgeting in his chair, I realized the true root of his dental problems: fear and anxiety. He was scared to death of the dentist, and had an incredibly strong gag reflex. He would gag as soon as I moved toward him with a tool in my hand.
After evaluating his mouth and taking x-rays, I asked him about the migraines and spasms. He said no doctor had been able to find the cause, so he was resigned to living the rest of his life in chronic pain. I looked over all of his x-rays and noticed that his jaw was severely out of alignment. Many people don’t realize that headaches, and neck and shoulder pain can be caused by incorrect alignment of the jaw. I asked him if he would consider wearing an orthotic device to try to fix his bite, and he agreed.
Treatment: We took care of the gum disease and did a full cleaning with root scaling and planing. His bite was what we call a Class 3: his underbite was so severe that his front teeth came down behind his lower teeth. He had been told by another doctor that he needed to have very expensive surgery in order to correct his jaw alignment. But I was able to use K7 computer analysis (advanced technology that measures and records mandibular function and masticatory muscle status) and a neuromuscular orthotic (a custom-made splint worn on the lower teeth) to gradually align his bite. We found the most comfortable position for the jaw and analyzed how we had to change its vertical height and dimension. This treatment required three months of custom temporary orthotics for the teeth. They would train his muscles and joints to slowly get used to the correct position.
After three months, Ira reported that all the headaches, migraines, and neck spasms were gone. Now that he wasn’t suffering from chronic pain, he allowed us to do cosmetic work on his smile using the blueprint that the orthotic provided for me. We did 28 crowns — a full mouth reconstruction. I selected a custom shade, color, and contour for the teeth that matched his age and facial shape.
End Result: By the time we were done, the patient looked 15 years younger. His wife came into the examination room after the final treatment and started crying. Ira decided he was going to use this opportunity to change his entire outlook on life. He stopped smoking and doing drugs. He was reenergized and seemed like a totally different, self-confident person. Everyone told him he looked good, so he wanted to feel good. This was a life- changing step for Ira and his family. To this day, Ira is still my patient. He has not had any neck spasms or migraines since his treatment. His entire family of nine brothers and sisters all come to my office for treatment.
Extra Side Note: When I tell people Ira’s story, I compare it to renovating a rundown house. Making an orthotic device is like drawing a blueprint for the new building. It has to be customized to exactly what you want and need. We made sure his new jaw alignment was the perfect position for his teeth. Rebuilding his bite was like tearing down a house and pouring a new foundation. Adding porcelain veneers was like building the house. Now, Ira has a happy home and a dazzling smile.
Dr. Sid Solomon graduated from the University of the Pacific Dental School in San Francisco California and has been practicing in Los Angeles, California ever since. He enjoys seeing his patients walk out with a beautiful smile and has devoted his practice to quality patient care in a comfortable and friendly environment.