Protocol for the Treatment of Dystonia

6 months

Results of 6 months of splint therapy with the protocol described below

EXECUTIVE SUMMARY:

In this post we will outline the DIY (do it yourself) protocol that we have developed for the treatment of Cervical Dystonia.

This protocol does not invent anything new. It is the result of extensive study and integration of decades of previous research, experiments and practice  of medical professionals, professors, dentists, orthodontists, technicians and parcticioners such as: Dr. Gelb (father and son), Dr. Gerber, Dr. Bennet, Dr. Stacks, Dr. Brown, Dr. Mew (father and son), Starecta, Dr. Lee, Dr. Nordstrom, Dr. Sims.

A complete bibliography of the relevant research papers is published in the page of this blog dedicated to Resources

CONTENTS

We will start this exposition by describing the symptoms of the tipical case that we wish to treat with this protocol.

Next, we will describe the 3 phases that make up the protocol:

1) Phase 1: Stabilization of TMJ
2) Phase 2: Structural Alignment
3) Phase 3: Finishing Prosthetics

In order to implement this protocol correctly, you should be familiar with the concepts and procedures we introduced in the post dedicated to Principles of Splint Therapy and with the theory that we set out to test as we describe in the post A Bio-Mechanical Approach to Cervical Dystonia.

This protocol has shown to be effective also for the treatment of other occlusion related movement disorders, with varying levels of neurological symptoms (from postural collapse driven by a sinking skull to Parkinson’s, Generalized Dystonia, Oromandibular Dystonia and Tourette’s).

We do not claim to have found a cure. We have just observed empirically that the application of this protocol results in a major improvement of the quality of life – and often full discontinuance of neurological symptoms – for the patients who applied it.

The characteristics of this protocol are:

– Non invasive
– Non traumatic
– Fully reversible
– Inexpensive – it can be carried out for as little as 100$
– Compatible with every other drug based treatment that may have been prescribed by neurologists or dentists.

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WHAT IS THIS PROTOCOL FOR?

This protocol is directed and recommend for the treatment of cases which present all or some of symptoms like the ones described below.

Neurological symptoms such as movement disorders of different levels of intensity: from Postural Collapse to Cervical Dystonia, Oromandibular Dystonia, or Generalized Dystonia, or Tourette’s or Parkinson’s.

– Cranial collapse and derangement

 

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Collapse and derangement of cranial bones results in the axis of the plane of dental occlusion being out of alignment with the axis of the skull and the spine

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– Twisted and side-bent sphenoid bone

The sphenoid bone is the key to cranial alignement. It sits in the middle of the skull and is connected to 20 different cranial bones. 

Postural collapse and lateral-frontal sinking skull

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Subluxation and misalignment of upper cervical vertebrae

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Unstable Centric Relation lateral to Max Intercuspation

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Displaced condylar disk

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Torsion of the spine, postural collapse, scoliosis, neurological movement disorders (dystonia, Tourette, Parkinson, blepharism, etc.) happen when ONE CONDYLAR DISK IS ANTERIORLY DISPLACED and the OTHER IS POSTERIORLY DISPLACED.

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A pathologic ocular tilt reaction

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Resulting in asymmetric input to the central nervous system and a tilt in the subjective visual vertical perception.

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Please be advised that the great majority of dentists (even self proclaimed experts in TMJ disfunction) do NOT have experience with this sort of neurological symptoms and skeletal imbalances and instability. They do NOT understand the relation between neurological symptoms, cranial collapse and dental occlusion.

That is due to the fact that traditional mainstream dental school teachings are based on an oversimplified model (the articulator model) that considers the skeletal relation of skull bones and cervical vertebrae as FIXED and INDEPENDENT of dental occlusion.

Most of the patients who present these symptoms are likely to have been diagnosed by a neurologist with a specific kind of neurological movement disorder (be it Dystonia, Tourette’s, Parkinson’s, etc…) and are likely to have received prescriptions for Botox injections to paralyze specific muscles, systemic antiepilieptic, antidepressant drugs and pain killers. Many may have varying levels of functional disability.

This protocol will not “cure” and “heal” them of their condition, but it has empirically proven to be effective in the great majority of cases in massively improving their quality of life by reducing the intensity and range of neurological symptoms.

In particular, for many cases of Cervical Dystonia, this protocol has resulted in the complete discontinuance of neurological symptoms

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THE PROTOCOL

The protocol that we recommend has 3 different phases:

  1. Phase 1: Stabilization of TMJ
  2. Phase 2: Structural Alignment
  3. Phase 3: Finishing Prosthetics

In order to implement this protocol correctly, you should be familiar with the concepts and procedures we introduced in the post dedicated to Principles of Splint Therapy, the Rectifier, the ALF and with the theory that we set out to test as we describe in the post A Bio-Mechanical Approach to Cervical Dystonia.

 

PHASE 1 – STABILIZING THE TMJ

 

rectifier

In the first phase of the protocol we will deal with stabilizing the TMJ and recaptureing the condylar articulation meniscus. We will use a Gelb-Rectifier, partial coverage, indexed lower splint is used to stabilize the TMJs in the first phase of the treatment.

 

The derangement of the Temporomandibular Joint (TMJ) has been associated to neurological symptoms and neurological movement disorders like Dystonia, Tourette’s and Parkinson’s, as well as chronic pain conditions like Occipital Neuralgia.

TMJimage

In the following video you will be able see inside a deranged Temporo-Mandibular joint and appreciate how a displaced condylar disk moves.

Manufacturing the Splint

We will use a Gelb – Rectifier partial coverage (i.e. covering only lower molars and premolars) lower splint and proceeded to “O” phonetic bite registration.

The patient will need a base splint for the lower dental arch. What works best is a clear orthodontic retainer of 2 mm of thickness. You can ask any dental lab (or even a dental technician student) to make one for as little as 32$. They will take an impression of the patient’s lower teeth and in 7 minutes (!!) produce a clear retainer. Please watch this video to see the whole process, lasting 7 minutes.

Polimorph to Register the Bite

On top of the base splint it necessary to register a new bite – whenever needed –
with polimorph (a plastic that melts at 66 degrees Celsius). Please watch this video to understand how to place polimorph on the base splint.

Polimorph is a non-toxic plastic material that melts at 66 degrees Celsius. It is possible to find it by googling “buy polimorph”. With 9 US$ you can get by mail delivery a bag with enough polimorph to make thousands of splints.

Phonetic Bite Registration

Bite registeration is carried out by closing the mouth on the fresh polimorph diretly in the patient´s mouth.  The cusps of the upper molars and premolars will leave “pits” on the  polimorph. We wil let the polimorph harden in the patients mouth (30 seconds).

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The upper cusps will leave «pits» on the polimorph when we close out mouth on it

In the picture above, the upper cusps have registered «pits» that fully embrace them on the polimorph. You can clearly notice the registration of both external (vestibular) and internal (palatal) cusp. For the purpuse of this protocol, we nees to have contact only on internal cusps and only between molar and premolar teeth.

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4 internal upper cusps have registered 4 pits on a lower modified Gelb splint.

Bite registrations have to be taken while the patient is standing or sitting straight and adopting the position of the mouth and lips that is the result of pronouncing the letter “O”.

“O” phonetic bite registration will produce an anterior, protruded and lowered position of the mandible and condyles which is referred to as “Gelb 4/7” in the scientific literature.

Gelb47

Various scientific papers published on academic journals describe how this method and condylar position is highly effective to recapture the condylar disks.

Cross Bite Splints

Due to the twisted and collasped skull, it may be necessary to use a “cross bite” splint to achieve stability.

first splint

A cross-bite splint is registered by imprinting on the polimorph pits that fully embrace upper cusps, leaving internal cusps on one side and external cusps on the other. Cross bite splints produce orthopedic forces that act on the canted maxillary bone and the sphenoid bone.

Vertical Dimension

The splint should have a high vertical dimension (5-9 mm) to produce strong orthopedic forces by means of a lever effect centered on molar teeth to transform the force of swallowing and chewing muscles into a stretching force on different sides of the upper cervical. The process is described in the post dedicated to Treating TMD with the Molar Lever

The harder you clench... the further you stretch the TMJ

The Molar Lever at work: the harder you clench… the further you stretch the TMJ.

The high vertical dimension is also necessary in order create enough room within the TMJ to unjam the articulation and allow the disks to recover a healthy physiological position.

In order to find additional information and how-to videos about the specifications of the base splint and the procedure for bite registration, please refer to the following posts on this blog: Principles of Splint Therapy and The Rectifer.

Re-iterative bite registration

We would use two splints to make sure that each time we register a new bite in the splint, it works better than the previous splint (by the patient’s assessment) or we can go back to the previous splint.

Over a few cycles of phonetic bite registration in a few days (only changing to a new splint if it is better than the previous one), we will get a fully functional Gelb – Rectifier that stabilizes the TMJ as much as possible given the circumstances.

In order to promote movement of cranial bones, we recommen that bite registration should be carried out very frequently – even daily.

Indexed versus flat splints

It s worth noticing that the protocol that Dr. Brendan Stack s and Dr. Jeffrey Brown reccomands call for the use of a flat plane Gelb splint for this phase. And they reccomand a registration of a new bite on the splint every 2 months. The reason of their recommendation of flat plane Gelb splints is to avoid the blockage of cranial bones.

We recommend the use of an indexed splint (where the splint has lower pits that fully embrace upper cusps). We  found that the use of the polimorph DIY technique to register new bites on a splint allows for very frequent (even daily) bite registrations conducted by the patient in his own home and without any cost.

We find that the frequent registration of new bites on the splints promotes suficient cranial motion while at the same time maximizing the strenght of the masticatory muscles and stimjulating muscle tone in the body in general. Lower indexed Gelb-Rectifier splints have a proven record in stimulating muscle tone of the neck and upper body.

In essence, we consider that Cervical Dystonia is an impairment of the mechanism that the body has to support the skull. Therefore, we find that there is a therapeutic advantage in stimulating muscle activity and tone through the use of an indexed splint while recapturing the TMJ disk in this phase.

Myofunctional Therapy

The second essential part of the treatment for this phase that we recommend involves specific tongue exercises: it is necessary to train the tongue to support the skull and reshape the palate.

The tongue is one of the biggest and strongest muscles in the body. Morover, it is one of the very few muscles that is built to push. The great majority of muscles are built to pull.

Whenever the patient is not speaking or eating, he should use the tongue to support the skull and reshape the palate.

Support of the skull can be achieved by using the tongue to push up on the palate pronouncing the letter “N.”

Reshaping of the palate can be achieved by sealing the tongue against the roof of the mouth with suction.

In all cases, the patient has to train to keep the lips closed, teeth in slight contact and breeth through the nose.

The following video by Dr. John Mew explains the basics of Myofunctional Therapy. We recommend it as a starting point. The patient should do his own research on Google Videos to continue this essential part of the protocol.

It takes 21 days to develop a habit. At first, it may be cumbersome for the patient to keep consciously an active tongue most of the day. By the end of 21 days, it will become an unconscious habit. It is just like learning to ride a bike or drive: when it becomes a habit, the patient will not even realize that he is doing it.

Duration of Phase 1

The splint will be used almost 24/7 for a month. The succes in stabilizing the TMJ will be judged by the personal assessment of the patient of being symptom and pain free.

In the second phase of the treatment (which we describe here below), the splint will only be used to sleep and to do sports and stretching exercises.

Cost

Cost: 32$ x 2 lower clear orthodontic retainers + 9$ of polimorph. Total: 71$

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PHASE 2 – STRUCTURAL RE-ALIGNMENT

upper lower alf

In the second phase of the protocol we deal with structural alignment. The dental-othopedic appliances tha we use are: an upper-maxillary ALF (advanced lightforce functional appliance) to correct cranial derangement and a lower-mandibular Rectifer to stretch and untist the spine

ALF TO UNTWIST AND EXPAND THE SKULL AND PALATE

In the post dedicated to ALF Orthodontic/Orthopedic Aplliance you will be able to find a longer explanation of the working of the ALFas well as photograpich and RX evidence of case studies and a bibliographic reference.

The following video will provide you an introduction to ALF in 2 minutes.


The ALF appliance was originally designed in 1983 by Dr. Darick Nordstrom to be a vehicle in a comprehensive dental orthopedic/orthodontic treatment approach. What Dr. Nordstrom initially discovered and later a handful of his disciples is that the ALF proved to be the best instrument to unravel the structural distortions of the skull bones and stabilize the cranial/dental complex.

cranial derangement

ALF treatment is designed to correct cranial assymetries and derangement

The ALF System represents the missing link between conventional orthodontics and the more progressive functional orthopedic/orthodontic concepts. In reality, the ALF concept goes beyond the dental realm and supplies many answers to solving the age old problems of chronic somatic pain and generalized ill health.

The ALF appliance allows to:

  • Correct cranial bone distortions
  • Correct maxillary cant
  • Align teeth to stabilize the cranium

This is how an ALF device looks like when positioned on the maxillary teeth.

ALF in place

An ALF device placed on the maxillary arch. Note the Omega Loops that activate orthopedic forces.

ALF is little more than a wire anchored on first molars and upper canines. It is activated and creates orthopedic forces by expanding the omega loops. In essence, it takes advantage of the force of the tongue when swolloing to expand and align the maxillary arch, palate and teeth. The force that it uses is extremely limited and light but constant.

The fact that the ALF is not anchored to teeth (unlike traditional brackets for orthodontics) allows for the maximization of cranial movement.

The final goal of ALF treatment is to achieve balance of the dental planes:

  • Vertical
  • Transverse
  • Sagittal

The key to making the ALF appliance work is to adjust the appliance so that it balances four cranial indicators. Only by correcting crania bone alignment will the patient experience a cure.

When used properly, the ALF appliance enables orthodontists to correct cranial base abnormalities, which in turn corrects bodily function.

cranial base

The maxillae represents the anterior 2/3 of the cranial base

Since the maxillae represents the anterior 2/3 cranial base and functions as the balancing mechanism for the entire skull, foramen magnum and atlas, it must be corrected first. By aligning the maxillae, it provides the foundation or template to build into.

From a clinical perspective, if the maxillae is distorted so goes the rest of the body. Since 46% of the motor and sensory neurons of the cerebral cortex of the brain relate to the face and mouth, maxillary distortions have the potential of disrupting the central nervous system and changing neurological function throughout the entire body.

cranial otrhogonal

The body functions best when its structures are aligned at right angles

Balance of the maxillae is critical for maintaining total structural integrity of the entire craniosacral mechanism. The dental complex via the occlusion provides the self-correcting mechanism for balancing the skull bones.

When the maxillae is crooked and teeth alignment is faulty the entire body goes into a compensation mode. This fact is exemplified by patient feedback that their structural manipulations do not hold. Invariably a dental component exists when there is strutural instability. No amount of symptomatic treatment will correct the underlying dental problem. It is for this reason that patient problems linger.

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The following video will provide a description of how to carry out adjustments of the ALF appliance to correct cranial derangement.

 

 

 

RECTIFIER SPLINT THERAPY

While the ALF takes care of the structural alignment above the neck, the structural alignment below the neck is carried out by menas of a  Rectifier-Gelb lower splint therapy to stretch the spine and untwist the upper cervical and bring the barycentre of the skull back on the axis of the body.

wpid-screenshot_2015-11-03-17-53-56-1.png

The Starecta Facebook Group is an open, voluntary, online clinical trial. Around 100 people are sharing their RX and MRI evidence of the application of the same protocol to straighten the spin with the use of the Rectifier.

A full description of the function and procedures to use the rectifier can be found in the posts dedicated to Principles of Splint Therapy and the Rectifer.

The Goal of Splint Therapy

The research line that we are following is based on the hypothesis that Dystonia and other neurological symptoms that bring about movement disorders are strictly related to a postural collapse driven by a sinking skull that does not find adequate support in the dental arches. To learn more about the rationale behind our bio-mechanical approach, please read this post: A Bio-mechanical Approach to Cervical Dystonia

The sinking skull creates compression and subluxation of the upper cervical vertebrae that result in twisting strain on the brain stem.

stage5

Cervcal Dystonia: postural colapse affects the Brain Stem

The pressure can distort and limit the transmission of the nervous signals between brain and body. Moreover, compression of the brain stem will trigger automatic, involuntary and asymmetric muscle movements to ease the twisting strain. In short, it triggers Dystonia.

Picture1

Lee, Young Jun. “FCST (Functional Cerebrospinal Technique).” Lecture

Therefore, the goal of splint therapy is to produce orthopedic forces that will progressively stretch and realign the upper cervical vertebrae (C1 – Atlas- and C2 – Axis) with the axis of the spine and the skull.

In the next picture you will see RX evidence of how the orthopedic forces produced by splint therapy can realign the upper cervical and eliminate pathologic compression strain on the brain stem over a period of a few months.

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All cases of Secondary Idiopatic Cervical Dystonia that we have treated with this method have resulted in complete discontinuance of neurological symptoms.

The following picture describes how we  use orthopedic forces acting on dental occlusion to stretch and un-jam the upper cervical area.

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It is also worth highlighting that this approach has resulted in the radical improvement – in some cases complete solution – of other occlusion related disorders like TMJ pain, clicking, disk displacement and bruxism in a matter of days from the beginning of treatment. In all cases, general body posture and symmetry improved dramatically.

And the next picture shows the skeletal and postural effects of 6 months of splint therapy.

6 months

Vertical Dimension

The splints would start with a high vertical dimension to produce strong orthopedic forces in different sides of the upper cervical vertebrae by means of a lever effect centered on molar teeth to transform the force of swallowing and chewing muscles into a stretching force on different sides of the upper cervical.

The Starecta “O” shaped incremental bite registration would be used to stretch the spine vertically. “AH”, “E” phonetic bite registrations would be used to reduce the subluxation and untwist of the upper cervical vertebrae (with normal and cross bite splints to produce twisting force on the upper cervical and sphenoid).

Each splint would be used at least a week and we would still use the double splint system to make sure that each new splints produces better effects than the previous by the self assessment of the patient’s symptoms. In case a new splint produces stress or pain to the patient, we have a previous well adapted splint to fall back to.

We would use the same splints that we used for TMJ stabization in this phase. At no additional cost.

The splint would be used to sleep, to do sports and rehab and whenever the patient feels he needs it. Not 24/7.

 

NEUROLOGICAL REHAB

Neurological Rehabilitation is one of the most important parts of the protocol that we have developed.

Eyes give your brain information about the level of the horizon. If they are not tracking well, the result is faulty propioception, uneven shoulders and  scoliosis.

Here below we will describe a basic Eye Tracking Exercise that helps balance and rehabilitate the nervous system in case of Dystonia, scoliosis and postural collapse. For further information, you can read our post on Neurological Rehab for Dystonia.

Convergence Test

The following test can show the extent of the imbalance. It is done by placing a pen vertically with the tip at the level of the eyes and the body of the pen touching the nose. When the eyes focus on the tip of the pen, the result might be like like picture 1 or picture 2.

eyetracking

Picture 1: Poor eye tracking with one eye turned in, while the other is not able to do so. This pattern is tipical of scoliosis and postural collapse.

eyetracking2

Picture 2: Good eye tracking with both eyes turned in equally. This result can be achieved with training.

To improve your eyes, you can perform eye exercises as shown in the video below. The effects on posture, skeletal alignment and propioception are nothing short than amazing.

 

 

 

SECONDARY TREATMENT AND PROCEDURES

The treatment using the upper-maxillary ALF and lower-mandibular Rectifier has to be carried out along with some secondarytreatmets which include:

– Postural Rehab

– Manual cranio sacral and atlas therapy to help mobilize the skull and the upper cervical vertebrae from the outside and help facilitate the lever effects of the splints.

– Exercises to increase lung capacity and rib cage volume

– Myofuntional therapy (toungue).

 

DURATION OF PHASE 2

This phase would last one year. Splints would have high vertical dimension at the beginning and gradually work towards the lowest possible vertical dimension that maintains thr patient symptom and pain free.

Cost: no extra cost for the splint. Cost of ALF would depend on the dental lab that manufactures it. But in the end it is just a bent wire with less than 1 hour of work to produce from start to finish.

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PHASE 3 – FINISHING PROSTHETICS

After one year, if the patient is stable and symptoms free with one splint he has been using for a few months, he has two options:

1) Prosthetic work to build onlays that reproduce on lower molars and premolars the pits of the last Gelb – Rectifier splint

2) Using a splint to sleep and do sports for the rest of then patient’s life and concentrating in physical therapy that increases he capacity of the body to adapt and stay for up to 24 hours without a splint and still be symptom free.

 

 

 

 

Navigate Through this Blog

To further understand our reasearch, approach and method, please read:

A Bio-Mechanical Approach to Dystonia
An introduction to the theory and analysis that support the pilot research project to use an adaptive intraoral appliance to treat and possibly cure Secondary Idiopatic Cervical Dystonia.

Principles of Splint Therapy
A description of the principles on which we base our protocol for the treatment of Cervical Dystonia and other occlusion realated movement disorders with varying degrees of neurological symptoms (from Tourette’s, to postural collapse, Parkinson’s and Generalized Dystonia).

Protocol for the Treatment of Cervical Dystonia

A step by step description of the 3 phases of the DIY protocol that we have developed for the treatment of Cervical Dystonia.

The Molar Lever

Our analysis of the bio-machinics of the Molar Lever and how dental occlusion is related to posture and skeletal allignment.>

Phases of Lateral Postural Colapse

Our analysis of the descending skeletal and postural effects of a collapsing and twisting skull that does not find adequate support in the dental arches.

The Rectifier

A description of the adaptive intra-oral aplliance -dental splint – that we use to treat Cervical Dystonia and the orthopedic forces that it produces by progressively pushing the mandible in retrusion, maxila in extrusion and elevating the skull by stretching and aligning the cervical vertebrae.

Resources

Bibliography and links to scientific research on the treatment of Dystonia and other neurological movement disorders with a bio-mechanical approach.

Postural Colapse and Dental Arches

A set of animations that present grafically the type of skeletal and postural effects that we intend to produce over a few months by modifying occlusion and the direction of forces between the skull and the mandible.

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101 thoughts on “Protocol for the Treatment of Dystonia

  1. Hey… It looks like you are on to something. My advice: people want your results but they don’t want to have to do the thinking. They want the Apple computer but they don’t want to have to understand the process and assemble it themselves. Steve Wozniack didn’t understand that, and Steve Jobs did. Don’t try to push your information on a grudging public, figure out how to offer them the product that will resolve their issues, and they will happily pay you and be healed and you will be a billionaire. And you deserve this.

    Oh, and I’m still questing for a model for the Ideal Occlusion so I can invent my Disposable Dentures, aka “Birkenstocks for your mouth.” I’m trying to fix a dental issue. You have studied so hard and long and you are so dilligent and informed. Can you help?

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    • Your right. I agree with you. I am working on it.
      As far as the “perfect” occlusion… I have experienced that it can vary greatly from person to person. The mainstream models (aka Dawson, acticulators, vertical forces) only work on reasonblu symmetric skeletal structures.
      I find it necessary for you to study personally how YOUR occlusion-mouth works. A base splint with a layer of polymorph will allow you to do just that.

      Base splint +polymorph could be your “Birkenstock for your mouth” 😉

      Like

  2. In addition to splint therapy, would fixing the occlusion via traditional means (invisalign, braces etc) be a good idea? Assuming the molars remain heightened.

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  3. Hola

    Tengo distonia cervical, por lo que he leido, entiendo que durante un año hay que ir subiendo la altura vertical de la férula hasta que se consiga una estabilidad, ¿la altura máxima es de 9mm. o se puede necesitar más?. He visto en internet casos tratados por diversos doctores y parece que los pacientes se quitan la férula y vuelven los síntomas, entiendo que esto depende de cada caso ¿es así?. Si hay que usar la ferula de por vida durante el dia, ¿hay alguna solucion estética para aquellos pacientes que no puedan cerrar la boca?. y por último, ¿se puede hacer ejercicio cogiendo mancuernas o peso durante el tratamiento?

    gracias por tu atención y el esfuerzo que estas haciendo para ayudar a tanta gente que busca cómo mejorar de su problema

    un saludo

    Like

    • Hola.
      Al revés. Hay que empezar con férulas altas para descomprimir las ATM y recuperar la posición sana del disco condilar. Luego hay que ir bajando la altura de la férula hasta conseguir la altura mínima que permite eatar sin síntomas.

      Ejercicios con mancuernas los desaconsejo. La distonia cervical comporta tener el cuerpo “enroscado” y ese tipo de ejercicios empeoran kos síntomas dando mas fuerza a los músculos que tiran de forma asimétrica y e involuntaria.

      Al final, estarás sin síntomas (entre itros muchos factores) cuando recuperas una inclinación del cráneo alineada correctamente con la columna cervical y vertebral. Por eso habrá espacios entre los dientes. Podrás rellenarlos con prótesis o composite. .. pero al final necesitarás una férula para dormir para el resto de tu vida.

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  4. Pingback: The ALF – Bio-Mechanical Dystonia

  5. Pingback: Treatment of TMD with the Molar Lever – Bio-Mechanical Dystonia

  6. Pingback: About Bruxism – Bio-Mechanical Dystonia

  7. i suffer from structure unbalance. My pelvis is shifted, knee is rotated and i have some scoliosis. lately i have been having health problems with my heart and constant but not severe lightheaded and dizzy spells i have a whole month with these. could the bone structure deformities be causing my health problems? i need serious help, someone reply to me please.

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    • In your case it depends very much on the situación (which teeth have implants, how strong the roots of the other ones are, how twisted your skull is, etc.).
      You need MRI, RC, to be advised by a real expert in ALF to see if you can make a custom ALF (not the general standard one).
      Chances are that ALF could not be advised in your case. Do not do DIY treatments.
      I recommend Dr. Brown in Washington DC and Dr. Nordstrom in California.
      You illustrate the case that we are in: going back to the original egg after it has been broken, scrambled and fried.

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      • I have spoken briefly with Dr Brown in VA, & I’m currently in myofunctional therapy with Joy Moeller in California. Joy actually mentioned Dr Nordstrom. Hopefully I’m on the right track. Thank you Marcello!

        Liked by 1 person

  8. Pingback: Neurological Rehab for Dystonia – Bio-Mechanical Dystonia

      • That is just amazing. I can only hope for that kind of success. I have been using polymorph to register my bite. I just really hope I’m doing it right. I’ve read it over a dozen times. Kinda tricky to know how much polymorph to use. Also, do you put it over molars and pre- molars?

        Thanks again for all your help!

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      • Your there is a learning curve. Just experiment. Sleep with a new bite regitration on the splint and in the morning you will know if it is working.
        It works if you feel better. That is how you can know if you are dooing the right thing.
        Yes. Over molars and premolars, with high vertical dimension 24/7 at the beginning… but the goal over months is to have the splint as low as possible and with contacts on all teeth.

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  9. Pingback: Cervical Dystonia or Spasmodic Torticollis: Positive Evolution after Neurophysiological Treatment – Bio-Mechanical Dystonia

  10. I have craniocervical instability and a retroflexed odontoid which is a candidate for surgery because it may be causing anterior brainstem compression. My symptoms include blurry vision, double vision, weakness, headaches, cognitive difficulties.

    Essentially what I need as an alternative to surgery is a way to lift the skull up and back from the dens of the c2 vertebrae which is exactly what your technique says it does! It almost seems too good to be true. The other thing that really intrigues me about it is I got my jaw stuck open for three hours ten years ago, before these disabling symptoms. And since then I always had a shifted bite and TMJ issues.

    So the first question is could a retroflexed odontoid be helped by your technique?

    And secondly are there any specialists in the upper midwest in the United States? For someone as sick as me as with very blurry vision I do not think I would be capable of doing this protocol myself and frankly becuase of the extreme nature of my case I really would like an expert to look at the biomechanics of my neck, palette, face, jaw, etc instead of just trying to figure it out myself.

    Thanks!

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    • Thanks for your comment. I too have high cervical instability and odontoid that shifts out of place.
      Based on your description, the answer is YES. This technique can help and is for sure a major part of any effective solution to inprove your condition.
      How much can it improve depends on how bad and conpromised your situation is now.

      In all of our complex cases we are talking about going back to the original egg after the shell has been broken, the yoke scrambled and fried.

      Nobody that I know in the Midwest. I know Dr. Brown in Maryland-Washington DC.

      I eouldr definitely advise you to try anyway. Ask a local orthodontist for a lower clear retainer of 2 mm of height and buy polimorph online. And try it. Register a bite on the splint. I am sure that you will be amazed by how easy and effective it is.

      Like

      • I just call up an orthodontist and ask for it? I would imagine in the US it would be considered medical equipment and they would be worried about getting sued if I misused their equipment.

        So to be clear in cases like mine it is the lower teeth, the rectifier that is likely the most important part? Because I have heard about the ALF device in the United States:
        http://www.alforthodontics.com/Practitioners%20&%20Labs.htm

        But it sounds like what you are saying is the biggest effect initially would be from getting that lever effect on my back teeth and decompressing my upper cervical spine.

        Like

      • Of course. The crap about «medical equipment» is all a corporatist ploy to protect business and maKe more money. If you are willing to pay 300$, any dentist or orthodontist can do it. If you are wlling to be creative and smart, ypu can get it from dental lab for 30$.
        Yes: the most important part is the lower rectifoerr. You can evem go without the ALF for the rest of your life.

        Like

  11. Yes, I fully agree the medical system is a racket trying to protect itself and justify its own existence, I was just pointing out the reality of the system we are in.

    So I get a splint of 2mm of height , but then use the polimorph to achieve 5-9mm on back molars? And I eat with it as well? I may get proteethguard or something I order online as a starting point. I can’t travel easily because of my vision problems and weakness.

    I have gotten a good intuition biting a pencil with my back teeth. Here I thought it would not feel good because I have TMJ issues but it definitely seems like there is something to it.

    Like

    • It is normal to have TMJ issues in our case. You may not need such a high splint. I started conservatively with a low one. Make experiments. use two splints. For TMJ pain use «O» phonetic bite registration until it heals.

      Like

  12. What’s the duration of phase 1? and can wa become notice significant improvement only from phase 1? if yes what’s the purpose o phase 2 besidewhat you described in the article?

    Like

  13. you said the splint used in phase 2 at night is the same used in phase 1. will the splint used in phase 2 contain also polymorph with bite registration or only the splint that’s gonne be used?

    Like

    • As the article states, phase 1 is centered on stabilizying TMJs. Phase two is centered on structural realignment. And the article states that 1 month of phase one should be enough. Phase one has «oh» phonetic bite registration and high vertical to achieve a Gelb 4/7 condylar position. Phase two is very similar but with lower vertical and other phonetic bite registrations: «A», «O» and «E».

      Like

  14. beside what you wrote on the artcle, can you simply the purpose of doing regular new bite registrations? can one bite registration still work?

    Like

    • No. One bite registration will not work. This is a therapy lasting atvleast 1 year in which you use orthopedic forces to move the cranial and skeletal bones.
      Think of braces (traditional orthodontics)… Would just one wire be enought to move tour teeth? No.
      The sae applies to cranial bones and cervical vertebrae.

      Like

  15. knowing that the maner in wich one pronounces a letter can be wrong and different from a person to another how can we ensure the usefulness of the phonetic registration? can bite registrations without phonetic still work and cure dystonia with time?

    Like

    • phonetic will ensure symmetry of muscles and the desired protrusion or retrusion of the mandible. Without phonetic registration there is no way you can use this method. Also, please read the part about reiterative bite registration. We use two splints to work so that we can constantly improve the mandibular position in relation to the skull spine.

      So… ot seems to me that you have not realized that the issue causing dystonia is a collapsed, unstable, assymetric on 3 planes, movable cranial and skeletsl structure.

      The splints use orthopedic forces to act on the spine and skull and rea align them. There exists no single correct position of the mandible thta you can use or mesure.

      Like

  16. Pingback: Bio-Mechanichs of Dystonia – Bio-Mechanical Dystonia

  17. Ciao io ho da tempo vari problemi tra cui maldi testa, vertigini maldi schiena che si sono alleviati con un apparecchio mobile che mi ha spostato i denti incisivi di sopra in avanti e fatto muovere in avanti la mandibola oltre che allargare il palato ma ora faccio fatica a toccare i molari e ho chiaramente bisogno di un bite.
    Ultimamente ho dei forti problemi visivi che peggiorano quando metto gli occhiali, un forte fastidio e non focalizzo bene e possiblie che questo sia dato dal problema mandibolare?avete qualcuno a Londra che mi possa aiutare?

    Like

    • Ciao Gianmaria.
      Cerca nel gruppo do Facebook «Dystonia, TMJ and the connection».
      Hanno compmilato una lista di medici.
      Comunique, io ti consiglio di cominciare a fare il tuo proprio bite in casa con polymorph prima di vedere uno e vari dentisti.

      Like

  18. Hola Marcello, tengo serios problemas de TMJ, discos adelantados, mordida desviada hacia la izquierda, hombro izquierdo mas elevado y cabeza que se tuerce hacia ese hombro. Por lo que lei en tu blog quizas tenga distonia cervical, pero no podria asegurarlo.
    Me interesa hacer el tratamiento que propones pero no vivo ni en Europa ni en USA , si no en Argentina, como veo que hablas varios idiomas (ingles, italiano y español) me atrevo a preguntarte si tenes alguna referencia de algun especialista que trabaje con ALF en latinoamerica, o especialmente en Argentina. Y si no fuera asi, habria alguna posibilidad de hacer ALF a distancia con algun dentista de los que conoces?
    Ya que si hago solo la parte DIY del rectifier, me faltaria la fase 2, alguna recomendación?

    Muchas gracias por el enorme aporte que este blog significa para todos los que padecemos de problemas temporomandibulares!

    Like

  19. I ill start splint therapy soon after reading all the important articles on tjis site. However i still have some ununderstandings:

    1- i went to a laboratory that took my down teeth imprents and created a basic splint of the down teeth made of resin. I have now a down theeth, Is it ok?

    2- the “oh” phonetic, when i try to simulate pronouncing it my upper and down teeth get in contact. Am i pronouncing right knowing that the phonetic is capital to succeed in this method?

    3- you said high vertical is used in the first month. And lower vertical is used during the phase 2 (1rst year). What’s practically high and low vertical an how can i be sure i’m doing them right.

    Like

  20. ALF must be used during phase 2 for 1 year with the night splint.

    The splint and polymorph are eady to get. But how about ALF?. But should i tell my dentist to get this ALF knowing that it’s esdential to acheibe balance of dental planes?

    Like

  21. This video is a sort of splint therapy you already explained the only difference is that polymorph is placed directly on teeth whereas in your metho we place it on the splint. My question was is splint therapy without ALF will make it possible to acheive a good result?

    Like

    • No it will not. But it can get rid of dystonic symptoms. It is a temporary solution. You can achieve better results with a solid splint that will allow for simultaneus registering of the bite on both side for example.
      But… for many this is the only option they have available.
      Morover, it is better to have a splint than not to have any if you have dystonia. And the sooner the better.
      Whith this method you can start at home in days and start learning and experimenting with your own condition. As a result, if you eventually find a dentist or dental lab that can help you, you will ñnow what you are talking avout.
      And it really only costs pennies. And it is truly DIY and homemade.

      Like

      • What do you mean by temporary solution?. The splint will be used all day and night for the first month and later by night for all life. In starecta website it’s all about the splint rectifier and continuous registring of the bite wich will cotrect the posture and make symptoms free..

        Like

      • A splint done only with polimorph as in the video above is a temporary solution. Ypu can not use it to eat for example as ot will eventually move. It is necessary to have a base splint done by a dental lab for a better treatment.

        Like

  22. Thank you for all what you do to help regarding this method. The splint part is clear and easy to understand, whereas the ALF part is unfortunately difficult to understand or explain to a local dental lab to manifacture it. I hope i’ll find a way to understand it clearly..

    Like

  23. The orthidontist showed me a device similar ti the ALF with a link between the 2 sides. He told me they use it to widen the uper teeth structure to make it fit with the down teeth. He told me that in my case the upper and down teeth fit exactly to each other. Is this the correct ALF device he showed me?

    Like

  24. Hi I posted here half a year ago. Since then I’ve gotten a splint and some polimorph but whenever I just test it out by putting about 3mm of plastic in between my molars, my left jaw joint and face aches quite badly. Within a minute even.

    The thing is I noticed increased cervical range of motion within that timeframe too, but I simply cannot try the protocol with that much jaw pain. Any ideas how to make that work? I tried biting on back in right and left and both induce jaw pain. My jaw is (not suprisingly significantly off center when I bite and deviates when I open).

    Thank you!

    Like

  25. Hello
    You explained lot of important things about the protocol, unless how to fix the fresh polimorph on the splint to take the bite and how to keep it solid on the splin?
    We cannot use any kind of glue in our month because it’s a toxic produuct.. so what to do?

    Like

    • HI. I replied on the Facebook group. There is even a video on how to use a thin layer of polimorph mixed with resin to create a base that polimorph will stiick to.
      Also, thebslternative is puttin a lot of polimoprh, as to cover the whole splint around the arch and make it a solid polimorph arch

      Like

  26. second question: in starecta website he explains that the rectifier must stay in the mounth for 1 year at least to acheive a good skull alignement. so what about eating speaking and what to do at work because rectifier majes them difficult?

    Like

    • You can eat and speak with a Gelb-Rectifier.
      My protocol calls for a month 24/7 to recapture condylar disks and decompress the TMJ and thereafter to use it to sleep, sports and as much as possible (while training the tongue to support the skull when not wearing a splint)

      Like

  27. Hola quisiera saber si podes ayudarme con lo siguiente, ya tengo el polimorph, me falta la placa de base, tipo retainer de ortodoncia, averigüé con varios laboratorios dentales y algunos los hacen de acrilico y otros de acetato, que material es mas recomendable? el polimorph se adhiere bien a estas superficies? gracias

    Like

  28. Muchas gracias! voy a probar con el policarbonato que me dijeron que es el que usan para los retenedores. Y te pregunto una cosa mas, tengo la mandibula desviada hacia la izquierda, entiendo que seria un “crossbite” , no logro comprender del todo el sistema para hacer la registracion fonetica en el caso de crossbite,
    “registering a bite on the lower splint that has pits that embrace internal molar and premolar cusps on one side of the dental arch and external on the other”
    tendria que poner el polimorph de un lado sobre el borde externo del splint y del otro lado sobre el borde interno? y luego registrar con la “o” por ejemplo?

    le pregunte a Moreno en el grupo de starecta y me respondio “i can say it’s better always to use internal cusps on splint, instead external cusps we can use their contact but without crestes around pits, only contact for external cusps”
    y no termino de comprender que significa “only contact for external cusps”
    como me aconsejas que empiece con el tratamiento? muchisimas gracias por tu ayuda

    Like

  29. Muchas gracias!!! solo una pregunta mas, un splint normal seria poner el polimorph totalmente parejo en el splint y morder haciendo la “o” y en ese caso tendria huecos donde calzar las cuspides tanto internas como externas de mis molares superiores?
    Perdon pero al tener que traducirlo me da mas trabajo entenderlo!

    Like

  30. Muchisimas gracias, no sabes cuanto valoro tu trabajo y tu interes por ayudar a otros sin fines de lucro, muestra los valores que tienes como persona! Espero tener exito en este experimento, y quizas vuelva a molestarte mas adelante con alguna otra duda! Infinitas gracias!

    Like

  31. Hola Marcello! Comparti las preguntas en el grupo TMJ Discussion con fotos de mi primera placa, para que puedas ayudarme con algunas dudas y de paso que sirva para que otros puedan tambien beneficiarse con tus respuestas! gracias!

    Like

  32. Hello
    Is there any relation between dystonia and a condition called cholinergic urticaria wich is a condition where the skin developes hives when becoming warm after increased temparature or exercice.
    In some studies they talk about the body who necomes sensitive to its own sweet. And talke about some patients with acquired idiopathic generalized hypohidrosis are theorized to have a defect in the nerve-sweat gland junction.

    In fact someone is affected with noth of them. Is applying the rectifier correctly can treate those two conditions?

    Like

    • I am not knowledgeable of connections with auto-immune syndromes. But I do not rule them out.
      ALF treatment has shown to have effect on Multiple Sclerosis.
      I doubt that the splint alone can make any difference. ALF, on the other hand, has wide systemic effects as it improves circulation of cerebral-spinal fluid.

      Like

      • When i test the “O” phonetic i get the following:

        – my iper teeth go to the right side a llitle bith and the down teeth to the left a little bit

        – the upper ane dow teeth get in contact

        – the big joint sound i have in my righ joint decreases and it become like normal

        My current dystonia is in the left side.

        I git it when i was training at the gym ligting height and i think i was doing wrong movement.

        I have an upward head position with a C in my lower back that hurts if i try to straighten my body when i stand up.

        Like

  33. Hello, Leonard

    I have sent you an email and I want to join your study and participate in research process. Please check your mail.

    I also have sent a request to join your closed Facebook community (its from Dmitry Fisher). Please give me access.

    Thank you

    BR, Dmitry

    Like

      • Marcello, I’m sorry but for some reasons facebook blocked my account! While I’m investigating, could you please copy your answers to my last comment here, please.

        I’d really appreciate it!

        Thank you!

        BR, Dmitry

        Like

  34. Hello Marcelo,

    I also made another request to your facebook group due to blocking my previous account. Its also from Dmitry. Please approve.

    I’m sorry to ask you twice.

    Thank you

    BR, Dmitry

    Like

  35. Hi Marcello,
    I have been following the protocol for some months now and while I have seen glimpses of some benefits I have not made any true progress.
    I believe my issue to be in the bite registration–that I’m unable to create an impression of the correct therapeutic occlusion.
    I have found that there is no consistency when making the o or e phonetic, and the motion of having to close my mandible into the polymorph introduces another level of variance(the trajectory is different with each closing). Using the s phonetic, by counting from 66 to 70 or repeating 66 pulls my mandible into a consistent position but I am unable to capture this occlusion in the splint as I am unable to vocalize the s phonetic properly with the splint in my mouth. Trying to align my occlusion into the s posture visually via my reflection has been the most successful but there is still a good deal of variance between each impression. I can then test this impression by wearing the splint and repeating “she sells seashells by the seashore” and feeling if my teeth fall into the pits on the s and sh sounds. Perhaps the s phonetic lacks the orthopedic benefits of the other phonetics but I am hoping that the s phonetic will help align my joints and allow me to close my jaw enough to use the o phonetic. While the s has made a small improvement in my symptoms (nervous system dysfunction), there is no day to day or week to week developmental progress.
    Repeating ele or olo will more consistently align my mandible for those phonetics but are unusable for the greater closing distance required.
    I have also tried a flat non-indexed splint but this was not at all useful.
    Do you have any advice or know of any other methods to make an accurate therapeutic occlusal impression into a polymorph splint?
    Thank you.
    (Sorry if this is a doublepost)

    Like

  36. Hi Marcello,
    I have been following the protocol for some months now and while I have seen glimpses of some benefits I have not made any true progress.

    I believe my issue to be in the bite registration–that I’m unable to create an impression of the correct therapeutic occlusion.

    I have found that there is no consistency when making the o or e phonetic, and the motion of having to close my mandible into the polymorph introduces another level of variance(the trajectory is different with each closing). Using the s phonetic, by counting from 66 to 70 or repeating 66 pulls my mandible into a consistent position but I am unable to capture this occlusion in the splint as I am unable to vocalize the s phonetic properly with the splint in my mouth. Trying to align my occlusion into the s posture visually via my reflection has been the most successful but there is still a good deal of variance between each impression. I can then test this impression by wearing the splint and repeating “she sells seashells by the seashore” and feeling if my teeth fall into the pits on the s and sh sounds. Perhaps the s phonetic lacks the orthopedic benefits of the other phonetics but I am hoping that the s phonetic will help align my joints and allow me to close my jaw enough to use the o phonetic. While the s has made a small improvement in my symptoms (nervous system dysfunction), there is no day to day or week to week developmental progress.

    Repeating ele or olo will more consistently align my mandible for those phonetics but are unusable for the greater closing distance required.

    I have also tried a flat non-indexed splint but this was not at all useful.

    Do you have any advice or know of any other methods to make an accurate therapeutic occlusal impression into a polymorph splint?
    Thank you.

    Like

  37. Pingback: The ALF Appliance Is Useless Without the Starecta

  38. Hi Marcelo,
    I was talking with someone in the starecta academy, he said that the O phonetic is not enough, and that sometimes we have to go right left backward

    in your protocal you say that first month (phase 1) we have to use the O phonetic, but what about the calendar of the other phonetics in the phase 2 Where the rectifier is only used at night?

    Like

      • so it’s O for the first month, then if the TMJ is pain free switch to the “A” phonetic starting from the second month.

        In fact in dystonia patients, their teeth contact even though it appears to be normal with no space between maxila and mandibilar teeth, but in reality they are deviated and not aligned, once the patient moves and alignes his jaw to the body center the gap and space appears in the left part of the teeth. It’s This gap that causes dystonia i think.

        Like

      • It is a process by wich you gradually (over months) move the Atlas and Axis back into place and alignment.
        You will have to alternate A and O, regular and cross bite splints, sometimes even within the same day.

        Like

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