TMJ 'dysfunction' - Health implications

Testimonial - Lucie Webb, 7th December 2018
"For the last 13 months, I have been a patient of Dr Amir. I have a retrognathic jaw, which he has been working to improve. I contacted him because I thought he could help me with my symptoms of ‘Fibromyalgia’.

I am 66 years old with a 3-year diagnosis of fibromyalgia, which was preceded by IBS or at any rate a gut infection (although the NHS seems unable to accept gut infections because they do not have the facilities to do the necessary tests). Labs in The States are set up to advise you if you can pay. I had Eintamoeba fragilis overgrowth, which Australian Doctor, Graham Exelby, has linked to IBS. How long before doctors in the U.K. catch up, or even acknowledge that digestive enzymes can help?

........At our first meeting, Dr Amir asked what reason I had to go on living. In the mould of the great German doctor, Groddeck, I could see he was ascertaining whether my spirit was prepared for a fight. That is the power of belief to invoke magic.

Structurally, my body has never been as Mother Nature intended. I lost an adult tooth in the lower jaw as a child and was advised to have my wisdom teeth removed in my 20s since they were a nuisance to clean. From this time, I regularly had stiff necks and tail bone, which I learned, could be ‘maintained’ by visceral osteopathy and cranial sacral therapy, but it is possible to overwork the mechanism. Dr Amir likes to point out this is hardly a cure.

In my 40’s I had an adjustment to the cuboid in my left foot, which led to a spell of labyrinthitis. Gradually I lost the ability to cry (I used eye drops) or feel a concomitant emotional release, and then a little before the physical collapse I had tense shoulders and neck which could not relax however consciously I tried.

I began to get a lot of pressure and throbbing at the base of my brain and by the time, I found Dr Amir, my breathing was restricted. I had to drag myself slowly across Putney Bridge from the tube station to reach him. Dr Amir spent some months correcting my dental arches. The first improvement I noticed was in the duration and depth of sleep. My breathing improved although I seem to have some shrinkage of my diaphragm muscles. My energy levels improved.

I have had tests on mitochondria done privately that show DNA damage, I still have pains in my legs most of the time, and occasional muscle spasms, but I am only 1/3 of the way through treatment. I am writing now to endorse Dr Amir’s treatment as, for the last few months, since Dr Amir started to bring my lower jaw forwards, I have had a tremendous release from pressure at the base of my brain. The permanent ache in my right shoulder blade has lessened.

I can cry with laughter or sadness, I have a big increase in the variety of words spouting from my tongue - (I keep thinking where did that word come from - have I ever used it before and was my brain really storing it for years without use?)

Most impressively, I look at least 10 years younger. The ageing process seems to have gone into reverse and I have now reached my teenage years, and I am looking forward to my second childhood!

I believe my endocrine and neurological systems stopped functioning properly because of pressure on the limbic brain and this has had a knock-on effect on the cardiovascular, digestive, and respiratory systems in particular. I have some permanent damage - sometimes my left arm, hand, ring finger twitch, but I am enjoying life again.

In reigniting my enthusiasm, I regard Dr Amir as a healer in the true sense of the word. TMJ dentists are the new healers. So glad that I am able to avoid all those ghastly drugs, tests, pain relief that is all that conventional western medicine has to offer due to its specializations leading to a fractured approach".
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The Fibromyalgia myth, however, keeps getting perpetuated:
Fibromyalgia is now considered a lifelong disease of the central nervous system

Conventional advice from the NHS about the management of Fibromyalgia is:

"Painkillers: Simple painkillers such as paracetamol or "Your GP may prescribe a stronger painkiller, such as codeine or Tramadol".
These painkillers can be addictive, and their effect tends to weaken over time. This means that your dose may need to be gradually increased, and you could experience withdrawal symptoms if you stop taking them. Other side effects include diarrhoea and fatigue (extreme tiredness).

Antidepressants: Used for "pain relief for some people with fibromyalgia". Patients are informed that "they boost the levels of certain chemicals that carry messages to and from the brain, known as neurotransmitters. Low levels of neurotransmitters may be a factor in fibromyalgia, and it is believed that increasing their levels may ease the widespread pain associated with the condition".

Antidepressants used to treat fibromyalgia include:

• Tricyclic antidepressants – such as Amitriptyline;
• Serotonin-noradrenaline reuptake inhibitors (SNRIs) – such as Duloxetine and Venlafaxine;
• Selective serotonin reuptake inhibitors (SSRIs) – such as Fluoxetine and Paroxetine;
• A medication called Pramipexole, which is not an antidepressant, but also affects the levels of neurotransmitters.

Antidepressants can cause a number of side effects, including:
• Feeling sick;
• Dry mouth;
• Drowsiness;
• Feeling agitated, shaky or anxious;
• Dizziness;
• Weight gain;
• Constipation.

Sleep medication: To enable better sleep.
Nightmares and waking up with a fast heart rate can often occur.

Muscle relaxants: Such as diazepam for stiffness or spasms

Anticonvulsants: The most commonly used anticonvulsants for fibromyalgia are Pregabalin and Gabapentin.
Some common side effects of Pregabalin and Gabapentin include:
• Dizziness;
• Drowsiness;
• Swelling of hands and feet (oedema);
• Weight gain.

Antipsychotics: Antipsychotic medicines, also called neuroleptics, are sometimes used to relieve long-term pain.
Side effects include:
• Drowsiness;
• Tremors (shaking);
• Restlessness.

Unfortunately, none of these medications make a dent in the symptoms that fibromyalgia patients experience, as is apparent from the next story which unfolds below:

A new patient contacted us with the following story:
"I have been ill for 27 years, suffering from extreme exhaustion and severe muscle and joint pain. I have had numerous diagnoses, such as CFS & Fibromyalgia & Arthritis (Sjogren’s syndrome), hypermobility and depression. Having come across your website and various blog posts, I am now wondering if this is all related to my pains and a Jaw which locks that I have had for many years. Hoping that you can help.

My current medication is:
Buprenorphine Patches (Morphine)15 Micrograms/hour.
Tramadol 50mg 3 x daily.
Naproxen 500mg 1 x daily.
Hydroxychloroquine 200mg (immune suppressant) two x daily.
Mirtazapine (anti-depressant) 30mg 1 x daily.
Fem Seven Sequin patches (HRT)"
Ventolin (Salbutamol) inhaler 100mcg four times a day"

The patient further adds, "I have suffered for 27 years with chronic exhaustion & severe muscle and joint pains. I first became ill following a bad viral infection aged 22 during my pregnancy with my daughter. Despite exhaustive tests and multiple different diagnoses from many different medical professionals

I remain locked in a cycle of pain and exhaustion, unable to work and left with no alternatives but to rely on ever stronger pain relief."

Comment: It is interesting to try to decipher what medication the patients are actually being given, especially this particular patient, compared to the very innocuous-looking advice put out by the NHS as listed earlier in this article:

Buprenorphine is an opioid used to treat opioid addiction, acute and chronic pain.
Side effects may include respiratory depression (decreased breathing), sleepiness, adrenal insufficiency, QT prolongation, low blood pressure, allergic reactions, and opioid addiction. Can cause severe withdrawal symptoms, so care and supervision advised.

Tramadol is an opioid pain medication used to treat severe pain.
Common side effects include constipation, itchiness, and nausea. Serious side effects may include seizures, increased risk of serotonin syndrome, decreased alertness, and drug addiction. It is not recommended in those who are at risk of suicide.

Naproxen is a nonsteroidal anti-inflammatory drug.
Common adverse effects include central nervous system effects (e.g. dizziness and headache), blood effects (e.g. bruising), allergic reactions (e.g. rash), and gastrointestinal complaints (e.g. heartburn and stomach ulcers). It has an intermediate risk of stomach ulcers compared to other drugs in the same class (NSAIDs). NSAIDs appear to increase the risk of serious cardiovascular events. Serious drug interactions may occur in combinations with other drugs that affect the blood, or with drugs that also increase the risk of ulcers.

Hydroxychloroquine is a medication used for the prevention and treatment of certain types of malaria. Other uses include treatment of rheumatoid arthritis, lupus, and porphyria.
Common side effects include vomiting, headache, changes in vision and muscle weakness. Severe side effects may include allergic reactions.

Mirtazapine is an antidepressant primarily used to treat depression.
Common side effects include increased appetite, sleepiness, and dizziness. Serious side effects may include increased suicide among children, mania, and low white cell blood count. Withdrawal symptoms may occur with stopping. It also has strong antihistamine effects, which contribute to its prominent side effect of drowsiness.

Ventolin inhaler belongs to a class of drugs known as bronchodilators. It works in the airways by opening breathing passages and relaxing muscles. Side effects can bring about:
• Nervousness;
• Shaking (tremor);
• Headaches;
• Mouth/throat dryness or irritation, changes in taste;
• A persistent cough;
• Nausea;
• Dizziness;
• Raised blood pressure;
• Fast/pounding heartbeat;
• Chest pain;
• Irregular heartbeat;
• Rapid breathing;
• Confusion;
• Rarely, this medication has caused severe, sudden worsening of breathing problems/asthma.

This is a pitiful state of affairs. Alarmingly, what I deduce from the adverse side effects of these medications is that they actually cause or perpetuate patient symptomatology. In other words, the side effect derived symptoms than become the basis of the worsening and chronic lifelong Fibromyalgia illness spectrum!
Hence, despite numerous very addictive medications, the patient remains in a cycle of "pain and exhaustion".

Fibromyalgia patients already have a serious breathing problem. Prescribing them opioids with their depressive effect on breathing is a serious error of judgment. Opioids are the major killers in the USA currently. From this patient's experience, it is clear that the opioids do not help.

Fibromyalgia patients also have a serious bowel problem including heartburn. Prescribing them NSAIDs is heresy.

Also prescribing an antidepressant, which increases anxiety and depresses breathing, further endangers the patients' well-being.

The patient writes:

"Here is a brief update as to how my first week since starting treatment has been:

Saturday, having just left your surgery, my husband asks how I am feeling, and I am shocked to hear myself reply. “I feel like I have awoken from a dream, my mind is clear without the brain fog that has clouded everything for years, my breathing is so easy and relaxed and the world suddenly looks a much brighter place”. We return to the hotel for some much-needed rest before our journey home on Sunday.

Sunday sees us still in shock. My breathing through the night has been much better, and I wake feeling more refreshed than I have for a long while. The journey home sees me reaching for my sunglasses despite the overcast day, as mentioned yesterday, everything seems much brighter & clearer. My muscles also seem less sore and despite still being painful, the 3-hour journey back home was far more comfortable than the one down just two days before.

Monday finds me somewhat down as over-excitement from the weekend leads to a poor night's sleep and the associated pain and exhaustion that comes from not enough quality rest.

Tuesday Wednesday Thursday are all good days when I see much improvement, particularly with my breathing, my body feels much more relaxed, and I even manage a little walk around to my mother's house. This would normally be a challenge, but this time it feels like “I am walking on air”.

Friday is painful and see’s me crashing back down to earth with a bump, sadness and anxiety mean another poor sleep, sadness that I had not found you earlier and anxiety that your treatment might only be possible for a few months. I am so desperate for this to work and hope that today is just a little blip.

Saturday, following a better sleep and reassuring words from my husband, and again I begin to see much improvement. I am happy today and dare to dream, I shall see what the next week brings and keep you posted.

We remain optimistic, and thank you once again for starting me on this treatment, and look forward to seeing you in January."

Comment: At the early stages of treatment, patients do get many ups and downs. The symptoms are usually fewer and of shorter duration and intensity. The drugs being taken by the patient can also interfere and because of the adverse effects of the medications, an element of unpredictably is always present. It all starts settling down some three months down the road. Meanwhile, the patient is encouraged to take their focus off their unwellness and try simple exercises like Pilates or pursue some other hobby like writing, reading or drawing.

I have read hundreds of medical articles about these illnesses over many years. There is absolutely no mention anywhere that the jaw asymmetry, TMJ dysfunction or malocclusions could be the cause of the patients' symptoms. It should be mandatory for clinicians to check for TMJ dysfunction in their differential diagnosis; otherwise, they leave themselves open to litigation.

The wholly unscientific diagnosis of 'Fibromyalgia' must be the lowest point in the history of medicine.

Update from our new patient Tegan :
Wed 1st January 2019
"Hi, Dr Amir,

I thought I would send you a little update before my appointment with you this Saturday.

Things continue to progress well, I approached the Christmas period with my usual trepidation but also some optimism that I would cope that little bit easier with the added demands on my health from having to entertain and feed family and friends that in past years has inevitably left me with dread at this time of the year.

I am pleased to say that although, still very exhausting I managed to cope much better as I generally felt stronger with a little more stamina and energy.

I have now been able to come off the anti-inflammatory medication altogether and have reduced my Morphine by 2.5mg. I still have some muscle pain but find walking so much easier and more comfortable without the burning muscles that used to accompany even moderate exercise.

The biggest area of improvement has been with my breathing, I no longer need my inhaler and am able to sleep lying down, which for me is spectacular as for years I have needed to sleep propped up with multiple pillows.

I am looking forward to seeing you at the weekend and hoping that the coming weeks and months as I continue my treatment will bring further enhancements in my energy levels and reduced pain in my muscles and joints.
Many thanks
Tegan"
Progress report:
Sun 1/20/2019, 20:42
Hi Dr Amir,

I am 6 weeks into treatment and here is my latest update.

As in my previous report, I continue to feel a lot happier and more comfortable, with reduced muscle pain and much easier breathing.

I now feel ready to start doing some light exercise, This for the last 27 years has been impossible for me, having done so little for all these years leaves me as weak as a Baby. I mean to start with just a small amount of walking and not to push myself too hard, as the temptation is to overdo things, but this leaves me exhausted the next day. Slow and measured seems to be the way to start.

I continue to practice the exercises you taught me and feel sure that soon they will become second nature.

I am also pleased to report that I have started to reduce the dose of the immune suppressants that I was put on by a consultant at the hospital. I was started on this medication to supposedly dampen down the symptoms of Arthritis but have seen little evidence that these actually help. I am convinced that my recovery will be hampered by all the medication that I am on so this is the next thing on a long list that I aim to come off completely over time.

All in all, I feel positive that my recovery will continue and with your kind and patient guidance I feel confident that I will continue to feel better and stronger over the coming weeks and months.

Many thanks for all you are doing for me,
Speak soon, Tegan.

Update 05/02/2019
This month saw me approach my 50th Birthday with the growing realisation that I have been unwell for more years than I have been fit and healthy. This year we determined it would be a better day for me and indeed, not only did I manage lunch out and a trip to the Cinema, I was also able to visit a couple of shops on the way. While to many this may not seem like a very exciting way to spend your 50th Birthday, in previous years I would have scarcely managed to achieve one of these activities.

Immediately after this, however, I came down with a nasty bout of Flu which lasted 10 days. During this time, it has been difficult to measure progress, as any improvements in symptoms have been masked by having the Flu.

I have now recovered from this and continue with renewed optimism & boosted by my forthcoming appointment with you, I am pleased to report that I have been able to start reducing my dose of Tramadol.

I look forward to seeing you at the weekend
Many thanks
Tegan

UPDATE 26th September 2019
Hi Dr Amir,

It is now 10 months since I started my course of treatment with you, so here is my long-overdue update.

Following the initial and dramatic improvements to my health that were a result of improved breathing brought upon by wearing the first braces that you provided me, the following months have seen slower but noticeable further improvements to my situation.

Having worn your braces continually for the last 10 months I have gradually begun to feel stronger & stronger with much less Fibromyalgia pain and a feeling, that I was beginning to feel much more like myself and not a dumbed-down version of who I had been for some 27 years before.

I finally felt ready to start reducing some of the prescription medications that my rheumatologist had prescribed me, as I really felt that I no longer needed them. The following list is the drugs that I managed to STOP in the months since starting treatment with you:

Naproxen (anti-inflammatory)
Souletin (anti-depressant)
Zopiclone (sleeping pill)
Hydroxychloroquine (immune suppressant)
Ventolin inhaler (asthma)

As the summer grew nearer, I was feeling brighter, so we booked a week away in Wales with our daughter and grandson. This was a major milestone for me, as previously my health had only allowed for very short breaks with them. I am pleased to say that despite my anxiety, I managed the whole week without needing to rest and was able to enjoy the holiday so much more than on many previous occasions.

I did, however, return home very exhausted and decided to discuss my continued lack of energy with you, Dr Amir. You were adamant that a major barrier to further improvements in my health and energy levels were the strong opioid painkillers that I continued to take.

With newfound enthusiasm, I was determined to start reducing the Tramadol that I felt I no longer needed for pain relief. I had been taking them for 10 years so was worried about possible withdrawals and side effects so with the help of my husband and some empty pill capsules bought of the internet we started splitting the Tramadol pills into reduced doses, gradually lowering the amount of drug in each pill every few weeks.

When I got it down to taking just one reduced dose pill per day I began to feel a flicker of energy inside me. Dr Amir was again right, and I was so excited to tell him that my energy was returning.

I took my last Tramadol three weeks ago. I did have some withdrawal symptoms, most noticeably hot flushes and what can only be described as a strange feeling that worms were crawling underneath my skin. Not pleasant, but these are now beginning to fade. I would recommend to anyone this slow method of withdrawal from using opioid painkillers.

My mind is now clearer and my emotions less dulled down, this brings a sadness that for so many years such heavy medication has been stopping much-needed energy from coming through.

I am still on Morphine patches for pain relief which I intend to start reducing in the coming weeks and a low dose anti-depressant that was prescribed to relax my muscles at night. I am sure that with your continued help and as your treatment continues in the coming months that I will finally be free from all these nasty prescription drugs which have actually contributed to my condition.

My visits to you continue to be the highlight of my month, and I remain hopeful that your treatment has set me on the road to full recovery from serious long-term health problems.

Looking forward to seeing you on Saturday.
Many thanks, as always, Tegan

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PS: Taking a stand against the existing paradigm of dental and medical care is very costly. My website has highlighted the practices of those who knowingly or unknowingly perpetuate illness. This is not acceptable to the power structure controlling our health. To continue to produce evidentiary articles on my website and this forum - which have enlightened thousands of health practitioners and patients all around the world, to keep my staff employed and my offices viable, we request a little help. If you feel that this article has made an astonishing change in your symptoms, please donate through a window that comes up after a few seconds at dramir.com.

A paradigm shift in the care of Fibromyalgia.

CONDITIONS OF USE AND IMPORTANT INFORMATION: This article is for educational purposes only. The improvement or benefits identified in this article or on this site are based on individual experiences which are dependent upon the patient’s unique health condition, medical history, and other individualised factors, and should not be considered representative of all treatment outcomes. You must do your due diligence by consulting your physician before embarking on what may be suggested here. This information is meant to supplement, not replace advice from your doctor or healthcare provider, and is not meant to cover all possible uses, precautions, interactions or adverse effects. This information may not fit your specific health circumstances. Never delay or disregard seeking professional medical advice from your doctor or other qualified healthcare provider because of something you have read on this forum. You should always speak with your doctor or health care professional before you start, stop, or change any prescribed part of your health care plan or treatment and to determine what course of therapy is right for you.