TMJ 'dysfunction' - Health implications

Published in the Aug 2015 issue of Positive Health Magazine

Thousands of former and current patients understand our health depends a great deal on how symmetrical our cranium, jaw, teeth and the skeleton are. Any asymmetry, especially in the temporomandibular joint, can give rise to some 40 different symptoms. These can only be treated through corrective orthodontic interventions. Attempts at treating these jaw asymmetry caused symptoms through conventional medicine result in utter failure and create millions of chronically ill people not only in the UK but worldwide.

In this article, we report the experiences of one patient, which sheds some light on why so many patients are unnecessarily suffering from very treatable illnesses and why healthcare costs are spiralling out of control. Our NHS is in a state of utter chaos and about to be scandalously handed over to private enterprises. This will, without any doubt, propagate further scams and quadruple costs both for patients and for the government despite the ministers reassuring you otherwise. The financial waste in our health care system is glaringly displayed in the handling of this one patient. Just imagine the scenario that follows, repeated many thousands of times in every hospital in the country. The system is a bottomless pit that cannot be satisfied by any amount of funding.

I had a 30-year-old patient attend our office with numerous health problems, as shown in the graph below. She was a regular, run-of-the-mill patient, who could have been easily handled through corrective orthodontic care. She was advised to get other consultations before returning and perhaps starting treatment.
GRAPH
Please note that the vertical axis denotes the severity of patients' self-reported symptoms from 0 to 10 with 10 being the worst.

Here are some excerpts from the words of a prominent orthodontist she first consulted:
"This patient is here because the parents do not know what to do with her set of complex (and they feel - interrelated) problems. She has a set of very confusing conditions (emphasis mine). She has, at times, been given some unusual advice (emphasis mine)about how to deal with it. The main complaints relate to the Gastrointestinal system, but she believes her problems are related to her TMJ problems, neck, shoulder, hip, knee, and ankle problems, all on her left side. She also feels she has a 'nerve' problem in the right arm.

EXTRA ORAL EXAM: Oval, balanced face.....The maximum mouth opening is 35mm. Had orthodontic treatment 20 years ago with 4 premolar extractions. Several posterior teeth are in cross bite, bilaterally, the upper arch is narrowed. She had her wisdom teeth extracted 3 years ago)."

COMMENT: All of the above the orthodontist considers a "normal state of affairs" and balks and ridicules any attempt by the patient or anyone else, to relate her medical problems to the state of her jaws. He finds the loss of eight teeth (four premolars and four wisdom teeth) acceptable. This loss would shorten her jaws, and the overall balance of the head would make it bend forward to bring some semblance of normality upon the neck. The neck vertebrae would distort, causing compensatory distortions write down the spine and consequential malfunction of many bodily systems. Please read my article on the dangers of extracting wisdom teeth.

He finds her cross bite, her narrow upper arch, and severe limitation of jaw opening as normal. A cross bite often causes numerous health problems from hypersomnia, neck and back pain, fatigue, to name a few. A narrow upper arch causes constant sinusitis and a blocked nose. Such patients develop mouth breathing and sleep apnoea and eventually right-sided heart enlargement and failure - ALL because of extraction orthodontics! For the record, a normal jaw opening is 50mm, not 35mm. which is indicative of serious pathology.

The orthodontist finally says:
"I am unable to compile a sensible diagnosis and treatment plan due to the many extra-oral complicating factors. She may need a multidisciplinary approach in trying to solve these complaints" - and forgets about the orthodontics, but goes on to refer her for an opinion from a hospital orthodontic consultant asking him to supervise the "multidisciplinary consultations" she needs for her many 'medical problems'. although this patient, now aged 30, had already spent a lifetime pursuing a "multidisciplinary approach" only to find that her symptoms got progressively worse.

COMMENT: Working with many patients over many years shows that, these problems can affect the musculoskeletal system, the heart and the circulatory system, the cerebrospinal fluid flow hydrodynamics, the neurological system, and the function of all the body's viscera. In fact, the TMJ dysfunction and other bodily asymmetries are behind most of the 'medical' illnesses that afflict society.

The symptoms emanate from bodily asymmetries and need physical intervention by a dentist. The absence of an understanding or acceptance of such remedial treatment by the medical profession, has plagued society with chronic illness. In fact, the system is geared to keep illness ending strategies out of the public domain and keep methods which perpetuate illness alive and well. The governing bodies do a damn good job of that.

Further notes:
This patient returned after 9 months seeking to be re-accepted for treatment. She also dropped off the letter from the hospital consultant orthodontist along with copies of numerous consultations with various medical specialists that she had undertaken in the previous nine months.

Here is a summary of the hospital consultant orthodontist's verdict:

1) "I have advised that her temporomandibular joint pain is NOT(emphasis mine) related to abdominal pain."
2) ".......the temporomandibular joint should NOT (emphasis mine) be treated to relieve symptoms associated with her abdomen."
3) "The temporomandibular joint would be best managed conservatively with the use of a removable splint in order to alleviate the muscular symptoms." [This the patient duly undertook, and her symptoms deteriorated considerably]
4) "There is NO (emphasis mine) evidence to suggest that orthodontic treatment can improve Temporomandibular Joint dysfunction. It is likely that orthodontic treatment would result in the condition remaining the same, or could perhaps get worse."
5) "I would NOT (emphasis mine) advise the placement of dental implants."
6) "I suggest she await the results of her colonoscopy and attend her upcoming rheumatology appointment related to her abdominal pain."
6) "The issues relating to her facial pain should be managed as a separate entity."[No mention is made as to how this would be addressed.]
7) "In the long term, if there are still ongoing issues with left-sided body pain, no pathological cause identified, a psychological evaluation (emphasis mine) may be of benefit."

This is pathognomonic of orthodox medicine - when no cause is found because of the medical system's inadequacies and cock-ups, write the patient off as a psychiatric case, whilst throwing cold water on anyone else who may have a solution to the patient's problems.

This embarrassingly ill-informed consultant, at the helm of Orthodontic teachings at a teaching hospital, probably had a few orthodontic students around him as he went over the patient's symptoms and rendered his rather incompetent opinion. Unfortunately for the patient, she opted to follow some of the advice of this academic consultant even though that advice sharply contradicted both, another Harley Street practising orthodontist's and mine.

The patient was then handed over to the medical department starting with medical consultants mainly centred around gastroenterology, ignoring all skeletal asymmetry issues.

Some excerpts from the gastroenterology consultations follow. We shall keep a note of the number and extent of the medical investigations this patient was subjected to as you read along, within these brackets [] to emphasise the utter waste of NHS funds on futile and dubious checks and on consultants who find "nothing wrong" and yet command phenomenal salaries.

Here is an excerpt from the first gastroenterologist:
1) "I am pleased to report that the blood tests that we sent which included full blood count [1], urea [2]and electrolyte [3], liver function tests [4], calcium [5], and C-reactive protein [6] were all reported with normal limits. An abdominal ultrasound [7] was unremarkable. Endoscopic 'top and tail' [8] identified no pathology either. Remember, she had lifelong symptoms of extreme gastric problems and yet, the consultant found nothing wrong!

......I wonder if it will be helpful to refer her now to Rheumatologists....... I shall be seeing her again in-clinic routinely." [He has netted a lifelong patient to keep earning his mullah.]

2) Another gastroenterology consultant writes:
".....She has been troubled by such symptoms, which may have been precipitated by events at work (emphasis mine)."
"She has had an ultrasound scan [9], MRI scans [10], repeated stool samples [11], and blood tests [12] as well as less conventional investigations including hair analysis [13].
In addition to seeing conventional doctors, she has consulted chiropractors and an osteopath......She is taking probiotics and Ayurvedic supplements...........Relatively recent blood tests taken include a negative coeliac antibody screen [14], normal vitamin D levels [15], and thyroid function [16], and calcium [17] all within normal levels as well as an unremarkable IgE [18]. A faecal antigen test [19] for hepatic pylori was negative [20] in April.
In addition to the GI features, she also comments on several bony issues including what appears to be temporomandibular joint pain, and problems with her left pelvis and left ankle which "clicks out" She comments on problems at C5/C6 too."

[No further comment is made about these significant points. The gastroenterologist recommends repeating all the above tests, 20 more tests- at the taxpayer's expense, so the merry-go-round goes round and round again while the patient continues to get worse.

3) A private gastroenterologist’s remarks:

"If further investigations prove to be normal, she may benefit from dietetic advice."!

4) Yet another gastroenterologist gives his verdict:
"On examination, she looked clinically well. She was not anaemic. There was no lymphadenopathy and her skin was fully intact (emphasis mine). I do not think any further investigations were required, and I thought her symptoms were very much in keeping with an irritable bowel......... she should make dietary modifications to obtain better symptom control."(emphasis mine) We know this is going to get her anywhere.

5) A consultant urologist now comes into the picture:
"...She has been extensively investigated with a CT scan and ultrasound of the abdomen, has recently been to India, and has had an MRI of the lower back and intravenous pyelogram, all of which have been normal.
Whilst in India, she underwent investigation of the urine and underwent further extensive blood tests including sugar, liver function tests, urea and electrolytes, and staining for acid-fast bacilli. All these tests, including Mantoux and health tests, were normal.
Abdominal tuberculosis has been excluded on CT scan, and there appears no abnormality on the intravenous pyelogram..... the most significant finding is an elevated ESR of 39.

In the first instance, I do not think she needs a flexible cystoscopy and hydro distension, but I am organising a four-day frequency voiding volume chart [21]and performing an MSU [22]to see whether there is still sterile pyuria........
She will need further investigations regarding the raised ESR [23]."

6) In comes a private rheumatologist:
"......At the moment, the only working diagnosis is Irritable Bowel Syndrome [meaning we do not know what it is. Her high ESR and platelets suggest a possible underlying inflammatory process......as you know, there is a long list of possible causes of her symptoms, and I am sure some of the symptoms may be related to her irritable bowel. Inflammatory processes involving costochondral joints in the ribs are a possibility, and instability in the ribs can cause this type of pain.

I have asked her GP to organise some further blood tests and refer her to my NHS practice for further investigations with isotope bone scanning [24]and possibly MRI [25]. In terms of the high Erythrocyte Sedimentation Rate (ESR), we will need to do autoimmune screening [26] and both protein [27]and urine electrophoresis [28]."!
[God help! Did I read autoimmune? This is an entirely different subject that regularly sucks in thousands of patients. Please read under Multiple Sclerosis many postings on this blog]

7) Back comes an original gastroenterologist:
"Symptoms have improved by taking Motilium [Domperidone used for nausea and vomiting and associated with an increased risk of serious ventricular arrhythmias which could be life-threatening]. The left-sided abdominal pain has not entirely cleared. She has not improved with anti-spasmodic and the next agent to be used is amitriptyline [This drug is supposed to be prescribed for depression and nocturnal enuresis] which is known to improve the symptoms of IBS."

COMMENT: I had been wondering when they will get to these 10 pence a tablet amitriptyline - a mainstay of most IBS patients after costing the NHS some £50,000 of expenses on the various futile tests, scans, consultant and hospital costs - to date and ongoing. This drug carries several warnings and I have seen it used on patients for dozens of conditions from headache, tummy ache, to back pain to name just a few.

It is ironic that despite the expertise of a dozen 'specialist' consultants costing the country upwards of £250,000 each per annum, the use of equipment and facilities costing billions of pounds, in the most modern health care settings, the patient is no better and if anything worse and still on the 'medical investigations' merry-go-round.

IBS affects one in five people in the UK. Our NHS is indeed paralysed with useless "multidisciplinary approaches" wasting some 20 billion pounds a year on these futile investigations, ordered by specialists, which fail to find anything wrong perhaps 98% of the time. It keeps many hospital departments abuzz with activity, whilst the taxpayers pay for these dramas enacted day in and day out in almost every hospital.

The gastroenterology departments are usually the biggest part of most hospitals - they need to be to carry out the millions of tests and scans, to finally condemn the patients into syndromes such as Irritable Bowel Syndrome (IBS) meaning we do not know what is wrong with you; Here take these anti-depressants!
The finality is as crude as that.

This scenario is repeated all over many other departments in cases of Myalgic Encephalomyelitis (ME), Chronic Fatigue Syndrome (CFS), Fibromyalgia (FM), Multiple Sclerosis (MS), and Rheumatoid Arthritis (RA) to name just a few.

In some countries, this system regularly bankrupts families who fall victim to a myriad of 'manufactured' illnesses and syndromes, with not a semblance of a cure in sight. In fact, medicine has conveniently made the word "cure" a taboo and no one dares ask their physician if they have any chance of a cure.

There is a pill for every illness, mostly inappropriate and often with serious adverse reactions. The idea of altruism remaining at the heart of medical professionalism appears to have long disappeared, and instead been engineered into a societal monster.

More particularly, do these specialists, on whom the public so relies, ever think that after failing, again and again, day in and day out, to bring any relief to the patients, there could be something seriously amiss in their knowledge and methodology? They should perhaps open their eyes and ears and listen to the patient who is screaming out, "it is my jaw, it is my neck, it is my shoulder, it is my hip". No one listens.

It makes it very difficult for a general dentist or orthodontist to accept such a patient for treatment as she has the backing of a hospital consultant who categorically claims that such treatment does not work. This would override the opinion of any dentist in any court of law, where the judges are equally dumb. She is condemned to the medical specialists who are already contemplating putting her in the cuckoo's nest through the illicit use of antidepressants because they have absolutely NO answers for her illness.

I am not only sorry for this patient, but sorry for thousands of others who are victims of such disgraceful inadequacies in our teaching institutions and decadent and obsolete governing bodies who would back the woefully ignorant consultants as exposed in this article.

My point could not have been better emphasised than what appeared in the Telegraph newspaper today and reads:
NHS tests and drugs 'do more harm than good'.

"Senior doctors have warned that patients are given drugs and tests they may not need because [color=#FF0000]GPs and hospitals are paid for the quantity of treatment.[/color]

Please read more here. Tests and drugs do more harm than good

On reading this blog, some comments received from patients:
1) "I have experienced a gastroenterologist before; I was very anaemic a few years ago, I should have been referred to a gynaecologist, but my GP referred me to a gastroenterologist instead. Only based on the anaemia, he did a colonoscopy, gastroscopy, and capsule endoscopy! What a complete waste of time and money! It transpired, a few months later, that in fact I had fibroids and needed a hysterectomy!"

2) "This has very much been my wife's experience over the last 8 years. We have spent many hours in hospital waiting rooms waiting for consultants to tell her they have done all their tests, which have come back negative or inconclusive.
Ultimately, my wife ended up at the neurologist's door and had the tests that suggested that it was, in the absence of other possibilities, MS. When Ruth asked what she should do next, his response was, "Go and get on with your life. See you in a year's time".

Then my wife had alternating 6 monthly visits between the very well-meaning, but ultimately useless, MS Nurse and the not so well-meaning, but equally useless neurologist. Usually, after having to wait an hour or more at the hospital, she would have 5–10 minutes to tell them how her symptoms were progressing and list any new symptoms. They would then send letters to the GP to prescribe more/different (often off label) drugs to treat the symptoms. Some of the drugs had very nasty side effects with no perceivable therapeutic effect......

The neurologist in question has his own theory, which he published in 2010, that MS was more likely if you were born in certain months. How convenient to have as a speciality a disease caused by something that cannot be changed... your birthday!
Ultimately, he is paid huge sums of money, to treat (but not cure!) people with a disease that neither he nor any of his colleagues understand. Moreover, he is almost certainly being "encouraged" to prescribe lengthy courses of expensive drugs that are not designed to cure a disease which they little understand.

30th August 2016
A comment received by another patient after she sought a second opinion from an orthodontist:

"I am not sure who you saw in London, but there is no scientific evidence behind what you have been told. This will mean that you are very likely to undergo a very long, uncomfortable and expensive process that will not work. I would not want that for you and therefore would not want to be involved in any such treatment. There is no evidence that extractions can cause ill effects, and no evidence that orthodontics have any effect on the TMJ. There is also no evidence of any link with ME."

Comment: This, I am afraid, is a sad situation not only in the UK but also in many other countries, as exemplified by the numerous requests for treatment I receive from all over the world
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ABOUT: Dr Amir’s dedication to promoting an alternative approach to dental and medical care, focusing on prevention over intervention, has not come without significant personal cost. Taking a stance against mainstream practices which contribute to ill health has put him at odds with powerful vested interests in the medical and dental fields. Dr Amir's work has led to groundbreaking achievements, with 48 identified illnesses which can potentially be treated through dental interventions. Despite facing funding challenges, Dr Amir's resolve remains undeterred. This site aims to highlight those issues and promote an alternative approach, to change current dental and medical practice paradigms. To help Dr Amir continue his work and maintain his practice, he invites contributions, no matter how small. Please donate through a window that comes up after a few seconds at dramir.com.

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