Dr. Adams' Alabama Headache Blog

In this retrospective study, 519 subjects were selected at random from a pool of 5000 patients who had completed treatment of attended at least three treatment sessions before terminating treatment. Treatment consisted of intraoral appliances: a soft upper for sleep and a mandibular repositioning device for daytime and a self administered home program for muscle relaxation. When indicated physical therapy was prescribed. Prior to treatment, on the next to last treatment and on the last treatment day, patients filled out a pain score sheet composed of 20 Visual Analogue Scales(VAS). Ten pain sites were monitored, each by a VAS for the right and left sides. Possible scores were 0-1-for each site and 0-2- for each site when left and right scores combined. A global pain score for each site was obtained by adding scores of all ten sites yielding a maximum possible score of 200. Pre-treatment mean pain was 54.6, next to last visit was 29.9 and last visit mean was 24.9. Each mean was significantly from the pretreatment baseline. Only subjects reporting pain in a site were studied. Each of the ten sites showed a significant reduction from a range of means 7.2-10 to 2.5-4.6. The post-treatment means of the five major diagnostic sites for TMDs (TMJ Pain, Clicking, Headache, Face Pain, and Neck Pain) were compared to scores of 220 dental students as a control. The pain levels of the two groups were almost identical (means ranging from 3.8 to 4.2) Overall, 92% of patients showed improvement and 8% were worse. An interesting finding of this research is that Neck, Upper Back, and Lower Back pain decreased significantly with a treatment of the oral condition. This lends support to the view that TMD treatment may affect areas outside the stomatognathic system. It was concluded that multidimensional treatment of TMDs is effective, reducing pain in 10 sites and in five sites to levels of dental student controls.