doxie

My 15 year old son is wearing the appliances made by Dr. Garcia in Tampa. He does wear his day time retainer while eating (per instructions) and has had approximately 3 adjustments in the 4 months he has been wearing it. His motor tics are considerably better - almost 90% gone. He never had verbal tics. I completely relate to your mind set about deciding not to "fix" your child. My knee-jerk reaction to anything is to "fix" - and I really am trying to shift. NOT EASY! I do try to keep only healthy foods in the house, and buy as much organic as possible. But when my ds wants a rare treat-a slurpee from 7/11, stays up too late and doesn't get enough sleep, skips breakfast, I am really trying to bite my tongue. I realize my incessant vigilance over every aspect of his life isn't good for him - and it certainly isn't good for me.

My son is still doing well. His eye blink, bunny nose wriggle and mouth pull are almost non-existant. The only thing I see, once in a while, is a slow eye blink. We are going to Tampa tomorrow for another adjustment. One note - every adjustment (this will be my son's second) is an added fee. I was not thrilled to learn this - I think it is around $180. However, honestly, it is hard for me to complain - my son is so happy with the results. In addition, my son used to sleep walk frequently and talk incessantly in his sleep (he would wake up on the couch having no idea how he got there, etc..) - that is all gone too. Not sure if it is related, but something sure has shifted in his body. Two weeks ago, part of the daytime retainer had become rough, so he went 2 days without wearing the daytime retainer because it was bothering him. Around 3 pm on the second day, he announced that he felt the eye tics coming back, and put in the night time appliance. The next morning he was tic free, and decided to wear the day time retainer with the rough patch (which now is not bothering him). Dr. Garcia's office called me today and asked me to call someone who has inquired about my son. I am assuming that it is from this link. I am happy to speak with anybody who has any questions. Beth

Michael, So far, my son has received one adjustment after the retainers were created. I wasn't paying strict attention while this was going on, but from what I remember, I believe he determined the adjustment just from examining my son's bite with the retainer. I know he was looking inside his mouth as well as looking at the alignment of the teeth and jaw. He used his fingers and hands to feel the alignment of the jaw. There were no electronics at this point. We have another appointment in 2 weeks and I will pay better attention as to what is done. I think I remember watching Dr. Stack's video and he used a similar technique when he was doing his adjustments.... Michael, are you using your appliance from Dr. Simms? What is going on for you now? Have you needed any adjustments? Beth

Hi love..nfp I agree with Michael. It would be difficult to do this from such a distance. We have been 3 times so far, and another visit is scheduled in 2 weeks. At that point, I believe we would go a few months before returning. Dr. Garcia does extensive education of other dentists - traveling to various cities as well as having dentists visit him locally. In fact, when we return at the end of October, the receptionist warned me that there would be a few students observing Dr. Garcia. As far as what happens after the year, I think there might be the chance that we have to "redo" the braces, but we will wait and see. At this point, his teeth are still intact and straight. I know how hard a decision this is.....I agonized over it for a long time. Beth

love nfp I also tried to perform the stick test with my son to see if there would be any change in his tics. I tried, 3, 4, - all the way to 8 sticks (he was gagging and begging me to stop). There was no change. However, as you know, I still went ahead with Dr. Garcia's appliances. My son has now been wearing the appliances (daytime and nightime) for approx 3 weeks. His eye blink and bunny nose movements are gone. However, I notice at times that he does a slow blink - like a relaxed closing of the eyes. Not noticeable to anyone else but a very neurotic mother who watches every move he makes - lol. Interestingly, yesterday he forgot to wear his daytime retainer. I was unaware of this until he commented around 6 pm that he had forgotten - and he felt his eye tic coming back. He immediately ran to get his retainer. For the rest of the evening, I was aware that he had a bit of a head shrug and his eyes were blinking. However, this morning he was fine. When he came home from school - still fine! I truly am hesitant to share this, because I can't believe it really has been this effective for him. It seems so strange - but it is the truth. I still take this whole thing one day at a time...we are scheduled for another visit with Dr. Garcia in 2 weeks. Beth

Faith, My son is severly ADD bordering at times on ADHD- so balancing the TS and ADD has been a real challenge. We have been on every drug imaginable. And I really, truly tried to avoid this route - but he was not successful in school The magic formula at the moment is Tenex 1 mg twice a day to help with the tics, and then Adderall XR 30 mg for the ADD. He had a big upswing of tics for 3 days after starting the Adderall, but it subsided (as the psychiatrist said it would). He has only been on the Adderall since August - previously he was on Abilify and Ritalin L.A. My son hated Abilify - it really seemed to numb him out - and make him so flat-lined. Sad to say he was on it for almost 3 years. He took himself off of it gradually this summer, and the tics never escalated. However, the Ritalin LA, which previously had worked, was doing nothing without the Abilify. When he came off of the Abilify, it was like a veil lifted. Our goal will be to remove the Tenex once these appliances are adjusted and he is stable. I probably will wait until winter break. And yes, Faith, NO EYE BLINKING. I know - I can't believe it either....

"His persistent irritability is very, very difficult to live with - even more so than the tics. Anyone else experience this?" Distinguishing between normal teenage surliness and irritability from TS is challenging, however, I can say that my youngest son has been a "bit" lighter with his mood since getting the retainers. Although, the way he was acting yesterday after school- he was far from the cute, adorable child that I like to think is mine. FYI - my middle son, who does not have TS was chronically irritable in high school (now a freshman in college and only slightly better as long as I say exactly the right thing on the phone....lol). My oldest, is the easy, breezy, good guy. So - bottom line, so much has to do with their own genetic predispositions. However, it would make sense that the overriding tics going on every moment of their waking day is so annoying - and just another layer on top of all their "stuff". I will certainly ask Dr. Garcia about the braces on Thursday. Beth

Omg - just tried to edit my above reply with additional information and LOST IT!!! Guy, We did try the popsicle test for my son with no success. Today was day 5 of my son wearing the night time appliance and his precious face was as calm and serene as could be. I am pinching myself and terrified that I am dreaming...... Faith, The back molars do not touch with the night time appliance, but the daytime appliance allows the molars to touch and is designed to be worn during meals to permit chewing. All of Dr. Garcia's patients - TMJ and TS - are supposed to continue to wear the nighttime appliance forever. The nighttime appliance does not move the teeth to this position permanently, I think it is designed to allow muscles to relax and decompress at night. I don't think Dr. Garcia knows if trigeminal nerve involvement is present in all TS patients. He felt the spasms in my son's neck and face while doing his exam (which I never could see), and felt this would all be alleviated with the appliances. Hope this helps - not sure if I am very clear. Beth

Guy, I took some photos of the bite splints with my phone, emailed them to myself, but now can't figure out how to get the photos to show up here. I am a bit challenged - especially in the morning. Any advice? Beth

Love Nfp and Faith - A little more history about my son - we have completed braces. He was finished 1 year ago. TMJ was never brought up, though my son tells me now that he always has had a popping in his ear (which is now gone when the appliance is in place). He lost his retainer 2 months ago, and developed a gap in between his front teeth within 1 month. I held off on getting the retainer replaced because I kept considering Dr Sims. Then when I discovered that Dr. Garcia was only 90 minutes away, I decided that was an omen for us to proceed. Within 1 day of my son wearing the new appliances, his gap was gone in his teeth. I never expected that. But, the most exciting thing I can tell you - I think his tics are basically stopped. I keep looking, but the eye blinking, bunny wiggle nose and sniffing motion which would pull down his upper lip, are gone at the moment. Those specific tics have never been gone! They were normally non-stop - usually not overly noticeable to other people, but ALWAYS noticeable to me! At the moment, my son has a ferocious headache - and he put the night time appliance in immediately. I think since he is unable to wear the day time retainer, that perhaps it contributed to the headache. I am still cautious, but really, truly hopeful. Even when I ask him about how he is feeling (i.e. - which always means - how are your tics- which just asking always used to make him tic) - there are no tics! We are seeing Dr. Garcia on Thursday to get the daytime appliance adjusted. Hopefully, there will be no more headaches after this.

We have been out of town - and on the run since Thursday. It is late, but I want to post to give you all the latest update. Please forgive typos, poor grammar....etc! My son received his 2 bite splints on Thursday from Dr. Garcia - one for daytime and one for nighttime wear. The process of confirming the fit of the retainers required a lot of "in and out" of the retainers. There were quite a few adjustments to be made. What was so interesting/frightening was that as soon as one of the retainers were taken out of my son's mouth - a flurry of tics erupted. I was acutually a bit scared, thinking, omg, is this exacerbating the whole thing - or is it helping? At one point, Dr. Garcia left the room to work on the appliance, and my son said, Mom, when it is in my mouth, the feelings making me want to tic are gone." Ok, I was holding back the tears, but also reminding myself that we still have to wait and see. In the fitting process of the night time retainer, Dr Garcia, was intent on confirming that the back molars would not touch, regardless of how hard my son chewed on anything. Dr. Garicia's instructions were for my son to wear the night time appliance as much as possible, as this is the one that will be of the most benefit. Even though it is quite large, my son LOVES to have this in his mouth, because he has complete relaxation. He looks a little odd, but is learning to talk with it - however, you can be sure that this 15 year old will not be out in public with it. The day time retainer is very easy to wear. Within a short time , he was speaking much better with the daytime appliance and wore it to school on Friday, the next day. However, by the end of the day on Friday, he had developed a sore spot from it - and wants to wait until it is adjusted (next Thursday), before wearing it again. So for now, he is wearing the night time appliance when we are home - and at night. We have been out of town all weekend, so it was worn only at night. SO, what do I think so far - I have to tell you, I think the tics are less. In fact, today I saw very few. Are they gone? No, they are not - but they are better! But Dr. Garcia likened this process to peeling an onion - and we have quite a few layers to get through. One important piece of info - Dr. Garcia believes in wearing the night time retainer FOREVER. The day time retainer should only be needed for one year. Everyone in the office wears an appliance at night - and they all have the most beautiful teeth I have ever seen. Praying that this continues to help.....will let you know if anything changes. Beth

Thanks so much for your post, Michael. We had our visit with Dr. Garcia on Thursday. I don't know exactly what I was expecting, but it was very surprising. The physical exam of my son involved the manipulation of various pressure points located on his face and neck. Dr. Garcia was engaging and playful with my son. He told my son to let him how the pressure points felt - on a scale of 1-4 - with 4 being "Dr. Garcie, please stop, I don't like that!" To my surprise, most of the pressure points were 3s and 4s. Dr. Garcia commented that my son had extensive spasming going on in his neck. I almost felt like crying never having realized the amount of tension and spasms my son had been experiencing. In addition, there were many tests involving wires affixed to his head and neck - and then biting and releasing. The computer was able to gauge the muscles being used. The tests were Electromyography (muscle test), EGM - which checks the range of motion of the jaw, the JVA - checking joint vibrations. At one point, a small magnet wrapped in gauze as put inside his lower lip. My son was given a piece of gum and asked to chew on the right side, left side, etc. I am curious if Dr. Sims performs these tests or similar ones. In addition, there were x-rays done also. The woman performing many of the computer tests told me an interesting story. Her son, 8 years prior, had tics. He was 4 years old at this time. She noticed when he ate that his tics worsened. Since she was already working with Dr. Garcia, she asked him to look at her son and that perhaps the tics were being exacerbated by the chewing motion. Dr. Garcia agreed with her, and he created the bite splint for her son. Sure enough, once the splint was in place, the tics stopped. She actually videotaped her son - and I was able to see the DVD. In addition, her now 11 year old son came to the office while we were there (school had just let out and the bus drops him there). He came into the room to meet us - and he was completely tic free. Dr. Garcia actually credits her for the theory about the splint reducing the tics caused from tension and muscles spasming of the jaws. I have a copy of the DVD - it isn't professional at all, but I think I should upload it so you can see the results. Bottom line - we are returning next Thursday for the splints. Total cost is around $3200. There will be 2 of them. One is worn during the day at all times. You are able to eat with it in your mouth and you do not take it out until bedtime. The second is bigger, but it allows complete muscle relaxation of the jaws and keeps the jaws from being able to clench. Dr. Garcia showed me a paper that he presented in March 2002 at the International Association for Dental Research regarding this special night appliance and its superior ability to reduce night clenching versus a normal orthodpedic repositioning applicance. I am hopeful but cautious - and I certainly will let everyone know our results. Wish us luck! Sincerely, Beth PS - If you have any questions, I am happy to answer them.

This is my first post, but I have been following this link with great interest. I did speak with Gail, whose son has experienced significant success with the bite splint made my Dr. Sims. I know that Michael from Tampa had an appointment last week with the doctor from Tampa. Have we heard any information from him? I am scheduled to take my son tomorrow to Tampa to meet with this doctor, whose name is Dr. Ralph Garcia. I originally was planning on flying up to see Dr. Sims, but decided to try and stay local, since we live in Orlando. My son is 15 and has tics involving the eyes, nose, facial grimace and throat clearing. The tics morph from one thing to another - all confined to the neck and above. Interestingly, when he was 3 years old, he had an acciident from jumping off of the couch (my dh was babysitting - lol) and banged his chin and bit his tongue. The bite was so deep, the tongue needed to be stitched (dreadful moment). Anyway, his first tic, which was eye blinking, surfaced when he was 4 years old. Who knows if this is related, but I have decided to bite the bullet and give this appliance a shot. My son also tested positive for Pandas, but this wasn't caught until he was 10 years old - and the antibiotics made no difference. I have tried vitamns, supplements, neurofeedback, accupuncture, etc. and figured we might as well add this to the list. Wish us luck!! Sincerely, Beth