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Dr. Stack appointment. TMJ


Gemi
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It’s been a while since my last post. I visited Doctor Sims in July of 2009. Dr. Sims was explaining about trigeminal nerve and this explanation was pretty knowledgeable. Some people were following me and ordered the moth piece. I did not order the mouth piece, because something was missing in Dr. Sims explanation. I could not figure out what but I was probably looking for some more explanatory proof. I’ve decided to make an appointment to Dr. Stack. This name also was mentioned in the previous posts. Today finally we made a trip to Virginia to his office. It took so long because I wanted to get done all needed test. I contacted his office in September and his assistant send me a list of required tests. Here they are:

 

In addition to a closed MRI of the TM joints, these are the x-rays that you will need:

 

Submentovertex

Panoramic

Frontal Tomographs

Lateral Tomographs (mouth closed, relaxed, and open views for each side)

Lateral Cephalometric

Lateral Cervical Spine

Frontal Skull

 

I was able to do almost everything paid by my insurance except Frontal Tomographs

Lateral Tomographs (mouth closed, relaxed, and open views for each side)

Lateral Cephalometric. Even MRI was paid by insurance. Actually, we did open MRI first and Dr. Stock requirements was closed MRI so we did the closed MRI also. Insurance paid for both of them because there were some findings on the open MRI. Here what they found on the MRI:

“Evidence of possible anterior disc displacement with the posterior aspect of the disc at approximately the 9 o’clock position oh the close mouth view. On the open mouth view there is evidence of recapture.” (if you read carefully you will understand why the stick test does help. Because on the open mouth view the condition does not exist, there is a recapture. ) Other tests were fine. When I came to the appointment today I immediately asked about the anterior disc displacement and that is what Dr. Stock explained, he actually showed me a picture that helps to understand everything. If you look at the picture of the jaw you can see somewhere where the jaws meet by the ear there is a little disk which looks like an almond. The right position of this almond has to be with the pointy side slightly turned toward the neck. Between this almonds shaped disk and the upper jaw there is like a tissue or mussel. In my daughter case this disk is slightly turned, it is actually perpendicular instead of being slightly turned toward the neck. Because of that the tissue or mussel is pulled or displaced out of the right position that is actually creates a pressure on that trigeminal nerve that Dr. Sims was talking about. Dr. Stock did not talk about trigeminal nerve. On my question about Touret syndrome or ticks he just answered that 80% of the patients with ticks will show displacement of that disk on the MRI, the other 20% might have a perfect disk position but the jaws would be pulled out of the place toward the neck. He told me that he stopped talking on fingers 20 years ago and he relies only on tests. He tolled me that if we decide to do the mouth piece than it has to be worn until the MRI will show the clearance of the condition. (It may take a year or more.) He told that Dr. Sims comes to his office every Monday for training. He follows his technique. I saw Dr. Stock mouth piece; it looked quite elegant I asked about mouth piece being the only option for correction he said that they also do the surgery, to put the displaced disk back. He said that the surgery is not complicated, but it takes 8 weeks of liquid diet afterward. He also said that even after the piece is worn for a year some people might require surgery anyway, because the disk did not go on the right position. We asked, why not to do the surgery right away, he answered that insurance will not pay for the surgery right away but will ask to try a moth piece first. He told that if we decide to go with his procedure he will redo all the tests anyway not because the tests are not good but he makes it a package for his work. He also mentioned that he was able to put the topic about his findings in the health magazine.

I made this post just for people to be aware that there are tests that can at list show where the problem is and insurance can pay for majority of them.

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Thanks for the info. I'd love to hear from others who've tried the mouth appliance from Dr. Sims, Stack, Garcia or other doc. I think my son is a bit young for it right now (non-compliance would be a big issue), but am curious (for future consideration) if anyone out there is having a good experience with it. Please keep us posted on how well it works for you.

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I was wondering how everything was going? Did you get the retainer from Dr. Stack? From what you wrote in your post Dr. Stack gave alot better explanation than Dr. Sims. Please keep us up to date. My son has worn the Dr. Sims retainer now for about 7 months. Right now he has really bad vocals. Making sounds every 1-2 seconds. We are having a hard time right now. Maybe worth a trip to see Dr. Stack. Hope eveything is going well for your dd.

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ccc,

 

Do you think you child's vocal waxing has to do w/ the retainer applicance? My son is seeing an orthdontist who is aware of Dr. Stack & Dr. Sims research and also is using a similar retainer to correct his severe underbite. He believes there is a connection bet jaw misalignment & neurological issues. 3 days into wearing it, my son started a vocal tic and his spiked his OCD symptoms.

 

After 2 weeks of wearing the retainer, i stopped my son from wearing it since all his symptoms continue to escalate. It has been 4 days after removing the retainer and all symptoms are starting to improve. My son is also getting craniosacral therapy, taking epsom bath and magnesium.

 

Pat

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Dr.Stack had a simpler explanation of the issue. Also he is very old and he’s been working for a long time. As well he is treating people with different tremors. As well I understood when I was in the office, he wants his patients to stay at the place for 4-5 days in order to make a proper adjustment of the mouth piece because this is important. Plus, he is doing a lot of tests and MRI. But he also mentioned that some people would require a surgery any way. As he explained, they usually perform the surgery for the patients from abroad of US because they do not have insurances. The surgery cost $35.000. American Insurance will require a year of wearing of mouth piece before they will pay for the surgery. As doctor Stack mentioned, some patients would require the surgery even after wearing this mouth piece for a year. He also said that not every oral surgeon can do a proper surgery, because this one require 8 stitches and regularly oral surgeon put 2-4 stitches which is not enough. But in majority cases mouth piece will help. He gave me a DVD with the testimony. On that DVD there were women, who could not walk, was shaking all over. Than he showed her on the 3d day after surgery, she was perfectly fine. She just has to follow liquid diet for 8 weeks post surgery. The surgery is inside the mouth as any oral surgery is. As I understood each case is different but in order to get result proper adjustments needed to be made and proper tactic applied, doctor has to be experienced enough and use the MRI comparisons. Dr. Stack mentioned he is performing MRI before putting mouth piece, in a year, etc. I can not advice any one to make or not to make an appointment to the doctor, but what I think, who is really interested has to do the MRI test and to find out through the test if there is any abnormality. As I mentioned in my previous e-mail, Dr. Stack thinks that 80% will have abnormality with TMJ and 20% will have jaws going to far to the neck area, which other test will show, if TMJ is fine. If there is available physical prove of abnormality than it is easier to understand what to do. If you call Dr. Stack office girls there will tell you what test needed (like I believe TMJ test has to be done on open and close mouth position.)

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Patty,

My son has always had vocals but there was a time about a month after we got the retainer that all of his tics went down and stayed down for about 3 months. So originally we thought retainer was working. It never made tics go away but were much milder. Now I don't know. Sometimes I wonder if this retainer has moved his jaw foward but cnat move it any more. I did not have any MRI's done only the x-rays Dr.Sims took. I have thought about carnial thearpy but we are in the middle of changing insurance companies so I have to wiat.

 

Gemi,

I wish I would have done the MRI before. Dr. Sims preferred them but did not make us do them. Wish I could go back. So did you decide to let Dr. Stack treat your dd. I would love to hear how her treatment is going. Thanks for all the info.

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Patty,

My son has always had vocals but there was a time about a month after we got the retainer that all of his tics went down and stayed down for about 3 months. So originally we thought retainer was working. It never made tics go away but were much milder. Now I don't know. Sometimes I wonder if this retainer has moved his jaw foward but cnat move it any more. I did not have any MRI's done only the x-rays Dr.Sims took. I have thought about carnial thearpy but we are in the middle of changing insurance companies so I have to wiat.

 

Gemi,

I wish I would have done the MRI before. Dr. Sims preferred them but did not make us do them. Wish I could go back. So did you decide to let Dr. Stack treat your dd. I would love to hear how her treatment is going. Thanks for all the info.

 

ccc have you gone back to get your retainer adjusted....i believe that is also key

as you child grows things move, as the mouth piece is in its moving things, also as he talks, sleeps etcs it changes the shape of the retainer..so that would make it inneffective....

You can go to Dr S for a second opinion, I did....he is up there in age and i don't think he's passed all his knowledge on yet, which scares me.

He also does think he could help my boy and would agree to work with us......ds showed a minor possible abnormality, but maybe that's all it takes,,,,but he does bite off to the side and overcloses soooooo

 

I cannot say i am having great success with Dr G's appliance...but i may be chasing a dragon...so i may, God help me, try to wait it out till he is older,,,,i will probally do one more visit as we had a whole new retainer made in Jan(as in addition to the adjustment it wouldn't fit right in combo with his growth) my boy is 10 and probably grew 4-6 inches this year

Ds has a loose tooth and a filling was loose in one of his baby molars...so i am assuming these are some how irritating his nerves....i wonder if dr G would just pull those out if that would help.

 

the theory i grasped was if it was you or i with the same missalignments etc..we are graced with not have these repocusions...however it is how the nerves are layed out a little different in these patients..ie 2 micromillitmeters higher or lower than you or i that they are being affect.....another ie no ones anything is exactly the same distance from another part of their body compared to someone else.....but it is more likely my kids heart will be exactly the mm distance from what ever body part as mine.....and these nerves also can effect other hormone/chemical levels in your body.....ie stress raises cortisol, blah blah blah

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We have not gone back to Dr.Sims. Honestly I was not impressed with him or his office, so I think when we left I felt I would never go back to him. We called him a few month ago for a referal close by that could adjust and he never called back. That was something we did dicuss there in his office and he said he would help us find someone closer. Also knowing that my sons tics never went away and he claims that he has fixed him to about 80%. I just have a hard time trusting him or giving him any more money. Sorry for venting:( I just would prefer to see someone else if they have sucess.

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We have not gone back to Dr.Sims. Honestly I was not impressed with him or his office, so I think when we left I felt I would never go back to him. We called him a few month ago for a referal close by that could adjust and he never called back. That was something we did dicuss there in his office and he said he would help us find someone closer. Also knowing that my sons tics never went away and he claims that he has fixed him to about 80%. I just have a hard time trusting him or giving him any more money. Sorry for venting:( I just would prefer to see someone else if they have sucess.

 

i would say go to dr St ..I believe they share the same appliance patent

he seems to be the one taking the reigns with this IMHO. i think sims is definite intereested but more just using the infor being fed him by dr St...as Dr st has treated other movemnet disorders and i believe his mind is trying to keep putting the pieces together.(ps i never met sims) and if you already put in thousands i would do a couple hundred more to follow through

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