Prosthetic dentistry in the treatment of movement disorders: dyskinesias and other neurological abnormalities.

As long as the scope of dentistry is limited to teeth and supporting structures, their care and repair, probably no body of medical knowledge can be considered more traditional. However, a number of muscular and neurologic phenomena have been related to the dentition: unconventional dental prosthetic therapy has been shown to be effective in the treatment of temporomandibular joint disorders and movement disorders such as spontaneous orofacial dyskinesia and tardive dyskinesia. Although only anecdotal, the above results and an unanticipated event that occurred in one case of dystonia muscolorum deformans question everything that had been previously assumed about the limits of dentistry.

Tardive dyskinesia: dental prosthetic therapy.

The object of this study was to demonstrate that the dental prosthetic therapy that has long been shown to be effective in the treatment of idiopathic ov Spontaneous Orofacial Dyskinesia (SOFD) was also effective in the treatment of the orofacial manifestations of Tardive Dyskinesia (TD). This preliminary work consisted of evaluation of the results of dental prosthetic treatment provided to TD patients at the University of Illinois, College of Dentistry at Chicago. All patients who presented demonstrating orofacial manifestations of TD were accepted for treatment. No standard dental appliance exists to treat either SOFD or TD. Each case requires an individualized approach. Natural teeth should be maintained because the more natural teeth present, the easier it is to fabricate a stable and effective prosthesis, and TD occurs with greater frequency and severity in edentulous than in dentulous patients. Effective treatment of such patients requires the dentist to be flexible and tailor his therapy to idiosyncrasies of each case, rather than being wedded to rigid theories of what is supposed to be appropriate treatment and appliance design. Two representative cases of treatment of TD with dental prostheses are presented. Prosthetic dental therapy should be considered in the management of the orofacial manifestations of Tardive Dyskinesia because it often is effective and has no known side effects. Since the treatment described here is prosthetic, any team approach to the treatment of TD should include an interested general dentist or prosthodonist.

Hypnosis as adjunctive therapy for multiple sclerosis: a progress report.

Several reports suggest that hypnosis can facilitate healing in various physical pathologies. This is a preliminary report, supported by three cases. They demonstrate that suggestion by a hypnotist of symptom improvement can be used beneficially in the treatment of the physical impairment caused by Multiple Sclerosis. The first patient, severely affected, had Multiple Sclerosis for over 35 years. He had been wheelchair bound for many years. The second, recently diagnosed and minimally affected, had difficulty with balance and walked with the aid of a cane. The third, also minimally affected, reported pain in her right leg. All three showed improvement either immediately or within several weeks when the hypnotist suggested improvement or displacement of symptoms with the patients in hypnosis. No attempt was made to deal with psychodynamics or to suggest alternative symptoms to the patients. Symptom substitution did not occur. When symptoms improved, even slightly, these patients exhibited increased hopefulness.

Etiology and dental treatment of severe involuntary orofacial-cervical movement disorders.

A number of electromyographic studies have demonstrated evidence of the effects of dental sensation on stomatognathic muscle function. Dental occlusal imbalances have been shown to affect markedly altered EMG patterns: asynchronism, hyperactivity, and loss of bilateral balance have been noted. In most patients, distorted dental occlusions affect muscle function so that the changes remain observable only on EMG recordings. In some patients, however, the asynchronism, hyperactivity, and loss of bilateral balance may become distressing to the patient and clinically observable. Dental occlusal therapy in two patients reduced involuntary dyskinetic movements involving the face, mouth, and neck. Sustained improvement has been noted for over 8 years.