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For more information about neuromuscular dentistry, contact:


James R. Harold, DDS

700 Exposition Place, #151
Raleigh, NC 27615
Telephone: (919) 848-3636

Both Jaw and Atlas Need Adjustment

Raleigh Dentist Dr. James Harold frequently works collaboratively with Dr. John Boccella of Atlas Chiropractic of Raleigh to help patients overcome the often agonizing pain of TMJD—temporomandibular joint dysfunction.

Dr. Harold reviews Kelly Dillon’s file, pleased with the results of her TMJD treatment.

The magic of movement, sometimes subtle, always precise, is central to the work of both practitioners.

With over a thousand hours of special training and years of experience, Dr. Harold has become known as the region’s leading neuro-muscular dentist, employing high-tech methods to bring a patient’s jaw into harmonious, pain-free alignment. His patients come from across the state and beyond.

Kelly Dillon was a patient of Dr. Boccella’s for a decade or more before he finally convinced her to see Dr. Harold. “I had a lot of TMJ issues, just like my mother, a lot of neck and back issues, and my jaw was locking up creating even more pain in my facial muscles,” she says. “The adjustments to my neck were not holding, so I finally overcame my resistance and contacted Dr. Harold’s office.”

That call set her on the path to healing. “When I walked into the exam room,” says Dr. Harold, “I could instantly tell that she was overclosed. That means her lower jaw was too close to her upper jaw. She had a lot of TMJD symptoms: tingling in her fingers and right hand, popping and clicking of her jaw, ear pain. In her words, she said she was having headaches through her jaw.”

Harmony and Balance

Dr. Harold and his staff engaged in their customary extensive testing in pursuit of important goals: bring this patient’s jaw and joints into a neuromuscularly balanced position, correct the misaligned bite, and relieve the TMJD symptoms.

Dr. Harold employs an array of high-tech devices in the search for balance, including a low frequency TENS unit.

“The TENS unit helps us relax muscles and allows us to measure the electrical activity in the muscles in order to find a comfortable position for the jaw to relate to the skull,” he says. “Through the use of electromyography, we can accurately measure muscle comfort, and find a bite that will allow the muscles and joints to work together comfortably. Sonography is also used to ‘listen’ to the joint and determine if there is neuromuscular disharmony or degenerative joint and disc processes at work.”

Good Science

“The science that allows us to achieve proper jaw alignment and pain-free movement has been used in medicine for years,” he points out, “and now it is being used in dentistry to measure muscle dysfunction of the jaw, a major component in unraveling the mystery of chronic headaches.

“The data we gather are measured objectively and a comprehensive, individualized and precise treatment plan is formulated to provide both short-term relief and long-term stable elimination of symptoms. TMJ problems are chronic and degenerative, and many take years to develop. With objective computerized data and new techniques, we are now able to offer relief for patients who have suffered the debilitating symptoms of TMJ and who have often spent fruitless years seeking relief.”

The Magical Orthotic

With testing complete, Dr. Harold fashions a precisely designed therapeutic orthotic for the patient—a simple little plastic device intended for use around the clock, 24/7.

As is true for so many patients, Kelly Dillon experienced remarkable relief from her many pains within two days of placing the orthotic. “It felt a little strange at first, and I think it slightly affected my speech for a day or two, but very quickly I felt something important was missing if I took it out.”

But within a week of first getting her orthotic, her pain was back, as relentless as ever. She called Dr. Harold to express both her physical and emotional distress.

“He told me to come in immediately; he wanted to check both the orthotic and my bite,” she remembers. “And so I did that, and after examination, he said, ‘Your jaw is fine, your bite is perfect, but I’m almost positive your atlas is out of alignment. You need to see Dr. Boccella right away. We’ll call and make an appointment for you.'

She protested a bit, remarking that she had received a chiropractic adjustment less than a week earlier. But Dr. Harold felt strongly she needed chiropractic care. “If I’m wrong, come right back and I’ll work until 9 tonight to make you a new orthotic.”

Within the hour, Dr. Boccella confirmed that precision upper cervical adjustment to correct misalignment of the atlas was precisely what this patient needed. The atlas is the single, small, doughnut-shaped vertebra at the top of the spine that surrounds the brain stem. Talk about the magic of movement! If the atlas is misaligned by as little as one degree, it can have significant, even profound effects throughout the body.

“Kelly Dillon has benefited from chiropractic care for many years,” notes Dr. Harold, “and it’s likely she will continue to do so. The combination of moving her jaw to an optimal physiologic position, creating harmony between her bite and her facial muscles, and providing her with an orthotic to maintain this balance, will also give her the support and relief she needs.

“Her plan is to have orthodontic treatment at a later time to ensure that she can maintain this balanced position for her jaw without the need for an orthotic. Some of our patients use their orthotics for long periods of time. Others chose to have reconstruction work to permanently maintain the optimal position of their jaws to maintain health and avoid unnecessary pain.”

Multiple Benefits

Neuromuscular treatment, Dr. Harold reports, “often proves to be of great benefit in relieving a variety of issues, including headaches, facial pain, worn, chipped, or cracked teeth, cracking or chipping of dental restorations, neck and shoulder pain, jaw pain, ear congestion, ringing in the ears, clicking or popping in the joints, clenching or bruxing, limited opening of the mouth, loose teeth, and even tingling in the fingers.

“TMJD is not necessarily the root cause of these many problems,” he says, “but in many instances it contributes to the discomfort in a direct way. Basically, the problem is often a lack of harmony between the joint, the muscles, and nerves, and is thus ideally suited for neuromuscular treatment.

“And really, we need very little movement of the jaw to effect dramatic changes. It just simply needs to be movement that is absolutely and precisely correct.”