TMJ Treatment VA ALF applicance The Case of the Imperfect Patient Flickr cc credit junaidraoIn the past weeks of August in 2017 marks a shift in my education that will forever change how I see things with my patients. I spent five days with Dr. James Bronson at the ALF Educational Institute and then one day later flew to Oslo, Norway, and taught side by side with Dr. Darick Nordstrom, the inventor of the ALF appliance. This past week has now brought me to over 500 hours of actual training with the ALF appliance, and now I am into my fourth teaching trip with the ALF. Now, when I teach, I do NOT do cases like Dr. Nordstrom does- he is doing ALF on patients with severe cleft palates and the required surgery along with it. This, I admit to dear readers, ‘is not my cup of tea’ as they say. He was, however, impressed just a bit that we see many Tourette’s and Parkinsons cases. Dr. Nordstrom is an amazingly brilliant man and lives in a world where he makes his own appliances, by his own hand, and does research on a regular basis. He has even developed an amino acid supplement protocol that I would like to offer to our patients with tremors!

So back to the title of this blog. I have had it further ingrained into my rather thick cranium that a patient often needs a bit more than just what the ALF can do, although, based on this morning’s patients, we are doing pretty darn good just with the appliance therapy alone! So now I must put on my humble hat and admit that we could, and should, be doing even better. What that means is that many of the patients I see could do even better if we use a myofunctional therapist during the course of treatment- referred to as ‘MFN’ therapy. What this entails is exercises to keep your tongue working correctly (and believe me, MOST of us have poor tongue posture and movement). In addition, many people have a forward head posture, twisted neck, etc. so they would also need an osteopath – a ‘D.O.’ to help with distorted cranial bones, uneven leg length, out of place hips, and cervical spine (neck) problems.

In my world, I see people every day who have an amazing variety of ‘whole body’ problems that need to be dealt with. It is simply not enough for them to wear a couple devices in their mouth. Sometimes it will take a lot more effort and time to help them get better. And sometimes, about 10% of them simply do not get better without surgery or similar interventions. Some patients are simply in such bad shape that I cannot help them- they end up getting frustrated and angry because they spent ‘all this money’ and expect results. Unfortunately, sometimes there are just too many ‘imperfections’ in the person to help them get better. I see this when a person has been in an accident or two, was in a bar fight, or was T-boned while on a bicycle and a drunk driver outright nailed them. Yes- these are all my cases folks- and they are all quite difficult to fix due to the extent of damage.

I find it interesting that when people come to me, they expect me to fix all their problems with just an appliance or two. When I explain that they also need body work- i.e. an osteopath or physical therapist – many of them just will not do what needs to be done. This is due to cost or time in most cases. But I can tell you that when I see their xrays and their neck is all twisted up or their cranial bones are completely uneven, then I know they need that bit of ‘extra’ help- it’s as simple as that! And when the patient finally listens and does the required ‘extra’ therapy, that is when they get the results they are looking for – almost every time! So when I ask, request, demand, or simply advise that you also do myofunctional therapy or osteopath or physical therapy work, please take heed and just do it!