Dr Sutter Trigeminal Neuralgia

[@lariat9447]

Thank God for Dr, Sutter and what he does !!!.....

[@lfaber2747]

Dr. Ben Sutter is a GOD SENT❤ I was bedridden for about 6 months trying to figure out what was wrong with me. Your KZbin videos saved my life! Solved my complex puzzle! I have Trigeminal Neuralgia on one side of my face & Eagle's Syndrome as well which I'm going to an Orthopedic Specialist who will be correcting my bite & realigning my teeth. I would love to share my story with Dr. Ben! More than I can type here😊

[@taniafleming4859]

I had facial surgery, and my mandibular nerve has been cut. The trigeminal nerve was cut too. I had serious earache and blood coming out of my ears after the operation. I tried to see a neurosurgeon but he said i didn't Type 1 TN. The burning, aching pain never stops but gets worse when i have attacks, my eyebrows, cheeks ache. The doctors have started me on carbamazepine. My life is ruined.😪

[@subhash7408]

Continue carbamazepine if it works for you. It's frist steps of treatment. Tks

[@taniafleming4859]

@@subhash7408 I tried taking it 3 times but made me violently sick, wicked headaches and vomiting. 😫😫😒

[@Emily-xl2cr]

Hi Dr Sutter - I would hugely appreciate if you could answer this one for me: If a dental specialist puts a patient in Central Relation (relaxing jaw sending off moulds then doing equilibriation).... and that hasn't worked... is a dentist like yourself still able to do DTR using T-Scan, ie, bringing them from Central Relation into Central Occlusion - if so how?

[@DrBenSutterEugene]

Emily, thanks for reaching out, your question has a lot to unravel. Originally Centric Relation (CR) was used to find a repeatable position when there was no teeth as a reference for starting a denture case. Many dentists hold CR to be some magical position, its not. It also has like five different definitions in the glossary of prosthodontic terms, 2 are superior posterior position and 3 are superior anterior position. There really is not agreement across the profession on CR or its relevance. If you want to know more check this out. www.ncbi.nlm.nih.gov/pmc/articles/PMC3732724/ So which definition did the doctor that did your equilibration use? Who knows. Unfortunately using molds of a patients teeth and doing an equilibration on the casts using an articulator really is not relevant either as an articulator is not a one size fits all for condylar guidance across all people. Also the Articulator does not take into account that a person has a central nervous system that is constantly reacting to whatever changes the dentist just made. This is the difference between biomechanical occlusion vs bio-physiologic occlusion. Lastly, if your treating doctor used or bite paper to figure out where to adjust the teeth he or she might struggle with accuracy. Bite paper regardless of brand is not accurate and doctors are about 13% accurate when asked to judge the most forceful mark, when I published my study the random chance of getting it right was 16%, this means dentists are guessing at paper marks. This study has been repeated 5 times now and there are no studies touting the reliability of bite paper in a meaningful way. We opened up a huge can of worms here, cant wait to see what others have to say. Dentistry really has not adopted biometrics like medicine has which is sad. Can you be helped with DTR? I don’t know, the first thing I would recommend would be a consult with T-Scan to see how those teeth are coming together. I hope that helps.

[@DrBenSutterEugene]

DTR is not done at CR btw....

[@Emily-xl2cr]

​@@DrBenSutterEugene thanks so much for replying. really interesting answer. i've actually had a t-scan done by a dentist I was referred to (in the UK) and shows roughly 50/50 bite pressure across both sides of my mouth however one of the molars (which is where i feel too much contact) shoulders around 30-35 percent (can't recall exactly) of the biteforce and I feel that significantly. He also wanted to do an EMG at our next consult. I don't believe he is DTR certified as I don't think anyone is in the UK but he's one of the few who go off data not bite paper. He also prepared me for the possibility that if adjustments based on the t-scan don't work we'd need to look at additive work like composite to restore certain non-contacting parts. If I were to pursue new treatment with the dentist who uses data the costs would run me into several thousands so it is an option but one i can ill-afford right now, but as a last resort I may. But what I have asked the dentist who did the t-scan to do was to forward the data to the dentist who originally put me into central relation (who is very open to new ways of doing things and who I have paid already to adjust the teeth but under the CR method/moulds/articulator/bite paper method), and to see if he can use that data set to adjust that tooth. Of course, if he does that, and then the bite goes 'off' elsewhere... the original data set forwarded to him becomes useless and then I'd need to begin the expensive treatment with the t-scan dentist. I did notice that when my jaw was massaged and manipulated into CR originally it didn't feel like a 'comfortable' or 'right' bite for me. Then I went back, back, back again using bite paper and ink each time to adjust and each time it got worse so the T-scan has at least shown where exactly is off and that my perception is correct of the weightiness on the tooth. That's what led me to the data-led-referral dentist, the fact that bite paper just seemed useless. The dentist doing it seemed to be guessing. It's such a complete minefield. Hopefully this can be fixed soon though as it's a miserable way to live. It is nice having it confirmed on screen though as I have been told by general dentists and others (like physios) that occlusion is meaningless, all the research proves that etc etc. When I have debated them (in a calm way) on that they have labelled me with occlusal dysthesia without any data and have said it's all psychological and need counselling etc. Exhausting to be gaslit like that by 'professionals'. Meeting with a data led dentist and having a dentist who (if wrongly using cr) is still open to new processes has still been a hope for me. It's scary truly terrifying how behind the UK actually is.

[@DrBenSutterEugene]

@@Emily-xl2cr To be effective one cannot take the data and return to the original doctor and say, see here it is, can you correct this, because the bite will start hitting in other areas and the bite force will change! Imagine how you walk with a rock in your shoe! The neurology will change based on the force and time, also you need to have 3-4 visits because as the muscles of the face and jaw relax the bite will alter slightly, it will need to be refined. The results here that you see (and want) are done under tight tolerances with specific endpoints, with measurement and data taken before and after each session AND in between each iteration of corrections per visit. Sometime I have 5 to 12 scans on 1 appointment because I am checking and rechecking each adjustment. I hope I explained that well. All of Europe is against adjusting occlusion, as if Enamel is sacred. It’s not , one needs to be conservative and measure, also a 50/50 (right to left balance) is meaningless if 30% of total bite force is on one tooth. Balance is only one aspect of the bite, and as it turns out the TIMING of the bite trumps force like 80% of the time. I hope that helps.

[@DrBenSutterEugene]

@@Emily-xl2cr one last thought, the technology is fantastic, but unless the Dr has been trained, understanding will be limited. In other words, just because I buy a hammer does not mean I am a homebuilder.

[@dnonya5208]

Dr. Sutter...where do you practice?

[@DrBenSutterEugene]

Eugene, OR

[@catherinewong157]

Dr. Sutter can u recommend a doctor for the San Francisco BayArea. I’ve had Trigeminal Neuralgia for 20 years and the last few weeks my Carbamazepine is no longer as effective. I up to four 200 mg a day right now and the pain does not totally disappear. They’ve tried other meds but doesn’t work.

[@DrBenSutterEugene]

@@catherinewong157 there are 2. www.digitalocclusionseminars.com/dtr-providers.html