For those suffering from orofacial dyskinesia, the search for solutions can seem hopeless. With a degree in nursing from University of California at San Francisco and several years medical editing experience, I was determined to find solutions for a family member suffering from this condition. This post was written after months of intensive research in hopes of aiding anyone else suffering from tardive dyskinesia or oromandibular dystonia.
Orofacial tardive dyskinesia and oromandibular dystonias are involuntary facial movements capable of causing social stigma and isolation. The repetitive, involuntary movements cause chewing motions of the jaw and often indicate a history of anti-psychotic medications, anti-emetics or hard drug use. These movements can also result from idiopathic (unknown) causes and in these instances, the condition is known as oromandibular dystonia.
Tardive dyskinesia and oromandibular dystonia – physiology
Orofacial tardive dyskinesia and oromandibular dystonia both derive from excessive firing of neurons that innervate the trigeminal nerve leading to contraction of the masseter and pterygoid muscles responsible for chewing. Anti-psychotic and certain emetic drugs working as dopamine receptor blocking agents seem to create a sensitized reaction to the presence of dopamine, particularly after the drugs are withdrawn, causing an over-firing of neurons. In dystonia the basal ganglia in the brain is believed to be behind the excessive, involuntary innervations.
Tardive dyskinesia and oromandibular dystonia prognosis – treatment
Tardive dyskinesia and oromandibular dystonias are characteristically incurable and irreversible although there are efficacious treatments including Botox and vitamin megadose therapy. Unfortunately, these treatments have side effects. Botox can cause jaw weakness, loss of the smile and other side effects although these symptoms often diminish with increased injection accuracy and adjustment of dose (http://cdn.intechopen.com/pdfs-wm/32225.pdf). Vitamin megadose clinical studies have been performed short term with physician supervision; however, over time these vitamins can overwhelm the kidneys and liver and also cause irreversible nerve damage as in the case of B6. There is another method to effectively treat tardive dyskinesia and oromandibular dystonias using mechanical sensory tricks (geste antagonists) to interfere with muscle contraction firings.
Tardive dyskinesia and oromandibular dystonia – sensory tricks
Tardive dyskinesia and oromandibular dystonias often respond to the presence of a custom molded retainer or a prostodontist device to inhibit or overcome the firing of responsible muscles. Sensory tricks include touching of the lips, the jaw and even holding a toothpick between the lips. All these tricks involve use of the hands or a temporary prop and the question is, would an ordinary, over the counter dental guard work as well as a custom designed retainer?
Tardive dyskinesia and oromandibular dystonia – dental guards
In private testing (afflicted family member), we have found that tardive dyskinesia and oromandibular dystonias do diminish with daytime use of standard over the counter dental guards (to date, DenTek’s Comfort Fit Night Guard). This is not a guaranteed solution for everyone; however for those who would rather not have Botox injections, nor risk overdosing on vitamins, and prefer not to be involved with ongoing doctor’s office visits, over the counter dental guards can be an affordable, effective option worth trying.