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Polymyalgia Rheumatica - Is it a Dental Problem?

by M Amir(more info)

listed in dentistry, originally published in issue 276 - February 2022

“Only those who attempt the absurd can achieve the impossible” - Albert Einstein

It was interesting to come across a patient who had been diagnosed with Polymyalgia Rheumatica. This is a self-completed list of the symptoms that the patient presented with:

 

Symptoms Table

Symptoms Table

 

Whenever a patient completes a proper list of their symptoms no matter what illness labels they have been given, it never actually coincides with the published list of symptoms for that particular illness. Patients who may have been diagnosed with this illness should compare their symptoms with this list and see if they are in agreement.

After 30 years of experience, I can see that the symptoms listed above are typically related to TMJ dysfunction. The extraction of wisdom teeth as per the above list is a crucial contributory factor in worsening the symptoms in patients. I had never treated any patient with this condition before so I decided to inquire further. Here is what I came across. (Where I feel the symptoms are jaw-related, I have highlighted those symptoms in blue):

According to Wikipedia, Polymyalgia Rheumatica encompasses a wide range of symptoms classically:

  • Pain and stiffness (moderate to severe) in the neck, shoulders, upper arms, thighs, and hips, which inhibits activity, especially in the morning/after sleeping. Pain can also occur in the groin area and in the buttocks. The pain can be limited to one of these areas as well. It is a disease of the "girdles" meaning shoulder girdle or pelvic girdle. [Here please note that we come across hip asymmetry and pain universally in most patients.]
  • An overall feeling of illness or flu-like symptoms.
  • Low-grade (mild) fever or abnormal temperature is sometimes present.
  • In most people, it is characterized by constant fatigue, weakness, and sometimes exhaustion.
  • Tenderness and sensitivity on the scalp
  • Jaw claudication (pain in the jaw when chewing)
  • Tongue claudication (pain in the tongue when chewing)
  • Reduced visual acuity (blurred vision
  • Acute visual loss (sudden blindness)
  • Diplopia (double vision)
  • Acute tinnitus (ringing in the ears)

All these symptoms also occur in patients who have any asymmetries around the jaws head and the skeleton as per numerous articles on my blogs.

About 15% of people who are diagnosed with Polymyalgia rheumatica also have temporal arteritis, and about 50% of people with temporal arteritis have polymyalgia rheumatica.

Symptoms of temporal arteritis are also caused by a retruded bite, inflaming the temporalis muscle every time one swallows! This was the exact experience of one of my patients suffering from Palatal Myoclonus. He experiences a flaring of his temporalis regions on palpating the region where temporal arteritis emanates by retruding his lower jaw – retrognathia – and biting the teeth together.

Causes:

Medically, The cause of Polymyalgia Rheumatica – PMR – is not well understood.

Reading carefully through the explanation below it sounds neither scientific nor evidence-based but a highly speculative statement geared to steer patients towards a highly lucrative drug-based treatment modality:

"Pain and stiffness result from the activity of inflammatory cells and proteins that are normally a part of the body's disease-fighting immune system, and the inflammatory activity seems to be concentrated in tissues surrounding the affected joints. During this disorder, the white blood cells in the body attack the lining of the joints, causing inflammation.

[Getting ready to draw in more patients into the "auto-immune disease which generates a massive income in terms of supplying immune function killer drugs costing £20k plus per patient per year"]

Inherited factors also play a role in the probability that an individual will develop PMR. Several theories have included viral stimulation of the immune system in genetically susceptible individuals. [This is another typical ruse - blame a virus or genetics!]

Tests Available:

One blood test usually performed is the erythrocyte sedimentation rate (ESR) which measures how fast the patient's red blood cells settle in a test tube. The faster the blood cells settle, the higher the ESR value, which means inflammation is present. Many conditions can cause an elevated ESR, so this test alone is not proof that a person has polymyalgia rheumatica.

Another test that checks the level of C-reactive protein (CRP) in the blood may also be conducted. CRP is produced by the liver in response to an injury or infection, and people with polymyalgia rheumatica usually have high levels. However, like the ESR, this test is also not very specific.

[Both these tests do not test for pain and stiffness which are the main features of this illness.]

Treatment:

"Prednisone is the drug of choice for PMR, and treatment duration is frequently greater than one year. If the patient does not experience dramatic improvement after three days of 10–20 mg oral prednisone per day, the diagnosis is reconsidered. [ Steroid use can cause serious complications - one of which is damage to the femoral head which would make the pelvic girdle pain much worse and possibly lead to serious incapacity and a need for hip replacement.] Also, Treatment with Corticosteroids can have widespread undesirable effects such as osteoporosis, type 2 diabetes, hypertension, glaucoma and cataracts. These occur because steroids can affect the gut (and nutrient absorption) and cause weight gain. The high blood pressure and eye conditions may be related to fluid retention"

"Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are ineffective in the initial treatment of PMR, but are used in conjunction with the steroid maintenance dose." Patients are also prescribed PPI drugs with their serious adverse effects.

Regarding my patient, the evaluation of his symptoms indicated a primary jaw problem. I embarked on treating the obvious first – the treatment to correct the jaw asymmetries. The patient rapidly recovered. Here is what he wrote after recovery:

"I booked a consultation with Dr Amir, initially for dental purposes, which led to a discussion regarding very challenging physical symptoms I was experiencing. I had received a diagnosis of Polymyalgia and Fibromyalgia, both discovered/confirmed via numerous scans under consultation with a Cardiologist and Respiratory Consultant. I was experiencing muscle weakness and pain and was unable to do basic functions such as lift a moderate weight above chest height. Following several scans and consultations, I was prescribed a high dosage of steroids and advised I may need to remain on steroids on a long-term basis. I did not take the steroid medication, but instead discussed an alternative plan with Dr Amir, which involved wearing a dental appliance, for the purpose of achieving cranial symmetry. Considering the remarkable improvement I had seen in my children, I chose to work with Dr Amir. After 3 months of wearing and adjusting the mouth brace, my symptoms were dramatically reduced and within 6 months, I had completely regained my strength and I was pain-free.

I went for another series of scans, the results of which showed a reversal of the opacification of the lung deposits, providing physical evidence that I was indeed getting better (despite not having taken any medicinal intervention). I am now completely well and healthy, much of which I attribute to Dr Amir’s remarkable treatment!

Throughout all of our family’s treatment, Dr Amir has been both gracious and professional. He is a humble, yet brilliant man, doing great work. We are sincerely grateful to him and would highly recommend his practice to everyone we know.

I think Dr Amir should be praised for the remarkable work he is doing and sincerely hope his work is indeed given the recognition and praise it deserves, and that more aspiring dental professionals would follow in his footsteps. Indeed, I have suggested to my children that they may want to consider being trained by and working with Dr Amir."

He was also a witness at the PCC where he pointed out that physical signs of lung damage had completely disappeared as was demonstrable on radiographs and to the bafflement of his rheumatologists, but his testimony was completely ignored. In fact, the cheek of one of the panellists was to try and attribute his recovery to probably lesser stress at his work as a senior banker. The patient corrected him by telling him that the stresses at his work were exactly the same throughout.

Unfortunately, the GDC does not believe in these incredible accomplishments. The verdict of the PCC was:

"...that all your patients speak very highly of you and your treatments and their positive outcomes, but that the results they ‘think’ they may have received is possibly the reason why you believe in your practices and that you may have been misled by your patients", while their eminent "expert" dismissed my patients' success stories to a placebo effect!

I shall introduce a graph of one of my recovered patients. An objective analysis of this graph completely dismisses their speculations about having been "mislead" or a consequence of a "placebo effect" in their conclusions about my success stories:

 

Graph of Recovery

Graph of Recovered Patient Progress

 

How sad for all the recovered and recovering patients. It is an insult to the intelligence of my very eminent patients. It only confirms the invalidity of the GDC's judicial process faced by many dentists in my view.

It is time that all dentists got together and demand a reduction of some 50% for their subscriptions/registration fees which are not used to elevate dentistry but to destroy it by employing whole armies of lawyers to crucify dentists and other registrants for puny errors.

They give little credence to the valuable work that dentists could provide. The health of millions of patients is entirely dependent on the care provided by dentists and NOT medical doctors.

"Service to others is the rent you pay for your room here on earth" - Muhammed Ali.

Please bring these articles to the attention of all the patients who are chronically ill all over the world suffering from a wide variety of symptoms as per many articles on this website so they can go to the right person to get relief. Please also bring these articles to your dentists' attention so that dentists can realize their true potential and bring about true healing.

 

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About M Amir

M Amir BDS MSc (U. London) Dental Surgeon was a dental surgeon practising holistic dentistry in London. He specialized in the treatment of patients with medical problems emanating from the dysfunction of the jaw joint. He took particular interest in the field of body symmetry and its relationship to health He may be contacted on Tel: 0208 780 3433 (secretary); amir@dramir.com  www.themsforum.org/  www.dramir.com   www.thesymmetryforum.com

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