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The Relaxing and Moderating Treatment (RMT)

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Stress and Orality

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Abstract

We decided to call our method as “relaxing and moderating treatment” (RMT). RMT has three combined therapeutic actions: towards sensory inputs, motor inputs, and central spastic factors because it affects both the peripheral side (sensory and motor) and the central side (relaxation to eliminate stressing psychoemotional factors). The local procedure is based on Travell’s technique: block of anesthetics into the spasmed muscles. We have adapted to the lateral pterygoid muscles (LPMs) by injecting into the fossa infratemporalis with a possible added action towards the afferents and efferents of the mandibular nerve (V3). The block is completed by functional exercises (stomatognathic and lingual), by an awareness and self-control of the parafunctional clenching (Hartmann lips technique), and by general relaxation and myorelaxant drug prescription. The results are amazing on TMD but also on some clinical signs and symptoms of fibromyalgia, migraine, or chronic fatigue.

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Notes

  1. 1.

    Long mistrusted, anesthetics began to attract a number of clinicians [1, 7, 37, 41, 46, 47, 65, 74, 79, 81, 92]. Injection of bupivacaine 0.5 % or etidocaine 2 % in painful muscles [41, 43] has a long-lasting sedative effect on craniofacial pain, while the physiological serum has only a transitory effect.

  2. 2.

    Today a molecule with amine function is preferred for its minor allergic risk: 2 or 3 % lidocaine (or lignocaine) and 3 % mepivacaine. However, whatever the molecule, an associated vasoconstrictor remains absolutely contraindicated. In effect, any vasoconstrictor interferes with a relaxation objective because muscular tissue is injured by an ischemic and anoxic phenomenon [26, 64, 73, 100].

  3. 3.

    For instance, there is danger in associating anesthetics with a β-blocking treatment. There is fundamental incompatibility with antiarrhythmics (tocainide, β-lytic, digitalin, etc.). Other interactions with antimyasthenics can cancel their therapeutic effects.

  4. 4.

    At any rate, clinicians must keep in mind that disparities do exist between patients in morphology and size.

  5. 5.

    Disinfectant containing heavy metal must be eliminated due to local risks of irritation and edema.

  6. 6.

    One may imagine combining the anesthetic liquid with a radio-opaque substance to identify it precisely in the radiological status. Inversely this protocol may not be appropriate to track the anesthetic liquid for the next hours or days, because of possible variation in the mixture viscosity.

  7. 7.

    About tinnitus, both Relaxing and Moderating Treatment (RMT) and awareness of clenching give good results in managing some cases of tinnitus such as buzzing caused by trigeminal dysfunction; but patients who complain about whistling must be informed that this treatment is noneffective for this particular symptom.

  8. 8.

    As written in the Part I (chapter “Objective Signs”), the direct digital contact with the PLMs is real [6].

  9. 9.

    Current data do not allow to identify the nervous locus of this phenomenon: cortical suppressor area, brainstem, or other?

  10. 10.

    For reinforcement, some dentists add an occlusal splint.

  11. 11.

    Hormone synthesized in the pineal gland. Melatonin receptors are located in the thalamus, hypothalamus, dorsal horn of the spinal cord, spinal trigeminal tract, and trigeminal nucleus. A change from substance P to melatonin secretion has been revealed recently [75].

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    Francis Hartmann & Gérard Cucchi

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Hartmann, F., Cucchi, G. (2014). The Relaxing and Moderating Treatment (RMT). In: Stress and Orality. Springer, Paris. https://doi.org/10.1007/978-2-8178-0271-8_15

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