Prolotherapy, Prolozone for treating Myofascial Trigger Points, Tendon Attachment Pain and TMJoints

Dr. Shapira Fibromyalgia, fibromyalgia SPG Block, Jaw Pain, Jaw Problems, Migraine, Schaumburg TMJ, TMJ ARTHRITIS, TMJ CREPITUS, TMJ is a painful condition, TMJ Neck & Back Pain, Uncategorized 0 Comments

I have successfully utilized Prolotherapy and trigger point injections for many years using lidocaine and dextrose. I had both of my torn rotator culls treated with Prolo with great results. More recently I had Ozone and lidocaine in both knees giving long term improvements in pain. The procedure was remarkably easy and except for initial injection practically painless.

I recently went to Phoenix to learn the best way to use Ozone from my friend an colleague Nick Meyer DDS. He recently wrote “The Holistic Dental Matrix”

He showed me how to use it and did some injections on me and I taught him how to do a Suprazygomatic Sphenopalatine Ganglion Block.

This morning I decided to try out the Prolozone on myself. I first injected Lidocaine and followed up with injection of Ozone. Remarkable comfortable and little post op pain. I did several areas and there was no pain after, barely even felt like I had done injection. Much more comfortable than lidocaine and dextrose.

Ever the scientist I tried an injection with dextrose and followed by Ozone. More sore than just lidocaine and ozone but not a lot of discomfort.

I recently read “Delayed onset muscle soreness at tendon-bone junction and muscle tissue is associated with facilitated referred pain.” (abstract below) and I did my elbow and and the tendon/ muscle area. More tender than a trigger point but far less painful than prolotherapy on the elbow and 30 minutes later virtually no discomfort similar to the experience with my knees. Previous injection with lido and dextrose was worse but was done when I already had a lot of tenderness.

I am now set up to do Prolozone in my office. I am pretty sure this will give my patients more comfort and better results, but time will tell.

Abstract below:
Exp Brain Res. 2006 Sep;174(2):351-60. Epub 2006 Apr 25.
Delayed onset muscle soreness at tendon-bone junction and muscle tissue is associated with facilitated referred pain.
Gibson W1, Arendt-Nielsen L, Graven-Nielsen T.
Author information
Abstract
Delayed onset muscle soreness (DOMS) involves central and peripheral pain mechanisms. Referred pain patterns following stimulation of DOMS affected tissue have not been fully described. Referred pain may provide information on how central mechanisms are involved in DOMS, as referred pain is a central mechanism. Further, tendon tissue involvement in DOMS is not clear. This study assessed pressure pain threshold (PPT) sensitivity at the tendon, tendon-bone junction (TBJ) and muscle belly sites of tibialis anterior pre- and during DOMS in 45 subjects (34 males, 11 females). Furthermore, pain and referred pain areas at these three sites in response to hypertonic saline injection (n = 15 per injection site) were investigated pre- and during DOMS. DOMS was induced using controlled plantarflexion from a platform (bodyweight as resistance) causing eccentric contraction of the tibialis anterior muscle. DOMS induced PPT decrease was found at the TBJ and muscle belly sites only (P < 0.001). No mechanical effect was found in the unexercised limb. Maximal pain intensity induced by hypertonic saline given pre-DOMS was significantly higher for the tendon and TBJ injections compared to intramuscular injections (P < 0.05). Significantly higher referred pain frequency and enlarged pain areas were found at the muscle belly and TBJ sites following injection during DOMS compared to pre-DOMS. The results indicate that muscle belly and TBJ sites are sensitised while tendon tissue per se is unaffected by DOMS. Central sensitivity changes caused by DOMS may explain the increase in referred pain frequency and enlarged pain areas. PMID: 16642316 DOI: 10.1007/s00221-006-0466-y

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Chicago ProloTherapy and TMJ Disorders: TMJ AND PROLOTHERAPY

Dr. Shapira Blog, Causes of TMJ, Clicking & Popping, Uncategorized 0 Comments

Prolotherapy is used for many musculoskeletal conditions including joint laxity. It can be used to treat varying conditions like rotator cuff injuries, tennis elbow or any joint laxity.

Prolo is short for Proliferation therapy and involves use of an irritant to increase collagen production. Prolotherapy alone cannot treat TMJ disorders but combined with a physiologic orthotic can actually fix some TMJoints.

Physiologic Dentistry is amazing at addressing myofascial components of TMD but does not correct joint laxity.

I frequently utilize prolotherapy in my office for select patients with TMJoint instability.  Prolotherapy can be curative for clicking and popping from loose capsule and ligaments of TM Joint.

In Chicago area Dr Ron Hauser is one of the top prolotherapy experts worldwide. I refer numerous patients to his office for prolotherapy in areas outside the TMJoint. I also refer some of the most severe TM Joint patients for him to do the Prolo because in problem cases he is the number one expert!

I do not know of any other doctors in the midwest who use Prolo therapy for TMJ Disorders. Dr Hauser is now practicing in Oak Park, Illinois and in Frot Meyers, Florida. His PA who has worked with him for years is in Chicago full time and does an excellent job as well.

The following is from Pactical Pain Management Journal. ALL CApitals are my comments.

Dextrose Prolotherapy and Pain of Chronic TMJ Dysfunction
Many of the subjective symptoms of pain, stiffness, and crunching sensation in patients with TMJ dysfunction were reduced greater than 50% in 92% of the prolotherapy patients in this study.

FREQUENTLY
By Ross A. Hauser, MD, Marion A. Hauser, MS, RD and Krista A. Blakemore, BA
According to the American Dental Association, more than 15% of American adults suffer from chronic facial pain.1 One of the most common causes is Tempomandibular Joint Disease (TMD),

A GREAT DEAL OF THEIS PAIN IS ACTUALLY MYOFASCIAL PAIN AND DYSFUNCTION OR TRIGGER POINTS AND TAUT BANDS IN MUSCLE AS WELL AS PAIN FROM FASCIAL ISSUES.

a collective term used to describe a group of medical disorders causing temporomandibular joint (TMJ) pain and dysfunction, and is estimated by The National Institute of Dental and Craniofacial Research of the National Institutes of Health to affect 10.8 million people in the United States at any given time.2 It occurs predominantly in women, with the female to male ratio ranging from 2:1 to 6:1, with 90% of those seeking treatment being women in their childbearing years.3,4

The TMJ is often predisposed to similar degenerative changes and pathologies seen in other synovial joints as a consequence of the frequent and repetitive stresses that the TMJ undergoes.

ALMOST ALL TMJ DISORDERS ARE THE RESULT OF REPETITIVE STRAIN INJURIES AND MICRO TRAUMA OR MACRO TRAUMA LIKE MVA’S.

5 Symptoms commonly associated with TMD include pain at the TMJ, generalized orofacial pain, chronic headaches and earaches jaw dysfunction including hyper- and hypo-mobility and limited movement or locking of the jaw, painful clicking or popping sounds with opening or closing of the mouth (INTERNAL DERANGEMENTS), and difficulty chewing or speaking.6 While pain is the most common symptom, some people report no pain, but still have problems using their jaws. Sometimes the bite just feels “off.” Additional symptoms may include ringing in the ears, ear pain, decreased hearing, dizziness, and vision problems.7

MANY CHRONIC HEADACHES TREATED AS MIGRAINES, CLUSTERS, AUTONOMIC CEPHALGIAS, TENSION HEADACHES, FACIAL PAIN, HEMIPLEGIC MIGRAINES ETC ARE IN FACT REFERRED MUSCLE HEADACHES AND ASSOCIATED WITH TMJ AND MPD. CORRECTION OF ORTHOPEDIC ISSUES CAN OFTEN ELIMINATE THEM WITHOUT MEDICATION.

The first-line approach to managing TMD typically includes resting the jaw, relaxing the jaw muscles, and doing jaw exercises as recommended by a physical therapist.
A NEUROMUSCULAR DENTIST TRAINED IN DIAGNOSING THESE ISSUES CAN BEST DETERMINE WHICH ARE MOST IMPORTANT ISSUES.
Recommendations may also include eating a soft diet that minimizes hard repetitive chewing of crunchy or chewy foods, such as bagels and steak. All gum chewing must be stopped, talking minimized, and teeth clenching discouraged. Relaxation exercises that emphasize gentle range of motion of the joint are recommended. Application of warm compresses to the affected area twice daily, for 10 minutes, to decrease pain and increase joint movement are done. If this fails, then typically a short course of an anti-inflammatory medication such as ibuprofen is prescribed and often a dental consultation is given. The dentist then evaluates the patient for malocclusion and bruxism. Many times, a mouth splint used at night can completely resolve or control the problem.
A NIGHT-TIME APPLIANCE IS USUALLY INDICATED IF PAIN IS ONLY AT NIGHT OR FIRST THING IN THE MORNING. DAYTIME PAIN IS BEST APPROACHED WITH 24/7 ORTHOTIC. NEUROMUSCULAR DENTISTRY UTILIZES A 24 HOUR ORTHOTIC WHICH USUALLY GIVES THE BEST RESULTS.

When pain, clicking, and locking symptoms persist, TMD sufferers commonly seek out the advice of a myriad of TMJ dental and surgical specialists. Because the causes of TMD are varied and run the gamut from mechanical issues—such as disc degeneration and dislocation or erosion of the fibrocartilagenous surfaces of the condyle, fossa and articular eminence—to hormonal as well as psychological causes,9,10,11 the treatment approaches for the chronic TMJ case are also quite varied. As surgery is considered a last resort for TMD, it is common for sufferers to seek out alternatives and one of the treatments they may consider is prolotherapy.
NEUROMUSCULAR DENTISTS ESPECIALLY REALIZE THE IMPORTANCE OF THE MUSCULAR AND FASCIAL TISSUES.

This article presents a retrospective analysis of patients who received dextrose prolotherapy to their tempomandibular joints, and was conducted on a patient population from a charity clinic in rural Illinois. Patients were called by an independent data collector and asked numerous questions concerning their response to the dextrose prolotherapy they received. The data was analyzed in all TMJ pain patients, as well as a subset whose medical doctors told them there were no other treatment options for their TMJ dysfunction and pain.
DEXTROSE PROLOTHERAPY IS WHAT I ROUTINELY UTILIZE IN MY OFFICE, WHEN I REFER PATIENTS TO DR HAUSSER HE WILL UTILIZE DEXTROSE AND OTHER MODALITIES.

Prolotherapy Modality
Prolotherapy, as defined by Webster’s Third New International Dictionary, is “the rehabilitation of an incompetent structure, such as a ligament or tendon, by the induced proliferatin of cells.” “Prolo” comes from the world proliferate. Prolotherapy injections proliferate or stimulate the growth of new, normal ligament and tendon tissue.12 In human studies on prolotherapy, biopsies performed after the completion of treatment showed statistically significant increases in collagen fiber and ligament diameter of up to 60%.13

I LIKE TO THINK OF PROLOTHERAPY AS REGROWING WORN OUT PARTS.

Prolotherapy is based on the concept that the cause of most chronic musculoskeletal pain is ligament and/or tendon weakness (or laxity). NEUROMUSCULAR DENTISTRY AGREES BUT FEELS THE CAUSE OF THE TENDON OR LIGAMENT WEAKNESS IS SECONDARY TO MISUSE OR CHRONIC REPETITIVE STRAIN INJURIES AND THAT CORRECTING UNDERLYING ISSUES IS ESSENTIAL FOR THE BEST RESULTS.
PROLOTHERAPY IMPROVES PROGNOSIS AND OUTCOMES COMPARED TO TMJ TREATMENT ALONE.

Prolotherapy has been shown in one double-blinded animal study over a six-week period to increase ligament mass by 44%, ligament thickness by 27%, and the ligament-bone junction strength by 28%.14 Another animal study confirmed that prolotherapy induced the normal healing reaction that occurs when an injured tissue is healing itself. In this study, the prolotherapy caused the circumference of tendons to increase by approximately 25% after six weeks time.15 I HAVE FOUND IN MY PRACTICE VERY LITTLE NOTABLRE CHANGE ONTHER THAN REDUCTION IN PAIN AND LOOSE LIGAMENTS OF THE JOINT.

HISTORY OF PROLOTHERAPY:
Prolotherapists have a long history treating TMD since the time of Louis W. Schultz, MD, DDS in the 1930’s. Dr. Schultz was unique in that he was both a dentist and a medical doctor. He was an Associate Professor in the Department of Surgery at the University of Illinois and Rush College of Medicine. He published several papers on the treatment of subluxation of the temporomandibular joint, including one in 1937 in the Journal of the American Medical Association.16 In this paper he described just how common TMJ syndrome was and that the traditional treatments of rest, appliances in the mouth, physical therapy, and surgery were only partially successful. He described a simple method of shortening and strengthening the TMJ capsule by injection (later termed prolotherapy). He tested various solutions in animals until he found one that caused a strengthening of the ligaments that support the TMJ but caused no injury to other structures.17 In regard to prolotherapy into the TMJ he found that:

There was no alteration of the normal joint cavity; the proliferation occurred in the ligaments.
There were no gross changes in the ligaments other than their thickening.
Lymphocytes infiltrate the area injected within 30 minutes.
Proliferation of tissue can be seen in four to six days.
He found that a series of three to five injections were required to often permanently stop the clicking, pain, and hypermobility of the TMJ joint. Dr. Schultz noted that over the course of his twenty years of doing prolotherapy for TMD, not only was it effective, but the treatment lacked significant side effects.

Dr. Schultz taught the technique of TMJ prolotherapy to Gustav S. Hemwall, MD. The primary author has worked with Dr. Hemwall and eventually assumed his practice upon his retirement from medicine in 1996. After acquiring Dr. Hemwall’s practice, Dr. Schultz’s son came to the clinic for a prolotherapy evaluation. He commented that in his father’s many years of practice as a dentist, medical doctor, and surgeon, the procedure that gave him the most amount of satisfaction in treating a TMJ case was prolotherapy.

I CERTAINLY UNDERSTAND THAT SENTIMENT. I HAVE BEEN UTILIZING PROLOTHERAPY FOR WELL OVER 30 YEARS AND HAVE ALWAYS FOUND IT TO BE VERY EFFECTIVE. IT CAN OFTEN BE THE KEY TO CURING RATHER THAN JUST TREATING THE TM JOINTS (TMJ)

THE FOLLOWING REFERENCES ARE FROM THE ARTICLE BUT I SUGGEST READING THIS ARTICLE FROM THE NHLBI OF THE NIH TO BETTER UNDERSTAND THE FULL SCOPE OF TMJ ISSUES.
CARDIOVASCULAR AND SLEEP-RELATED CONSEQUENCES OF TEMPOROMANDIBULAR DISORDERS (LINK BELOW)
https://www.nhlbi.nih.gov/files/docs/workshops/tmj_wksp.pdf

THIS ARTICLE BY SHIMSHAK EXPLAINS HOW IMPORTANT TMJ IS RELATED TO OVERALL HEALTH EXPENDITURES.
Cranio. 1998 Jul;16(3):185-93.
Health care utilization by patients with temporomandibular joint disorders.

Shimshak DG1, DeFuria MC.
Author information
Abstract
The claims data base of a large New England managed care organization was used to compare the health care utilization patterns of patients with TMJ disorders to non-TMJ subjects. Inpatient, outpatient and psychiatric claims data were examined over a wide range of diagnostic categories. Age and sex adjusted results showed that, overall, patients with TMJ disorders were greater utilizers of health care services and had higher associated costs than non-TMJ subjects. For some of the major diagnostic categories, such as nervous, respiratory, circulatory, and digestive, the inpatient and outpatient claims differences in utilization and costs were as large as 3 to 1. For only one diagnostic category, pregnancy and childbirth, were utilization and costs greater for non-TMJ subjects than TMJ patients. The psychiatric claims for TMJ patients exhibited differences that were at least twice as large as those for the non-TMJ subjects.
PMID: 9852811
[Indexed for MEDLINE]

1. American Dental Association. Available at http://www.ada.org/public/topics/tmd_tmj.asp Accessed 11/9/07.
2. National Institute of Dental and Craniofacial Research. Available at: http://www.nidcr.nih.gov. Accessed 11/9/07.
3. Van Korff M, Dworkin, SF, Le Resche L, and Kruger A. An epidemiologic comparison of pain complaints. Pain. 1988. 32: 173-183.
4. Ta LE and Dionne RA. Treatment of painful temporomandibular joints with a cyclooxygenase-2 inhibitor: a randomized comparison of celecoxib to naprosyn. Pain. 2004. 111: 13-21.
5. Helland MM. Anatomy and function of the temporomandibular joint. JOSPT. 1980. 1(3): 145-52.
6. Mayo Clinic. Available at: http://www.mayoclinic.com/health/tmj-disorders/ DS00355/DSECTION=6 Accessed 11/9/07.
7. The TMJ Association. Available at: http://www.tmj.org/basics.asp Accessed 11/9/07.
8. Eriksson PO and Zafar H. Musculoskeletal disorders in the jaw, face and neck. In Rakel RE, Bope ET, eds., Conn’s Current Therapy in TMJ. WB Saunders. Philadelphia, PA. 2005. pp 1128-1133.
9. Malone TP, McPoil T, and Nitz AJ. Orthopaedic and Sports Physiotherapy. Third Edition. Mosby. Philadelphia, PA. 1997.
10. Tabassum N, Trang D, and Gihan H. Relaxin’s Induction of Metalloproteinases is Associated with the Loss of Collagen and Glycosaminoglycans in Synovial Joint Fibrocartilaginous Explants. Arthritis Res Ther. 2005. 7(1): R1-R11.
11. Meldolesi G and Picardi A. Personality and psychopathology in patients with temporomandibular joint dysfunction syndrome. A controlled investigation. Psychother Psychosom. 2000. 69: 322-328.
12. Dorman T. Treatment for spinal pain arising in ligaments using Prolotherapy: A retrospective study. Journal of Orthopaedic Medicine. 1991. 13(1): 13-19.
13. Klein R. Proliferant injections for low back pain: histologic changes of injected ligaments and objective measures of lumbar spine mobility before and after treatment. Journal of Neurology, Orthopedic Medicine and Surgery. 1989. 10: 141-144.
14. Liu Y. An in situ study of the influence of a sclerosing solution in rabbit medical collateral ligaments and its junction strength. Connective Tissue Research. 1983. 2: 95-102.
15. Maynard J. Morphological and biomechanical effects of sodium morrhuate on tendons. Journal of Orthopaedic Research. 1985. 3: 236-248.
16. Schultz L. A treatment of subluxation of the temporomandibular joint. JAMA. September 25, 1937.
17. Schultz L. Twenty years’ experience in treating hypermobility of the temporomandibular joints. American Journal of Surgery. Vol. 92. December 1956.
18. Hagberg C, Korpe L, and Berglund B. Temporomandibular joint problems and self-registration of mandibular opening capacity among adults with Ehlers-Danlos Syndrome. A questionnaire study. Orthod Carniofac Res. 2004. 7(1): 40-6.
19. Darnell M. A proposed chronology of events for forward head posture. The Journal of Craniomandibular Practice. 1983. 1: 62-66.
20. Ernest E. Three disorders that frequently cause temporomandibular joint pain: internal derangement, temporal tendonitis, and Ernest syndrome. Journal of Neurological Orthopedic Surgery. 1986. 7: 189-191.
21. Headache Relief Newsletter, Edition 13. Philadelphia, PA: The Pain Center, 1995.
22. Al-Ani MZ, et al. Stabilisation splint therapy for temporomandibular pain dysfunction syndrome. Cochrane Rev Abstract. 2007. Available at: http://www.medscape.com/viewarticle/486213_print Accessed 11/9/07.
23. Hauser R and Hauser M. Prolo Your Sports Injuries Away! Beulah Land Press. Oak Park, IL. 2001.
24. Epker, J. A model for predicting TMD: Practical application in clinical settings. Journal of the American Dental Association. 1999. 130: 1470-1475.
25. Tecco S, Festa F, and Salini V. Treatment of joint pain and joint noises associated with a recent TMJ internal derangement: a comparison of an anterior repositioning splint, a full-arch maxillary stabilization splint, and an untreated control group. Cranio. 2004. 22(3): 209-219.
26. Rao V, Ferule A, and Karasick D. Temporomandibular joint dysfunction: Correlation of MR imaging, arthrography and arthroscopy. Radiology. 1990. 174: 663-667.
27. Hall L. Physiotherapy treatment results for 178 patients with temporomandibular joint syndrome. Am J Otol. Jan 1984. 5(3): 183-96.
28. Laskin D. Diagnosis of pathology of the temporomandibular joint: Clinical and imaging perspectives. Radiol Clin North Am. 1993. 31: 135-147.
29. Temporomandibular Joint. Available at http://en.wikipedia.org/wiki/Temporomandibular_joint Accessed 11/9/07.
30. Roth C, Ward R, and Tsai S. MR Imaging of the TMJ: A Pictorial Essay. Appl Radiol. 2005. 34(5): 9-16.…

Patient Testimonials: TMJ, Orofacial Pain and Sleep Disorders

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Dear Dr. Shapira,
I wanted to thank you for taking my sense of fatigue seriously and trying to help me overcome it. You noticed things that sent me to a surgeon to stop my snoring and fashioned a mouth guard for me. This is in addition to other tips you have given me.

I appreciate you asking for my recent blood tests and analyzing them. You even went a step further and contacted my internist. She suggested, as did you, I see an endocrinologist. I have an appointment next month and will request you receive a copy of the results.

Again, thank you for caring.

– Bonnie S.


Dr. Shapira, or as I like to call him, Ira, is an angel in every sense of the word; blessed with a great brain and a greater heart and his hands work pretty good, too. His top qualities are that he provides great results, he’s an expert, and he is creative. I will never forget his devotion to one client he met with for eighteen months, on a weekly basis, at Rush Pres St. Luke’s who still has never received a bill for all services provided. May God bless you and yours always.

– Patrice C.


My longtime acupuncturist recommended Dr. Ira Shapira as an expert on Sleep Apnea when I shared with her my frustrations with my CPAP. Less than three months later, (and a sleep study to prove it), I am cured of my moderate condition of sleep apnea. Dr. Shapira created an oral appliance that is easy to sleep with and maintain. I am so relieved, feeling much better, significantly fewer headaches and more energy I would recommend Dr. Shapira to anyone. His knowledge of dentistry goes well beyond the norm. Anyone that suffers from TMJ and or sleep disorders should have a consult.

– Karen G.


I saw Dr Shapira for TMJ problems and chronic Migraines. I wore a plastic appliance for several months. All of my issues with jaw locking and clicking resolved as did my daily headaches and chronic migraines. I no longer have dark circles under my eyes either.
I could not afford a full mouth reconstruction but have been wearing a permanent appliance for several years on my bottom teeth..Expensive but worth it.
I did have 10 veneers done and now have killer smile, partially because I am no longer in chronic pain.

K.C.

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I have been a patient for over 15 yrs. When I came to Dr. Shapira I was in very bad TMJ pain. He and his staff worked with me for hours and when I left that day the pain was gone. I continued treatment until my bite was fully corrected and not only that but thanks to Dr Shapira’s talent in cosmetic dentistry, my teeth look more beautiful then they ever have. Dr Shapira and the staff continue to gain education on the most innovative ways to help people look and feel good. The staff there are very kind and I always so cared for when I go for my appointments.

Michelle H.

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I received TMJ treatments from Dr. Shapira and I was pleased with the results. I had terrible migraines as well as smaller headaches for as long as I could remember and they dissipated upon receiving treatment. I would recommend Dr. Shapira to anyone with TMJ.I received TMJ treatments from Dr. Shapira and I was pleased with the results. I had terrible migraines as well as smaller headaches for as long as I could remember and they dissipated upon receiving treatment. I would recommend Dr. Shapira to anyone with TMJ.

– Christopher J.


I was referred to Dr. Shapira for TMJ issues almost 30 years ago. Not only did the TMJ treatment plan resolve my issues but, over the years, I’ve also received excellent dental care and had some cosmetic work done, which I am very pleased with. Dr. Shapira has a real passion for what he does, and that passion has brought him vast knowledge and expertise. I trust him completely. Also, Barb has been my hygienist over those 30 years and I am completely pleased and satisfied with her skills and commitment to keeping my teeth and gums in the best condition possible. I’ve had Dr. Amidei a few times over the years when Dr. Shapira was not available and those interactions led me to believe that he is of the same top caliber as the rest of the Delany Dental Care staff.

– MK


Rating: 5.0 5.0 stars,
By: Charlene Bown
On: Google, 05/11/2018
Comment: I cannot imagine my dental work ever being done by any other dentist than Dr. Shapira!! I have been seeing higm for several years to help correct my sleep apnea. I cannot tolerate CPap so Dr. Shapira created an oral device that has literally been saving my life!!! I am a high risk patient and absolutely swear that I might not even be here if it weren’t for this incredible Doctor! He knows more about medicine from all different perspectives than most of my doctors and has exceptional skill in the practice of dentistry!! I truly believe this man is also a philosopher, a practitioner in natural remedies and has become a very special person in my life. Don’t even bother seeing any other dentist cause after you have seen Dr. Shapira you will be horribly disappointed!! I highly recommend Delany Dental for a real experience in what dentistry should be and rarely is!!!

I’ve been seeing Dr Shapira since 1998. In college I developed severe TMJ symptoms where I could no longer open my mouth more than an inch. I saw numerous specialists all over the state, visited top hospitals including the Mayo clinic. My family spent a lot of money and I got no relief from my symptoms. It wasn’t until my mom called the TMJ association in Texas and got Dr Shapira’s name. I was skeptical when I had my first appointment at Delany Dental Care but I was told it’d be a long road to recovery but I’d eventually be pain free. Within the first month of treatment, I noticed the headaches lessened. A few months later I could open my mouth further and within a year I had many days were I was able to forget about TMJ. This practice gave me my life back. While I still have some symptoms a few days a year, I am overall pain free. I was told though once you have TMJ as severe as my case; it would be something that I would have to deal with for the rest of my life but for the most part; most days I will not even know I have it.

– MEK


I am so grateful for Think Better Life and Dr. Shapira. I have been suffering from TMJ for 10+ years and have been to countless dentists who all have told me that I am “fine.” Dr. Shapira was the first dentist to actually listen to my pain, thoroughly examine me, and talk me through my options. My first meeting with him lasted over an hour! Dr. Shapira is not only a great dentist, he is an incredible human being: kind, compassionate, and sincere. After only a month, I am already beginning to feel relief from my chronic headaches and facial pain. It is a feeling I honestly didn’t know was possible. Think Better Life is a warm, caring, and friendly office. Dr. Shapira and his entire staff have are truly competent and hospitable!

Laila N.


When I came to Doctor Shapira I was at the end of my road with severe TMJ pain. I went to many doctors and somehow no one could solve my problem. After many months of research I found Dr. Shapira’s website. I was hesitant to make the appointment due to the distance I would have to drive and feeling hopeless, but after being astonished from watching all the testimonials on his website I thought it was worth a shot.

At the first visit I could instantly tell he had superior knowledge about my issues than other doctors I met with previously. He was open and honest about my condition, the long treatment plan, and the high cost of care. Although this information was intimidating, I finally knew what the saying meant “health is wealth”, life is not worth living in constant pain and discomfort. Therefore, I decided to proceed with his treatment plan.

1 year later I can honestly say that it has been the best money I have ever spent. I am about ~80% better and I will hopefully continue to improve over time. The constant clicking and popping of my jaw is gone, I have normal range of motion again, and most importantly I am mostly pain free.

Not only is Dr. Shapira one of the best and most knowledgeable practitioners I have encountered, he treats you like family and is honestly one of the most interesting people I have ever met. I never leave his office without learning a fun new fact. He truly cares about his patients and work. You can tell he loves what he does. I can’t recommend him enough if you have TMJ pain/issues.

BRITTANY B.


I’ve been seeing Dr Shapira since 1998. In college I developed severe TMJ symptoms where I could no longer open my mouth more than an inch. I saw numerous specialists all over the state, visited top hospitals including the Mayo clinic. My family spent a lot of money and I got no relief from my symptoms. It wasn’t until my mom called the TMJ association in Texas and got Dr Shapira’s name. I was skeptical when I had my first appointment at Delany Dental Care but I was told it’d be a long road to recovery but I’d eventually be pain free. Within the first month of treatment, I noticed the headaches lessened. A few months later I could open my mouth further and within a year I had many days were I was able to forget about TMJ. This practice gave me my life back. While I still have some symptoms a few days a year, I am overall pain free. I was told though once you have TMJ as severe as my case; it would be something that I would have to deal with for the rest of my life but for the most part; most days I will not even know I have it.

– MK


Dr. Shapira has been treating me for TMJ. We started with an oral appliance to relax the jaw and make a better bite. Then we went to a DNA Appliance. I have been pain free since almost day one. Now I can’t wait to see the results of the DNA which will reshape my jaw so I won’t need an appliance in the future. Dr Shapira is a miracle worker. His staff is Awesome as well!

Suzan B.


Very Caring and professional staff! Most definitely the best dentists I have ever been to. After an orthodontic mistake that left me disfigured and with a few less teeth, I was feeling very sad and hopeless. I decided to check out restorative dentistry. They basically pointed out everything and how your jaw can affect your entire body. The doctors were very kind, considering I was in tears. They were completely understanding. They also specialize in sleep dentistry. They did a sleep study on me and I got to choose where I could have it done. They will definitely get my business in the future.

– Marty S


Terrific place for Dental and TMJ healing…I’ve been a patient for 13 years. Not only did they fix my cavities very well, but the incredible relief from my jaw problems was unexpected. My jaw would sometimes lock up on one side, and Dr. Ira discovered that my bite was misaligned. I had the painless TENS treatment, wore a plastic appliance made for my mouth (like a retainer), and then my jaw was fixed, my bite was fixed, and my jaw pain was gone!!
Better still, this treatment apparently also aligned my sinuses, because my life-long sinus congestion disappeared. AND, I no longer require a small shim my right shoe for which I had long ago been diagnosed as having needed “because” one leg was longer than the other — which is no longer the case! Alignment works! This is a great place to get healed for life!!

– Marty S


I have going to this practice for 23 yrs. with Dr. Mark Amidei as my dentist and Dr. Ira Shapira for my Sleep Apnea.
I can not say enough about their staff, friendly and professional.
I enjoy going to the dentist.
A+ all around. Do yourself a favor and look no more, call and make an appointment. You will not be disappointed.
I began working with Dr. Shapira several months ago regarding a case of debilitating TMJ. He uses innovative technology to measure jaw movement, ensuring that his splint treatment is precise. He also works with patients to help them understand and treat the muscular component of TMJ (something not offered by the four previous dentists I had seen for my condition). Dr. Shapira works in conjunction with Dr. Mark Freund of Natural Care Chiropractic for TMJ cases; together they are relentless in finding a solution for their patients. I have been particularly impressed that both doctors continually seek out further education and knowledge in their respective fields. I cannot recommend their work enough!

– DS


I don’t know where my health would be without Dr. Shapira. I have been a TMJ patient for 20 years. I had no idea that TMJ treatment can effect your sinus, sleep, and migraine health as well. Dr. Shapira has been a lifesaver for me more times than I can count. This past January we started DNA treatment which stands for Day and Night Appliance. The improvement I’m already feeling is incredible! I wear this new, comfortable appliance 12 hours a day-basically after dinner and while I sleep. It is expanding my upper and lower jaw which is going to correct my TMJ, open my breathing passages, and greatly improve my allergy and chronic sinus infections. It’s mind-blowing how all of my medical issues are inter-twined with what Dr. Shapira treats. He is always on the cusp of the newest technology and treatments and many of his treatments offer instant relief. Dr. Shapira and his staff treat everyone like family. You couldn’t be in wiser or better hands.

Barbara K


I have been a patient of Dr Shapira and Dr Amidei for the past 24 years. My husband, myself and our three sons are all patients here and I cannot speak highly enough about everyone there! Dr Shapira diagnosed me with TMJ issues about 15 years ago and I have worn a night guard appliance from him ever since. I noticed a remarkable difference within a few nights of starting the appliance and have never had any uncomfortable issues with TMJ since then. Both doctors have seen all three of our sons since they were toddlers. Barb, one of their hygienists, has been treating our entire family these past 24 years and she is the absolute best.
Two years ago, Dr Shapira helped me with the decision to get porcelein veneers and I am thrilled with the results! The level of expertise he has, the wealth of knowledge that both doctors have, the kindness and care that everyone there displays – honestly, there is no place I would rather go and I have recommended many friends to this practice.
You can really tell that at Delany Dental Care, everyone there is treated like they are part of their family. Everyone there makes you feel like you are as important to them as members of their own family. I highly recommend this practice to anyone looking for themselves or their entire family to be treated! You cannot go wrong with choosing Delany Dental!

– DS

100+ VIDEO TESTIMONIALS https://www.youtube.com/channel/UCk9Bfz6pklC7_UluWFHzLrg/videos…