ep #46 jim garry, dds v3

www.occlusionconnections.com James F. Garry, D.D.S. – the Einstein in Dentistry

• Barry Raphael [mailto:[email protected]] • My friend Mark Cruz (fine restorative dentist from

Orange county) and I run a webcast on Monday nights at 6:00PM Pacific.

The Legacy of James F. Garry, D.D.S. “the Einstein of Dentistry”

Ron Reeves – Son of Dr. Jim GarryClayton A. Chan, D.D.S.

mailto:[email protected]?


OCCLUSIONPresents …

Connections®

The Legacy of James F. Garry, D.D.S. “the Einstein of Dentistry”

Ron Reeves – Son of Dr. Jim GarryClayton A. Chan, D.D.S.

www.occlusionconnections.com


1995From this add I was able to contact his office and came to a course he held in in Fullerton, CA.

• During this 3 day Jim Garry course I asked a lot of questions (disrupted the class on day 2) and at the 10 am break, Dr. Jim asked me to come to his private office and sit down behind his large oak desk. He dialed up his friend “Bob”…and I conversed with Bob J. for the next 3 hours while Jim G. went back to lecture to the rest of the attending doctors.

• These guys were “Class Acts”, gentleman at their best. True leaders who encouraged me.

• They also encouraged me to start measure…. And I did!

…..Things have never been the same.


PIONEER and LEADER IN AIRWAY(Upper Airway Obstruction and Upper Airway Deformaties) and Craniomandibular Disorders

James F. Garry, D.D.S. (1925-2004)


Jim was the Einstein of Dentistry

• Pediatric Dentist• Board Certified Pediatric Dentist in the State

of California• General Dentist, State of California• He helped develop the Nuk, aspirator ,3m Ion

Crown, TMJ materials • Him and Vernon Gray Airway, Bob Jankelson


Ron Reeves – Jim Garry’s Son


Jim Garry’s Family• Jim's first love in life #1 his Tmj work

and #2 was his family.

R Reeves on April 18, 2015 at 8:36 PM said:

“He was the best dentist, father, grandfather, and friend a person could have. It's been 11 years(4/18/14) since his passing and I have yet to have met a person like him. He was an amazing grandfather and not a day goes by that I don't think about him or is wife (my grandmother).

Their spirits live on with us all and the memories of them will last generations and future generations. RIP Grandpa. Love you and miss you.”


Japan lecture


CONTINUING EDUCATION AND TEACHING• Dr. Garry has taught continuing education

courses• Lectured extensively on Neuromuscular

Occlusion (TMJ Disorders) at the University of the Pacific, the University of New Jersey, University of West Virginia and the University of Southern California.

• He also was a renowned lecturer nationally and internationally on craniomandibular orthopedics and upper airway obstruction.


ACTIVE MEMBERSHIPS:• American Dental Association• California Dental Association• Orange County Dental Society• American Society of Dentistry for Children• Southern California Unit A.S.D.C.• American Academy of Pedodontics• California Academy of Pedodontics• Psi Omega Fraternity, Century Club of University of

Southern California• European Endodontic Society• American Endodontic Society• Fullerton Community Hospital Staff• St. Jude Medical Center Staff• Institute for Myofunctional Therapy

• American Institute of Hypnosis• Western Association of Hospital Dentists• American Association of Hospital Dentists• Royal Society of Health• Society for the Advancement of Anesthesia in

Dentistry• American Society of Preventive Dentistry• Academy of Dentistry for the Handicapped• Academy of Gnathology• Dentistry Associates of University of Southern

California• International College of Craniomandibular

Orthopedics• American Academy of Pain Management


• He is a life member in the American Dental Association, California Dental Association, Orange County Dental Society, and American Society of Dentistry for Children and

• Held office in numerous dental organizations as:

• President and past president of the American Endodontic Society

• Board of Directors of the ADA, Board of Regents

• Fellow Chairman, President-elect, International President and Immediate Past President of the International College of Craniomandibular Orthopedics.

• He is also founding member of the Western State Study Group for Functional Jaw Orthopedics.


• Dr. Garry holds fellowship status with the International College of Oral Implantology, the American Endodontic Society, the American Society of Dentistry for Children, the International College of Dentists, the American Association of Hospital Dentists, the Academy of Dentistry International, and the International College of Craniomandibular Orthopedics.

• He also holds mastership status in the American Endodontic Society and the International College of Craniomandibular Orthopedics.

• He is a diplomate with the American Academy of Pain Management.


PUBLICATIONS:• There are numerous publications that have been written both

nationally and internationally by Dr. Garry on children’s endodontics, upper airway obstruction and musculoskeletal occlusal disorders with prominent publishers as Quintessence International,

• Dental Survey, • Pharmacology and Therapeutics in Dentistry, • International Journal of Oral Implantology, and • Association of Professional Sleep Societies.• He did TV spots –CNN, CNBC, KCBS, KTLA, KABC


“A few years ago, I was lecturing at White Memorial Hospital in Los Angeles and made the statement that 80 percent of all head and neck pain was muscular. At the end of my lecture, an elderly, short woman came to the podium and stated that she had enjoyed my lecture; however, my percentage of muscle pain was not correct and stated that it should be at least 90 percent. I asked her if she was a physician and she confirmed that she was. I asked her what her name was and she smiled and said, "My name is Janet Travell." I told her if I had known she was in the audience, I would have acknowledged her as she has been my idol since I read her textbook titled "Myofascial Pain and Dysfunction -The Trigger Point Manual." She was President Kennedy's personal physician and an adorable human being.

We became close friends over the years and shared our experiences.”


TMJ Exam with Janet Travell, M.D.


Jim Garry’s Developments• He helped develop the Nuk• Aspirator • 3m Ion Crown • Numerous TMJ written materials


Immediately after filling

4 years post op

TREATMENT OF A DECIDUOUS TOOTH WITH NO PERMANENT SUCCESSOR1973, 1975


Note extend of lesion

6 month post-op. Note resorption of gangrenous root

1 year post-op. New bone formation replacing distal root


Jim Garry’s TMJ Work


CONFUSION REGARDING THE ETIOLOGY OF HEAD AND NECK PAIN

• Oral Surgeon IT’S YOUR JOINT• OB-GYN IT’S A PREMENSTRUAL SYNDROME (HORMONE)• Neurologist IT’S AN IMPAIRED NEURAL PATHWAY• Nutritionist IT’S JUNK FOOD• Podiatrist IT’S YOUR FEET• Physical Therapist IT’S YOUR POSTURE• Psychologist IT’S YOUR STRESS• ENT IT’S YOUR EAR, SEPTUM, OR TURBINATES• Allergist CHRONIC ALLERGIES• Family Practitioner FRANKLY I DON’T KNOW• General Dentist ITS YOUR BITE


The Neuromuscular Dentist

Understands that the etiology of head and neck pain can relate to numerous pathologic conditions and requires a

multi-disciplinary approach to treatment.


“A Pioneer Against Pain”


What has been the most surprising thing in your professional journey?Dr. Garry: “First, learning that I could document optimal craniomandibular relationships utilizing biomedical electronic instrumentation. Imagine having the ability to relax muscles of mastication,

(Dental Economics Interview, 2001”

Second, the rapidity of pain resolution and the stability of occlusion.

Third, the resolution of medical symptoms that are not recognized by most dentists as often arising from a craniomandibular disorder, such as otalgia, subjective hearing loss, fullness in the ear, retro-orbital pain, vertigo, tinnitus, cervicalgia, migraine-type headaches, tearing of the ears, etc. When medical treatment for these symptoms has failed, neuromuscular alignment of the mandible to the cranium is often successful.”

verify relaxation with electromyographic recordings, and record, with precision, the physiologic rest position from which occlusion can be established along a myotrajectory path of closure 1 to 1.5 mm from physiologic rest.


Who or what has been the most inspirational in your professional career?Dr. Garry: “The most inspirational colleague I have ever had the honor of knowing was Dr. Bernard Jankelson. He is the father of neuromuscular dentistry, as well as a teacher, inventor, and practitioner of prosthodontics. He pioneered computerized diagnostics as an aid in the diagnosis and treatment of craniomandibular disorders. He taught me that if you could measure it, it is a fact, and, if you can't measure it, it is an opinion.

He stood alone among his fellow colleagues for years, professing the need for dentists to become physiologists of the head and neck. He utilized surface electromyographic recordings (sEMG) to document muscle activity at rest and in function; utilized ultra-low-frequency TENS to facilitate relaxation of all masticatory muscles; developed jaw tracking instrumentation to measure, analyze, and display mandibular movement in multiple dimensions; and developed sonography to record joint sounds. These are the same technologies used for comparable purposes in medical diagnosis and treatment. The measurement devices have the ADA scientific council seal of acceptance and FDA regulatory clearance.”


Barry Cooper, Jim Garry, Bob Jankelson and Dr. Bernard Jankelson


Did you immediately use neuromuscular techniques when you began your clinical practice?

Dr. Garry: “When I graduated from the University of Southern California in 1954, there was no neuromuscular technology. In fact, computers had not been invented.

I was taught to push the mandible to the most retrudedposition from which unstrained lateral movement could be made. This propelled me into pedodontics for 20 years to avoid retruding the mandible. Twenty-seven years ago, my sister developed severe head and neck pain resulting from equilibration of her teeth by a good friend of mine, and was treated with several splints. His inability to relieve her pain forced me to seek another mode of treatment.This changed my life.”


“I met Dr. Jankelson, who insisted I take his course on neuromuscular occlusion. I told him that I was a pedodontist and had no need to learn neuromuscular dentistry. He asked me if I wanted to be a "mechanic" or a "physiologist of the head and neck" for the rest of my life. What could I say? So my staff and I sat through one week of the most exciting, informative dental course I had ever taken. Thirty dentists and their staff members were in attendance; 15 of those dentists had severe TMJ pain and had been treated previously without success. Dr. Jankelson smiled and said, "I will have each of you out of pain by the end of this week." I thought to myself, "I'm in another voodoo course!"Dr. Jankelson performed a comprehensive history, evaluated radiographs supplied by the dentists present, and proceeded to use biomedical technology as an aid to his diagnosis and treatment. By the end of the week, every dentist treated was asymptomatic, as Dr. Jankelson had promised. So, 27 years ago, I went from a pedodontist to a general practitioner with an expertise in neuromuscular occlusion. My bonus was that I had my sister asymptomatic within 24 hours.”


Fullerton community hospital lecture late 1970's with the k-5.


J3 Myotronics - Noromed, Kent WA


“Relaxation and decompression are elemental to all therapeutic paradigms for treatment of the musculoskeletal system.”

- James F. Garry, D.D.S. – Pioneer in Upper Airway Obstruction and Upper Airway Deformaties


A True Supporter of Computerized Mandibular Scanning CMS (Jaw Tracking), lower frequency TENS and EMG Technology


Jim Garry’s Airway• Jim and Vernon Gray Airway • Bob Jankelson• Life Mission and Message – Pioneered and Authority on Upper Airway

Obstruction….Sleep awareness in dentistry?

Cause and effect of oro-facial imbalance and the deviate swallow (tongue thrust) 1959 revised 1975 and 1977


Upper Airway Obstruction

andUpper Airway Deformities

James F. Garry, D.D.S.


Every dentist has watched patients develop Class I, Class II, Div 1 or

2, and Class III malocclusions.


Teeth are not set in stone. There is a dynamic relationship between

tooth position, arch shape and mandibular posture.


When the pathologic position exceeds our

accommodative capacity, patients begin to complain either of pain, discomfort,

or esthetics.


GARRY’S DOGMATIC DICTUMALL CHRONIC MOUTHBREATHERS, WITH A DENTITION, DEVELOP A MALOCCLUSION

Therefore ……It is essential that an upper airway evaluation be performed prior to initiating orthodontics, prosthodontics, periodontics, etc.


Note:• Dolicocephalic face

• Narrow nasal oriface (disuse)

• Open mouth habitus (chronic mouth breather)

• Arched upper lip

• Rolled dry lower lip

• Deep labial mental fold

• Steep mandibular plane angle

• Chronic contracture of mentalis muscle


We do not breath through each nostril evenly, which can effect

airway obstruction if a turbinate is hypertrophied.


Is this Vasomotor Rhinitis or Hypertrophied Turbinates?

Turbinates reduced with vasoconstrictor (Afrin) therefore the patient has Vasomotor Rhinitis.


What is the Etiology?


The upper airway anatomy of the human newborn approximates the

anatomy of primates. There is a close approximation and locking of the

uvula and epiglottis which allows for simultaneous sucking of milk and

breathing. The tongue remains entirely within the oral cavity eliminating the oropharynx.


For the first 6 months of life, an infant is an obligate nose breather as a result of contact between the epiglottis and soft palate at birth.


Contact between the epiglottis and the soft palate at birth provides a channel from the external nares through the nasal cavities, nasal pharynx, larynx, and trachea into the lungs. Food passes on either side of the inter locked larynx into the esophagus through the isthmus fauciumwithout interfering with the patent airway.


During the first approximately 18 months full term post partum, the laryngeal complex migrates from its original subcranial position to lie opposite the 5th cervical vertebra eliminating the interdigitation between the soft palate and epiglottis developing an oropharynx.


Mouth breathing occurs when nasal airway flow is diminished. This usually occurs when goblets cells within the nasal passages react to

allergen producing inspissated (thick) secretions. The thick secretion reduces cilia locomotion resulting in bacterial stagnation

within the nasal passages.


He was instrumental in the development of the Nuk Saugernipple and pacifier, working with Dr. Baltars, an orthodontist in Germany.


Before NUK Exerciser

4 months later


During the first four years post partum, growth and

development is often adversely affected by environmental

influences resulting in orofacial deformaties.


Myofunctional TherapyOrofacial Muscle Balance Can Be Accomplished By:

1. Remove hypertrophied tonsils and adenoids when they’re obstruction is causing orofacial deformities due to airway obstruction.

2. Motivation to exercise3. Developing a proper exercise regimen

4. Carefully monitoring the child or adult’s progress5. Working with an dentist who does functional orthodontist to

establish a palatal vault that will accommodate the tongue.


BEFORE AND AFTER CASES THAT HAVE HAD ADENOTONSILLECTOMIES

Treated By Myofunctional Therapy


3 Months of Myofunctional Therapy

No Appliances



No Appliances


3 Months of MyofunctionalTherapy

No Appliances



Upper Schwartz Appliance



Upper and Lower Schwartz Appliance


1 year, no appliances


11 months, no appliances, just exercises


The most significant principle to understand is that teeth seek a neutral position within a system of forces acting on them. The force system changes constantly during growth, and teeth move in response to stimuli in their environment.

Clinical observation can, with experience, enable a dentist to assess the force system in a child or adult and determine

whether the position of the teeth may improve or deteriorate when balance between the dentition and force

system has been established.


The most important thing you can put in your body is not food or water but it is

OXYGEN!We must be chronic nose breathers not

mouth breathers to maintain a stable occlusion.


BOOK PUBLICATIONS

• Garry, J.F., Pedodontic Endodontics, AES Seminars, 1973, Revised edition 1975.

• Contributor to text, Diseases of the Temporomandibular Apparatus, by Morgan, Vamvas and Hall, published by C.V. Mosby Co., 1982.

• Contributor to text, Das Kiefergelenk und seine Erkrankungen, Herausgegeban von Morgan, Hall, Vamvas, Quintessenz Verlags GmbH, 1985.

• Contributor: Anthology of Craniomandibular Orthopedics, Vol. II, by International College of Craniomandibular Orthopedics, Buchanan Publishing, 1993.

• Contributor, Anthology, Volume V, International College of Craniomandibular Orthopedics, Upper Airway Compromise and Musculoskeletal Dysfunction, ICCMO, 199

AUDIO TAPE PRESENTATIONS

• Pedodontic Endodontics - Dr. James Garry and Dr. Paul Greenacre; Medfacts, Ltd., Ottawa, Ontario, Canada, 1980.

• Biomedical Electronic Instrumentation - Dr. James Garry; Northeastern Oral Health Foundation, Williamville, NY, 1987.

• Sleep Apnea and the Dentist - Dr. James Garry; Northeastern Oral Health Foundation, Williamville, NY, 1988.

• Neuromuscular Occlusion – Dr. James Garry, Richards Report, Tape Series, for Dr. Richard Madow, 2001.


MONOGRAPHS• Environmental and Iatrogenic

Influences on Oro-Facial Development Leading to Musculoskeletal Dysfunctions of the Head and Neck (TMJ Disorders), Reprinted 1988, Myodata, Dallas, TX.

• Upper Airway Compromise and Musculoskeletal Dysfunction of the Head and Neck (MSD), Reprinted 1989, Myodata, Dallas, TX.

• The Role of a Dentist in Sleep Apnea, 1982, Myodata, Dallas, TX.

• VIDEO TAPE PRESENTATIONS• Oral and Facial Pain - Dr. James

Garry and Dr. Ramon Werts; Host, Derek Partridge; Healthline, 1987.

• Nasal Airway Dysfunction and Growth of the Orofacial Complex; Dr. James Garry; Myodata, Dallas, TX, 1988.

• A Comprehensive Musculoskeletal Examination of the Head and Neck; Dr. James Garry; Myodata, Dallas, TX, 1989.


August 2001

www.occlusionconnections.com James F. Garry, D.D.S. – the Einstein in DentistryA few months before he died in bed having his martini.


Clayton A. Chan, D.D.S.Craniomandibular Facial Pain

Ortho/Orthopedic & Esthetic Restorative Rehabilitation

Director/Founder of OCCLUSION CONNECTIONS

www.occlusionconnections.comLas Vegas, Nevada

(702)271-2950

Email: [email protected]


• Bite Management• Spatial Relationship Management• Dot Finishing Management

(702) 271-2950Las Vegas, NV www.occlusionconnections.com

Craniomandibular Facial Pain Aesthetic Rehabilitation

Orthodontic/ Orthopedics Occlusal Management

Craniomandibular Facial Pain

Aesthetic Orthopedic Rehabilitation

Comprehensive

CLAYTON A. CHAN, D.D.S.Director/founder OCCLUSION CONNECTIONS™

ep #46 jim garry, dds v3

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