Anne: Hello, everyone. It's Anne Duffy and welcome to dental entrepreneurs, the future of dentistry podcast. I'm very excited today because I have a new friend. I just met him through Lou Sherman, Dr. Tony Urbanek. When I found out about him i'm like I have to have him on the podcast.
I'm so excited. I don't know much about How he got where he is today and he's going to share that because a lot of you that are listening are entrepreneurs out there Dental entrepreneurs, but basically entrepreneurs you're visionaries. You see a problem and you find a way to fix it That's my idea of an entrepreneur.
So let me tell you about dr. Tony before we get started. He is a double degree oral and maxillofacial surgeon who performed surgery for over 35 years. He decided to figure out a better solution to treating TMJ, TMD, and now teaches healthcare providers a solution for the debilitating symptoms of TMD using a patented FDA approved device and protocol.
This is very big. Please help me welcome Dr. Tony Urbanek. Hello, Dr. Tony. How are you?
Tony: I am well, I am just well and very pleased to be here and looking forward to our discussion. Very much so. it was my pleasure meeting you just a few minutes ago. And, I um, know you by reputation and thank you for inviting me so much. this is a great opportunity to spread the word about what I had to say about TMD, TMJ.
Anne: It's so cool because so Lou sent me your information. He was all excited and I read your bio. I saw some of your videos and don't you know I was at yoga class that morning and my yoga instructor had just had her tonsils out because she had TMJ and ringing in her ears and all these or whatever.
It was a problem. every symptom she had was mentioned in one of your videos. And so I sent her your information. I'm like, this is a problem. I am just kind of newly retired Tony from dental hygiene 46 years in. I had so many people in my chair that had these problems that could never figure it out.
And then I saw what you have discovered. And I want to know. How you got into this, why you got into this and how you found the solution.
Tony: that's the starting question. And I have the description. So as you said am an oral maxillofacial surgeon. I do not do surgery anymore. I quit doing the last little bit of surgery about a year and a half ago, but I spent most of my career in the operating room of the years career.
I spent 40 of it in the operating room doing major facial reconstruction. Part of that major Part of that was temporomandibular joint surgery. I did lots of orthognathic surgery, tremendous amount of that, cleft palate, cleft lip lots of trauma, cancer reconstruction. But actually I was known here in Middle Tennessee, and I'm from Nashville, Brentwood, Franklin, Tennessee.
was the TMJ surgeon in Middle Tennessee for many years, but Here's where it starts. So after 2000 surgeries, both open joint half of them through the skin and half of them through an arthroscope, I came in one Monday morning and I said to my staff, I said, we're not doing any more TMJ surgery anymore, call them off.
And that was because that weekend, I spent looking over the results, thinking about the results. And actually about percent of people were back within a year or two with symptoms again, no matter what kind of surgery I did. And that is pretty much what's usual and customary, in the surgical arena.
you know, nowadays, you can't hardly find a surgeon who really wants to do surgery on the temporandibular joint, except for total joints. So that was 12 years ago. and they were surprised and I said no, no, just call them off. We're not, I'm not doing any more surgery.
But at the same time, because of my broad, broad background. With both a dental degree, a medical degree. I also have academics degrees in cell biology and anatomy. And I was a fellow with the NIH and IDCR for two years with my own research project, as an aside, I was supposed to have been a professor and at Vanderbilt in the early seventies, they were just minting professors out of there.
And I won't give you names, but all of my. colleagues in the residency with me, pretty much all of them end up running oral surgery programs. At the end of all that, training, I decided that I was going to come out into private practice, which for me was a good decision.
But the point getting back to when I decided not to do any more surgery, I decided I had to take a look at TMJ TMD. And the consensus is and continues to be the consensus in this day and age that there is no solution for TMJ, TMD. Everybody knows nothing works. You can Botox everybody until their face shines and they'll be back every three months.
all the other symptoms. Persist. So here's what I did. As a researcher you start at the beginning. What's the beginning? You start with the patient who has the problem. I quit reading the journals. I quit reading the books. I quit going to congresses. Don't listen to what my colleagues said to do because I knew after 36 years and 2000 surgeries, that was not the answer.
So, I start interviewing ladies. This is a female problem. It is 45 percent of females have temporandibular joint symptoms. I do this constantly at meetings and things, if I'm talking to two females, I know one of them has TMD symptoms, almost for sure.
Anne: Wow.
Tony: 45%. I'll make that clear in a few minutes why it's most people think it's in the 20%.
Well, that's much less than actual. But I started interviewing patients. I had no lack of people who wanted to see me. And so instead of a patient coming in, listening to their symptoms, doing an x ray or two and a little exam and saying, this is what I'm going to do for you surgically. I would sit them down and I would say, I want you to tell me all about it.
Tell me what you think about it. Tell me. What do you think makes it better? What makes it worse? What does your husband think about it? What phase of the moon is it when it hurts? Does the dog bark when it hurts? I want to hear it all. And I would sit there and encourage them for 30 minutes, 45 minutes.
If I could keep them talking, I just keep them talking.
Anne: Wow.
Tony: And this is what I heard. After 24 interviews, at least half of them said, if I take my finger, a pencil eraser, my tongue, a piece of cloth, and gently put it between my front teeth, it feels better. After I heard that a dozen times, the light bulb went off, and I thought, Huh, I wonder what would happen if I made a device that went in between the front teeth and put the patient into it and see what happens.
the first patient didn't know she was going to be an experiment, but I went in my little lab and I made a little device of my own design that did nothing more, nothing less than only the front six touch, the incisor's canine, separated the posterior teeth. And I gave it to the first woman and I said, put this in your mouth, keep it in 24 seven, except when you eat.
And I want to see in three weeks. It was fortuitous because the key is you have to start out strong. And the device I made was something that I knew the patient could speak with because of my experience doing orthognathic surgery and, you know, wiring people, not wiring people. And I knew, what it would take to keep something in the mouth that they could use.
They could speak with, you could drink with it. You just can't. Chew with it in your mouth. So the instructions were 24 7, except when you eat, come back in three weeks. And this is a typical woman who had 30 years of headache, earache, jaw pain, neck pain. Walked in the room three weeks later and I said, how you doing?
And she looked up at me and she said, quote, thanks doc. My pain is gone. and I took a step back sure I had a surprise on my face and She looked at me like, were not you expecting that? and the truth was no, I wasn't.
And that's where it started. And then to, carry this forward. I did, Several other patients. 10, 20, 30 patients after that. The results were spectacular. Patients all come in at three weeks and say 100 percent of their symptoms are gone, but we now know what the average is.
The average is 70. After now 4, Patients treated successfully out of my practice here in Brentwood, Tennessee, we have 4, 000 people, and at three weeks, the average, some below, some above, will come in and say 70 percent of their symptoms are now diminished or gone at three weeks. And then it continues from there.
There's a protocol I had to work out. But to continue the story, so now I'm, 30 patients into this thing, and I'm going, oh my god, and the next thought I had is I had to figure out how this works, because I had no idea how it works, but I'm going to tell you how it works. And it was a series of events and a little bit of knowledge.
what I learned and what I was able to learn the advantage I had was that I had a lot of background to draw from. from both dental, medical, and academic science. And none of them could smooth me, and I knew all about how to do each of those. it's a three leg stool that supports the whole thing.
Number one, how does it work? had to figure, how does this thing work? Number one, Every dentist in the country is taught that 90 percent of the loads on the temporomandibular joint come from the posterior teeth. That's why we chew nuts with our back teeth, not our front teeth. So we all know that 90 percent of the loads on these joints, posterior teeth. Number two, when I did those 2, 000 surgical cases, every time I did a surgical case, whether it be through an arthroscope or through an open joint incision, and eyeballing the stuff inside the joint, I would get a piece of tissue and send it to the pathologist.
That's standard operating procedure in an operating room. 100 percent of the time that tissue came back with the first line of the pathology report as chronic inflammation, whether it's spelled out the cell types or it just said chronic inflammation and blah, blah, blah. It was always chronic inflammation.
So you could deduce from that experience that if you have TMD TMJ, 100 percent of the time, the joint has chronic inflammation in it. True.
The third leg. Nobody knew about it. And dentistry doesn't know about it, but orthopedic surgeons know all about it. And in my, studies and experience back at Vanderbilt in the the early 70s and mid 70s, my orthopedic colleagues in that rotation told me about something they called, in their vernacular, joint splinting, as it works out.
What is joint splinting? Best described is as tennis elbow. If you have a bad joint by motion back and forth of your arm, and you can, you can get it other ways other than tennis,
Anne: Yeah, I've had
Tony: This little area.
On the end of the elbow will get inflamed, it hurts right there.
They know all about this because if that gets inflamed, it sends a signal up to the brain stem where all the, commotion goes on in coordinating all of the autonomic signals within the body, your heart rate, your breathing rate, all kinds of stuff is the brain stem. A signal goes from the joint, let's just say this is the elbow joint now, goes up to the brain stem and says, I'm inflamed.
The brainstem takes a look at the information, says, I'm going to help you out, but don't move that joint and sends a signal back down to the muscles that move the joint, which happened to be in the forearm. The problem with tennis elbow is people don't complain if it hurts there. Although if you push on it, it hurts.
They complain of the pain and numbness and tingling of the forearm, all the way down to the wrist. That's tennis elbow. And that's where the complaints are.
play tennis.
Anne: I did, and I had tennis elbows, so I'm tracking
Tony: You're tracking. Yeah, every time I tell this story, I'm getting yeah, yeah, yeah. Well, I hope you're tracking with me because let me lay this on you. Tennis elbow and TMD, TMJ are the same disease. Different joints, I want to organize this for you. the problem, what happened here over the past 60 years in dental industry and dentistry is that every dentist in the country, when they go through school are told and taught that this joint is so different.
It's special. It's different. It's complicated. You'll never understand it. That's what they're taught to begin with, and that's where it got off the rails. I do a podcast myself once a week. I'm on Dentaltown, and I do an episode, a 30 minute episode. There's 109 of them now, and I talk about all these different aspects.
But the point is to say on purpose, this joint is not different. This joint operates like any other joint in the body, like your elbow, like your hip, like your knee. The operations of it is the same. Yes, it's in a different place, it's a little smaller, it has two different kinds of motion, a rotation and a translation.
All those things are true, but this joint works just like the elbow. That being understood, remember this is the third leg of the stool that I'm trying to describe. When this joint becomes inflamed, and there's only three things that cause inflammation in this joint, three concepts, which is bruxism is the most common, for sure, clenching or grinding, better known as bruxism, clench or grind, same thing, acute trauma, which in the females is most often motor vehicle accidents, especially any kind of whiplash will create bruxism.
Damage and chronic inflammation. Men, it's usually bar fights and 4x4s off the back of the pickup truck. And they clench and grind too. big difference between male and female in this problem, by the way. And then the third is what is called generically functional malocclusion. Which is teeth not fitting together.
Whether it be big class 3 jaws, mandible way out here. Class 2s that are way back here. Or even more minor. two, three millimeter differences between, centric relation. Centric occlusion is where your teeth mesh and centric relation is where the condyle is all the way back in the fossa back here.
Those are the three causes that damage the joint. There are only three causes that damage a joint. They all fall into those three categories. Now, once this joint becomes inflamed sooner or later, if it is not Limited in motion, you will create chronic inflammation and chronic inflammation is the centerpiece and the only cause that drives all the symptoms.
The first symptom works like this up here. We talked about tennis elbow. They're the same disease. When this joint becomes inflamed, it sends a signal to the brainstem. The brainstem gets a signal, says, Hey, I'm going to help you out. Don't move that jaw. Tighten up. And it sends signals down to the muscles of mastication.
I'm not going to name them, they're not making a difference. Here, here, here. There are five major, muscles. And they don't send the signals all at the same time to the same muscles. So sometimes it hurts here, and sometimes it hurts here. And Monday morning it'll hurt over here. And Friday, and you go to your physician, PCP, and you describe this.
And he says, I think you're crazy. I've heard that. Bunch of times from ladies coming in. My physician thinks I'm crazy and the dentist will never say that, but physicians have pretty much blown back off anyway. that is just the facial pain, okay? There are ten primary symptoms of TMD TMJ.
Some of them you're going to be aware of, some of them you're not. But I'm going to list them off. These symptoms of TMD are frequent or recurring headache, earache, jaw pain, neck pain, ringing in the ears, tinnitus, subjective hearing loss, which is feeling like your ears are full and you can't clear your ear, dizziness, vertigo, upper back and shoulder pain and tightness, arm, hand, finger tingling and numbness. That's the one you didn't hear about. Nobody heard about that one. And various kinds of locking of the jaw. And in the next five minutes or six minutes, I'm going to explain to you how inflammation in these joints Create all of those symptoms Directly had nothing to do with where the disc is. It has nothing to do with how much damage is in the bone. It has nothing to do with anything other than how much inflammation is in these joints. And if you can make the inflammation go away by unloading the joint long enough, adequately enough, like a set of crutches would unload a bad knee, the symptoms go away. That's it. And then the rest of it is just, I'm going to explain to you how inflammation in these joints directly create each and every one of those symptoms.
Anne: Wow. It's ridiculously logical. Keep going.
Tony: Yes, ma'am. And what I scratched my head about when I did my own research I mean, most of this was able to do just like Einstein used to say thought experiments. I had the data. I didn't have to pull out the books because medical degree, dental degree, academic degrees.
I mean, It was in there somewhere and I just started lining up the dots. And believe me, everything that I talk about. has been in the literature for 50, 60 years or more. It's there to look at. So we're down to the point, and then I'm going to quit talking. You can ask all the questions you want. How does inflammation in these joints create all those symptoms directly? Well, I already told you about the face and the headaches. And by the way, I'm on a mission. The physicians, remember, I'm a card carrying physician. they're misdiagnosing this all the time, not all the time, constantly.
an abomination. And we're working really hard here in Middle Tennessee. And my goal is to bring this out throughout the United States to other doctors who know how to do it. We teach them how to do it. We bring them into the network. let's get to the point. Headaches. are constantly diagnosed in the medical profession.
In fact, 99 percent of the time diagnosed is migraine headaches. If you read the studies, and I have, good science, good scientists, on migraine headaches, the first paragraph or two of any good scientific study will admit that they have no idea what causes migraine headaches.
Anne: Mm
Tony: Why I say down here in Tennessee, the ladies come in and say, I have a migraine.
Anne: Yeah.
I love it.
Tony: But here's the thing At least two thirds of those 4, 000 patients have been given the diagnosis of migraine headaches, either through a physician and many of them on drugs, many of them on treatments, all kind of things for migraine headaches.
And each and every one of those 4, 000 patients, their migraines went away when you unloaded the joint adequately. So the inflammation died down. That is a fact.
Anne: Wow.
Tony: don't quote me as saying there is no such thing as a migraine headache. There are other reasons for headaches, no doubt about it.
And this gets really wild. I mean, I'd lectured to a group of 30 family physicians in a room, large family physician group. And we started talking about what I just told you, the migraines. And I said, ladies and gentlemen, what do you do when you have somebody to come in chronic migraine headaches?
What's the first thing you do? And all the hands went up. They order a 500 MRI looking for brain tumors. Everybody, you know how common a brain tumor is? as far as in relationship to headaches, one in 10, 000, but everybody gets a 2, 000 MRI.
That's a dip. We're going to go down dirt road here. I don't want to
Anne: man. There's so much here to unpack. Oh, my
Tony: Yes.
Anne: I'm thinking of all the patients I saw over my years in clinical hygiene right now. they're just coming into my head. So, Keep going. I'm so fascinated.
Tony: so was I. I was like, this was a rabbit hole. I had no intention to be in this rabbit hole. I was just trying to figure it out for my patient's sake. Somebody needs to sit down and figure this out. so how does the rest of this work? so you got inflammation, you get headaches, they'll come in and say, it hurts right there every morning, doc, or it hurts there.
It goes all over the place. Headaches, that's your head. If it hurts, you got a headache. If the inflammation is not diminished, if you don't make it go down, the signals keep getting out there. It's like, hey, I'm inflamed. The central nervous system, back in the brain stem, says, hey, look what I told you.
Don't move the jaw, tighten up. Now what I want you to do is hold the whole head tight. Tighten up. And patients will come in and they will complain of gobs of neck pain. And they'll show you right where the muscles excuse me, but I'm an anatomist, cell biologist by training also. So neck pain is the second most common symptom of TMD. Headache first, neck pain second. Remember what I said, headache, earache, jaw pain, neck pain, ringing, fullness, dizziness, shoulder pain, arm pain, arm and finger tingling, numbness, and various kinds of locking.
All right, so let's get on with it. Now, the interesting thing don't have a solution. Your Botox in this muscle over here, but the joint's still inflamed. And by the way, Botox is off label. Botox is not approved by the FDA for the treatment of TMD. You want to use it for your wrinkles? I got plenty.
Go for it. It's approved by the FDA. Botox is not approved by the FDA for the treatment of got a dozen stories about that. Top one is the young woman who came in and worked for a plastic surgeon had bad TMD. She had so much Botox in her face. She couldn't smile.
She could not smile. And her face shined like the moon. It was so shiny and she was Botox. That's a different dirt road.
Anne: I know.
Tony: All right, so now we go into, it's not fixed, more inflammation. Central nervous system says, hey I told you don't move the jaw, then I told you don't move the head.
Now what I want you to do is hold the whole upper shoulder girdle tight. I mean tighten up buddy. And now, when that happens, the little muscles, they're called scalenes, there's a bunch of little, little muscles here, finger muscles on the side of the neck, they squeeze down, and they squeeze the brachial is a bunch of nerves that come out of the base of the brain, actually more in the cervical spine and they come out and they supply feeling and motion to the arm.
when the brachial plexus gets squeezed, it causes arm, hand, finger tingling and numbness. I did not know about that. How I found out about that, I was into this a couple of years and a patient came in. She said, thanks doc. I said, I'm so happy. my headache's gone. My jaw pain is gone.
My neck pain is gone. Does this have anything to do with my arm, hand, finger tingling numbness? Cause it's gone too. And I went, I never heard of that before. And I went back to the books and sure enough, when the muscles tighten up, squeezes the brachial plexus, it causes arm, hand, finger tingling and numbness.
Now to carry on, there's a few others here that I'm going to briefly go over. There's an entity that some of you, I don't know how many people are going to listen to this, but let's just say a hundred people are going to listen to this by me. Almost 50 percent are going to have TMD symptoms.
some of those symptoms are going to include ringing fullness and dizziness. How does ringing fullness dizziness get caused by inflammation in this joint? Because we know it goes away. I don't claim 100 percent of anything, but I can tell you that the vast majority by far of ringing fullness dizziness.
If you make this inflammation go away, those symptoms will go away. Well, how's that happen? this joint TMJ is about three millimeters. That's about three millimeters away from the contents of the middle ear. First of all, the middle ear is within the temporal bone, which is in a solid piece of bone, medial or inside next to the jaw joint, but it's encased in solid bone. Again, pulled out my Grey's Anatomy and sure enough, there's a, fissure, literally A highway, that goes from the back posterior part of the glenoid fossa directly into where? The middle ear. And when the inflammation or more likely inflammatory fluids with a decreased pH, I don't want to get too deep in the weeds. Inflammation is not a good. Actor. I mean, It's a good thing. And by the way, inflammation is nothing more, nothing less than the body's response to damage, any kind of damage, cellular damage, trauma damage, any kind of damage creates inflammation. So when that inflammatory fluid and more likely decrease in just the pH of the inflammatory fluid gets inside the middle ear, it affects the hearing mechanism, which is in there and the vestibular mechanism that's in there.
And it creates. The problems of tinnitus, ringing in the ears, subjective hearing loss, fullness in the ears, and vertigo. Locking is a little different story, and of course ear pain. It's terrible. I have seen so many people that gone to walk in clinics two, three times and been diagnosed with ear infections.
They're well meaning. I lectured to two state groups of, recently and physician's assistants. Two state groups. And the thing about nurse practitioners, I say this sincerely and with all respect, Tremendous amount of respect, but physicians assistants and nurse practitioners in comparison to physicians, know that they don't know and they admit it.
Anne: Ah, mm hmm.
Tony: to talk to, easy to train. nurse practitioners frequently misdiagnose, ear infections when it's really TMD constantly. And then finally, sooner or later, it ends up in an ENT office. I'm educating the ENTs here in middle Tennessee.
they finally look at it. No, that's not infection. And then they push on the joints, which we teach them to push on the joints. It's inflamed. It hurts. Go see Dr. Urbanic. This must be TMD. and ringing fullness, dizziness. Are well known by the E n T doctors is Meniere's disease.
You probably heard that word may not know what it is, but the definition of Meniere's disease are the three symptoms ringing, fullness, dizziness. That's what Meniere's disease, no, more or less and the e n T doctors have no solution for Meniere's disease. They do a two or 3000, $4,000 workup.
The patient looks up, What do you do about this? And the doctor will look at 'em, roll their eyes and say, we don't have it. solution. But we know we now see thousands of people with ringing fullness, dizziness that have been misdiagnosed was Meniere's disease. The symptoms go away when you get the inflammation to go away.
And then the locking of the joint has everything to do with the synovial fluid, which is the fluid which is inside the joint, which is supposed to be a lubricant, but under the influence of inflammation becomes more like glue. And when the joint glues down, it causes the disc to get displaced.
And then you hear all about anterior displacement and all the damage of the disc and all that stuff, which is irrelevant if you can get the synovial fluid to get more like Oil rather than glue, and you do that by just decreasing the inflammation. So that is how each and every one of those symptoms goes down, diminishes, by just decreasing inflammation.
And how do you, decrease inflammation? And that is what I already told you. You have a device that unloads the joint like a set of crutches would unload the knee. You do it long enough. There has to be a protocol. You don't put it in whenever you want. patients can't just use it wherever they want.
The protocol is quite simple. That's the crazy thing about this. It all turned out to be quite simple. It stunned me. It stuns me to this day. The patients who go through this process, they're stunned. today my associate brought to me a story from a patient. She was just so stunned, He had a patient a while back who had all the symptoms and this patient was angry. He said, when I did my interview, when I did my consultation, she, I could tell she was just angry, but I just blew it off.
And she was very angry woman. And I see that when you have been abused by the system unintentionally. I don't think anybody does this stuff intentionally. and you have pain for 10, 20, 30 years and nobody has the answer and they shuttle you around from doctor to doctor. I think angry is a, good emotion that goes with it.
He says she was very angry, but she accepted service. She accepted the treatment. She comes back in three weeks and I walked in the room and she was sitting there. with tears running down her face. he's only been with me a couple years. He hasn't had the 12 years of experience that I had.
I knew what his rest of this story was going to be, but I just let him speak. And he said, I walked in the room and he said, Oh my God, I remembered how angry she was. And I thought she, maybe she's angry at me. And, she hesitated. She looked up at me and she says, I can't believe my pain's gone.
Anne: Oh,
Tony: I can't believe my pain's gone, and she's crying. I have had many, many patients just halfway through the consultation and I go through those symptoms and I tell them how it works. Here's the symptoms and here's what you have to do to make, and ladies will just start to cry.
and the first time I saw this, I backed off a little bit. I said, why are you crying? She says, You understand this problem, I've been to 10 doctors and you seem to understand this problem. I go, yes, ma'am. I do understand this problem. And they're crying and I'm ready for it.
Now we have a set box of Kleenex. I sit back on my little stool and I just let it happen. until I say, go ahead. When you're ready to talk, just go. Let me know.
Anne: What a beautiful service you're providing. I have so many friends. I know so many women so many patients. that have had Meniere's disease, that have had chronic headaches, that have had Botox all over to get rid of the headaches. I mean, the list that I've heard over my career is very long.
And it's interesting. It just makes so much sense, it is kind of like Einstein. I'm not going to lie. It's just wow, it's all right in front of you. But you had to take all your experience and, you happened to solve mystery. And now, us a little bit more about the appliance.
Tony: I want to add something else. I want to get it in so I don't forget it
I saw that you started out in hygiene. as I said, I do a podcast once a week on Dentaltown TMD Demystified is the name
of it, TMD Demystified. I did one, oh, I don't know, a month or two ago on the issue of hygiene is the solution.
for bringing this to the dental patient, the dental industry, because you hygienists have the ability to see and listen to these patients constantly who have these symptoms. And all you have to do is say, we now understand this problem. Here are your symptoms. And then you make the referral.
Whoever your doctor, whatever, but you have the ability to actually these patients who don't know what to do, and they've seen a bunch of doctors. so watch the episode if you want to. It's just, I bring it out, I talk about it and I realized a while back, you're the magic bullet here, the hygienist or the magic bullet in the dental office regarding this.
All right so, let me show you words only do, you know, pictures worth a thousand words
Anne: No, that's not it. That can't be it.
Tony: know, That's it. All right, so you got to send a dental models.
Anne: I can see it.
Yep, it's perfect. We got it on the camera.
Tony: Device
Anne: doke.
Tony: fits in the roof of the mouth.
Right behind the front teeth as an anterior pad that does nothing more nothing less than have the anterior six touch separates the posterior teeth a millimeter or two. You have to separate them all pre molars molars. And it doesn't direct the mandible anywhere. In fact, frankly, the only thing this does besides unloading the joint, it allows the condyle the ball of the ball and socket, to go back into the socket nicely into centric relation, there's several monikers for centric relation, but one is it lets the jaw go back to the healthy position.
Anne: does it rest? Yes.
Tony: Rest, rest position. That's one of the other words for centric relation, rest position. That's all it does. And then you have to use it according to protocol. Now, this was the first This little thing shaped like that fits in the palate right behind the front teeth.
This was the first iteration that used to be made in dental labs. I made the first one in my little lab and then Once we found out we were doing hundreds and hundreds of patients, I subbed it out to a large dental lab in Cleveland, Ohio. But I couldn't get consistent quality.
I'm not going to name it, but they are good lab. But I just couldn't get constant quality out of it. because you get different lab technicians all the time. So I bit the bullet and about a year and a half ago, I developed or opened our own manufacturing facility so we could get quality, you know, I'm not a dental technician, but I got the people.
I finally got the people lined up where we have our own lab. By the way, this device I didn't mention, I don't even know if it's important, but it's patented, FDA approved, it's a non surgical device and a patented non surgical FDA approved device has to be made in an FDA approved lab.
They're supposed to be, and that doesn't happen all the time, but it's supposed to be. Well, There are only about 25 or 30 FDA approved labs in the United States of America. So we now have an FDA approved lab to make the urbanic device and protocol, because protocol always goes with device. It's not a piece of plastic.
It's not a widget. It's a tool.
You got to
Anne: doesn't work if you don't use it properly.
Tony: You'll learn how to use the tool correctly, you'll get the response. you don't use it correctly, you won't get the response. But it's a tool. So anyway, to carry on that, about eight months ago because of various reasons, we had the quality, but I said, we make this thing better?
you can talk with it in your mouth, it's really, everybody does pretty well with it, but it had ball clasps on it, you know, and the ball clasp broke once in a while, and this kind of stuff, and you had to adjust the ball clasp, and so I talked to my technical people, and I had an idea, I said, can we make this thing CAD CAM.
Can we 3D print it rather than the dental way? Sure enough, I didn't figure it out. I'm not smart enough to figure that out. I hired people. This is the new of the same device. It looks different, right? But it is the exact same thing, except I don't know if you can see it or not, but instead of clasps, it has coverage over the premolars
Anne: I, I thought when you held it up a little bit higher, but I could
see. Yep. Yep. That's good. No, I got it. I
Tony: little caps over the premolars, the anterior pad is the working motion on it, and that's what keeps it up, because you got to have something to keep it up
there. Well, What I found out about making a CAD, so now we can either take a PVS, or we obviously prefer scans, get a scan, my technicians like go through the doctor's office in Manhattan, which we have somebody in Manhattan now doing this, into our computer like that, it comes up on their computer, and they CAD CAM a set of models
Immediately, and then they CAD CAM this, and then they push the button and print them out.
What I found out is that the accuracy between this iteration made in a dental lab and this iteration made CAD CAM is night and day. This is so much more accurate. Tremendously more accurate. I didn't realize that about printing. Between CAD CAM computer and what we can do technology now wise.
All right. So it's really simple. And the rest of the story is the protocol. and I, by the way, I had to call it the urbanic device. I didn't want to. I did everything I could to avoid calling it the urbanic device. Once we got deep into this, I did a survey for my patients, and we had plenty of those.
they did it from the front desk. I said, you know, have a little Survey for everybody is should we call this? Because I call it something. We're in the middle of getting the FDA approval. We're in the middle of getting patent and the word came back was they want to call it the miracle device to save my life device.
I said, we can't do that. And I finally fell back and I finally gave in and I said, okay, we're just going to call it. I had to call something. We call it the Urbaniq device and protocol. And that's the point I'm trying to make is the protocol is as important as the device itself. Now I know how the device works. You know the three legs on the stool that supports the concept. And so now it's the protocol. What's the protocol? The protocol is 24 seven, except when you eat for the first two months and then nighttime the rest of your life indefinitely.
Anne: Wow.
Tony: Or when you nap. Now, there are a few variations there.
But what we find is that 85 percent of the patients, that's all they need to do. That protocol. 24 7 for two months, nighttime the rest of their life.
Anne: And honestly, it sounds like Invisalign, only you don't have to wear it that long.
Tony: there are more 90%, percent male. There are more ladies who need this than they need Invisalign. Or
Anne: Oh, yeah. But I mean, that's not a big deal, is my point. It's like, that's easy to do. to save yourself what you're saving these people. patients and these people, lifetime of pain, agony, that flows out into their home life, their work life, everything, it is a miracle.
Tony: On that point, this is what we do around here. when they come back and say a minimum of 85 percent of their symptoms are diminished or gone, we ask for a success story. And the point I wanted to make about that is that most of those people, or a lot of those people say, I wish I'd have known this 30 years ago.
Dr. Urbina, my associate, had one today, She said, why didn't I know this 20 years ago?
so the protocol 15%, what's the 15 percent Fifteen percent, they need to wear it more during the day. You can't wear it 24 7 longer than two months. There's a reason for that because you can get super eruption in the posterior teeth, but not in adults in two months.
And we do treat young females I have treated young females as early as age 12. And you have to be very careful, I mean, once they're out of mixed dentition, then you can treat a patient, but moms bring. Daughters in all the time frequently 14, 15, 16 year olds.
Oh yeah. All the time. And they say you have to do something because Molly is crying all night. And we put them into the device, and in those cases, we get them out of 24 7 as soon as possible, usually sometimes within a week or two, because teeth move fast in youngsters, But the point is that can do this in younger people.
But the 15%, getting back to 15%, it's all about, Using it whenever you may be clenching or grinding and those 15 percent most often is where I learned. I learned so much from my patients. They come in here in middle Tennessee and they go. I figured out when I'm in traffic. I put this thing in my mouth.
I figured out when I'm sitting on the computer. I put this thing in my mouth that's the way it works. 15 percent wear it more during the day. 85 percent nighttime only hold them until they lose it. Break it. Let the dog chew it up, which is frequently. Thanks. Uh, Safe in your mouth, safe in the case, if it's not safe in the case, if you do not put it in the case, sooner or later, something's going to happen to it, and you'll be back in the office wanting another one.
The other point I want to make about this, I don't think it's funny, but wish it wasn't that way but once you get them where they're satisfied, you cannot get them back in your office. The protocol is Bring them back at three weeks, two months, four months and six months.
It's rare to get somebody back at six months. it's pretty uncommon to go four months. Once they're fixed. You can't bring them back. They don't want to go back. Police come back. He wants to see, he wants to document, he wants to see how you're doing. and we want everybody to do well, and I assume because if they
Anne: done with it,
Tony: if they weren't doing well, they'd be back,
Anne: they're singing and dancing now. That's what they're doing. They don't think about it anymore. Don't think about why can't this be solved? Why my head hurts? Why my arm tingles?
all of the things that you're solving with something that looks pretty easy to wear. Yeah. This needs to be like on 60 minutes Tony. Come on now. We need to get you on 60
Tony: Oh, the last thing I need is pets on the back. My mission is to solve this problem for as many people, primarily females, because I've listened. since I was a young surgeon coming right out of Vanderbilt, doing surgery on these things. I've listened to it.
I've had the stories. I know how much it ruins lives. If I can do that, then I'm happy. I don't need anything else. It does need to be brought widely.
Anne: Well, That's what I thought about 60 minutes. I think everyone that's hearing this podcast and seeing this And I hope that we'll get it out there I'm gonna put it on dental entrepreneur woman as well just because it's so valuable and we all know people, Tony, they've had these symptoms their whole life and they've been to so many doctors, they've had surgeries, nothing works.
And I've heard it over and over again. And I'm in the business. I was excited when I read your, press release saw the videos. This is just very enlightening to me today. And I'm just so happy that, I can share your story with our audience.
Tony: I'm pleased that you can and do. I stick by it. We solve this problem. Now it's a matter of getting the word out as widely and getting the cooperation of the dentists and the physicians who misdiagnose it. And we figured out how to deal with that, too.
That's why we have. I call it awareness, not a marketing program. Here in Middle Tennessee, believe it or not, We make the physicians aware of this problem by sending them letters from their patients who had Meniere's disease or ear infections, who state that now 70 percent of their, or 90 percent or 85 percent of their symptoms are now gone.
And sooner or later, those physicians and nurse practitioners and dentists and oral surgeons will wise up and they'll go, Oh, this is TMD. This is not Meniere's. This is not migraines. This is not ear infections. By the way, you have to listen to this before we end. You have to. Diagnosis is simple.
You can diagnose yourself. You don't need to be a doctor. you know the symptoms now. I reeled them off two or three times. you don't diagnose off a symptom. That's just a red flag. You get enough symptoms, you're suspicious. Okay, you got these symptoms. I'm suspicious in your differential diagnosis.
But you make your diagnosis by doing this. Either the patient themselves or the doctor standing beside or the hygienist standing beside or behind the patient says. I'm going to put some pressure on your jaw joint. I'm going to have you open widely. Then I'm going to ask you to close your mouth rapidly on your back teeth like you normally do. don't open till I say, don't close till I say. And when you open widely, when the condyle comes out of the fossa, there's going to be a depression. You put your fingers in that depression and press firmly, not just press, but press firmly and say, bite your teeth together. And when they bite down rapidly, boom, just once, boom.
If it hurts, the joint's inflamed. If it's inflamed, they have TMD. You got the symptoms. You got the physical examination done. You made your diagnosis. you have to have some kind of x ray. So we get a Panorex. You don't need MRIs. You'd certainly don't need CT scans. beam scans.
All that you need is a Panorex and a history and that. And if it hurts, they got inflammation. If they got inflammation, they have TMD and we know how to make the inflammation go down,
Anne: with
Tony: device and protocol
Anne: and everything needs a protocol, Tony. I love that you're putting a lot of emphasis on that. So often, we get something, we have a surgery, and we leave, and we have no idea, what to do, or these little tips like that, the fact that you care so deeply, and it has to do with just not the device, but it's the protocol.
happens when they leave the office, right? Beautiful. I'm just so thrilled to know you, to hear your story. It makes perfect sense to me. I will be on the bandwagon for you. I'm just thrilled. I'm going to tell everybody I know. and we need an article for that for dental entrepreneur, because honestly, this is the future of dentistry.
Let's save the people that have been doing all these other things and let them spend their time living life to the fullest, healthy, out of pain Honestly, it sounds too good to be true, but I know it's true. And I really thank you for your digging in and not giving up, Tony.
That is the mantra of an entrepreneur. You knew you could solve it. You just never gave up and thank you. The world will thank you. Women will thank you. 10 million plus people have TMD, TMJ out there and we can help them the statistics back up that this is so needed and it's almost like now that we know this information and if you're listening and you've heard this information, you cannot go back.
You have to go forward. And reach out, Tony, how do people find you? Get in touch and get a little bit more information because I hope that we've piqued their interest. Certainly.
Tony: very good question. And thanks for that. So the website for the doctors who want to join the network, we didn't go into that. We now have a network of doctors growing network with the help of Lou Schuman, It's starting to grow rapidly. Now, I did it by myself. We now have about 25 doctors in the southeast, few in the Midwest, few on the East Coast.
Our goal is to have several thousand doctor practices, but the website for the doctors is www. org. Do com
Anne: We'll put that in the show notes and the people can get in touch with you. And it has been a delight. Getting to you, I'm sorry, I didn't see what in Denver because, I mean, I would have loved to have had that hug actually know that we
Tony: Uh,
We'll meet there next year. I'm planning on being there next year for sure. Hey, and by the way, as long as I know, I want people to communicate with me. I'm going to give you my, email address,
Anne: Great.
Tony: truly, you know, if anybody wants to comment or criticize, I'm over criticism, Tony, at TMJ services, plural Tony at TMJ services.
net.
Anne: We will be in touch with you. You have opened our eyes and our joints and our minds for this amazing breakthrough really in health and wellness for our patients and people around the world. So thank you, Tony. Thanks everybody for listening here today. I appreciate you.
Please reach out with your questions and remember everyone keep doing you. Thank you. Thank you, Tony. See you next time.
Tony: Thank you.
