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The Psychological Burden of HNC Survivorship on Patients and Caregivers

An often neglected burden of HNC survivorship is that on the psychological effects of head and neck cancer on both the patients and caregivers. How can we, the providers, help?

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New Research! When is it best to start trismus therapy?

When is it best to start trismus therapy? Treatment for head and neck cancer may cause trismus, xerostomia and dysphagia negatively impacting a patient's quality of life (QOL).  A new study, Effects of jaw exercise intervention timing on outcomes following oral and oralpharyngeal cancer surgery: Pilot study (Sandler, MLLazarus, CLRu, M, et al, 2019), looks at the optimal timing for exercise initiation post-operatively in HNC patients. Initial findings suggest early exercise intervention has a positive effect on some QOL measures! 
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Radiation Fibrosis - Development & Impact in HNC Patients

Radiation, commonly used in the treatment of head and neck cancer, may negatively affect healthy cells by increasing the production of the protein, fibrin which damages soft tissues in the treatment field potentially leading to trismus, or limited mouth opening. Trismus affects patients negatively by making it difficult to speak, eat, maintain good oral hygiene, receive dental procedures and it even has the potential to complicate intubation. In patients that receive radiation treatments, approximately 30% will develop trismus. If the treatment field includes the pterygoid or masseter muscles incidence rises to above 80%. Loss of maximal interincisal opening (MIO) is continual and progressive in these patients. Therapeutic exercises will need to continue for the rest of the patient's life! The good news is that trismus is preventable and treatable with exercise therapy using jaw motion rehab systems such as the OraStretch press. 
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New Research Reinforces Prevalence of Trismus in HNC Patients up to 10 Years Post Treatment

New Research! Systematic review and meta-analysis reinforces the significant prevalence of trismus (equal to or less than 35 mm MIO) in HNC patients up to 10 years post treatment. 
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HPV Vaccine is Key in Fight Against Cancer

HPV Vaccine In The News!!!!

Published in The Lancet, an important new study demonstrates that vaccines against the human papillomavirus (HPV) are in fact decreasing HPV infections including precancerous cervical lesions and anogenital warts. This study indicates that the HPV vaccine has been more effective than expected, reducing rates of HPV infection in the vaccinated population and FURTHERMORE reducing rates of HPV-related diseases in the non-vaccinated population (herd immunity). 

In June 2019, the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices  approved the use of the HPV vaccine in some people through the age of 45. By expanding the pool of approved people, more insurance providers may cover the vaccine. 
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CranioRehab Update and Research Refresh

CranioRehab Update & Research Refresh. Review "Correlation Between Radiation Dose to Pterygoid and Masseter Muscles with Trismus" and "Successful Rehab of Facial Burns Using Jaw Motion Rehab Systems Including the OraStretch Press". Learn about CranioRehab products.
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Actress Aims to Destigmatize HPV- Related Cancers

In an effort to end the shame surrounding cancers caused by the human papillomavirus (HPV), actress Marcia Cross shares her personal story with anal cancer as well as her husband's with throat cancer. 
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New Research Correlates Radiation Dose to the Masseter and Pterygoid Muscles with the Development of Trismus (Article Review)

Reconfirmed!! New research reinforces the correlation between radiation dose to the masseter and pterygoid muscles with the development of trismus.


The study “Radiation dose to the masseter and medial pterygoid muscle in relation to trismus after chemoradiotherapy for advanced head and neck cancer” stresses the impact of radiation dose on the ipsilateral masseter muscle and the ipsilateral medial pterygoid muscle in head and neck cancer patients. A meaningful analysis of data was conducted across 83 patients treated for advanced squamous cell carcinoma of the head and neck. These patients participated in a preventive exercise program for mouth opening and MIO measurements were compared. The study concluded that radiation dose on the ipsilateral masseter muscle and ipsilateral medial pterygoid muscle is predictive for trismus.


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Successful Orofacial Rehabilitation of Facial Burns with the OraStretch Press and Therabite Device (Article Review)

The study “Full thickness facial burns: Outcomes following orofacial rehabilitation” (2015) examines the impact of orofacial rehabilitation on full thickness orofacial burn, specifically looking at mouth opening range vertically and horizontally. Results indicated that rehabilitation, including use of the OraStretch press or TheraBite device, had a positive effect on patients' opening range.  
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Swallowing Difficulties and the Holidays

Difficulty swallowing, dysphagia, may cause the sufferer to feel embarrassment eating and drinking around friends and family. This may lead to lack of participation during holiday celebrations. With some adjustments it is possible to make celebrations inclusive and enjoyable for all. We, at CMR, wish you and yours a very happy holiday season. 
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Trismus in Head & Neck Cancer

Trismus, or restriction to mouth opening, has many implications including difficulty speaking, eating, maintaining oral hygiene, receiving dental procedures and may even affect intubation. Typical measure of mouth opening is 50 mm and highly correlated to body size. An opening of 35mm or less is considered trismus. Trismus is preventable and treatable by engaging in exercise therapy and treatment using jaw motion rehab systems such as the OraStretch® press. 
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Article Review  on Trismus incidence and impact on quality of life in head and neck cancer patients (2013)

Article Review on Trismus incidence and impact on quality of life in head and neck cancer patients (2013)

This study assesses the negative impact of trismus (restricted mouth opening) on head and neck cancer patients daily life activities. 6-12 months post-treatment trismus was found to impact quality of life with decreased mouth opening, jaw related problems, eating limitations, muscular tension, dry mouth, swallowing and pain as well as anxiety and depression both pre- and post-treatment.
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Article Review on Exercise intervention for trismus in head and neck cancer (2016)

Article Review on Exercise intervention for trismus in head and neck cancer (2016)

Investigation into long term effects of exercise intervention utilizing jaw mobilizing device on trismus in HNC patients. Concluded that jaw mobilizing devices produce positive outcomes that persist over time. 
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New Research - Impact of Exercise with TheraBite device on trismus and health-related quality of life (2017)

New Research - Impact of Exercise with TheraBite device on trismus and health-related quality of life (2017)

The TheraBite's positive effects on maximum interincisal opening and health-related quality of life factors.
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Trismus Prevention and Treatment for Head & Neck for Cancer and Radiation Patients - Presentation at ASHA 2016

At the 2016 national ASHA convention, we presented on "Trismus Prevention and Treatment for Head & Neck for Cancer and Radiation Patients." Here we provide a copy of the slides for the presentaion and the handout from the session.
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Webinar on Trismus and Xerostomia for the Head & Neck Cancer Patient

We have posted our first user-controlled webinar presentation about Head and Neck Cancer Rehabilitation Webinar, including information on trismus, xerostomia, the OraStretch press and TheraBite system.

Learn about diagnosing trismus, when to order a jaw motion rehab system for prevention of trismus, how to order, treatment options for xerostomia and more.
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Tips for Great Oral and Dental Care for Patients with Disabilities

Problems with dental care? Quest, the magazine for the MDA Foundation, had a great article by Bill Greenberg with tips and ideas on how to maintain good oral health in people with neuromuscular disease, muscular distrophy, trismus and other disabilities. Tips include special toothbrushes, finding a dentist, and treating trismus.
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Need TMJ Relief? Here are Some Easy Self Massage Tips

TMJ pain is unpredictable and can strike at anytime, and anywhere. Knowing a few tricks to relieve your pain is essential to your comfort and life’s enjoyment.
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Internal Derangement: A photographic explaination of the Temporomandibular Joint through MR Imaging

Internal derangementInternal derangement is a Temporomandibular Joint disorder which manifests it's self in the abnormal position of the TMJ disk. It is 3-5 times more common in women, then men. You can find the details of this interesting Essay by The Boston University School of Medicine, on Medscape Nurse News.

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Is the steroid Dexamethasone effective when injected into the TMJ?

A new double-blind study at University of Groningen showed no increased effectiveness of Dexamethasone to improve TMJ arthrocentesis.
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Less is often More in Treating TMJ Disorders

Over their lifetime, over three quarters of people can have TMJ problems, but only 5-10% actually need therapy.  These and other interesting facts on TMJ disorder are reviewed in a great overview article in the NY Times by Jane Brody.
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Prelim Results from Seven Year Study on TMJ disorder (TMJD)



Preliminary Results Released from Seven Year Study on TMJ disorder (TMJD) by the National Institute of Dental and Craniofacial Research (NIDCR). The study, Orofacial Pain: Prospective Evaluation and Risk Assessment (OPPERA), collected excellent data on the risks for TMJD.
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New XEROS Dry Mouth Pump for severe chronic dry mouth from radiation of head, neck, oral and nasal cancer

Launch of the XEROS Dry Mouth Pump. This new product alleviates the debilitation from severe chronic dry mouth. Chronic dry mouth is often a side-effect from radiation therapy to the head, neck, mouth, tongue, jaw, and nose.

The XEROS Dry Mouth Pump provides continual hydration throughout the day and night by providing small amounts of liquid to the mouth via a controllable pump for improved hydration, function and health.
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A sample protocol for PNF stretching of the Jaw.

The CRAC 5-5-30 is an aggressive stretching protocol for the jaw to help overcome trismus with a TheraBite or OraStretch® press.  It updates the standard 5-5-30 or 7-7-7 protocol by incorporating a PNF CRAC (Contract-Relax with Antagonist Contract) stretching session.
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Keep Brushing, even when its hard to open your mouth! Oral Hygiene and Your Heart.

The details on how brushing can helps prevent cardiovascular disease. 
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