How to Measure MIO

Mouth opening is measured as a MIO or ROM distance. MIO (maximal interincisal 

opening) is the distance between the central incisors when the mouth is fully open. 

Average MIO for adults is approx. 50mm. By measuring MIO, a therapist can determine

if a patient is WNL or has trismus. ROM (Range-of-Motion) is the maximum distance

the mandible moves. ROM and MIO may be different, e.g. patients with an open bite.                        
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Trismus in HNC Patients - 2020 Update

80-90% of patients with radiation to the pterygoid and/or masseter muscles will develop trismus.  Learn how to diagnose and treat including therapy with the OraStretch press jaw motion rehab system.
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LEARN & EARN!!! SLP CMH REMOTE IN-SERVICE: Oral Complications of Head & Neck Cancer Care -- Trismus, Xerostomia, Mucositis & Dysphagia

Earn .1 CMH (1 hour) towards ASHA requirements with a remote live in-service.

Speech pathologist, Sarah Schuman, is providing a free in-service on trismus, xerostomia, mucositis and dysphagia in HNC cancer patients. The in-service takes approximately 1-hour and you will have the ability to ask all of your HNC rehab questions!

Please contact us via email to [email protected] or call us at 1-800-206-8381 ext 86 for scheduling.

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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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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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Living with Xerostomia - Mouth Care and Gum Health

Living with Xerostomia? Tried and true tips from cancer survivor Speech Pathologist, Marcy Maksail, for Saliva Substitutes, Mouth and Gum Health.
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IMPORTANT HPV VACCINATION UPDATE!!!

On October 5, 2018, the U.S. Food and Drug Administration (FDA) approved the administration of the Gardasil 9 vaccine for women and men between the ages of 28-45 years. Previously the vaccine was indicated for individuals up to the age of 27 years. "Gardasil 9 prevents certain cancers and diseases caused by the nine HPV types covered by the vaccine". Human Papilloma Virus (HPV) can cause head and neck cancer in men and women. It is the cause of most oropharyngeal cancers in United States. These cancers and their treatment may lead to trismus (limited mouth opening) and dysphagia (difficulty swallowing). 

The expansion in vaccination ages follows a study in which 3,2000 women between the ages 27-45 years were followed for approximately 3.5 years and it was found that Gardasil was 88% effective in preventing certain HPV related infections and cancers. The results were inferred to apply to men as well.

For further information, please see the complete FDA News Release at: https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm622715.htm
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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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When to order a Jaw Motion Rehab System for Trismus Prevention from Radiation Therapy.

When to order a Jaw Motion Rehab System for Trismus Prevention from Radiation Therapy.

When should you recommend using a jaw motion rehab system like the OraStretch press to prevent trismus after radiation therapy?  Who is most at risk for developing trismus from radiation treatment? We provide research and a decision tree to help you prevent trismus in head & neck cancer patients. 
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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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OraStretch Press vs. Therabite. A Testimonial from Dave Y.

We received a really nice testimonial about our service and the OraStretch press from Dave Y. Dave recently switched to the OraStretch press, and says, compared to the TheraBite, he really prefers the OraStretch press because it is smaller and easier to use. He also wrote us to commend our billing staff as being "kind and empathizing with the customer." Thanks Dave!
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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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Medicare Coverage for the TheraBite System

Medicare Coverage for the TheraBite System

Medicare coverage for the Therabite system has changed. It is no longer being billed to Medicare, and patients will have to purchase the device direct.
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How do I clean pads on the TheraBite system? How do I apply or replace the bitepads? I do I remove them? Here is a guide with tips and tricks.

Need instructions on how to apply, clean, remove, and replace the bitepads on your Therabite device?

Here are instructions on how to best use the ATOS TheraBite pads.
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What is included with the TheraBite System? An overview of the device, its parts, and what they do.

Learn more about what is included in the TheraBite jaw motion rehab system, including parts and their purposes.
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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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