Ep #46 Jim garry, dds v3

www.occlusionconnections.com James F. Garry, D.D.S. – the Einstein in Dentistry
• Barry Raphael [mailto:dralignmine@gmail.com]
• 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 Garry
Clayton A. Chan, D.D.S.

OCCLUSION
Presents …
Connections®
The Legacy of James F. Garry, D.D.S.
“the Einstein of Dentistry”
Ron Reeves – Son of Dr. Jim Garry
www.occlusionconnections.com

1995
From 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
• He also holds mastership status in
the American Endodontic Society
and the International College of
• 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 retruded
position 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
and
Upper 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 DICTUM
ALL 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 faucium
without 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 Sauger
nipple 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 Therapy
Orofacial 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 exercise
3. Developing a proper exercise regimen
4. Carefully monitoring the child or adult’s progress
5. 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 Myofunctional
Therapy
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

A few months before he died in bed having his martini.

Craniomandibular Facial Pain
Ortho/Orthopedic & Esthetic Restorative Rehabilitation
Director/Founder of OCCLUSION CONNECTIONS
Las Vegas, Nevada
(702)271-2950
Email: clayton@drclaytonchan.com

• Bite Management
• Spatial Relationship Management
• Dot Finishing Management
(702) 271-2950
Las Vegas, NV
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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Ep #46 Jim garry, dds v3