PORTLAND, Ore. Athletes can achieve their optimal performance by submitting to a dental procedure that combines electronic stimulation, measurement and analysis to create a custom "pure power mouthpiece" (PPM), according to its orthdondist inventor and others certified to perform the technique. As unlikely as it sounds, major league athletes such as the Boston Red Sox's Manny Ramirez are wearing the PPM to improve performance, sans drugs.
The approach, devised by Dr. Anil Makkar of Pure Power Athletics Group Inc. (Truro, Nova Scotia), uses "electronics technology first to relax the muscles of the jaw and then to record the bite, so that a mouthpiece can be created that puts the jaw into the optimal position to maximize performance," said Dr. Gary Lederman, who is certified to fit athletes with the PPM at his practice in Bellmore, N.Y. "Manny Ramirez, for instance, was just fitted with a PPM this spring. And while we can't take all the credit, you have to admit he is having a great season."
The theory is that the same technology that cures migraines caused by a misaligned temporomandibular joint (TMJ) can be used to put the jaw into its optimal position to improve performance by reducing stress, improving metabolic rate and oxygenating the muscles, according to Lederman. The PPM is the recreational version of an orthodontic TMJ appliance but can be designed to enhance performance for nearly any activity, he said.
"We custom design the PPM for any sport. For example, golfers don't need protection from impact like a football player, so we design [the golfers' mouthpiece] to allow them to breath normally and talk easily," said Lederman.
"Once we find the [individual athlete's] sweet spot, where the bite is most relaxed[a process that] typically takes about an hourwe record and reproduce that position on the computer, capture it in our bite-registration material and have the laboratory fabricate an appliance for the athlete to use," said Lederman.
In most people, the jaw comes forward and the mouth is more open when in its optimal position, which opens the air passageways for better oxygenation. To determine that position, the practitioner uses two electronic devices, which can be purchased from vendors including Myotronics-Noromed Inc. (Kent, Wash.).
The first device is an ultralow-frequency transcutaneous electrical nerve stimulator (TENS). Applying TENS electrodes to the fifth and seventh cranial nerves in the facethe temporomandibular join muscles that work the jaw and control facial expressionsand pulsing them every six seconds (0.17 Hz) relaxes the muscles into their optimal resting length. A second electronic device, called a computerized mandibular scanner (CMS), performs a real-time, continuous three-dimensional scan of the muscles of the face and jaw. When the optimal occlusal position is achieved, the mandibular scanner records that position as well as the path of closure when the jaw is in the mandibular rest state. An impression can then be taken and a mouthpiece fashioned that instantly puts the jaw in its optimally relaxed position.
After the custom PPM is fabricated, athletes can test their performance improvement with a variety of objective measures. According to PPM's proponents, the results thus far have convinced athletes in a wide array of sports to submit to the procedure. More than 150 professional and collegiate athletes are claimed to be using the PPM, with representation in Major League Baseball (MLB), the National Basketball Association (NBA), the National Hockey League (NHL), the National Football League (NFL), the Ultimate Fighting Championship (UFC) circuit and National Collegiate Athletic Association (NCAA) basketball.
"There are many different tests we can use to prove that the appliance improves performance, such as strength tests and flexibility tests," said Lederman. Athletes' performance is recorded both "with the appliance in and without it, and there is generally a marked increase in range of motion, strength and endurance."
One easy test, according to Lederman, is to have the athlete perform repetitions of an action until the point of exhaustion, then insert the PPM. "When an athlete hits a wall and can't perform any more repetitions of an exercise, we put the mouthpiece in, and they can immediately keep going because all of the stress in the upper body is gone," he said. "Allowing the bite appliance to correct their posture frees them up to allow their muscles to work at their full potential."