Timhottel
Timhottel
Timhottel
Timhottel
Timhottel

Clinical study researches use of oral appliances in mitigating severity, frequency of motor and vocal tics

Oct. 9, 2014
Timothy L. Hottel, DDS, MS, MBA, dean of the College of Dentistry at the University of Tennessee Health Science Center will conduct a clinical study on the effect of oral appliances on Tourette Syndrome.  
Timothy L. Hottel, DDS, MS, MBA, dean of the College of Dentistry at the University of Tennessee Health Science Center (UTHSC), will serve as principal investigator for a $340,000 clinical study funded by TicTocStop, Inc. TicTocStop has a mission focused on improving the lives of people with Tourette Syndrome. The study plans to enroll 65 participants (both adults and children) who suffer from either simple or complex tics. Dr. Hottel and his team will fit each participant with a specially modified oral appliance, much like a modified mouth guard for lower teeth. The study will then assess whether the appliance lessens the severity and frequency of the symptoms.

Titled, “Cranio-Facial Relationship Manipulation with an Oral Appliance Mitigating the Severity and Frequency of Motor Tics Associated with Neuro-Psychiatric Disorders such as Tourette Syndrome and Chronic Tic Disorder,” the clinical study was launched in mid-September and will run through 2015. The study will enroll children and adolescents ages 7 to 17 and adults ages 18 to 45 who are affected by simple or complex tics.

“This is the first time in medical history that a multisite study of this type has been done,” said Dr. Hottel. “We are proud to be part of this forward-thinking research initiative to determine the viability of the TicTocStop appliance. This device may have the potential to help tens of thousands of people who suffer from motor and vocal tics.”

Neurological disorders like Tourette Syndrome and Chronic Tic Disorder are characterized by repetitive, involuntary, painless, nonrhythmic movements and sounds called tics. Estimates indicate about 200,000 Americans, most often males, suffer from the most severe form of Tourette’s, and thousands more go undiagnosed. As many as one in 100 people can exhibit milder and less complex symptoms. Simple motor tics are sudden, brief, repetitive movements that involve a limited number of muscle groups. Some of the more common simple tics include eye blinking and other eye movements, facial grimacing, shoulder shrugging, and head or shoulder jerking. Simple vocalizations might include repetitive throat-clearing, sniffing, snorting, grunting or barking.

Complex tics are distinct, coordinated patterns of movements involving several muscle groups. Complex motor tics might include facial grimacing combined with a head twist and a shoulder shrug. Other complex motor tics may actually appear purposeful, including sniffing or touching objects, hopping, jumping, bending or twisting. More complex vocal tics include words or phrases. Perhaps the most dramatic and disabling tics include motor movements that result in self-harm, such as punching oneself in the face or vocal tics including coprolalia, uttering socially inappropriate words such as swearing, or echolalia, repeating the words or phrases of others. Coprolalia is present in only 10 to 15 percent of individuals with Tourette Syndrome.

Some tics are preceded by an urge or sensation in the affected muscle group, commonly called a premonitory urge. Some with Tourette Syndrome will describe a need to complete a tic in a certain way or a certain number of times in order to relieve the urge or decrease the sensation. Tics are often worse with excitement or anxiety and better during calm, focused activities. Certain physical experiences can trigger or worsen tics, for example tight collars may trigger neck tics, or hearing another person sniff or throat-clear may trigger similar sounds. Tics do not go away during sleep but are often significantly diminished.

WFAN Radio and CBS Sports personality Craig Carton founded TicTocStop in 2013. Carton has Tourette’s, as do two of his children. TicTocStop is a non-profit organization that, in its very first year, commissioned a pilot study to test the effectiveness of an oral appliance designed to reposition the lower jaw to lessen the severity and frequency of motor and vocal tics associated with Tourette Syndrome and Chronic Tic Disorder. The pilot study demonstrated that the TicTocStop appliance lowered the frequency and severity of vocal and motor tics by 65 percent. The amazing result occurred without drugs and invasive medical procedures. TicTocStop is now engaged in funding a multisite study to prove that the TicTocStop appliance will significantly help children and adults with Tourette Syndrome and Chronic Tic Disorder.

Carton is one of the hosts of the “Boomer and Carton Morning Show” on legendary sports radio station WFAN, the highest-rated sports radio morning show in the country. The “Boomer and Carton Morning Show” is also simulcast worldwide on CBS Sports Network, which is available in more than 90 million American homes. In addition to funding important research, The TicTocStop Foundation also created and completely funded Camp Carton, a one-week sleep-away camp for kids with Tourette Syndrome. For more information please go to www.tictocstop.org.

Related Articles
Living with Parkinson’s and looking for relief
Are you screening for sleep apnea when treatment planning occlusal guards?