Kaufman's mouthpiece, which he calls MORA—for mandibular orthopedic repositioning appliance—and which he custom-makes for $350, corrects the misalignment. It fills in any unevenness between the upper and lower teeth, even spaces where teeth are missing, and lines the teeth up properly. It also lowers the bottom jaw and brings it forward, taking pressure off the TMJ. Consequently, most headaches disappear, even cases of scoliosis (curvature of the spine) can improve, and the wearer experiences a feeling of well-being enhanced by extra energy and strength. While this may sound like a snake-oil pitch, the fact is that these improvements can be measured.
Paul Anderson, a 22-year-old decathlete at C.W. Post College in New York, has been training and competing with his MORA since January. He has discovered that it helps him most in the pole vault and the weight events. "I used to average 14 feet to 14'6" in the vault," he says. "The week after I got the mouthpiece I cleared 15 feet for the first time, and now I clear it pretty regularly. My personal best in the shotput has gone up by almost three feet."
Before the 1979 fall college baseball season, Kaufman fitted New York Tech pitchers Hank Iervolino and Nick Melito with mouthpieces. After the season, Iervolino said, "I was definitely throwing harder. I used to rely mainly on my curve and slider. This fall I went more to my fastball, and I was blowing it by the batters more frequently. I pitched more than 250 innings this year. I should have been tired, but I wasn't."
Melito added, "I don't know if I was throwing the ball faster, but I was throwing longer without getting tired. I seemed to have more strength and stamina. When I tried pitching without the mouth guard I got tired quicker and I felt more pain in my arm afterward. Some might say it's psychological, but I don't think so."
Kathy Martin, an 18-year-old lacrosse player at Massapequa ( N.Y.) High, has had a severe case of TMJ distress since childhood. She suffered frequent headaches and her jaw was often sore. When she was 10 she wore braces, and her orthodontist made her wear a chin strap at night. Other doctors told her not to eat apples. She bought her first mouthpiece, the standard plastic kind, for protection when she began playing lacrosse in ninth grade, but it was so cumbersome that she had trouble breathing while wearing it, nor could she talk. "When I wanted to yell something to my teammates, I had to take the mouthpiece out," she says. "I play 'cover point,' I'm right in front of the goal, and when the ball's anywhere near our goal, I really have to yell a lot." Besides, the mouth guard did nothing to alleviate Kathy's headaches, which were especially severe when she ran, and a lacrosse game amounts to almost an hour of constant sprinting.
Last March, Kaufman fitted Kathy with a MORA, and she has been free of headaches ever since. She used to wake up in the middle of the night with headaches, but now that she has gotten used to wearing the mouthpiece while sleeping, she no longer wakes up before morning. When she gets out of bed she feels "full of energy."
The MORA will cushion a blow to the top of the head or under the chin, and it may help prevent concussions, but it isn't recommended for heavy contact sports, such as boxing or football (except perhaps for quarterbacks), where more complete protection is needed. For athletes in these sports, Kaufman makes a larger mouthpiece that covers the top and bottom front teeth. Even though this mouthpiece is made of softer plastic material, it, too, has been shown to increase strength, but to a lesser degree than the more precisely fitted, more rigid MORA.
Most athletes who visit Kaufman have come to get the MORA. Typically, during a patient's first session, when Kaufman takes impressions of the patient's bite, he also uses a few simple demonstrations to persuade the patient of the Tightness of his decision to get a MORA. Kaufman sticks his pinkies into the patient's ears and asks him to open and shut his mouth. The patient will most likely feel either his jaw pressing back against the pinkies or a popping sensation in one or both of his jaw joints, a phenomenon that is known in the jaw biz as "the click." Each of these signals a misalignment of the TMJ, but the click indicates a more severe problem. It means that the disk separating the condyle (top of the jaw) from the skull doesn't move in unison with the condyle. Therefore, the condyle snaps over the thick part of the disk and produces an audible click.
Next, Kaufman shows how the TMJ and the bite are tied to muscle strength. He asks the patient to stretch out one arm and resist while Kaufman tries to push the arm down. Kaufman, whose arms tend to flab rather than brawn, doesn't succeed. Then the patient is asked to press down with two fingers on his right TMJ—the spot where the lower jaw meets the skull in front of his right ear—while his left arm remains outstretched. This time, Kaufman lowers the extended arm with ease. Kaufman then realigns the patient's jaw—which usually means pushing it forward—to simulate the effect a MORA would have and gives him two cotton wads to bite on while he again presses on his right TMJ and attempts to resist Kaufman's push on his outstretched left arm. The patient finds that his strength has returned. In fact, measured on a kinesimeter, his strength while biting the wads registers considerably higher than in the first phase of the demonstration.
The relationship between bite and strength is borne out in a study conducted by a doctor who isn't a dentist. Jeffrey Cartwright-Smith, Ph.D., of the department of psychology at Vassar College, measured the effect of a grimace—a facial expression made by altering the position of the bottom jaw—on the strength of the hands. Working with 32 subjects, he found that grimacing produced a significant increase in hand strength.