Jan 16, 2018
If you have followed the sequence of my other blogs about TMJ pain and TMJ Disorder in general, by now you could come to the following conclusion on your own.
Dentistry is closely related to the functional and dynamic systems of the body. This relation which has been termed an “Elegant Ecology” is so intertwined that discussing one without the other would be an artificial separation of anatomy and physiology.
Any change in dental anatomy, position and mechanics will have an influence on the Craniosacral System and other functional systems of the body. It really is a simple matter. The position of the teeth affect the function of the jaw, which in turn effects the head position.
Rene Cailliet, Director of Physical Medicine and Rehabilitation at the University of Southern California, has put it best: “It is an axiom that the body follows the head. You can realign your whole body by repositioning your head. Head held in a forward position can pull your entire body out of line. It can reduce the vital lung capacity by as much as 30 percent. The gastrointestinal system is affected, particularly the large intestine. When a hunched position is assumed, the body becomes more rigid, and the range of motion decreases. Since endorphin production is reduced, an increase in pain and discomfort results.”
Treating hundreds of patients including those with TMJ pain and all kinds of neck or cervical neuralgia, over the past 15 years in my Clinic at Miami Beach Dentistry, I have come to see this connection first hand. The body works as a complex unit, and when trying to treat it all parts need to be addressed based on their own merit.
What does this mean? I’ll elaborate. A very dangerous and persistent trend I see in patients today is the sum of fragmented information they have amassed from different sources be it websites or support groups. I say dangerous, because some of these patients believe that there is a holy grail in the form of a clinician or treatment that will take all their issues away.
The truth is far from that. Proper diagnosis and correct sequencing of the treatment is the key. This means that each segment of this complex “Craniosacral System” must be addressed by the correct practitioner specializing in that specific part. Yes, in my view, the best approach to treatment is a multi-disciplinary approach.
I have made no secret of my trainings and studies with Dr. Chan. I am a true believer in the fundamental basis of a physiologic bite, and the power of micro occlusion as taught by him. However, this is not a magic wand. While the correction of the jaw function can help many, it is not the only factor that needs to be addressed. What about the “Pain in the Neck”?
Many of the very advanced patients I see in my Miami Beach Dental Clinic today, have extremely poor postures, scoliotic spines, forward head and hips and unevenly developed musculature. Patterns that have developed over many years. Repositioning of the jaw and stabilizing the occlusion does not automatically correct all these issues. It does put you in a better position to correct them but it does not do the job for you. Without addressing the posture on its own, there will be residual symptoms, and in cases it can relapse the bite back to the previous position. It is a two-way street.
One of the most common issues I encounter, is lack of stability or integrity in the vertebral column. Specially in the cervical spine. Many of these patients have been cracking their own necks since they were kids. Later in life they have possibly seen Chiros and or other practitioners who have adjusted them. The result is the same, hyperlaxity of the connective tissue and ligaments that hold our skeletal system together. These patients can pull their vertebrae out by turning their heads suddenly or picking up a heavy object. This laxity needs to be addressed separately by another professional.
To look at this from another view consider the following. In my Dental Practice, I have a handful of patients that are partially edentulous and based on everything I know and have learned these past 20 years, they should be in severe pain and discomfort. However, they are not. A closer look at these patients revealed that they were in great physical form. They are swimmers, dancers, trainers and so on. The effects of proper postural stance and integrity should not be discounted.
Another complicating factor that is somewhat overlooked is airway patency. Although airway as of late, has become a hot topic, most of the solutions currently thrown around are quick fixes and palliative in nature. I believe that another segment of our patients who do not get the expected results are suffering from poor airway patency.
In my Practice, I try to anticipate these and other factors ahead of time in our patients and to address them each accordingly. This means working with other like minded and progressive practitioners and physicians who could help me bring a more complete treatment to my patients.
Here always for any progressive discussion.
Hamid Nassery, DMD, FAGD, FICOI, FICCMO
Owner of Miami Beach Dentistry/ RealSmile and Co Founder of The TMJ Research Foundation.