Finding balance and harmony for the head, neck, body, and hips
No part of your body exists on its own. We are all one connected organism trying to survive. We see this every day. What happens when your cold leaves your nose stuffed up? Well you open your mouth. The stabbing pain in your shoulder hurts too much? You contort your body to accommodate. A pebble goes in your shoe? Your gate and the way you walk alter to keep the stone from hurting you until you can get the pebble out.
Your bite is no different. The way your teeth function and bite is connected to the way your jaw, neck, and shoulder muscles work. If there is a very very tiny discrepancy in your bite (a malocclusion), your body’s musculature and alignment responds immediately to try and avoid. It also tries to compensate for the noxious, damaging and uncomfortable bite sensation.
And the compensation by your body’s muscle activity and postural alignment is not limited to the jaw, the teeth and the temporo-mandibular joint (TMJ for short). The muscle/posture compensation travels down your body in complicated patterns. While these compensation patterns are unique to each sufferer, there are patterns that show up that are commonly shared. Some of the common clinical signs and symptoms associated with muscle strain and body misalignment include:
- Cervical/ neck problems
- Forward head posturing
- Hip/Lower Back Pain
- Clenching/ bruxing of the teeth
- Loose teeth
- Sensitive and sore teeth
- Obstructive Sleep Apnea
- Ringing in the ears
- Ear congestion/Fullness in the ears
- Clicking/ popping in the jaw joints
- Limited opening of the mouth
- Tingling in the fingertips
- Facial pain /Jaw pain
- Worn/chipping teeth
The expanding role of dentistry
The field of temporo-mandibular joint disorders (TMD for short) and treatment is challenged by varying opinions, perspectives and treatment philosophies. Most of which are grounded on past knowledge of anatomy, occlusion, physiology and traditional approaches. Some have view that whatever happens in the mouth will not impact the physiology of the body connection of occlusion (your bite) and the body.
The word physiology is a medical term meaning “how the body solves problems”. Your physiology is the way your body allows you to be alive and survive.
I believe that dentists need to be leaders on the forefront of treating their patients’ physiology.
As dentists we have a unique perspective on the most finely tuned touch organs of the body … the teeth. Our teeth are so sensitive to the way they mesh together, they can feel changes in the bite as small as talcum powder dust. That is 50 microns or 5/100’s of a millimeter. And the way teeth mesh together is a complex and intricate dance of muscles, ligaments and bones of the head and neck.
To get teeth to touch without causing excess strain that leads to fracturing and breaking of teeth, we learn to move our jaw and neck muscles in coordination with the way our body functions.
Traditionally, dentistry has focused on the mechanical skills and tools needed to combat a variety of tooth injuries. And the gains in these skills and tools are amazing. Dentistry can rebuild even the most debilitated mouth. But I think there needs to be a greater focus in diagnosing and treating structural body strain that causes chronic head and neck pain. Pain that’s frustrating and defeating to many patients.
Patients with chronic pain often go from health care profession to health care profession seeking relief from their pain. And referrals to a dentist is not something most medical doctors would think to do. The medical model has too long been “Symptom = Disease = Drug”. Medical doctors have very little therapy available to use with their chronic pain patients.
Surprisingly, few clinicians fully comprehend the connection between occlusion and eventual dysfunction of many body systems. Further, many clinicians don’t realize that TMJ/TMD does exist in our medical and dental practices. Also, that further understanding is needed in treating this bewildering disease.
Clinicians often implement what they were taught in medical or dental school when confronted with this sometimes debilitating disease. I know personally that fear often strikes general dentists who recognize how little they understand when confronting this condition or disorder. This has to change. Our dental profession needs to move past being the “Tooth Mechanic” to be more of the “Mouth Doctor” and work with the medical and health care professions.
What I mean by “physiologic” and by a “whole body approach”
Traditionally, we dentists would concern ourselves with only the hard tissues – teeth and joints. Treating the physiology of your jaw function and bite requires that the dentist observe the balance and function of not only the hard tissues but also the soft tissues. And not only the head but the head, neck, shoulders, back, and hips.
Compromise from a malocclusion will provide strain throughout your body.While dentists are limited to working with the jaws and the teeth, taking a physiologic approach means that we may need to collaborate with other health care providers. These health care providers may be required to deal with a patient’s structural stress in the rest of their body.
Working with other health care providers is key
There are dynamic relationships that become instantly related to the physiologic range of motion and posture of the body. Structural strain in the hips can cause alterations in the bite and vice versa. This means co-ordination between health care providers is imperative for a patient’s recovery.
As well the physiologic approach, that uses the ability to objectively measure muscle function, tooth contact, jaw motion and TMJ degeneration, will allow the clinician to more quickly and accurately diagnose and treat the patient to comfort. Biometrics help the doctor/dentist correlate the bite of the teeth to a physiologically balanced jaw posture with the rest of the body and allow assessment of the functional movements of the bite.
TMJ disorder or TMD is multi-factorial
Medical professionals call this structural strain a Myofascial Pain Syndrome.
- Myo = Muscles (the things that keep us functioning)
- Fascial = Connective tissue (the stuff that connects everything else together)
- Pain = Ouch
- Syndrome = Something mysterious
Note: Some medical problems are labelled “Idio-pathic” which literaly means “Idio” = “no knowledge” and “Pathic” = “pathology or disease”. It is medical for I don’t have a clue! This is a very frustrating diagnosis to get when you are in pain.
Syndromes are often multi-factorial etiology including myofascial, musculoskeletal, and occlusal strain or dysfunction. It is complex and to understand it, it must be seen through a whole body approach.
Your stomatognathic system — your mouth, jaws and closely associated structures — work when bringing the upper and lower arches together in a physiologic (let’s not let the teeth bang too much) manner. It is too sensitive to observe visually. It is this lack of visual data that creates the significance of objectively identifying (Biometrics) an optimal physiologic balance and function.
Proprioceptive (the way we feel contact) micro-occlusal (50 microns) contacts between teeth creates ‘noise’ or hyper-activity in the occlusally compromised (malocclusion) patient. It’s up to the dentist to quiet this feedback system to prevent problems.
A greater respect for occlusion is recognizing and the need to develop neuromuscular and structural balance between the occlusion, the muscles and the temporo-mandibular joint, with the rest of the body.
Having a fundamental understanding of the occlusal principles of how the teeth, joints and muscle function is required to reduce structural, muscular, neural and respiratory stress in the dental patient.
General Dentistry & TMJ Calgary: Diagnosis and TMD treatment
Biometric technology and radiographic imaging data can enhance the decision-making process for an optimal diagnosis and definitive treatment of the TMD patient.
Recognizing the musculoskeletal occlusal signs and symptoms, and how they affect not only occlusion but the function of the entire body, is one of the crucial goals of the dentist learning to treat the complex TMD patient.
Some crucial points in understanding what TMJ is about.
These points have helped unravel the confusion of how best to diagnose and TMD treatment:
- Understanding the importance of physiologic interconnection of the head, neck, hips and feet in finding success in treating TMD.
- Diagnosing physiologic stress and finding the Health Care Provider that will work in synergy with your treatment.
- The importance of finding a physiologic trajectory for the mandible in any treatment of TMD.
- The importance of balancing micro-occlusion forces of the bite to calm neural sensory feedback loops.
- Using Biometric instrumentation and the ULF TENS to accurately measure function when finding a more physiologic bite.
- The importance of the right orthotic with the right protocol in reducing and eliminating chronic pain of the head, neck, back, and hips.
Understanding the “Mouth – Body – Life Connection”
The problem with medical and dental care is that the body is not conveniently broken up into health care segments. We are all connected systems and the alteration or compromise of a tiny aspect in your occlusion or “bite” can create a cascade of accommodations, parafunction and dysfunction in the body.
Further, our reliance on using ‘pain’ as a metric of health has kept dentists from being the primary caregiver that can intervene in the downward slide of a patient’s health. Just because a patient’s bite feel ‘Normal’ to them is no longer enough diagnosis. Any compromise or dysfunction or limitation that has been there for 6 weeks becomes the patient’s ‘Normal’. Normal does not mean ‘Healthy’.
My dental career and my downtown Calgary dental clinic are dedicated to the treatment and resolution of TMD signs and symptoms. Having the training and understanding to move into the more challenging and precise realm of treating TMD treatment as a clinician.
I am honoured and excited to present my experience and insights to Dentalife patients. To stay updated on my publications, patient video case studies and to learn about Dentalife’s lovely team of dental hygienists and assistants, follow me on Facebook.
If you believe you have TMD and not sure where to start you can book an Online Meet and Greet with me or fill the TMJ questionnaire. We will contact you with recommendations.We are accepting new patients for TMD treatment, cosmetic dental treatments, and general dental treatments.
Downtown Calgary Dentist
Dr. Curtis Westersund, D.D.S.