Updated: Nov 20, 2019
Our philosophy of care is to evaluate the "whole patient" and to collaborate with other like-minded healthcare providers who can enhance our knowledge of each individual patient's concerns and issues. Thus as a team, we can support them on their journey to healing from disease and ultimately living a life of optimal health and wellness.
What we have found to be true with many of our patients (both adults and children) is that there is a lack of awareness of the link between the nose, the mouth, the jaw joint, and the head and neck hard and soft tissue (ie. bones and muscles). The video below explains the link between all of these critical parts of this anatomy. More importantly, it explains the effects of when these biological processes are not in balance and the kinds of symptoms a patient can experience when this occurs.
When a jaw joint becomes dysfunctional and asymmetric, this can cause trigger points in the muscles around the head and neck as the video explains, but it can also lead to suboptimal spine posture and pain referral farther down the body. The radiographs below are from a study that evaluated the effects of asymmetric occlusion on the spine; it was designed to determine a full body response to changing the rat's bite such that its teeth would only touch on one side. More specifically, the researcher built up one side of the rat's mouth with filling material so that the opposing side could not occlude. Within one week, the rat developed almost a scoliosis-like curvature of the spine. At that point, the researcher then applied filling material on the opposing side (or "non touching side") to bring balance in the jaw; and within another week, the spine returned to a more normal, straight posture.
This relationship between poor oral habits (mouth breathing), malocclusion, TMJ disorder, tension headaches and migraines, and referral of pain down the spine is exacerbated by the frequent comorbidity of sleep-disordered breathing. Many patients who experience a displaced mandible in the posterior-superior position also suffer from sleep-disordered breathing due to a compromised airway. We often see adult patients who were treated with traditional orthodontics "braces" as an adolescent who experience these issues. They were treated to have straight teeth, but this outcome was performed without consideration to the TMJ and airway. As a result, we see a number of patients with a "pretty" smile who are struggling with chronic pain and inflammation. Below we've included examples of patients' CBCTs (3D scans of the head and neck that show the soft tissue of the airway). The first is an example of a healthy air in blue; its large volume facilitates appropriate amounts of airflow at all times.
The following scans are of patients who experience TMJ pain, migraines, head and neck pain, and sleep disturbances.
Not only do these patients have airway issues, but they also had evidence of boney deformation of their condyles, which is the part of the jaw joint that articulates against the base of the skull. Popping and cracking of these joints is a sign of improper positioning; it will worsen with age and can lead to pain, premature tooth fracture or loss, and decreased function. Not to mention, when these patients participate in a home sleep test to screen for airway and breathing abnormalities, we often see that these patients exhibit numerous interruptions in their breathing multiple times an hour that are causing them to desaturate to dangerous oxygen levels and cause a spike in their heart rate. And what many may find surprising is that these breathing disturbances can occur without the patient ever snoring!
So now that you understand the relationship between these root causes, you're likely wondering what can be done to improve a patient's quality of life who is suffering from this.
The best thing to do for this is to avoid it all together; this is possible in children by eliminating poor oral habit and guiding growth of the jaws and eruption of the adult dentition by leveraging natural forces during childhood development and growth spurts.
Unfortunately, once a patient reaches puberty, guided development of the jaws and dentition is no longer possible. The good news is that there is a non-surgical therapeutic approach to repositioning the mandible in adults to promote proper occlusion, functioning jaw joints, and a large, healthy airway. This therapy begins with a full diagnostic work up with one of our doctors. We typically begin with a CBCT scan, home sleep test, Joint Vibrational Analysis, a comprehensive head and neck exam, as well as a discussion with any other providers the patient has been working with to manage the symptoms associated with their condition (chiropractors, integrative or functional medicine doctors, acupuncturists, physical therapists, ENT physicians, etc).
Once we've gathered this information, we formulate a customized treatment plan involving a series of splints, aligners, dental restorations, ozone and laser therapy to advance the mandible, eliminate inflammation in the joint, open the airway, and stabilize the occlusion. Occasionally, patients may require surgical intervention by an ENT to address any anatomical enlargements in the nose or associated with the tonsils and adenoids if these obstruct the airway and prevent nasal breathing from being established.
Once the root cause of these issues has been addressed, the patients often have to continue therapy with their other providers to continue to relieve trigger points and coinciding inflammation until these remaining symptoms of the condition resolve.
For more information or if you would like to schedule a consult for you or someone you know, please contact our office at firstname.lastname@example.org or call us at 214-368-0900.