Updated: Nov 20, 2019
I recently had an "Aha!" moment (and by "aha", I obviously mean it was a realization that came gradually over many years of research, continuing education, and conversations with experts in a range of different topics; but we'll call it an "aha" moment for dramatic effect ;) )... needless to say, I'm so grateful to have arrived at this eye-opening place because I have no doubt that it will allow my team and me and other like-minded professionals in our community to really help heal our patients and support them along a path to being the healthiest, best version of themselves.
To add a little context, here's a brief history on how I finally put it all together and realized that I want to (and more importantly, my patients NEED me to) partner with like-minded chiropractors...
For decades now, our family dental practice has been treating pediatric and adult patients with TMJ disorder, airway/sleep disorders, and growth and development sub-optimization as well as the compromised orthodontic/orthopedic outcomes we see in so many of our adults. We've devoted hundreds of hours to continuing education, reading, research, etc. to understand how and why are patients are experiencing the symptoms they are, and then to learn how we can best help restore their health.
For children, our approach includes early interventional therapy to eliminate poor oral habits and guide proper growth and development so that they end up with healthy airways, good sleep & speech patterns, functional TMJs, and straight teeth, all before they enter puberty. This therapy is based on 50+ years of research from Dr. Earl Bergersen, who in my mind, is like a Steve Jobs of orthodontics.
But even beyond this 50 years of research creating and proving this therapeutic model, there's a century's worth of peer-reviewed research that has been published across all different fields (medical, dental, nutritional, anthropological, etc) that allows us to understand the etiology of some of the most common, modern-day diseases. Brilliant scientists and clinicians such as Dr. West Price and Dr. Kevin Boyd, among others, have devoted a large portion of their careers to studying the evolutionary and societal changes causing these diseases.
Because we study all of these great minds before us, we can become a conduit of their knowledge and experience for the benefit of our patients. It's a super easy thing to address in patients who are self-studies in these areas of preventive, holistic health. However, we've recognized over the years that while it makes perfect sense and has been proven over and over again, one of our biggest challenges in providing this care is providing this paradigm shift for patients who have yet to be exposed to the importance of whole body health. And what makes matters worse, when they don't understand:
Or said another way, what is "common" does not necessarily mean it is healthy. I can identify these kinds of patients when they say things like, "Well this traditional approach worked for me, so it'll work for my kids." or "This is what everyone else is doing, so I'm sure it's right." And I try to empathize and determine where that patient "is" in the moment mentally, emotionally, physically, and I try to speak to that.
But sometimes I just drop a WTF-bomb on them and say something like:
"Just because the majority of the adult US population is obese, we can agree that is not healthy, right?"
or in moments when I'm feeling extra feisty...
"Remember for so many decades when everyone thought it was 'normal' to smoke cigarettes, including pregnant women? Just because it was so commonplace did not inherently make it healthy."
But I digress. (And maybe after a few chiropractors read those last couple of comments, they may question a collaboration based on an occasional "spiciness" that I incorporate into my bedside manner ;)
*Slide taken from Dr. Kevin Boyd's lecture at The 2019 IAOMT Annual Meeting in Boston
But even if a patient doesn't understand the root cause and all of the interrelationships between our biological processes, they typically have the evolutionary instincts present that allow them to identify the deficient mandible/ Napoleon Dynamite/ mouth breathing esthetic is a less desirable, less esthetic than a full mandible/Superman/ nasal breathing esthetic. Instincts drive us to procreate with the healthiest specimens. And my goodness, I can't even imagine the number of trigger points and symptoms of chronic inflammation Napoleon must have been dealing with. Poor guy.
*Important to note, the intention of this reference is not to "cyber bully" or "shame" or whatever other buzzword that could be used to cast this post in a negative light. I love Napoleon Dynamite, and I only use this as an example because it is so well known, and the movie already identified the "struggles" that this character has. Specifically to the strangers on Facebook who like to share your unqualified, negative opinions all over the place, please know that you're barking up the wrong tree here.
**Other important note, I'm sure Dr. Boyd would appreciate me making it EXPLICITLY clear that this slide was NOT taken from any of his lectures, but instead was a custom creation of my very own (::insert laughing emoji here::).
Ok. Back to the point....
For adult patients, treating their symptoms can become more challenging because they no longer have the growth and development to leverage to reposition their bones and teeth, and oftentimes, they experience severe tension, trigger points, or are just "locked up" after years and years of poor posture and function. What this typical patient looks like is someone who may or may not have been treated with braces as an adolescent, but regardless of whether they were or not, they all share the commonality that it is exceedingly rare that someone has evaluated their airway, TMJ, mandible/maxilla, and occlusion (or position of their teeth) and explained to them the true root cause of so much of their pain, dysfunction, and chronic systemic inflammation. We think one of the hardest parts for patients in their pursuit of healthcare instead of sick care is finding like-minded providers and getting a proper, comprehensive diagnosis.
**Long story short, we see patients everyday with a mandible that has been positioned in a superior-posterior position that causes TMJ dysfunction, chronic inflammation and pain in this area as well as surrounding muscles in the base of the skull/temporal region/neck/shoulders, and a suffocated airway. In an attempt to breath better, patients will instinctually develop a forward head posture to bring their mandible forward and opening their airway, like they are performing CPR on themselves. While this may prevent acute suffocation or cardiac arrest, we know that this postural adaptation does not address the root cause and can introduce a whole host of other symptoms and issues.
As an aside, and to keep myself accountable and fully transparent, you may be asking, aren't there other contributing factors to these symptoms as well? Absolutely! I'm not being biased to head and neck anatomy as the ONLY root cause. Nutrition, gut health, mental/emotional well being, genetics, environment, trauma, etc. all of these play a big role in your overall health. And each individual patient is effected differently by their multi-variable experience going through life as to whether they are living well or are at registering at some level of "sick" each and every day of their lives. And just like peeling back an onion, we must peel back the layers of contributing factors to these conditions if we really want to help these patients. We discuss these other variables with our patients and make appropriate referrals as needed to help them repair and heal.
So back to our adult patients... these patients typically present with a whole host of different symptoms. More often than not, we are able to get great improvement in overall health as we work through therapy that includes a series of repositioning splints and myofunctional exercises. However, many of our patients have lingering symptoms of pain and inflammation down their bodies that are directly due to the lifetime of suboptimal health they've been experiencing. My dad has been an incredible resource and leader for our practice in his study and exploration of trigger point therapy, dry needling, ozone injections, laser therapy, the Egoscue Method, etc.... Honestly, if Janet Travell had a fan club, pretty sure my dad would be the president ;) JK dad, if you're reading this.
But beyond the recommendation to pertinent books and guidance on a few stretches, many of these procedures go beyond the scope of expertise. So we are able to treat our patients who have migraines, popping/clicking/painful jaw joints, poor sleep, and premature tooth fracture/wear, but at the end of their therapy, they oftentimes still have the trigger points in their neck, shoulders, spine, and hips, contributing to ongoing pain and inflammation throughout their bodies.
This is where chiropractors come in! I honestly didn't even put it all together until I recently started collaborating on a research project with Dr. Max Collins, a visionary chiropractor treating patients all over North America and training other providers in this cross-disciplinary approach. Thankfully, Dr. Collins inspired me to realize that chiropractors already "get it". Even though we have found a handful of awesome physicians who understand and value what we are doing and choose to collaborate with us, that's only occurred after many years of outreach and education. And it's really unfortunate to observe (at least in my humble opinion) that the Western medicine trained doctor has gotten trapped in this insurance-driven, sick care industry where they spend less than 10 min with each patient, and are typically only treating things once they are broken as opposed to investing the time and energy to educate and heal their patients. And to make matters worse, patients are referred again and again because each of your biological systems is subdivided and treated by a specialist. This is why I love functional medicine doctors like those at Carpathia Collaborative so much because they take the time to look at their patients as a whole person; they evaluate the relationships between ALL of those systems, and they help quarterback your solution towards health.
What I didn't realize until collaborating with Dr. Collins is that many chiropractors share this philosophy of whole body connectedness and therapy. Even if they have yet to make the connection between malocclusion/ airway issues and forward head posture, they definitely can take it from there in knowing the prolonged deleterious effects of a forward head posture. So together, we can help heal patients from head to toe, tooth to spine ;) Ok.
So thank you for coming to my Ted Talk ;) If you would like to learn more, I'd recommend this other blog, Mouth Breathing, Malocclusion, TMJ Dysfunction, & Migraine Headaches, where we share the research behind this malocclusion-induced curvature of the spine in 1 week.
And seriously, if you are a like-minded chiropractor and would like to collaborate to treat our patients, please reach out to me and my team either via the chat here, calling our office 214-368-0900, or emailing us at firstname.lastname@example.org . We are eager to take things to the next level in our whole body health approach.