Dr. Curtis Westersund: What is the whole body approach to dentistry & TMD Treatment
This blog post was originally published on downtown Calgary dentist’s blog on dentalife.com/blog.
Finding balance and harmony for the head, neck, and hips
We see this every day. What happens when your cold leaves your nose stuffed up? You open your mouth.
The stabbing pain in your shoulder hurts too much? You contort your body to accommodate the strain.
Now to bring this back to dentistry. 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 tiny discrepancy in your bite called a malocclusion, your body’s musculature and alignment will respond almost immediately to try and avoid discomfort. Your body will also try to compensate for the damaging and noxious 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 as we call it).
Some of these common clinical signs associated with muscle strain and misalignment include:
- Cervical/ neck problems
- Clicking/ popping in the jaw joints
- Limited opening of the mouth
- Tingling in the fingertips
- Facial pain /Jaw pain
- Worn/chipping teeth
- Forward head posturing
- Low back and hip pain
- Clenching of the teeth
- Obstructive Sleep Apnea
- Ringing in the ears
- Ear congestion/Fullness in the ears
- Loose teeth
- Sensitive and sore teeth
As you can see, muscle compensation ripples to other parts of the body. While it’s true that these compensation patterns are unique to everyone, there are patterns that are commonly shared.
Expanding role of dentistry
The field of temporo-mandibular joint disorders (TMD) is challenged by varying opinions and treatment philosophies. Most of which are grounded on past knowledge of anatomy, occlusion, and traditional approaches. Some see 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, Dr. Scott Rose and I have a unique perspective on the most finely tuned 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, believe or not, is a complex and intricate dance of muscles, ligaments and bones of the head and neck.
Traditionally, dentistry has focused on the mechanical skills and tools needed to combat a variety of tooth issues. And the gains in these skills and tools are amazing. Dentistry can rebuild even the most problematic mouth. Therefore, 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”.
Surprisingly, only a handful of clinicians fully comprehend the connection between occlusion and dysfunction of many body systems. Many clinicians don’t realize that TMD does exist. Also, that further understanding is needed in treating this bewildering disorder.
Clinicians often implement what they were taught in medical or dental school when confronted with this sometimes debilitating disease.
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 “whole body approach”
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 or means taking a “whole body approach.” Therefore, 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.
Treating under a “whole body approach” means co-ordination between other health care providers is imperative for a patient’s recovery.
Diagnosis and TMD treatment
Biometric technology and radiographic imaging plays an important role in the decision-making process, optimal diagnosis and definitive treatment of the TMD patient.
Recognizing the musculoskeletal occlusal signs and symptoms, and how they affect not only their bite but their entire body, is one of the crucial goals of the dentist learning to treat the complex TMD patient.
Some crucial points in understanding TMD
These points have helped myself and others unravel the confusion of how best to diagnose and offer TMD treatment:
An extended look at dentistry
The problem with medical and dental care is that our bodies are not conveniently broken up into healthcare 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 and dysfunctions throughout the body.
Our reliance on using ‘pain’ as a metric of health has kept dentists from being the primary caregiver that can help intervene in the downward slide of our patient’s health. Just because a patient’s bite feel ‘normal,’ diagnosis is no longer necessary. Normal does not always mean ‘healthy’.
If you are looking for a gentle, experienced, tmj / tmd specialist dentist practicing holistic care in the Solon or Cleveland OH area, you’ve come to the right place. We encourage you to contact us today to learn about the treatments we offer and to arrange a Meet and Greet with Dr Rose.