Monthly Archives: July 2008

Locating Prabu Point ….safely!

There have been some instances that the myotrode has been incorrectly placed right over the SCM at the level of Carotid sinus. This is potentially dangerous.

When I looked into it, this occurence is related to HOW the Prabu Point.

One way to locate SCM is to have the patient turn the head to the side. But if the Prabu Point is located when the head is turned, when the patient turns the head straight, the SCM rolls…as it should..and roll under the previously located point. This turned out to be culprit.

The proper way, as I had described in my ICCMO Masterhip thesis….is to have the patient continue to look straight. But offer resistance to the head to turn against. This makes the SCM stand up…even in heavy people…but once the Prabu Point is located…in the middle 1/3 of the Posterior Cervical triangle.. the SCM does not change location.

I have attached a Power Point to illustrate this here.

Download locating_prabu_point.ppt

Dental health affects fertility

The connection between dental health and overall health….the “Oral systemic link” is widely recognized. Most of the studies related to periodontal ( gum support) disease and heart disease, stroke, diabetes and low birth weight babies. It makes sense to expect that infection in one area of the body is bound to affect other areas. But this new study has an interesting twist.

Male infertility is often connected to connected to chronic bacterial infection of the epididymis. This is the structure that “stores” semen. This study from Germany showed a direct connection between male sterility and dental infections. An abstract with the references is below.

They only studied those that were resistant to antiobiotic therapy. I wonder if the results would be even better if all of the sterile subjects were included in the study.

One more reason to make dental health and its maintenance a high priority!

1: Andrologia. 1993 May-Jun;25(3):159-62. Links
Bacterial foci in the teeth, oral cavity, and jaw–secondary effects (remote action) of bacterial colonies with respect to bacteriospermia and subfertility in males.
Bieniek KW, Riedel HH.
Department of Obstetrics and Gynecology, University of Halle-Wittenberg, Germany.

Bacteriospermia requiring medical treatment were diagnosed in more than 70% of the subfertile patients who had since 1988 attended the gynecological clinic at the RWTH hospital in Aachen. In 23% of all cases specific treatment with antibiotics did not reduce the concentrations of bacteria in sperma. Thirty-six patients with bacteriospermia resistant to antibiotic therapy were then subjected to dental examination. A high incidence of potential dental foci was found in all patients. In a test group of 18 patients these sources of potential infection were eliminated. Between dental operations and therapy swabs were taken to determine bacterial levels and bacteriological composition. It could be demonstrated that the bacterial spectrum of the intraoral samples was almost identical with the spermiograms. Six months following completion of dental treatment a further spermiogram analysis was carried out. In the test group about two thirds of the spermiograms proved sterile. Spermatological parameters, such as motility, density and morphology, had also clearly improved. In the control group the findings of the spermiogram remained poor. This study indicates that a direct causal relationship exists between bacterial colonies (dental foci) and therapy-resistant bacteriospermia which probably leads to subfertility.

NM Dentistry helping vocalists – success stories

After, Dr. Sahag Mahseredjian recently raised the question: Could NM Dentistry help Vocalists, opera and other professional singers? …..there were a couple of actual success stories reported.

Another friend, Dr. Ritchey from Oklahoma, shared a case where he treated a music student who is in operatic training. Her main complaint was pain and stiffness in her neck and jaw. During his Q&A conversation with her she mentioned that her voice coach was always telling her to relax her throat and jaws. Truth was, she couldn’t, even though she did everything her coach said to do.

After he delivered her a NM orthotic, she came back a week later pain-free and, lo and behold, grinning from ear-to-ear. She can relax her throat and reach notes she had not been able to reach. Her coach was dumbfounded. She said she sang better than she ever had in her life. This was 2 yrs ago and she continues to benefit from pain relief and the relaxation of her head and neck muscles. She is convinced that the orthotic was the thing that “unlocked” her voice, and told everybody about it.

Another friend from Australia, Dr. Craig Duval shared this story: His mum is a music specialist and a singing teacher. She teaches for about 22 -24 hours a week. She also does a lot with her 3 choirs. He placed her fixed orthotic 9 weeks ago in preparation for a FM rehab.

She now has more freedom of movement in her neck (even though she didn’t know it was restricted before). She has also noticed a slight change in her posture (less rounded shouldered, ie what we typically call forward head posture but what is really forward neck posture). She’s been getting mild headaches every cycle for years and was mostly fine without pain killers, but has now had 2 cycles without headaches.

Her holidays started last week and usually by the time holidays start she really looks forward to it to give her throat a rest and allow some recovery time, however, this holiday she commented that it feels like she’s only at the start of term!

So, the potential is really unlimited in allowing people to be at their best when you have their bite in it’s ideal – neuromuscularly balanced position

Could NM Dentistry help Vocalists, opera and other professional singers?

A good friend of mine from Canada, Dr. Sahag Mahseredjian raised this question in an e-mail. I have edited and paraphrased the information below. Many professional vocalists impose very heavy demands on the mandible (lower jaw). When a singer performs vocal exercises for many hours, the jaw movements border upon the extremes of its physiologic range. Lower jaw motion is energized by the muscles that link the mandible above to the bones of the face and cranium, and below to the neck, including the hyoid bone, clavicle (collar bone) and sternum (breast bone).

Healthy mandibular movement for effective vocalization requires a neurophysiologic integration of all of the muscles and bones involved in carrying out this function. If the jaw is not in NM position, head & neck muscles are usually in a hypertonic (tight) state. This may affect their performance.

A common condition affecting professional vocalists is cranio-mandibular-cervical muscular dysfunction resulting from sprain of the muscles connecting the mandible to the head and neck. This dysfunction adversely affects the quality of the voice and also may cause head, facial and ear pains. The major muscles involved in voice production are strongly influenced by mandibular position. So, a craniomandibular-cervical muscular dysfunction can result in hoarseness and chronic voice irritation which interferes with the ability of the vocalist to produce sounds of good quality and high amplitude.

An explanation of the anatomy of this area is below:

The trachea is the main trunk of a system of tubes by which air passes to and from the lungs. The respiratory system which includes the lungs functions to inhale and exhale air through the trachea.

The larynx is the modified upper section of the trachea and contains the vocal cords. These include a pair of vocal folds that when drawn taut and subjected to a flow of breath, then vibrate to produce the sounds of the voice. In the context of the human voice, resonance refers to the quality imparted to sound vibrations originating in the larynx by resonator chambers formed by the oral and nasal cavities. The power or amplitude of the voice depends on respiration. Hence the breath control training for singers that emphasizes deep diaphragmatic breathing.

The larynx is composed of four principal cartilages: the thyroid, the cricoid, the arytenoid and the epiglottis. These cartilages are controlled by three primary groups of muscles. When contracted, the cricothyroid muscle brings the cricoid and thyroid cartilages together, thereby stretching the vocal cords to control the pitch of the vibrations produced thereby. The tension on the vocal cords is primarily controlled by the thyro-arytenoid muscle, while three sets of arytenoid muscles are involved with vocal cord adduction.

The proper balance of the muscles of the larynx is essential to effective vocalization. The laryngeal mechanism is a precision instrument requiring critical muscular tensions and cartilage positions to produce optimum sounds.

The larynx is suspended from the hyoid bone disposed in the throat between the thyroid cartilage and the roof of the tongue. The hyoid bone is linked by muscles to the mandible or lower jaw. The tension on these muscles is a function of the position of the mandible, and has a strong influence on the behavior of the larynx.

A Neuromuscular Orthotic exploits the relationship between mandible position and voice production to significantly improve the ability of a vocalist to produce sounds of fine quality and high amplitude.