Monthly Archives: July 2011

A call for a truly comprehensive view – Part 2 of 2 – Case history

This is a patient case history to support my call for a truly comprehensive view of the entire musculo-skeletal system – the whole person! The hyper-focused view of a specialist is useful but risks a “tunnel vision”.

Moira was fighting severe fatigue for over 8 years. It gradually worsened so much that every 5 days she will “crash” for 2 or 3 days. Her Primary Care Physician (PCP) referred her to an endocrinologist who prescribed hormone supplements for deficient thyroid function.

Few years later, her general dentist noted exposed tooth roots and referred her to a periodontist for gum grafts. The gum tissue receded after bone around the teeth were lost.

The next year, she developed migraines which devolved into a chronic 24/7 migraine for 8 months. One neurologist ordered MRI and diagnosed it as a psychosomatic headache. Lyrica, prescribed by another neurologist, broke the headache but gave her a foggy feeling and weight gain.

In the mean time, her teeth were getting very loose. Her general dentist got concerned and sent her to her periodontist again. He could not see a reason for the looseness and sent her to an orthodontist. He made her a hard plastic mouth guard to prevent further looseness. But Moira could not wear it since it was uncomfortable.

Later, she had ear pain and was referred to an ENT specialist who did not find any problems with the ears.

She consulted with her children’s dentist who referred her to a ‘TMJ dentist’ who made her a soft mouth guard. This one was more comfortable to wear but all of her symptoms – fatigue, headaches, ear pain, neck pain and shoulder pain remained. After all the time and money spent with the various doctors, she had come to a place of acceptance. She will just have to learn to live with these symptoms.

For 18 months one of her colleagues was telling her about our practice & NMD. But Moira did not see any point in going to “another dentist” when she has already seen so many. Finally she saw Michelle’s video. She saw that a common denominator for her symptoms could be a poor jaw- head- neck alignment which can be improved through NMD.

Moira saw that while I am a dentist, our NMD approach takes a comprehensive view of the musculoskeletal postural chain of the entire body. If jaw relation is poor AND it is shown to be the primary source of postural compensation, then correcting that it through NMD would be beneficial. Then the seemingly unrelated symptoms – debilitating fatigue, severe ‘migraine’ headaches, constant neck pain and ear pain would improve as well. While these are “medical symptoms”, the postural chain does not care what kind of doctor corrects the imbalances or through what methods.

After a lower fixed Neuromuscular orthotic, Moira started noticing improvement. She had the option to have that orthotic removed, if it did not help her significantly. The fatigue improved almost immediately. So after 90 days she chose NM orthodontics to move her teeth to an optimal position. Within few weeks, ALL of her symptoms have completely resolved. For the last two months, she remains 100% symptom and medication free. We are far from achieving the most optimal end results from my perspective. It will be another 2 years to complete the NM orthodontics. Her progress will be tracked with K7 jaw computer scans to measure her muscles and CT scans to check her TM joints. Moira is fine with that since she has no further
symptoms. She has not had a single “crash” since the beginning of NM orthotic, while the longest she had gone without a “crash” in the last 8 years was only 6 consecutive days.

Does this case illustrate a need for a truly comprehensive view of he entire postural chain? Moira will answer that question with a resounding “YES”.

A call for a truly comprehensive view Part 1 of 2

When someone has a tooth – dental – problem or symptom they go to their dentist.  If it is more than a routine tooth problem, then she may be referred to a dental specialist.  If it is a gum / bone support issue to a periodontist, if is a surgery issue to an oral surgeon, if it is a tooth alignment issue to an orthodontist and so on.

If the same patient has medical symptoms such as headaches, neck pain, ear pain or general fatigue, then she will go to her primary care physician.  PCP may, in turn, refer her to a neurologist, orthopedist, ENT or an endocrinologist for these symptoms respectively.

Specialized knowledge in one area is useful. But does it also lead to a “tunnel vision” view?  Human body, after all, developed from a single cell.  The various parts are very much connected.  This is especially true of the musculoskeletal system.  A human on two feet is constantly resisting gravitational forces.  So any imbalance in one area affects the entire postural chain from feet to head.

It truly is a chain – both in the left/right and front/back planes.  The spine with its alternating front to back curves from the head to tail connects these sections and allows flexibility in compensating for the imbalances, especially when the body is in motion.  These are the lordotic curves of the cervical and lumbar regions and the kyphotic curves of the thoracic and sacro-coccygeal regions.

This compensating system is challenged even more when walking and running in a gravitational field than when standing still.  When DOES this person really gets looked at as a “whole person”?  Let me share a case history to support my call for a truly comprehensive view of the entire musculo-skeletal system.