Can You Trust Your Dentist?

Please read this post before you consider the convenience of carrying out ANY dental treatment and before you choose the dentist who should carry it out. This post may save your life.

A negligent dental treatment that I underwent two years ago caused -within 24 hours- the onset of Cervical Dystonia. That dentists was just performing the procedures and applying the teachings that he had learned at Dental School.

Since none of the dentists I resorted to could fix my occlusion after that negligent treatment,  I started my own research.

And I am now sharing some conclusions, facts and thoughts that resulted from this research.

Dental School Teachings are Not Science

It is difficult to respect the teachings of Dental School as science when I consulted and asked questions to 20 eminent professors of different schools of occlusion who professed (with great personal and epistemic arrogance, as if they were God given absolute Truths) concepts that are antithetic.

Do not mind the technical terms that follow. At this stage, I only wish to let you appreciate how the KEY ISSUE of dental occlusion – where and how the mandible and teeth close – is open to completley opposite OPINIONS:

1) “Teeth have to close in Centric Relation”
as opposed to
“Centric Relation does not exist”

2) “Koiss deprogrammers to establish where the mouth should close are a heap of BS”

3) “Centric Occlusion has to coincide with Centric Relation”
as opposed to
“Centric Relation and Centric Occlusion have to be completely different.”

4) “The curve of Spee has to be flat”
As opposed to
“The curve of Spee has to be steep”

The above are textual quotes of words that eminent professors of different occlusion “schools of thought” spoke to me. Those different schools of thought with opposing views on key issues define themselves: Gnatologists, Functionalist, Gerber, Organic, Mio-Functional Rehabilitators, Koiss… it goes on…

Much of modern dentistry ia based on myths and opinions that have no empirical evidence or contradict common sense, nature (healthy mouths that have never been touched by a dentists) and a great body of research an scientific evidence.

First Do No Harm

The most frightening conclusion of my research is that the principle of “first do no harm to the patient” is absolutely absent from modern Dental School teaching.

Most dentists will arrogantly profess as God given absolute Truths some principles which are – at best – open to debate. They will act upon those principles, carrying out irreversible procedures in your mouth.

Many dentists will happily drill their way through irreversible damage to your teeth based on concepts and principles that are WRONG,  dangerous myths with no empirical evidence or at best- open to debate.

Run for the Door

Whenever you hear a dentist profess one of the following “dogmas,” as God given absolute Truths, we suggest to head for the door of the clinic as fast as possible. The dentist has no clue and is dangerous to let him touch your mouth. His ignorance is proportional to his arrogance.

Absolutely and dangerously wrong:

“Teeth have to occlude with vertical forces.”

Natural mouths (i.e. the ones which have never been touched by a dentists) present contacts between antagonistic teeth of the opposing dental arches that have many directions, be it vertical, lateral, diagonal, torsion or torque.

image

Look at the two pictures to realize that the force that teeth accommodate when the mandible presses against the skull may or may not be vertical. And you may become a top NBA basketball athlete with non-vertical forces in your mouth.

image

In my case, the elimination of all non-vertical contacts by a dentist with a drill resulted in a collapsed occlusion (picture on the left) that triggers dystonic symptoms. The use of a dental splint to reestablish diagonal, lateral and torque contacts between the dental arches (picture on the right) results in discontinuance of all dystonic symptoms.

image

The wrong paradigm of “vertical forces only” is all – pervasive in dental practice and leads to the fallacies that I describe next.

Absolutely and dangerously wrong:

“Contacts between teeth that shift the mandible sideways when the mouth is closing should be eliminated. They are prematurities and interference.”

Those lateral deflecting contacts are present in natural mouths and have a purpose: they articulate through the teeth a sideways and rotational movement of the mandible. The movement is necessary and of the utmost importance for it aligns the axis of the plane of occlusion with the axis of the cervical spine and the skull by ROTATING the mandible around its axis.

image

These deflecting contacts on teeth articulate a sideways and rotational shift of the mandible that is technically defined “Bennet Movement.” The Bennet movement is a sideways shift of one condyle while the other condyle stays almost fixed. The following picture gives you an idea of this necessary and important movement.

image

Most importantly, those deflecting dental contacts are fundamental, necessary and present in natural mouths because they articulate a movement of the jaw between TWO positions of the mouth as it closes: from the position of the jaw when the first contact between teeth occur to the one where the mouth is fully closed (and muscles of the masticatory system fully contracted).

Absolutely and dangerously wrong:

“The correct occlusion has the mouth closed in Centric Relation (or Centric Occlusion or Miofuntional Balance or Koiss Deprogrammer or any other SINGLE position arbitrary chosen by a dentist).”

Natural mouths (i.e. never touched by a dentist) have a natural movement between TWO very specific positions when the mouth closes:

– First contact. Sometimes called “Centric Occlusal Relation” (dental pseudo-science has controversy even about names and definitions). It is basically the position of the mandible that we use to chew . As you can appreciate in the picture below,  the mandible in this position works as a pair of “Chinese chopsticks,” or, technically,  as a class 3 lever.

image

– Maximum Intercuspation (called by some dentists also “Centric Occlusion”) It is the position that the mandible assumes when you close your mouth completely, reaching maximum pressure between your dental arches. This is the position that the mandible assumes when you swallow.  In this position the mandible produces orthopedic forces in a very different way. Technically, it works  as a class 1 lever machine. If a dental treatment “breaks” this bio-mechanical lever, the result is a colapse of the skull that lacks proper support on the dental arches. (Read our post on the Molar Lever to understand how it works)
image

Movement between these TWO positions is articulated by the molar teeth and can be forward, lateral, rotational and torque. If the teeth do not distribute force evenly during this movement, the tempo-mandibular joint (TMJ) suffers.

If the occlusion has been vandalized by butcher-dentists who thinks that there has to be only one position with vertical forces to close the mouth, the result is what dentists call “Tempo-mandibular Joint Disfunction” (TMD) and “Bruxism,” collapsed occlusion, disfunctional bite and impaired molar lever effect to support the skull.

In conclusion: The bio-mechanics of the jaw movement are based on TWO positions and the movement between them.

Absolutely wrong and dangerous:

“We have to make a model of your mouth in an articulator”

Most dentists will maintain that it is necessary to build prosthethics and occlusal splints using a model of your teeth mounted on an device called an articulator. They will charge you for an expensive “study” of your mouth.

The reality is that articulators are imprecise, over-simplified models that mis-understand and miss-reproduce the mechanics of the movements of the mandible. They simply don’t work.

Specifically, they do not reproduce diagonal, rotational and torque forces between teeth or the Bennet Movement (mentioned above).

image

Moreover, the use of the articulator is based on the obviously wrong postulate that the only force that moves the mandible is vertical gravity. It is obvious that the strongest force that moves the jaw is produced by the muscles, and its direction depends on where the muscles are attached to the skull and mandible. That affects the direction of the forces and point of contact between teeth when the mouth closes

If that was not enough, articulators have a fixed “hinge” relation between the head of the condyles (the attachment of the mandible to the skull), while the tempo-mandibular joint (TMJ) is NOT a “hinge.” The TMJ is, at best, an elipsoidal joint that can rotate and assume different positions that transfer force in any direction to the skull.

image

Up until 30 years ago, most dentists used “fully adjustable” articulators. Nowadays, 99% of dentists use “semi-adjustable” articulators. Dental pseudo-science goes backwards with time.

Some dentist who practice Orthognathic surgery have such blind faith in the articulator model of occlusion that they are willing to cut bones, completely remove whole dental arches, mandibles and maxillas and reposition them in a position that fits the articulator model – and hold them in place with screws or plates. I have personally not met a single person who underwent this obscenely traumatic surgery who says that he would recommend it or would do it again.

In my case – in an experiment that can be easily replicated by any dentist or patient – once I started building my own dental splints solidifying self curing resin on a base lower splint directly in my mouth, I could achieve occlusal stability in a matter of one hour, where top experts had failed using an articulator during months.

In conclusion: studies on articulators are wrong, imprecise, expensive, useless and dangerous.

Absolutely wrong and tautologic:

You are a bruxist

Patients (and sadly most dentist) may think that “bruxism” is a well defined, scientificly researched condition or desease (like pneumonia or the flu). It isn’t. The definition of “bruxism” by dental schools is tautologic.

A tautologic definition is one that uses formal logic, but is redundant and self fulfilling. For example: “A sunny day is a day when the sun is in the sky.”

By definition, if the false and oversimplified theories and myths of occlusion described above create instability in a patient’s mouth, it is because he is a “bruxist.” Please note that dental schools know that their oversimplified model does not work on a significant number of patient’s mouths.

The “Functionalist” school of occlusion goes even further in its nonsense: any activity of the mandible that does not fit its extremly narrow and over-simplified model of dental occlusion is labeled as “para-function,” a term reminiscent of paranormal phenomena from a bad episode of the “Twilight Zone” TV show.

The reality is that “Bruxism” is caused by a dental trauma (usually originated or aggravated by a dentist) that has caused dental occlusion to collapse from TWO positions to ONE position.

The autonomous (involuntary) nervous system will try to find a different, second position where teeth have grip to allow a stable contraction of all muscles to carry out the act of swallowing.

We swallow about 3000 times a day. During sleep, this involuntary reflex is triggered once every minute.

As we saw before, the acts of chewing and swallowing are carried out in natural mouths (i.e. never touched by a dentist) in TWO very different positions. And that happens because the mandible works biomechanical in TWO very different ways in those TWO positions.

Fortunately (isn’t that ironic), it is very easy to recover the swallowing position and be permanently cured of “bruxism”: just build your own dental splint solidifying self curing resin on a base lower splint directly in your mouth while you sit straight and close your mouth in the position that is produced by pronouncing the letter “E” or “O.” Those two positions force the muscles to stretch in a simmetric way, therefore pushing the mandible in the desired swallowing position.

Again, it wiuld be very easy dor any dentist or dental school to reproduce this splint-in-the-mouth experiment in a scientific way. But dentistry is not science.

In conclusion: “Bruxism” is caused by the absence of non vertical contacts (be it lateral, diagonal, torsion or torque) between antagonistic teeth of the opposing dental arches that provide a stable “grip” for the muscles to contact during the act of swallowing. Most of the times it is caused or aggravated by dentists who act upon the false belief that during chewing and swallow the teeth have to occlude in the same position.

Absolutely wrong and “criminal”:

“Wisdom teeth have to be removed because they are useless.”

Removing wisdom teeth condemns the patient to a collapsing skull, sooner or later in their lifetime.

The arrogance of considering that wisdom teeth serve no function because the dentist does not know or understand its function is overwhelming. Removing wisdom teeth acting upon ignorance is nothing short of “criminal”.

Extraction of wisdom teeth is a traumatic and irreversible removal of 2 cubic cms x 4 teeth of skeletal structure between the neck and the head.

Does anybody really think that removing 8-10 cubic cms of skeletal structure (considering ridge and bone reabsorption) where the skull and the mandible are connected to the cervical spine does not affect skull stability and support?

But, most importantly from a SCIENTIFIC point of view, can anybody PROVE that it has no negative effects?

Within the scientific method, “absence of evidence” of harm does not imply “evidence of absence” of harm.

Whenever scientists recommend a traumatic and irreversible medical procedure, THEY have to prove that it is not harmful.

Again. Dentistry is not science.

Regardless, the practical totality of orthodontic treatments start with wisdom teeth extractions.

The only reason why it is not evident to the general public that removal of wisdom teeth has extremely negative effects for skeletal and cranial stability is that the negative effects play out slowly, over the years. That makes it almost impossible to file a dental malpractice lawsuit.

Removal of wisdom teeth is probably the main cause that lies behind the epidemic of the need for knee and hip replacement surgery in the population over-70 years of age. More research on this correlation is due.

Absolutely wrong and a lie:

“There is no relation between posture, verticality of the spine, symmetry of the body and dental occlusion.”

There is overwhelming evidence, academic and scientific practical research and experimental treatments on how to best modify posture and the skeletal structure by acting on dental occlusion. The whole field of orthodontics is based on orthopedic consequences of orthodontic treatments.

No dentist could ever tell you with a straight face that such relation does not exist. He would be lying and he would know that he is lying.

Regardless, I could experience first hand an “eminent professor,” who even writes a blog about dental occlusion, trying to tell me that such relation does not exist in order to sell an expensive and wrong dental treatment.

Conclusion

In this post, I have not even touched the subjects of implants and endodontic killing of dental nerves (root canals); which are extremely common and highly dangerous and controversial treatments -often unnecessary.

Beware!!!

It is healthy not to trust whatever comes out of a dentist’s mouth.

When you are told that you need a dental treatment, think twice and do your own research.

The final conclusion of this research is paradoxical:

The best dentist (and often the most expensive and with the longest waiting list) is the one who touches your teeth and mouth the least.

He has a healthy respect for the complexity of the mechanics of dental occlusion. He does not profess any arrogant God given absolute truth about anything. He understands RISK and SAFETY. He would never carry out irreversible procedures based on ANY opinion, belief or theory, even if it is recommended by a prestigious and empirically arrogant dental academic institution. He is aware that all sorts of nasty neurological syndromes and movement disorders can be triggered by dental treatments. He does not use the articulator and prefers to work and study directly in the patient’s mouth, with reversible diagnostic and conservative procedures. He knows that the correct position for dental occlusion is “wherever the mandible wants to go.” He has worked hard during years to be able to forget the teachings of dental school.

The first words that one of those extremely rare good dentist told me when he saw me were:

Look at this dental drill. This is your worst enemy.

image

Your worst enemy

A bit of advise for the patients:
Whenever the dentist wants to put in your mouth articulating paper (carbon copy paper that leaves black spots on your teeth), asks you to tap your teeth and takes the drill… stop him. There risk of that procedure producing irreversible damage far overweights the possible positive results. Please note that I am using the words “Risk” and “Safer.”

13 thoughts on “Can You Trust Your Dentist?

  1. Seems like a pretty good well-researched article. I think in order to make it more user-friendly, you may want to tone down some of the high vocabulary. I think dentists would get great information from this article, However the layman, be be a little lost on what you are saying. Also, I recommend expanding your conclusion or providing an abstract at the beginning. Still, looks like you know your stuff.

    Liked by 1 person

  2. You claim that you’ve researched yet you post no specific references about articles, books or known occlusion specialists that you used to write this post. Some of the things you say are 100% incorrect such as saying articulators don’t work or that undergoing wisdom teeth surgery will eventually cause skull collapse. You also mention that a dental procedure might change the occlusion yet you fail to mention Dahl effect which causes natural eruption of the tooth and thus an occlusal readjustment. Besides that, some pretty solid points!

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    • Agree with Miranda. I think, the author’s main argument is saying that something is a lie or BS. IMO, this is not a scientific proof for any statement or a theory.

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      • Thank you Tania for your contribution.

        I think that the one of the main points of this post is that Dental School teachings are not scientific. And that the paradigme of “only vertical forces” (crystallized in the articulator) has no empirical proof.

        You have just proven these points with your comment!!

        I am not advicating for or reccomanding any traumatic dental treatment. Dental Schools reccomand traumatic procedures like wisdom teeth extraction and drilling of non vertical contacts between teeth.

        Based on what?

        It is clear in scientific research that “absence of prove” does not imply “prove of absence”.

        When a Dental School advocates for an extremely traumatic procedure like removal of wisdom teeth because “they are not used in mastication” THEY have to proove that it is not harmful.

        We are talking about removing 2 cubic cm x 4 of skeletal structure from the skull and mandible (without keeping into account ridge and bone reabsorption). A grand total of 8 cubic cm of skeletal structure at the base of the skull!!

        Do tou really think that it has no skeletal consequences? Can you prove that it has no skeketal and postural consequences? Are you sure deep inside that it has no skeletal and postural consequences?

        I think I already know the answer you will give to these 3 questions.

        But more importantly, it is not “scientific” to reccomand and perform traumatic surgery based on “opinions” and unproven theories.

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      • I agree with both Miranda and Tanya. Some of things you say like the TMJ not working as a bisagre, has been well known for decades, so no news on that. You just generalize and create a stereotype of dentists being arrogant, ignorant, negligent apes, but you don’t clarify how are people supposed to differentiate a good dentist from a bad dentist. Because the way you picture our daily basis is like the whole world is sick to death from all of the iatrogenic treatments from all of the dentists around the world. What kind of knowledge should a competent, wise, down on earth dentist should have, or what kind of test is needed to pass to certify you are not in the hands of “Dr. Mengele”? You can do as much research as you want, but if you do not have the right and solid basis to fully understand and intepret that information you can get absolutely lost. You can debate for ages about occlusion, and your post reviews so many concepts that I don’t think this should be done this way (I mean, there are entire books about it and courses that last years on this topic). Of course there are unprofessional people, it happens in everything, from teachers, to lawyers, and policeman, and priests too, but that does´t mean it is a generalized issue, and it doesn’t mean that all of the dentists around the world are against some of the thing you wrote previously, once again we already know that. It also does not mean we all have to agree on everything, even in theoretical physics you have different theories about one same thing that seem like opposite (like light traveling in waves or in photons) and both of them are right. And about the third molars I bet you haven’t had to perform an extraction of one of them after having severe caries, or causing severe periodontitis distal to the second molar. Most of third molars are impacted or retained, and if they do manage to erupt don´t have enough space in the dental arch to position rightly into occlusion, they tend to nest huge amounts of biofilm, and are almost impossible for people to clean them, affecting most of times to the second molars. So yes, nothing is perfect, and yes we rather prevent than mutilate to restore health, but most of times patients don’t give us dentists that option. Most of times people don’t go to te dentist because of fear and I find your post a perfect example of how to scare people and not giving solutions.

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      • Lily, thanks for your comment.

        Obvioulsy, dentists think of themeleves as doing whatever they can to help patients. With good intentions.

        The dentist who vandalized my occlusion and caused the onset of cervical dystonia even spends a month a year in Africa doing voluntary work!

        Nevertheless, he – like most dentists- was not aware that with their drill they can destroy people’s skeletal stability in 5 minutes. And they can.

        He had never heard of the exsitance of other occlusal scheams than the one he studied. He had never heard the word “Cervical Dystonia.”

        I had a Gerber bilaterally balanced lingualized occlusion with condylar shaped teeth in my mouth since I was 18. This occlusion scheame is based on only lingual, only posterior contacts. The opposite of what “mutually protected” occlusion teaches.

        He did not like it. He drilled it away. One day I was an athlete, the next I was crooked and twisted.

        This is not some theoretical debate on the particle or wave nature of light. This is real life drills blowing away all dental contacts because they are the “opposite” of what he learned at Dental School.

        And he was very arrogantly sure that nothing that he could do could with a drill could cause this kind of problems. He was and still is in denial. And he was sure hat what he did with a drill is science. It isn’t.

        There are some suggestions in the article on how to avoid this kind of problems: apply the principle of “first do no harm to the patient.”

        “Articulating paper and a dental drill are the worst enemy of the health of teeth”
        It is the literal quote of the technically best dentist who treated me.

        Wisdom teeth: they were extracted completly healthy and well positioned from my mouth when I was 18. “They serve no function in mastication.” was the reason. I had a completely impacted canine in my maxilla and another dental surgeon when I was 21 tried to convince me that I had to extract it . That time I did not listen.

        Anyhow, the real question is: why are dentists not trained in the potential damage that their procedures can cause?

        Why do they believe that the over-simplified methods that are tought at dental school are better than nature itself (a mouth that has never been touched by dentists)?

        The fact that dystonia can be caused by dental treatment is “generally recognized” in the field of neurological academic research.

        (“Generally recognized” – please read this article pubblished on a major scientific publication:
        http://www.ncbi.nlm.nih.gov/pubmed/10348476

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      • Lilly,
        The practical totality of orthodontic treatments start with the extraction of perfectly healthy, perfectly positioned wisdom teeth.
        I do not have exact stats, but I am sure that you will agree with me that it accounts for the great majority of wisdom teeth extractions.

        Like

      • Tanya: the only time the word “BS” appears in the article is when I textually quote an eminent professor and expert of occlusion speaking about the theories and opinions of other eminent professors and experts.
        I agree with you that it is not a scientific proof for any stament and theory.
        And that is the whole point: dentistry is not science.

        Like

    • Miranda, thank you for your contribution.

      This is a blog post and not a research paper. For that reason, it does not have a bibliography and it does not need it.

      But since you want some name dropping, here it is.

      The list includes (amongst many others): 4 hours and a splint made by Dr. Max Bosart (assistant of Gerber for decades); 8 hours with Dr. Nittert Postema of the University of Neijmegen and Anta from Amsterdam; multiple visits and a Koiss Deprogrammer diagnostic treatment done by Dr. Santiago Pardo (instructor at Koiss dental school); a 3 year orthodontic treatment and multiple year follow up carried out by Dr. Alberto Cacho (Director of the PhD program in Orthodontics at the Universidad Complutense de Madrid); ongoing frequent and constant analysis with Dr. Maurizio Festa of the Department of Clinical Pathology of the Masticatory System of the Università degli Studi di Milano… and many more studies to produce a model of my mouth in an articulator done by leading practitioners. Some studied at Harvard and Tuft Dental School.

      The Director of the Master program in Maxilofacial Surgery at the Universidad Conplutense de Madrid obviously thought that the only solution was to cut both maxila and mandible. If you are a hammer, you will see all problems as nails.

      And another university professor, trained in the USA, who markets himself as the best expert in Spain of Cranio-Facial Pain and TMD had never heard the word “Cervical Dystonia” and thought that the symptoms I described were caused by sleeping on the wrong side of the bed!

      And they all had disagreement on very basic key issues of dental pseudo-science.

      I had a Michigan splint, a Gerber splint and a Koiss Deprogrammer done for my mouth on articulators. … None worked. No surprise. The best experts in splint therapy for TMD cure resin to register the bite directly in the patient’s mouth to achieve best results.

      What was clear is that they all had very, extremely different OPINIONS on basic issues of occlusion, starting from where and how the teeth should occlude.

      And about what you state as being “100% wrong” (again those God given absolute Truths are hounting us): some of the professors and experts listed above agree with what I wrote (they told me – I did not in invent it) and desagree “100%” with you.

      They were all extremely critical of the ideas of the others. They did not hesitate in defining the beliefs of the other as BS (or “cazzate” or “gilipolleces”). At least a couple described what you exposed above about the need of the articulator and CR as absurd BS.

      Total disagreement on basic key issues of occlusion.

      Please be advised that most patients with neurological symptoms do NOT have a stable CR (as assesed by the manual manouvre of moving the chin to position the condyles). In my case, that manual registration of CR moved 5 mm lateral in two years with respect to other supposedly fixed cranial points of reference.  

      Liked by 1 person

  3. Pingback: Principles of Splint Therapy | Bio-Mechanical Dystonia

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