Chronic Pain, Posture and the Dentist 

Guest post by Dr. Curtis Westersund

The video shows a patient of Dr. Curtis Westersund suffering from Dystonia who gets relief from an anatomical dental orthotic as a part of her therapy. There were many steps to get to this point and many steps subsequent

Everyone knows what dentists do. Fillings, crowns, root canals, tooth extractions. Practically the last person you want to have to visit. And while for many dentists, this is the limit of the services they offer, there are a growing number of dentists who have a passion for something more. A passion for helping patients with complicated conditions that have caused chronic pain, limited normal function and producing long term damage.

It is these dentists who are looking at how the simple act of someone bringing their upper and lower teeth together can create long term and far reaching painful consequences. 

Medical doctors are great at dealing with acute pain. Break your leg skiing and the medical profession would have you walking again in not time.

But chronic pain patients were a different matter. The medical profession looks for advancement in pharmaceutical options to deal with their chronic pain patients. Or they determine that a problem is ‘idiopathic’ meaning the doctor has no knowledge of the cause of the pathology.

The other tactic is to label chronic pain patients into poorly defined groups. In the 1970’s and 1980’s there were increasing numbers of women diagnosed with Fibromyalgia and Chronic Fatigue Syndrome coming to my dental practise. They were frustrated, in pain and often depressed. All of them had been provided numerous prescriptions to overcome their problems. 

In truth these chronic pain patients were all exhibiting their own personal expression of various forms of stress. Stress that they have dealt with for many years. Stress is not limited to being emotional. Stress can be structural, muscular, neural, physiologic, and nutritional. Stress can be long term, starting with altered growth patterns from early childhood. Stress can increase with age, disease and injuries.

The head bone is connected to the neck bones

In Canada, mothers use to sing a song to their children that went “The head bone is connected to the neck bones; the neck bones are connected to the shoulder bones; the shoulder bones are … “.

The song, while simple, shows that all of the body parts are connected and it follows that adding stress in any one area of the body will have affects that can show up far from the cause. Symptoms are not helpful in locating the true cause of pain and stress. 

The human body is like a glass and stress to the body is like water being poured into that glass. As you add water (stress to the body) all is good until the volume of water overflows the top of the glass. In the human body the analogy means that if too much stress is added to the body symptoms appear.

Since there are so many ways stress can be experienced, signs and symptoms of pain and dysfunction are varied. In fact there are so many factors adding to stress, so many options of chronicity and intensity, the way that chronic pain can be expressed in any one individual is unique. The chance of any one person having the exact same symptoms as any other person has the odds of drawing a winning lottery ticket. 

The patient with Dystonia

My patient in the two videos attached had her own unique path to her problem.

The patient, SK, presented with Cervical Dystonia (CD) that had begun several months prior to my consult with her.

She could not turn her head right, could not hold her head straight and was frustrated and angry with her condition. She had been to two neurologists seeking treatment. Neither medical doctor had been able to help her. She was told that if the Botox treatment one doctor gave her did not work, there was no help for her. 

SK had seen another dentist’s treatment of a CD patient online and was hoping that I could do the same for her.

Her history showed that she had just had her second child two months prior to developing her CD. She had been a figure skater as a young girl. She had no other obvious relevant history. The cause of SK’s problem became obvious at this point. SK had  a malocclusion or bad bite. She had a deep overbite and compressed TMJ spaces. Her malocclusion would created a misalignment between her head and neck vertebrae.

She had long term misalignment of her hips due to the many falls she took in her figure skating career. When SK was coming to term in her pregnancy, hormonal changes in her body loosened ligaments in her body, part of the preparation for the birth process.  At two months post-partum, SK’s hips reset to an even more imbalance position. The resulting structural stress moved up to her neck and skull, altering muscle stress and creating the final expression was CD. 

SK’s treatment started with upper cervical care with a NUCCA (National Upper Cervical Chiropractic Association) practitioner. NUCCA doctors only deal with the alignment of the first two vertebrae (the Atlas and Axis) and the skull. They use a non-balistic adjustment that is akin to a gentle massage at the base of the skull to align the head and neck.

This is key for my work as a dentist as the alignment of the head and neck is intimately connected to the pattern of occlusion (the way teeth bite).

Added to her treatment protocol was a registered massage therapist (RMT) who worked to realign SK’s hips.

The goal of the efforts of the RMT, the NUCCA Chiropractor and my own intervention with a removable lower anatomical dental orthotic was to decrease the level of stress SK was under and the removal of the CD. 

The Take Home

The take home here is that we are not separate systems that require isolated therapies. The health care professionals have arbitrarily separated themselves from each other due to their individual training and focus. The problem for chronic pain sufferers is that their condition is not broken up into dental, chiropractic, and medical segments. I am a dentist. I do teeth and occlusion. I don’t do necks. I don’t do hips. I don’t do feet.

Chronic pain sufferers require health care providers that can communicate with other health care providers to find the solution to decrease or eliminate the stress they suffer from.

My advice for chronic pain sufferers is avoid the Doctor who says he or she can do it all themselves. Find the Doctor that works well with others and understands the limitations of their training and therapies. It is never just one problem. Humans function as a sum of systems.  Remember that pain is a poor metric of health. Health is not the absence of pain.

Health is being healthy. We do not ignore cancers that are not painful. We do not ignore partially occluded coronary arteries that are not painful.

Seek balance and health.

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