The Cause of Gareth Bale’s Injuries

balecauseofinjury

Gareth Bale is the world’s most expensive soccer player to date. He was transferred in 2013 from the British team Tothenham to the Spanish powerhouse Real Madrid for a world record 139 million US$.

In 4 seasons, Bale has suffered 12 major injuries, resulting in 44 missed games and 256 days without been able to train. He is currently injured and unfit to play.

The majority of Bale’s injuries affect the muscles and tendons of one leg and the muscles that stabilize the pelvis and hips.

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Bio-Mechanichs of Dystonia

EXECUTIVE SUMMARY:

In this post we will describe 10 bio-mechanical derangements, impairments and misalignments. Patients suffering from Dystonia (and other neurological movement disorders such as Parkinson’s and Tourette’s) tipically present some or all of the 10 described bio-mechanical impairments.

We end the article by discussing how mainstream treatments for Dystonia recommended by  academic and clinical Neurology  are compatible and complement bio-mechanical treatments.

For a complete bibliography of peer reviewed scientific reesearch papers, case studies and FDA approved clinical trials, please refer to the RESOURCES page of this blog.

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Cervical Dystonia or Spasmodic Torticollis: Positive Evolution after Neurophysiological Treatment

Guest post by Dr. Lidia Yavich.

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The patient of this post contacted me through a derivation from a colleague from abroad.

Soon after he sent an email, where he explained the reason for his consultation on Cervical Dystonia or Spasmodic Torticollis, I answered that it was not my area and that I treated TMJ Pathologies and Orthodontics and Facial Orthopedics.

The patient insisted, commenting that the colleague that recommended me and knew me from the AACP meeting where I was invited as a lecturer explained to him that he didn´t know if I treated Dystonia, but he thought that considering what he had watched I could help him.

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About Bruxism

Dear readers and friends, I post here below a simplified approach to my understanding of “Bruxism” as a form of oromandibular dystonia ad its relation to TMJ.

The post includes a possible treatment and instruction on how to build a lower splint to treat Bruxism.

The proposed treatment is inexpensive, completely reversible, not traumatic and -most importantly- can be executed by patients on their own, at their own home.

Please tear my “theory” to pieces in the comments below … and also tell me what makes sense according to you.

Natural healhty mouth never touched by a dentist compared to one treated by dentists

Natural healhty mouth nevert ouched by a dentist compared to one treated by dentists

LET’S START

The above picture shows the comparison between a natural healthy skull and mouth -never touched by a dentists- and a mouth which has clear signs of the result of extractions, treatments performed by a dentists and bruxism. Let’s use the image as a reference throughout this post.

I believe that nobody can deny 5 facts:

  1. All natural healthy mouths never touched by a dentist have a natural movement between TWO positions which are usually around 2mm apart: Centric Relation -CR- (first contact of the teeth) and Max Intercuspation -MAI- (full contact of the teeth with max chewing muscle contraction).
  2. This movement is articulated by contacts between opposing molar and premolar teeth.
  3. Max Intercuspation (MAI) is usually 2mm forward from CR and in many mouths even LATERAL
  4. In natural mouths MAI has a rock solid interlocking of the teeth, with lateral, torque, diagonal, mesial, distal contacts between teeth of the opposing arches. When the mouth closes with max muscular contraction, the mandible can not move even a fraction of a mm.
  5. The cusp-fosa relation in contact between opposing teeth follows the curves of the condyles (lower fossas have the curve of the glenoid fossa and upper cusps reproduce the curves of the head of the condyles

AND NOW…

For some reason (which I find insane) that goes beyond logic or understanding, the great majority of dentists apply a model of occlusion based ONE position.

Most dentists and dental schools think that nature is wrong and that the correct way for a mouth to close is:

  • Like a door where the condyles move in rotation as “hinges.”
  • With only vertical contacts between opposing teeth.
  • With “freedom in centric” – which is a way to define that the mandible should be able to move a few mm in any direction without lateral tooth contact when chewing muscle contract ti the maximum.
  • Without cusp-fossa relation between opposing teeth that create retrusion stops and prevent the lateral derangement of the condyles and disks of the TMJ.
  • With a flat curve of Spee.
  • In a retruded position of the condyles and mandible – in Centric Relation.

Most dentists consider that the contacts that articulate movement between CR and MAI are “prematurities” or “interference” and should be eliminated.

They think that the condyles do not need the teeth to provide a guide, retrusion and lateral stops.

SO….

In essence what dentist call “bruxism” is a neurological movement disorder, a form of oromandibular dystonia. The mandible goes “crazy” because it can not find a stable position of Max Intercuspation.

Patients (and sadly most dentist) may think that “bruxism” is a well defined, scientifically researched condition or disease (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 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 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 2000 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.

POSSIBLE TREATMENT

The best option to treat bruxism is to to recover a natural position of Max Intercuspation where teeth interlock firmly and provide a solid grip for muscles to contract when swallowing.

Upper splints are dangerous and inherently imprecise as they do not allownfor the movement of cranial bones (we may expand on the subject in another post). The best option is to register a MAI bite by covering a lower base splint with polymorph or self curing resin. It should be done directly in your mouth (not the articulator which is imprecise and based on the wrong model) while you sit straight and close your mouth in the position that is produced by pronouncing the letter “E” or “O.” or “AH”. Those positions force the muscles to stretch in a symmetric way, therefore pushing the mandible in the desired balanced swallowing position.

After the patient has reproduced a minimally stable Max Intercusption on a lower splint, it is time to start neurological rehab and specific exercise for the tongue.

HOW TO BUILD A SPLINT TO TREAT BRUXISM

Please read at point 6 of the post on Principles of Splint Therapy to find how-to videos and instructions on how to build your own splints.

It takes one hour to learn and master how to register a bite on it (trial and error), but in the end it is a piece of cake and the Do-It-Yourself slints you will make will work much better than any splint a dentist can make. That happens  beacuse you will be able to adjust the splints at will as your skull adjusts to the new occlusal realtion created bu the splint.

Natural teeth have condylar shape. If you look at the picture above, you will see that the protection, guidance, retrusion stops for the TMJ is provided in natural mouths by:

  • 32 teeth.
  • A very pronounced curve of Spee (allmost a section of a circunference).
  • 64 molar and premolar cusps.
  • 6 very pronounced lower molar fossas.
  • Anterior incisive guidance which breaks drammatically the curve of Spee.
  • Functional and balancing contacts that allow the mandible to have multiple (more than the minimum 3 points that define a plane) functional and balancing contacts in all positions of the mandible.
Condylar shaped teeth

Condylar shaped teeth

When a mouth has been traumatized by extractions, equilibration, age, use and the natural curves and cusps have been flatened… all you can do is try to recover the function in the best way given the cirmustances.

Building 4 deep lower pits that fully embrace the upper molar and premolar cusps are the way that I have found to try to reproduce the function of the curves that is lost. It is also advisable to build balancing contacts in poliforph on the incisives.

But the most important issue is that it is necessary  to reproduce on the lower splint 4+4 deep round PITS on molars and premolars that fully embrace lingual cusps of the uppermolars and premolars and a sliding controlled and bilaterally balanced guide from the points of first tooth contact with the splint (CR) to the final point where cusps are fully embraced (Max Intercuspation). Thus, the splint will guide the mandible towards a rock solid fixed MAI position.
If it is well done, it does not matter much if you use resin (harder) or polymorph (softer).

A lower splint with pits that fully embrace upper molar and premolar cusps

A lower splint with pits that fully embrace upper molar and premolar cusps. 

Be advised that the picture above reproduces a Gelb-Rectifier splint that does not have contacts between incisives in the front. It is advisable to use this kind of splint for the first part of the treatment (until the neurological movement  instability of the mouth is fully discontinued). Afterwords, for a long term stable splint, I would advise to reproduce with polimorph incisive and canine balancing contacts and guidance  for protrusion and lateral excursion.

THE PATH FROM CR TO MAI

As Far as how to reproduce protrusion and retrusion ramps on polimorph to guide the mandible in the movement from CR to MAI to Protrusion, this is my system:

  • Register the bite on polimorph in phonetic “o” Max Intercuapstion position first.
  • Let the splint cool down and the polimorph harden.
  • Put the splint again in hot water for only 10 seconds to soften the polimorph.
  • Register a bite in “E” phonetic (close to CR) without biting to hard (just first touch).
  • When the splint has cooled down, use a small kitchen knife to engrave a shallow connection between the points where the cusps have made contact in the two bite registrations.

The whole process takes 3 minutes. An you can do it again and again if it does not fell right in the mouth

CONCLUSION

In conclusion: “Bruxism” is a form of neurological movement disorder 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.

These contacts between”condylar shaped” molar teeth are also necessary for the TMJs to function properly as they provide protrusion and lateral guidance and restrusion stops.

Most of the times “Bruxism” it is caused or aggravated by dentists who act upon the false belief that during chewinging and swallow the teeth have to occlude in the same position and collapse MAI into CR with a dental drill.

A good way to try and treat Bruxism is by building a lower splint that creates  a rock solid and fixed Max Intercuspation 2 mm forward with respect to Centric Relation and reproduces the curves and balancing and functional contacts of the teeth in the movement from Centric Relation to Max Intercusption.

Phonetic bite registration on a Gelb-Rectifier splint directly in the mouth allows to find a functional position of Max Intercuspation and Centric Relation.

 
 
 

Navigate Through this Blog

To further understand our reasearch, approach and method, please read:

A Bio-Mechanical Approach to Dystonia
An introduction to the theory and analysis that support the pilot research project to use an adaptive intraoral appliance to treat and possibly cure Secondary Idiopatic Cervical Dystonia.

Principles of Splint Therapy
A description of the principles on which we base our protocol for the treatment of Cervical Dystonia and other occlusion realated movement disorders with varying degrees of neurological symptoms (from Tourette’s, to postural collapse, Parkinson’s and Generalized Dystonia).

Protocol for the Treatment of Cervical Dystonia
A step by step description of the 3 phases of the DIY protocol that we have developed for the treatment of Cervical Dystonia.

The Molar Lever
Our analysis of the bio-machinics of the Molar Lever and how dental occlusion is related to posture and skeletal allignment.>

Phases of Lateral Postural Colapse
Our analysis of the descending skeletal and postural effects of a collapsing and twisting skull that does not find adequate support in the dental arches.

The Rectifier
A description of the adaptive intra-oral aplliance -dental splint – that we use to treat Cervical Dystonia and the orthopedic forces that it produces by progressively pushing the mandible in retrusion, maxila in extrusion and elevating the skull by stretching and aligning the cervical vertebrae.

Resources
Bibliography and links to scientific research on the treatment of Dystonia and other neurological movement disorders with a bio-mechanical approach.

Postural Colapse and Dental Arches
A set of animations that present grafically the type of skeletal and postural effects that we intend to produce over a few months by modifying occlusion and the direction of forces between the skull and the mandible.

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.

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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.

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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.

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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.

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– 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)
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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.”