Iatrogenic Damage: When the Dentist is a Butcher

The term “iatrogenia” refers to the damage that is produced by the healer.

There is overwhelming scientific research that relates the onset of Dystonia to some sort of dental trauma. The scientific description (that you can google to find academic papers) is: “peripherally induced secondary Dystonia originated by dental trauma.”

And it is our experience, our belief and the result of extensive research we have carried out that much of modern dental practice is based on models that over-simplify, mis-understand and mis-reproduce the function of the dental arches in supporting the skull.

When you meet a dentist you are not meeting science, but merely a man of science with his baggage of personal experiences, with his qualifications and his intuitive capacities, that are more or less developed.

Moreover, in the specific field of occlusion (the way dental arches close on one another and what kind of forces are produced on the teeth when the mandible rests in the central position or moves to any side) there is great controversy. There are 4 main different schools of occlusion which are based on radically different -sometimes opposite-philosophies.

The disagreements are on fundamental issues: what position the mandible should have when teeth occlude? Which parts of the teeth should bear the maximum load? Should the teeth shape be rounded or with straight lines? Should the distribution of teeth be on a plane or ona curve? … and many more fundamental issues.

The great majority of dentist you may visit will tell you that “this is the way teeth have to occlude” as if it were a God given absolute truth. They base their views on conveinience, what they studied, their professional experience and, often, epistemic and personal arrogance.

Mutually Protected Occlusion

Nowadays, the dominant philosophy of occlusion is called “mutually protected with anterior guidance.” Its dominance depends on the ease of reproducing it and the aesthetic attractiveness that it gives to the smile.

The problem is that it is an over-simplified model that only works on reasonably simmetric skeletal structures.

By definition, if that occlusion produces skeletal, postural and mandible instability in your mouth, you will be labelled as a “bruxist.” In that sense, modern occlusion theories are very platonic: if reality does not conform with the theory. .. to hell with reality!

Some dentists will even reach the absurdity of denying that dental occlusion has any relation whatsoever with skeletal posture, even though the whole field of orthodontics ia based on that assumption.

Cervical Dystonia: the Dental Connection

In the case that we present, it was evident from the onset that the dystonic symptoms that the patient developped were related to dental occlusion.

One day, he walked into a dentist’s clinic healthy and, after a very negligent treatment, he woke up the following day with Cervical Dystonia and a collapsed skeletal structure.

The following pictures compare how the dental occlusion of the patient looked when he walked into the dentist’s clinic with the collapsed vandalized occlusion that I was left with after the treatment.

occlusioncompare

It is worth noting that this dentist had a reputation and thought of himself as an expert in occlusion and posture.  He was convinced that the only healthy way of a mouth to close is with purely vertical forces bewteen opposing teeth. Since the patient’s mouth did not close according to his theory, he vandalized it by drilling away contacts that produced lateral and diagonal forces between 9 teeth of the opposing arches.

The next picture shows how the patient was left a few days later -dystonic- with a lateralized and twisted mandible. His head was turned and shifted to the left with involuntary muscle contractions and the barycentre of the weight of s hiskull was no longer on thecentral axis of the skeletal  structure. His skull had started sinking.

colapsingskull

It is clear by comparing the two pictures that the patient had a skeletal asymmetry, but the whole system was balanced and in equilibrium. Forces between the mandible and the skull were clearly diagonal. As a matter of fact, before the negligent dental treatment he was actively practicing sports, running 10 km. and swimming 1 km. several times per week. At the age of 42, I was arguably in  the best physical shapes that he had ever been in his life, or close to it.

In the next picture we compare the previoss balanced body with the descending consequences of the sinking skull as the body tried to adjust to this iatrogenic dental trauma.

balance-unbalance

Before and after a very negligent dental treatment

Additional Evidence of the Dental Connection of Dystonia

The patient had a set of two orthodontic invisalign retainers that reproduced his occlusion at the end of an orthodontic treatment that he had endured 10 years before.

Invisaligns

 

When he slept with the invisaligns, all the symptoms of Cervical Dystonia went into remission and, within a few weeks after the iatrogenic dental trauma disappeared compeletly. Closing the mandible with the invisaligns in place caused the Atlas (the first cervical vertebra – C1) and the Axis (second cervical vertebra -C2) and pelvis to move and re-align themselves with the skull and spine.

In the following two years, the patient visited and consulted with some of the best dentists of Spain and Europe. None of them was familiar with the symptoms and characteristics of Cervical Dystonia. None of them even tried to reproduce the occlusion of the invisaligns he was using because, in their view, it was “wrong.” They all followed different philosophies as to where and how the mandible should occlude with the maxilla and the correct shape of teeth.

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. 

The Molar Lever
Our analysis of the bio-mechanics 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.

Beginning of Treatment
Postural analisys, MR evidence and description of the situation of our patient at the beginning of this experimental treatment.

First Rectifier: Cross-Bite Splint with Lateral Moral Lever Effect
Description of the dental splint that we are using for the first two weeks of treatment and the logic behind the selection of the direction and nature of the orthopedic forces that it produces.

Iatrogenic Damage: When the Dentist is a Butcher
Our review of how modern dental theories on occlusion oversimplify and misunderstand the biomechanics of the  stomatognatic system, leading to a high potential of traumatic dental treatments.

What is Dystonia?
A short description of the symptoms and clinical definition of Dystonia for those who are not familiar with this desease.

Team
Curricula of the team of professionals who are participating and contributing to this research project.

Patients
Please read this page if you are suffering from Cervical Dystonia and wish to try this experimental biomechanical treatment and be a part of this research project.

Fund Raising
Please read this page if you wish to support this research project financially.

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