Manipulate the Cranial Bones or Not to Manipulate? A Dentists Perspective

My Thoughts:
You know…..I got tired of working with folks that like to manipulate my TMD patients bones long time ago.  I have worked closely with osteopaths, chirodontic trained folks, chiro’s of various walks and trainings, and few if any could resolve the dental component.  They all had great hands and skills.  I have even taken training straight from the leader himself (chirodontics I, II even have chiro III videos along with the nutritional) years ago.  I realized, sutural bones move, they breath, flex, etc. I learned to do sutural releases, etc.  but knowing what I now know I rather focus on what my license of care allows me to do best and help my colleagues understand the issues.  I can measure, I can diagnose and I can effectively treat my cases.  In general, most of these adjunctive professionals don’t measure what they do, except  for a couple of chiro’s I have worked with who at least had the awareness to measure their adjustments.  These few have seen the power and effects of the GNM orthotic.

As dentist we often rather believe the bones, yet we also see the muscles at play.  We hear the constant back ground voices turning us back to the underlying bones to have them manipulated.  Manipulating the patient is just something that is in the blood of those who love the hands on approach to adjust the bones, etc.  They can’t seem to keep hands off the dental TMD patient…but the tradition of manipulations of jaws of joints and cranial bones still exists as an intriguing area amongst professionals as another view point to sort out.

Be A Happy DENTIST: Keep It Simple
I believe as a group we will be able to discover together these matters through our Research and data gathering project.  Dentist easily get distracted with concepts and ideas that steer us away from the discipline of what we are best trained at doing –  DENTISTRY, addressing the bites/occlusion and taking care of the neuro-muscular system (balancing the masticatory system).  That is are license of care, responsibility and Focus!

I realized that I don’t have to be the Chiro dentist, or the osteopathic dentist, or a dentist plus something else.  I just need to be a happy DENTIST.  Practice what my license allows me to do best. Keeping it simple. That is it!

Remember What We Have Learned
I will never forget when Dr. Jim Garry (my mentor) conveyed to me in his lectures how the myo fascial exercise of both the intra oral tongue and buccinators mechanism was powerful enough to redevelop maxillary and mandibular cants of mal aligned arches, teeth and the oral cavity without intervention of brackets, wires and appliance therapy (we showed these slides in our recent Ortho 1 and 2 course last week).  It was the muscles themselves that moved the anterior open bites closed and the muscles themselves that rounded out the V shaped arches.  The muscles did the changing of the teeth and underlying bones.  Dr. Bob Jankelson (my mentor and great teacher) showed to use the Millar studies of the guinea pigs when their nerves unilaterally were denervated resulting in the cranial bone distortions and how joint condylar shapes altered from normal symmetrical growth and development to abnormal comparing the test group and control group that were left alone (I showed those slides in Level 2).  Our profession often forgets the classical monkey studies done by Harvold, et al, which demonstrating clearly the power of muscle and the developmental role on the masticatory function of the gnathic system (Level 2).  Our profession either forgets or ignores these core principles.  This is the amazing mystery of the power of muscles.  Studies have demonstrated how significant their role is on the “Functional Matrix” (Enlow and Hans – Ortho 1 and 2).

“Let the Muscles Do the Talking”
Man naturally has a desires to intervene (possibly too prematurely to correct something that perhaps can with minimal efforts resolve on its own).  We fail to see and discipline ourselves in what we can do as dentists not realizing the unobvious (invisible realm) the muscles are our most powerful ally once tamed to work for you and not against you.  They want to balance and support a balanced structural system if they are given opportunity. There was a saying once, “Let the Muscles Do the Talking”.

If one takes care of relaxing the muscles first regardless of the clearly observed orbital cants, or the canting of the maxillary or mandibular arches, or AP frontal discrepancies, joint displacement issues, pitch, yaw and roll patterns, etc. and the list of all the distortions that naturally are present throughout the rest of the skeletal system (head to toe) prior to involvement we have proven amongst ourselves through the GNM orthotic protocols that muscles win!  Things unwind and balance without a lot of cooks involved.  I don’t believe for once a GNM orthotic could lock in cranial problems as long as you are on an myo-trajectory.  Bones move when given an opportunity.

Are You Anxious For Nothing?
Yes, we dentist want to see things happen right now!  Immediately, to perhaps give us the feeling that we are involved and doing something constructive to help our patients distortions.  We are always in a rush to correct the obvious.  But we are not willing to spend time addressing the unobvious and let nature have an opportunity to unwind the kinks, the strains, the distortions it created when the occlusion was out of balance.  We all know that “teeth dominate, muscles accommodate and joints accommodate” to the dictation of whatever occlusion is present (Dr. Bob Jankelson).  I believe and practice this.  When my patients come in with various forms of distortions, I focus on getting the muscles and occlusion balanced.  As I focused on doing what I could do as a dentist (masticatory muscles and occlusion), over time I have seen my patients faces balance without manipulations of the sphenoid bones.  There are always some who can’t help but push and prod on the mid line sutures of the maxilla, etc. but if anything changed the patient ends up coming back to me and I have to correct the problem, once again and get the muscles and occlusion balanced again.  I just realized for me and my patients it is less hassle if they would not have so many cooks in the kitchen while I am doing the treatment.  Many of my patients as you know have had all kinds of previous modalities and therapies attempted on them with limited help and results. So…. Why not trust the muscles and establish an occlusion that support calm happy muscles.  While the muscles are calm and happy, they will move and redevelop the bones on their own accord over their own time.  Yes, occlusion will change. Our job as dentist is to support and accommodate the occlusion of the orthotic to those muscles that desire to stay happy, comfortable and relaxed.  It shouldn’t be that complicated.  But when others get involved and don’t measure their cranial manipulated changes and expect us dentist to fix and cover for them…well that is a problem as Greg Y. has conveyed.

If changes have occurred due to others involvement then there should be additional charges and fees for one’s services to support those occlusal changes…and the other party should know and be aware.

Simple is Better:  It’s been proven!
“Keeping the main thing the main thing” .  It works for me.  The OC concepts has worked for many of you who have been in dentistry for over 21 years you all know it. And it will continue to work for the newer doctors as well, if you simply follow the protocols we teach.  It is proven.  No need to make things more complicated and confusing.

 If you are dentist and want to learn more you are welcome to come to Level 1 and join in our great OC forum Study Club.  Don’t be shy or embarrassed.  Just ask us… We learn from one another!  We have a whole team of great forum members to help and assist you in the OC GNM way.

– Clayton A. Chan, D.D.S. – Las Vegas, NV

 

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Manipulate the Cranial Bones or Not to Manipulate? A Dentists Perspective