Holistic and Wellness Dentistry:
Dentists were traditionally regarded as teeth doctors. However, I believe dentists are oral and maxillofacial physicians for the following reasons:
- We have education in general medicine, surgery and pathology in dental school.
- We have training in recognizing (and sometimes diagnosing) diseases in the said areas. At the same time, we can see manifestations of some illnesses in another part of the body in the head and neck area.
- Like osteopathic medicine, dentists base diagnosis and treatment on the theory that the body’s systems are interconnected. They combine disease prevention and health maintenance with conventional medicine.
From the time babies are born, their growth and development are subjected to nurturing. Genetic makeup may control their traits, but what they eat and what environment and conditions they grow in can stifle or modify the expressions of the genes.
Nurturing or nature? There are numerous studies by Dr Robert Corruccini and Dr Jerome Ross, both are malocclusion anthropologists, showing modern humans have more malocclusion, small upper and lower jaws with teeth overcrowding than the population a few years ago in Western society. They also studied isolated rural peoples, and they found that the peoples do not have a malocclusion. But, once they were exposed to the western prepared-processed foods and culture, the malocclusion started to show in their children.
Animal studies demonstrated that animals fed with a soft diet always end up with smaller body mass, less dense bone and more petite, weaker oral musculature, narrower maxilla, smaller mandible, thinner jaw bone and weaker TMJs.
Today, babies are bottle-fed and have soft food come in a jar like the Gerber. In ancient times, infants drank milk from their mothers’ breasts and started chewing tough meat and vegetable soon after weaning.
Breastfeeding results in proper training and development of the tongue; a functional tongue, in turn, promotes the appropriate mouth and airway developments. Then the early hard diet continues the process. We get ideal growth when the tongue postures, swallows, and speaks properly.
Babies who use pacifiers tend to have improper arch form, small arch width, narrow and high vaulted palate, underdevelopment, and airway compromise.
Dietary consistency and toughness promote proper oral and maxillofacial muscle strength, bone growth and permanent teeth eruption.
According to Dr Jerome Rose, 95% of all malocclusions is acquired. Genetics plays only a 5% role.
As a family dentist who treats patients for their overall wellness, I pay more attention to the signs and symptoms of craniofacial dysfunction in my patients. During an examination, I look for black eyes (venous pooling). Dark circles can tell us a lot about a patient’s airway health. Children with less optimal development due to poor nutrition and restricted airflow through their noses would have a “droopy” appearance in their eyes or visible sclera (the white part of the eye) below the iris.
Before I even look at the teeth, I look for the cue of proper nasal breathing in my patients – lips together and at rest, tongue at the roof of the mouth, teeth are invisible and silent. When the patient sits upright in my dental chair, I check their subconscious swallowing. Patients with healthy nasal breathing should show no movement of lips and cheeks during subconscious swallowing.
The patient’s facial shape and face height, whether the lower jaw is short or not, can indicate their overall health.
Inside the mouth, I look for the symptoms of constricted arch forms, deep overbite, large tongue size, scalloped tongue lateral borders, large and inflamed tonsils, long and flappy soft palate, and tongue and lip ties.
Our teeth do not typically touch between chewing. Our teeth only contact for less than 10 minutes a day, including the time for chewing food. So, the patients with excessive enamel wear based on their age can indicate teeth grinding or clenching during their sleep. They are part of the risk factors for sleep-breathing disorder (SBD).
All the signs and symptoms mentioned above are related to SBD and chronic mouth breathing.
Mouth breathing can lead to malocclusion, increased upper respiratory infections, ENT infections, and asthma. Craniofacial deformity, snoring and obstructive sleep apnea (OSA).
Patients with OSA often have increased face height, decreased nose prominence, decreased nose width and retrognathic mandible. Narrow arches, high vault, elongated soft palate, retrognathic maxilla, retruded mandible are also the results of OSA and mouth breathing.
Chronic mouth breathing increases nasal airflow resistance, sympathetic nervous system activation and altered biochemistry and physiology during sleep. Whereas nasal breathing –diaphragmatic breathing leads to optimal CO2, O2 and Nitric Oxide balance.
Nitric oxide is a compound in the body that causes blood vessels to widen and stimulates the release of certain hormones, such as insulin and human growth hormone. Nitric oxide supplements are a category of supplements that includes L-citrulline and L-arginine.
Snoring is associated with straight profiles, V-shaped palatal morphology, increased neck circumference, decreased upper arch length and shorter inter-first upper molar distance. Significantly narrower maxillary and mandibular arch widths when compared to control groups. – inadequate space for the tongue. As the space in the oral cavity is inadequate, the tongue gravitates to the back of the oro-pharynx when the patient is lying down during sleep. Hence snoring and SBD.
The patient with tongue-tie leads to restricted tongue mobility. The results were associated with narrowing the maxillary arch and elongation of the soft palate – affecting maxillofacial development.
Craniofacial deficiencies started with bottle feeding and a soft diet in the infants. They caused airway deficiency/compromise, resulting in mouth breathing and sleep breathing disorder. With imbalanced oxygen, carbon dioxide and nitric oxide exchange, compounded with sleep fragmentation, mental and physical health and development deteriorate, resulting in a broad spectrum of disease from day-time-lethargy to cardiovascular diseases.
I am a family dentist in Burlington practicing wellness dentistry for all ages – from infants through adults to seniors. I encompass wellness dentistry into every aspect of practice – from the office location, setup, and airflow to lighting, from the materials to the equipment, from the diagnoses to treatment planning. It is very rewarding for me to be able to help my patients who have the issues and symptoms mentioned to improve their health outside their mouths.