By Dr. Felix Liao, DDS, MAGD, ABGD, Dip. ASBA
In 2010, Dr. Jeremy Mao, professor in orthodontics at Columbia College of Dental paucity of fundamental innovations in orthodontics for decades presents intrinsic risks for the [dental] profession. “Fundamental innovations in orthodontics” involves not only clinical hardware, in this author’s view, but also mental “software” in orthodontic practitioners’ minds. This article explores epigenetics as a potential solution for various clinical issues that can arise during and after orthodontic treatment. Three case studies are presented to open a dialogue on expanding the criteria for orthodontic treatment success beyond straight teeth.
Introduction
Starting cases is easy, but an orthodontic practitioner will be confronted with various issues in time, such as pain in periodontal ligaments, TMJD, bruxing, abfractions, gingival recession, root resorption, relapse, and more.
Lesser known are the systemic issues in the wake of orthodontic treatment. In my 25 years of experience of focusing on oral systemic wellness, I have found that post- orthodontic issues can include persistent pain in from head to feet, chronic fatigue, anxiety, depression, snoring, sleep apnea, as well as hypoxia-related cardiovascular, endocrine, and erectile, cognitive and memory dysfunction in various combinations.
What are the causes of all these “head-scratcher” issues? I kept wondering after seeing thousands of such adult patients. Over time, I began to see a connection to a structurally impaired mouth and coined the term Impaired Mouth Syndrome.
Do you see new teeth erupting into malocclusion in children and wonder WHY? Failing to address this question clinically, the preteens undergoing orthodontics eventually grow into adults in due course, most with Impaired Mouth Syndrome.
How can we dentists and orthodontic practitioners do better for our patient’s long terms health and wellbeing? Opening our viewfinders acquired in dental school to see the whole patient and to reconnect the mouth with whole body physiology can be helpful. Let’s take bruxing as an example.
Growing New Eyes
Teeth grinding perplexed and fascinated me as an engineer ever since dental school clinics. Why would the body self-mutilate its hardest tissues? Is there a better answer for bruxing than night guard? These questions nagged me onto a career-long quest for answers. Thirty years later, here are some of the crucial dots that finally made sense:
A. “Oral health means much more than healthy teeth”, stated U.S. Surgeon General David Satcher, MD in 2000.
B. Bruxing is micro-arousal in EEG study, which shows spikes before bruxing and increased heart rate 10 seconds later.
C. Blood pressure surges 20-25% during bruxing events.