terecitaDeanPortraitWhole Body Health Patient Education

As a whole-body dentist, I consider the connections between the oral environment (teeth, mouth, jaw, tongue, saliva) and the rest of the body to bring about healing in the mouth and wellness in the body. The structures and functions of the oral environment are intimately connected with each other, as well as to other parts of the body. As the beginning of the digestive tract, the mouth contains structures that aid in the digestive process, including the teeth, tongue, salivary glands, and hard and soft palates that form the roof of the mouth. Properly functioning links between the mouth and the jaw are essential not only to healthy digestion, but also to breathing and sleeping.

Request a consultation if you require dental services, are experiencing jaw pain or have persistent sleep problems or other symptoms of sleep apnea. 


Connections between the oral environment, sleep, and the TMJ

Because the mouth and jaw are part of the head and neck area, dysfunction in the oral environment can often contribute to TMJ and sleep disorders. TMJ disorders can cause a great a deal of pain, and sleep disorders can pose a serious health threat. TMJ and sleep disorders are very often connected, and I specialize in treating both of them with whole-body, nonsurgical methods, including cranial osteopathy and the use of oral appliances, to allow patients to lead pain-free, healthier lives.

Here are a few ways that TMJ disorders affect sleep: The body’s myofascial system affects the back, jaw and TMJ through fascia stretching from the cranium the sacrum. Myofascial dysfunction results in restrictions in the head, neck and facial areas, which can lead to TMJ symptoms such as trouble opening and closing the mouth. It can also lead to a tight diaphragm, resulting in diminished oxygenation of the brain and consequent sleep fragmentation. As noted, disturbed sleep can wreak havoc with our circadian cycle, leading to hormone dysregulation, which can further disturb sleep, and weaken all our physiological cycles.

As mentioned, however, sleep disturbances more often cause TMJ rather than the reverse. This is due to the global effects of sleep disturbance on whole-body health, including the functioning of the TMJ. Fragmented sleep can lead to myofascial and postural issues as well as hormonal issues. It can also result in lessened ability to regulate cytokines (substances involved in the immune system, some of which are released in sleep), and this in turn can lead to inflammation.

Stress conceptSleep is important for tissue repair and growth and restoring energy to the blood that supplies our muscles and myofascial system. If the myofascial system is not refreshed, problems can arise with the fascia, particularly the pharyngeal basilar fascial chain and the deep cervical chain, which affect the alignment of the spine. Muscle tension thus affects posture, creating poor spinal alignment which in turn affects vascular pressure in the brain, leading to a variety of ill effects. Any disturbance in blood flow, as with high blood pressure resulting from sleep apnea, affects the heart-brain connection and brain function. There can also be muscle tension between the stomach and esophagus that can interfere with the autonomic functioning of the esophageal sphincter and precipitate gastro-esophageal reflux (heartburn). In addition, a narrowing of the pharyngeal airway due to muscle tension can exacerbate a heart problem.

In relation to the TMJ, poor sleep that results in myofascial tension and postural problems can lead to many head and neck problems. Postural problems can also affect the tongue, leading to bruxism (teeth grinding) and dental malocclusions (failure of the teeth to meet properly). All of these conditions can in turn lead to TMJ disorders.


Treating TMJ

Adobe Photoshop PDFWith my focus on whole-body health, I am also a neuromuscular dentist, dedicated to achieving a well-functioning TMJ through a stable, well-balanced bite (which dentists call occlusion) and proper alignment of the cervical spine. Occlusion, according to the American Association of Orthodontists, is the relationship between the upper and lower teeth as they come into functional contact, as when you bite, chew or close your jaws together. The way the occlusal (chewing) surfaces of any of your teeth come together affect your teeth, gums, neck and head, jaw muscles, oral health and TMJ.  I look at occlusion by evaluating not only the teeth, bones and gums, but the entire upper extremity, including the relationship between the teeth, the TMJ, and the head and neck muscles and nerves. I also use cranial osteopathy to help make this relationship harmonious, in order to benefit the TMJ and the body as a whole.

In treating the head and neck, I pay close attention to the temporal bones, to the occipital mastoid suture (the fibrous connection between the occipital bone and the mastoid portion of the temporal bone), and to the ethmoid bone, which separates the nasal cavity from the brain and is often involved in painful TMJ disorders. Via the ethmoid bone’s attachment to the dura mater (connective tissue surrounding the brain and spinal cord), I can influence the dura mater all the way down to the sacrum.

I also work to normalize the functioning of the cranial nerves, in particular the vagus nerve and the trigeminal nerve. The vagus nerve, the tenth of twelve paired cranial nerves, has sensory, motor and autonomic fibers and is involved in many vital functions, including breathing, controlling the heartbeat, visceral muscle movment and sensations, especially movement and secretion of the digestive systm, and reflex regulation of blood pressure. The trigeminal nerve, the fifth cranial nerve, is involved in the chewing of food and sensations in the face, scalp, and teeth, and has direct sensory and motor extensions to the brainstem. Because it affects the central nervous system, the back, jaw and facial muscles, the eye, the paranasal sinuses, the ears and the teeth, the trigeminal is often involved in TMJ dysfunction.

Do you have jaw pain or other symptoms of TMJ? Dr. Dean can treat your discomfort in a serene and compassionate environment to restore your health and quality of life.

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Treating Sleep Disorders

Adobe Photoshop PDFAn obstructed, or collapsed, airway due to a TMJ disorder or other factors is a primary cause of sleep problems, which can manifest as disordered breathing and snoring and, when severe, the life-threatening condition OSA, in which intense snoring is punctuated by frequent, short periods of ceasing to breathe at all.

I diagnose and treat mild to moderate sleep disorders in my office, using a combination of cranial osteopathy and appropriate oral appliances to provide relief when possible without surgery or use of the CPAP (Continuous Positive Airway Pressure) device. Surgery is effective in only 50% of cases, and the CPAP, though effective, is difficult to tolerate for many people.

We fabricate custom-fitted oral appliances for obstructive sleep apnea, especially for mild to moderate cases where patients prefer oral appliances to CPAP devices. Designed to be light and easy to wear, the oral appliance works by moving the lower jaw forward and downward, causing a change in jaw or tongue position which opens the airway to normalize breathing. The appliance thus creates extra airway space that keeps the airway open and prevents it from collapsing.

When I believe OSA exists, I refer patients to a sleep center for testing, and to a sleep specialist physician for a complete medical assessment, then work as a team member with the other health care professionals to determine if an intra-oral appliance can help.

There is no need to suffer with sleep disorders, persistent lack of energy and sleep apnea. Dr. Dean has the experience to properly diagnose and treat sleep problems, often without the need for CPAP masks or surgery.

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