DENTISTRY DILEMMA USA

HERE, THERE and EVERYWHERE

Lennon/McCartney

arr. Soren Madsen

Jefferson City,
MISSOURI

Phoenix,
ARIZONA

Valpariso,
INDIANA

Tustin and Santa Monica
CALIFORNIA

Reno,
NEVADA

Grand Rapids,
MICHIGAN

Colombus,
OHIO

Seeking and Searching | Before 1986

In 1978, the initial grinding (equilibration) of my bite (occlusion) by a dentist created instability in the jaw joint (TMJ) as well as permanently altered the natural teeth. I never asked questions; I had no knowledge of these differences of opinion.

On the other hand, the TMD (temporomandibular joint dysfunction) dental specialist used a splint for adjusting the bite rather than grinding permanent teeth. My searching in the Valley of the Sun was limited to Phoenix and Scottsdale, where I was shuffled among five different TMD dentists. The initial insult with the mandible (lower jaw) pulled forward to ‘capture the TM joint disc’ ricocheted down my spine that was fused at L5-S1. This Class III malocclusion provoked a ‘domino’ effect with my entire spine.   A bouncing back up to the top of the spine (atlas) at the base of the skull created instability in my compromised  skeletal  structure, not to mention pain from ‘head to toe’.  This created an impossible situation in which to equilibrate the bite due to abnormal movement as the body tried to find balance. However, this structural perspective was unknown at the time resulting in chaos amongst the treating dentists.

It wasn’t until after entering the world of the cranial Osteopath that I began to realize what a structural and functional nightmare had been accidentally created. I was thus catapulted into an area of dental specialization that was of differing practices and found myself in the middle of experimentation and disagreement. I became very proactive and educated for my own survival as my awareness grew and my health deteriorated. By the time I was referred to the cranial Osteopath, I was apprehensive and scared ….and could ask a million and one questions.

When my children started orthodontics, I was more vocal as well as  knowledgeable and could ask relevant questions. When I asked what impact the restriction of motion with headgear would have on the temporomandibular joint, the orthodontist seemed surprised at my question and said that he had no idea. Since I was keenly aware of ‘restriction of motion’ at this time, his response placed me on high alert as well as not returning.  I wondered if he had even questioned the impact of restricting motion during the growth spurt and the overall potential repercussions on the neck and back.

My personal experience with TMJ dental splints and the ensuing results obtained by the cranial Osteopath provided me with an understanding most patients did not possess.  I discovered there were cranial Osteopathic courses and training specialized for dentistry. The timing was fortuitous. My research located a local orthodontist who greatly respected this orientation and had even changed his practice because of the cranial  Osteopathic perspective:  he would not use headgear on his patients because of the stress on the TM joint. Instead, he implemented an ‘orthopedic’ approach.

 

Dentofacial Orthopedics

An ‘orthopedic’ approach began BEFORE teeth erupted, focusing on the lower jaw (mandible) rather than headgear restricting motion of the upper jaw (maxilla). This was an entirely different perspective in the early 1980’s. Implemented during the growth period of a child, this approach involved the guidance of facial growth and jaw development for better occlusion as permanent teeth erupted. Both of my children had an overbite. When I questioned this ‘new’ orthodontist how his restructuring of their jaw would impact their upper back (cervical spine), he responded that he did not know;.

He had recently changed his entire practice because of his new perspective from having taken courses with the Cranial Academy. Thus, we agreed that it was prudent to have Osteopathic care in conjunction with the repositioning of their lower jaw that impacted their skull base…
which in turn affected the entire spine
during their growth spurt. Furthermore,
he stated that he wished that all of his orthopedic appliance ‘children’
would have this kind of care!

Thus, my children walked through the door of the cranial Osteopath after orthodontic adjustments. Both parents agreed in writing at the orthodontist office: craniofacial orthopedics with a splint and follow-up Osteopathic care. 

In this era, this was a revolutionary approach. I was most thankful to have found an orthodontist who was aware
 of the the entire body and
 respected my questioning!

Today, the term for this orientation is ‘Dentofacial Orthopedics’. And, thus I became proactive and learned how
to ask questions, unlike the orthopedic experiences with back surgeries.

HERE

before 1986

Mother’s Death.
 Piano Students.
Marriage Malfunction.
Mediation Court.  
Post-graduate studies at ASU.
Brownie Scouts, Baseball, Swimming Team, Camping.

and Kittens.

1986 | The Cranial Connection

An ASU graduate class research paper, The Cranial Connection, landed in the annual American Academy of Osteopathy convocation. The response of this group prompted the publication of The Cranial ConnectionThis synthesis of published material became a professional introduction to the anatomical and physiological basis of Osteopathy in the Cranial Field. Osteopathic medical schools offered copies in their book stores and it was used as an introductory text for over a decade at Kirksville College of Osteopathic Medicine. The AAO invited me to their Seattle convocation where they hosted a “Meet the Author” recognition reception. Over the next several years, around 5,000 copies circulated around the world.

This was the era before computers and internet. I had rented a Selectric typewriter to type the paper for my class requirement. This was also the era of my divorce. The paper reached the mediation courts of Phoenix in addition to the AOA Convocation.  The Cranial Connection and my stacks of articles became my defense in a nine-month mediation saga in a custody battle with my attorney-husband to prove my ‘competency to raise children’. 

A Time of
Discord, Difference, Disparity, Divergence,
Dissimilarity, Disharmony, Discrepancy
DIVORCE

The mediation court competence decision coincided
with the American Academy of Osteopathy’s
recognition and praise of 
THE CRANIAL CONNECTION.

THERE

after 1986

I never became an Osteopath.
Life had radically changed in the five years following my introduction to Osteopathy.

The Cranial Connection reached more health care professionals
 than patients I could have treated had I been able to place
 the letters DO (Doctor of Osteopathy) after my name. 

A piano studio emerged….along with multiple instructors.
 I taught piano students how to use their two hands and ten fingers to create and perform music
   …instead of learning how to use my own two hands and ten fingers
to harmonize the body towards higher performance.
 The letters NCTM (Nationally Certified Teacher of Music) were placed after my name instead of DO.

– Piano students.

– Kids activities and adversities

– Publication of two books.

– Creation of PianoFonics curriculum.

and more Kittens

– Travel and explorations in the world of TMJ.

–  City of Phoenix 5-year zoning battle.

– Post-graduate studies at ASU.

– Music Teachers National Association (MTNA) presentations.

Seeking and Searching  |  After 1986

In my searching, I discovered there were TMD specialists
 around the country who were treating TMD from an Osteopathic orientation.

Was there a dentist who could restore my damaged occlusion
and who understood the ramifications of jaw posture on the entire body?
The equilibration (grinding) and further insults with a host of splints 
 had only created more trauma and destruction to my jaw posture and bite alignment. 

These TMD dental specialists were not in Phoenix.

HERE AGAIN

Local Explorations and Adversities

Continued searching in the local area led me to yet another TMD specialist who recommended nerve pain and anticonvulsant medications rather than appliances. Since my osteopath had wondered if I was having sub-clinical seizures based on what he perceived after my 3:00 am telephone calls to schedule a next-day appointment, I explored this avenue;  these ‘awakenings’ were in the throes of the Nardil withdrawal aftermath and lasted for five – six years, decreasing in frequency. Therefore, Neurontin and two neurologists entered my life, followed by more as the years progressed.

Neurology

A consult with one neurologist and an EEG confirmed that seizures were not happening.  According to the neurologist, I had worked my way up to a ‘grand mal’ seizure status of Neurontin per the TMD dentist. And this medication was doing nothing for the orofacial symptoms. I did not do a ‘cold turkey’ withdrawal as with Nardil.  I tapered off as recommended. In eight weeks, I was drug free.  A Trigeminal Neuralgia diagnosis floated in the air with a question mark.

Another neurologist diagnosed the symptoms as paroxysmal kinesigenic choreasthetosis, an involuntary movement disorder.  All I could think of was my Nardil experience:  the involuntary snapping shut of my jaw when going into REM sleep concomitant with biting my tongue and bleeding not to mention the seizure.

The osteopath was unhappy with the ‘superficial’ one-time study during the day- he thought the seizures were subclinical because they awoke me from deep sleep. In fact, he ordered two or three EEG’s over a period of several years; however, none were definitive. The osteopath also used a ‘medical’ diagnosis code :  Atypical Facial Pain (350.2) – in addition to his osteopathic codes.

How much of this was me and how much was medication aftermath?
The Neurontin trip ended experimentation with prescription drugs.

When I walked into the Osteopath’s office, I presented him with me, not medication side effects.
His pain management did not come with dangerous or adverse repercussions.
However, It was addictive – providing relief and sanity.
Plus my entire body was responding positively. 
I came to realize that the facial symptoms were an effect, part of a larger whole body pattern.
Hope was the byproduct rather than side effects.

Instead of medication and TMD specialists,
I chose a different route within the dental community:
Orthodontics.

The orthodontist, who was treating my children and was familiar with the cranial osteopathic perspective, was most vocal about the “problem” with my jaw position in the aftermath of the splint disasters. He recommended braces on the maxilla (upper teeth) to begin correction of this posture. I distinctly remember it was spring; and soon after the braces were on, I was sitting outside in a lovely garden at my daughter’s dance recital. For these first ten days, everything progressed smoothly.   Until, in the middle of the night, I awoke with a viscous ‘attack’ of the swirling vertigo and panic that had become very infrequent. I was unable to stand the pressure radiating upward into my head; the orthodontist worked me into his schedule the next day. Sitting in his dental chair, he decided to cut the wire at the midline of the braces.  Upon releasing this restriction, I had a mini seizure in the chair.  The orthodontist personally carried me out of his office and drove me to the Osteopath who treated me immediately. My body responded quickly and calmed down. The next day, the braces were removed from my upper teeth. 

No more braces.
Instead, I traveled beyond the local community.

HERE and THERE AGAIN

USA Travels and Local Encounters

East and North

My research into dentists who were exploring an osteopathic orientation, i.e. alternative dentists, led me to four different states:  Ohio, Missouri, Michigan and Nevada. All of these dentists had training in the Cranial Academy dental courses and thus were familiar with the osteopathic perspective of cranial motion and rhythm.

Ohio and Nevada offered anesthetic injections trying to block or change the facial symptoms – in the palate and on the face. Four trips and no results. Michigan offered a plastic mandibular appliance, split in at the midline, with kinesiologic testing for splint adjustments. Three trips and no results. Missouri seemed more promising, but ended in disaster;  this dentist eventually resorted to a bionator appliance on the mandible (lower jaw) which created more problems. In addition, this dentist attended a workshop in Phoenix hosted by my osteopath. I was the one of the patients in the demonstration of Osteopathic techniques for dentists; and it became very clear that the Osteopath had a much broader understanding and could address more than the jaw and face manifestations. The dental community, even with an osteopathic orientation, could definitely adversely more than the jaw and face! 

However, I did meet a Southern California dentist at this workshop who was treating WITHOUT appliances or injections. He bonded pivots on teeth in order to manipulate jaw position and thus alter occlusion. Furthermore, he utilized hands-on bodywork based on the osteopathic cranial perspective – his own labeling: Trauma Release Therapy (TRT). 

This sounded like a perfect avenue to explore for restoring my jaw posture and occlusion with a physician who had both dental expertise and cranial Osteopathic skills. 

Traveling West instead of East,
I literally changed my orientation not only in dental technique but also in geographical location. 
At least Southern California was a 45 minute flight!

In conjunction with my USA travels, I encountered 
The City of Phoenix. 

Unlike the mediation battle in the Courts of Phoenix of nine months, the battle with the City of Phoenix Planning and Development lasted five years. There was a necessary ‘about-face’ in my
 ‘career orientation’ as a single parent. 
This was my ‘visible’ life while my “invisible” life was dealing with the dental community in conjunction with continued osteopathic care. 

My piano teaching sideline transformed into a business, expanding into music technology with an Apple IIGS and a Macintosh computer and remodeling a portion of the house, Half of two-car garage housed a ‘music theory lab’ for my piano students and a very large closet became a smaller studio for another instructor. An upright Yamaha Disklavier moved into Music Works Academy along with the computers and  two piano pedagogy students teaching under my supervision.

My plunge into music technology paved the way for me to be one of four presenters in the first Music and Technology workshop at the annual Music Teachers National Convention. The Macintosh computer also inspired and enabled me to create a booklet that I promoted at this convention to a publisher; this booklet evolved into a
1989 publicationPractice and Progress’.  

In addition to the practice booklet, PianoFonics emerged – beginning instruction for piano students.  Returning to ASU, my coursework was not in anatomy and physiology, but rather Instructional technology and curriculum design. A studio parent, admiring my evolving PianoFonics curriculum, was completing her doctorate in this field and informed me this was precisely what I was doing in the  studio.  It seemed prudent to get a master’s degree in case I needed to be employed in a  ‘real job’.

In July of 1991, a knock at the front door changed my life forever.
A City of Phoenix citation was placed in my hand:
I had been turned into the Planning and Development Department
for operating a home-occupation and generating traffic
 in a residential neighborhood. 

Since I was on-record for making a proposal before City Council
 for the teaching of the fine-arts in residential properties,
I was not forced to quit doing business or move within the three-month time frame limit after citation – a fortuitous stroke of luck within chaos.

And thus began five years of searching for a home for my business.
Life became even more complicated
…..searching for health, home and business.