Physical Therapists trained and experienced in the use of osteopathic manual therapy understand the importance of orthodontic dentistry as a means of improving jaw and tooth alignment and as an important factor in people’s health. Many dentists recognize the importance of craniosacral or craniomandibular osteopathic treatment as an integral part of assisting the body in making an orthodontic correction and in maintaining good health throughout the process. Understanding these mutual benefits requires an understanding of the connection between osteopathic treatments and orthodontia.
The proper alignment of teeth is dependent on a correct anatomical relationship of the upper jaw (maxilla) with the lower jaw (mandible). Changing tooth alignment requires changing not only the relationship of the maxilla to the mandible but also in complex relationships of these bones to several other bones of the face and skull. Osteopathic research demonstrates that all places where skull bones meet have significant capabilities of motion in infancy and childhood, and usually maintain motion throughout life. Although very little motion is permitted at any one of these joints, that motion is essential to allowing a successful orthodontic correction. Craniosacral osteopathic treatment assists orthodontic correction by helping all the bones of the skull to adjust to the orthodontic changes created.
In Canada, where physical therapists trained in osteopathic methods are relatively rare, there is a large potential for greater cooperation between physical therapists, orthodontists and dentists who recognize the importance of normal cranial mobility as a factor in the success of orthodontic correction. Through osteopathic manual therapy, the therapist can help the individual to better tolerate the orthodontic changes and can alert the dentist to the possible need to adjust the orthodontic plan. It is not uncommon to find that when osteopathic treatment accompanies orthodontia, the desired results are obtained in half to two-thirds the time estimated by the dentists, and the correction is more likely to hold well over time!
It is typical for the normal mobility of the cranium to be compromised somewhat during orthodontic correction. The degree to which this happens depends on the types of appliances used and on the ability of the patient to tolerate the changes brought about by the appliance. Most orthodontic corrective appliances fall into one to two categories—fixed or functional. Fixed appliances, such as braces or head-gear, hold firm the relationship of some teeth to other teeth. Because teeth are imbedded in bone, this rigid relationship of teeth to each other results in rigidity in the motion of the maxilla and mandible and, through them, limits the normal motion of other bones of the skull. Functional appliances, such as adjustable plate expanders, permit the cranial bones to retain more of their motion pattern during orthodontic procedures. They are, therefore preferable whenever they are capable of making the needed correction.
The topic of tooth extractions is a controversial one! While there are times when avoiding extractions makes the orthodontic treatment plan unreasonably lengthy and complex, it is best to keep all the teeth whenever possible. Removing the canine teeth, which serve as stabilizers of the jaw, can have profound negative consequences to the cranial mechanism and to the general health of the individual!
Tongue muscle action is a powerful force in shaping the developing oral cavity. When the tongue is not functioning properly within the mouth, speech, and breathing are also affected. Conditions such as respiratory allergies or asthma, which prompt mouth breathing, foster the development of an oral cavity that is more likely to need orthodontic correction. Children who continue to such their thumbs or to use a pacifier after the age of about 30 months are more likely to have orthodontic problems requiring attention. Sometimes the dentist may recommend myofunctional physical therapy in order to help correct the position and action of the tongue, before attempting orthodontia.
Health Challenges during Orthodontia
A person’s posture and overall health can suffer both when jaw alignment is poor and when jaw and teeth are undergoing orthodontic correction. It is ideal when the only complication of correction is the experience of pain in the teeth for one or two days aftr obtaining or adjusting an appliance. Unfortunately, some people suffer persistent headaches as a direct result of the compromise in bone and membrane mobility of the cranium.
With many years of daily practice in osteopathically-based craniosacral therapy, Fred Samorodin, Registered Physical Therapist is able to assess and treat body conditions that can help optimize the benefits of orthodontic dentistry.