SOTO-USA’s Dental Chiropractic Position Statement
Chiropractic and Dentistry in the 21st Century: Guest EditorialBlum CLThe Journal of Craniomandibular Practice Jan 2004; 22(1): 1-3.
As interdisciplinary healthcare matures, understanding that patient care should ultimately be our focus, hopefully differences can be put aside in light of our common goal. Within the cranial manipulative field mutual research cooperation between chiropractors, osteopaths, and physical therapists will hopefully be imminent in the 21st Century. This is presently happening with the multi-divisions of dentistry as relating to the field of craniomandibular/temporomandibular dysfunction (TMD/CMD) and conditions affecting condylar positions, functional orthodontic care, and the relationship of occlusion to the stomatognathic system and posture. The best way for us all to proceed is with an open mind and heart and willingness to learn and work together.
The Journal of Craniomandibular Practice (Cranio) has been a guiding light for those of us in the field of TMD/CMD since its inception in the early 1980s. When Cranio was started there was a paucity of literature substantiating care of the TMJ and often times healthcare professionals would chalk up a patient’s profound symtomatology as solely emanating from a psychosomatic disorder.
In the early 1980s it was common to see the chiropractic and dental fields working separately with patients suffering with TMD/CMD. Often times our paradigms and mode of diagnosis were completely different. While it is not uncommon for chiropractors to treat patients presenting with TMJ disorders 1-13 often times that care can reach a “roadblock,” and the patient’s ability to improve can only be resolved with help from those in the dental field.
Dental – Chiropractic co-treatment models are being developed and what appears to be essential in these early stages is educating each other to a syntax that can be readily understood between both fields. Initially a large obstacle between the dental and chiropractic fields related the dynamics of the craniofacial sutural system. The chiropractic field, particularly those practicing Sacro Occipital Technique (SOT), worked under the premise that the cranial and facial bones were not completely fused in adulthood. 14-19 That concept was not readily accepted by those in the dental field since the whole paradigm of craniofacial orthopedics and orthodontics would have to be viewed in a completely new light. However in spite of this the dental field is beginning to open up to these possibilities, 20 which has also opened the door to greater co-treatment possibilities with the chiropractic profession.
As the issue of cranial and facial bone compliance and its affect on occlusion and TMJ functioning has gained greater acceptance in the dental and chiropractic fields what has become a common theme between our professions is the relationship between the stomatognathic system and posture. 21-24 While the pelvis and TMJ might seem to be distal and unrelated aspects of our patient’s presenting symptoms, research is suggesting otherwise. 25-27 “Before fitting dental splints or equilibrating the occlusion, the sacroiliac joints should be examined for proper function and any sprain should be reduced. Correspondingly, after occlusion-altering (or potential occlusion-altering) dental procedures, the sacroiliac joints should be examined for proper function to determine if they show ongoing functional stability.” 27 The rationale for greater relationships between chiropractors and dentists has been discussed in the literature, since in some cases the only possible chance of a patient having any resolution of their TMD/CMD was with co-treatment. 28-31
SOT chiropractors have found that patients can present with ascending problems, which are, lower extremity, lumbosacral or cervical spine dysfunction or at other times descending problems which are lumbosacral or cervical spine dysfunction secondary to craniomandibular or occlusion imbalance. Working together with a dentist familiar with CMD/TMD is sometimes the only way to help patients suffering from this complex condition. One way the professions can advance a working relationship is by developing methods of determining when a patient’s case is a dental or chiropractic primary. Presently there are no absolute gold standards, but evaluation of the TMJ in standing, sitting, and supine postures, for instance, can help determine if there are lower extremity, pelvic or other related conditions affecting the TMJ, independent of the occlusion. There are other tests and modalities being used by both dentists and chiropractors evaluating neuromuscular functionality of the body and its relationship to TMD and further need to be agreed upon and developed. 32
Sacro Occipital Technique Organization (SOTO) – USA is a multidisciplinary organization formed to promote the awareness, understanding and utilization of the Sacro Occipital Technique method of chiropractic as founded and developed by Major Bertrand DeJarnette, DC, DO. SOTO-USA has conferences and symposiums yearly and incorporate dental chiropractic co-treatment models, helping to integrate both professions. In April 2003 SOTO-USA had its spring conference with BioResearch’s Annual Conference in Milwaukee. This past October 2003 James Carlson, DDS and Steven Olmos, DDS helped present a 12 hour dental chiropractic co-treatment seminar at the SOTO-USA Clinical Symposium in Washington, DC.
Robert Walker, DC of “Chirodontics” has often stated that “The most complex case for a dentist is the easiest for a chiropractor to help and the most complex case for a chiropractor is the easiest for a dentist to help.” At the SOTO-USA dental chiropractic conferences the most common question is, “Where can I find a chiropractor or dentist that I can work with?” SOTO-USA plans in the near future to have a free directory on our website for dentists, chiropractors and patients who want help with treatment or treating TMD/CMD. If you are interested in working with a chiropractor or dentist and would like to be a part of this directory, please contact SOTO-USA at (336) 793-6524 or email@example.com online. Aside from the possibility that our professions working together can be mutually advantageous, ultimately from this partnership it will be the patient that will achieve the greatest benefit.
Alcantara, J, Plaugher G, Van Wyngarden DL, Chiropractic care of a patient with vertebral subluxation and Bell’s Palsy Journal of Manipulative and Physiological Therapeutics. 2003 May; 26(4): 253.
O’Reilly A, Pollard H, TMJ Pain and Chiropractic Adjustment – A Pilot Study Chiropractic Journal Of Australia. 1996 Dec; 26(4): 125-9.
Saghafi, D, Curl, D, Chiropractic Manipulation of Anteriorly Displaced Temporomandibular Disc Journal of Manipulative and Physiological Therapeutics. 1995 Feb; 18(2): 98-104.
Alcantara J, Plaugher G, Klemp DD, Salem C, Chiropractic Care of a Patient With Temporomandibular Disorder and Atlas Subluxation Journal of Manipulative and Physiological Therapeutics. 2002 Jan; 25(1): 63-70.
Schupp W, Marx G, Manual Medicine and Kieferorthopaedie : Manual treatment of the Kiefergelenke for the therapy of the kraniomandibulaeren Dysfunktion [Treatment of craniomandibular dysfunction by means OF manual manipulation of the temporomandibular joints Manual Medicine. 2002; 40(3): 177-83.
Curl D, Chiropractic Approaches to Temporomandibular Joint Dysfunction (TMD) Journal of the American Chiropractic Association. 2001 Apr; 38(4): 9-17.
Knutson G, Jacob M, Possible Manifestation of Temporomandibular Joint Dysfunction on Chiropractic Cervical X-Ray Studies Journal of Manipulative and Physiological Therapeutics. 1999 Jan; 22(1): 32-7.
Vernon H , Hu J, Neuroplasticity of Neck/Craniofacial Pain Mechanisms: A Review of Basic Science Studies Journal Of The Neuromusculoskeletal System. 1999 Sum; 7(2): 51-64.
Arcadi V, Birth Induced TMJ Dysfunction: The Most Common Cause of Breastfeeding Difficulties Proceedings Of The National Conference On Chiropractic. 1993 Oct: 18-22.
Curl D, The Visual Range of Motion Scale: Analysis of Mandibular Gait in a Chiropractic Setting Journal of Manipulative and Physiological Therapeutics. 1992 Feb; 15(2): 115-22.
Curl D, Acute closed lock of the temporomandibular joint: manipulation paradigm and protocol Chiropractic Technique. 1991 Feb; 3(1): 13-18.
Nykoliation J, Cassidy J, Manipulative Management of the Temporomandibular Joint Pain-Dysfunction Syndrome: A Report of Two Cases Journal Of The Canadian Chiropractic Association. 1984 Jun; 28(2): 257-62.
Vernon L, Ehrenfeld D, Treatment of temporomandibular joint syndrome for relief of cervical spine pain: case report Journal of Manipulative and Physiological Therapeutics. 1982 Jun; 5(2): 79-81.
Pederick FO, Developments in the Cranial Field , Chiropractic Journal of Australia, Mar 2000;30(1):13-23.
Pederick FO, A Kaminski-type evaluation of cranial adjusting, Chiropractic Technique, Feb 1997;9(1):1-15.
Pederick FO, For Debate: Cranial Adjusting — An Overview, Chiropractic Journal of Australia, Sep 1993; 23(3):106-12.
Blum CL, The Effect of Movement, Stress and Mechanoelectric Activity Within the Cranial Matrix, International Journal of Orthodontics , Spr 1987; 25(1-2): 6-14.
Denton DG, Craniopathy and dentistry Basal Facts , 1986, 8:4, 181-202.
Blum CL, Biodynamics of the Cranium: A Survey, The Journal of Craniomandibular Practice, Mar/May 1985: 3(2):, 164-71 .
Oleski SL Smith GH, Crow WT. Radiographic Evidence of Cranial Bone Mobility Cranio: The Journal of Craniomandibular Practice ; Jan 2002; 20(1):34-8.
Milani RS; De Periere DD; Lapeyre L; Pourreyron L, “Relationship between dental occlusion and posture” Cranio 2000 Apr;18(2):127-34.
Miyata T; Satoh T; Shimada A; Umetsu N; Takeda T; Ishigami K; Ohki K, “[The relation between the condition of the stomatognathic system and the condition of whole body. I-1. Concerning the effects of a change of occlusion on upright posture especially on the locus of the body’s gravity center]” Nippon Hotetsu Shika Gakkai Zasshi 1988 Dec;32(6):1233-40.
Frumker SC; Kyle MA, “The dentist’s contribution to rehabilitation of cervical posture and function: orthopedic and neurological considerations in the treatment of craniomandibular disorders” Basal Facts 1987;9(3):105-9.
Vernon LF, Ehrenfeld DC Treatment of temporomandibular joint syndrome for relief of cervical spine pain: case report. J Manipulative Physiol Ther. 1982 Jun;5(2):79-81.
Fink M, Wahling K, Stiesch-Scholz M, Tschernitschek H. The functional relationship between the craniomandibular system, cervical spine, and the sacroiliac joint: a preliminary investigation. Cranio. 2003 Jul;21(3):202-8.
Peterson K, A Review of Cranial Mobility, Sacral Mobility, and Cerebrospinal Fluid Journal of the Australian Chiropractic Association. 1982 Apr ; 12(3): 7-14.
Gregory, TM. Temporomandibular Disorder Associated with Sacroiliac Sprain Journal of Manipulative and Physiological Therapeutics May 1993; 16(4): 256-65.
Chinappi AS, Getzoff H, Chiropractic/Dental Cotreatment of Lumbosacral Pain with Temporomandibular Joint Involvement Journal of Manipulative and Physiological Therapeutics, Nov/Dec 1996; 19(9): 607-12.
Chinappi AS, Getzoff H, The dental-chiropractic cotreatment of structural disorders of the jaw and temporomandibular joint dysfunction, Journal of Manipulative and Physiological Therapeutics, Sep 1995; 18(7): 476-81.
Chinappi AS, Getzoff H, A new management model for treating structural-based disorders, dental orthopedic and chiropractic co-treatment Journal of Manipulative and Physiological Therapeutics, 1994; 17: 614-9.
Howat J, Varley P, Complementary Therapies Chiropractic Dentistry Monthly Feb 1998; 4(2): 16-25.
Esposito, V, Leisman, G, Neuromuscular Effects of Temporomandibular Joint Dysfunction, International Journal of Neuroscience , 1993; 68: 3-4.