The following pages describe Dr. Joseph Da Cruz’s personal philosophy on dentistry, medicine, collaboration within the medical field and the role dentistry plays in preventative health care for patients.
I believe the current perception of the dental field, viewed both by medical physicians and the broader community, is narrow and does not reflect the true capacity that dentistry can offer patients. A common understanding of dentistry is a surgically focused approach to treatment, dealing with fillings, extractions and dentures. While all of these features do predominate in dentistry, the capacity for treatment and benefit to patients can extend further than surgical treatment alone. Dentists can provide treatment for conditions previously thought not to have been connected to dentistry. Adjacent and associated structures that extend from the maxillo-facial region have profound effects on the human body. The trigeminal nerve is one such structure capable of these effects. The trigeminal nerve provides sensory feed-back from the oral and facial regions of the head and if compromised can create a wide array of physiological and psychological pain. For this reason, dentists can have a significant impact on human health through knowledge of cranial sensory and motor feed-back.
The potential influence dentistry can have on the functional neurology of the human body suggest more collaborative work is needed between dentists, neurologists and neurological physicians. Unfortunately this is currently not the case and consequently, many dentists feel powerless to patients needs in the area of pain management. Dentists are limited to observing health implications in the mouth exclusively. However, there are a growing number of dentist and doctors who are recognising the link between the mouth and the human body. It is now accepted that certain clinical markers in the oral cavity can infer systemic pathology. Dental x-rays can provide early warning signs of osteoporosis, while sleep disordered breathing may infer an increased risk of developing cardiovascular disease. I believe that there is a strong link between respiratory problems and blood pathology imbalance. Dentists can observe pathology of the oral cavity and infer possible systemic pathology. This type of detection is excellent for discovering early warning signals and I believe other warning markers should be explored further. Dental carries is one such condition where sugar is not affecting the oral cavity alone, but rather it is a blood acidosis condition affecting the whole body. Another area that needs to be explored is connective tissue break down in the mouth. Dentists can observe clinical markers of connective tissue break down in the mouth and infer connective tissue break down is occurring systemically due to a blood acidosis. More extensive training of dentists and more collaborative work with medical physicians can potentially provide more protective and earlier preventative care for patients.
Currently, I believe that there are patients who have fallen through the cracks of the medical field and cannot be treated as their conditions are not completely understood within the current medical format. These patients experience headaches, migraines, chronic fatigue, chronic postural pain or other chronic pain management issues that affect their normal day-to-day quality of life. From my experience in holistic dentistry, many patients present with these chronic pain problems despite having seen a multitude of medical physicians. Unfortunately the connection of cranial distortions, TMD, malocclusion, sleep dentistry, physiological acidosis and motor reflexes is not currently understood. Collaborating with other physicians has shown me that these features are all interrelated. Chronic pain problems (mentioned above) often result from compensation mechanisms through structural abnormalities or trauma that have not been addressed in dentistry or medicine alone. Collaborative dentistry and medicine can provide assistance and can improve quality of life for many people who have been neglected by the current medical format.
Collaborative work between dentists and medical physicians is only one aspect of a holistic approach to treatment. Working with cranial osteopaths and understanding cranial distortions and their effects on the mouth’s functional matrix is also an important aspect of treatment. There is a link between the structure of the cranial base (spheno-occipital synchrondrosis) and the mouth; both influence one another and both affect postural related muscles. The cranium’s influence on posture is considered to be a descending pattern where distortions in the cranial bone structure create a descending muscle pattern, distorting posture and eventually foot position behavior. Thus improper foot position may be compensating for a distortion originating from the cranium. Conversely genetic distortions in foot pronation may create acceding patterns, distorting posture and eventually jaw position. This may eventually lead to TMJ pain, TMD or even breathing problems. Dentists and other physicians treatment can indirectly influence other areas of the body, that is why a whole body approach to health treatment should be explored.
Cross disciplinary study between medicine and dentistry is an effective way to achieve a whole body approach to health treatment. This can allow practitioners to be mindful of their treatment and its affect on other areas of the human body. Medical practitioners who look at hormone imbalance, blood pathology and immunology to treat patients can create benefits for the integrity of bone and gum tissue repair in the oral cavity thereby enhancing the success of dental treatment. Conversely, if dentists change their operational behavior they can improve the patient’s health in other areas. By stopping the use of mercury fillings, dentists can reduce patient toxicity exposure thus improving patient’s blood pathology. Another area of dentistry that can prevent harm to patients, is reducing the unnecessary removal of teeth for orthodontic treatment, especially maxillary premolars. Removal of key teeth in the maxillary arch can contribute to the collapse of the maxilla and retrusion of the lower jaw. This can create a cascade of events leading to obstructive breathing problems and subclinical defects (e.g. blood acidosis). From my experience, patients who present with obstructive airway breathing problems have a higher risk of health related problems. For example, obstructive airway problems can increase the risk of developing chronic-fatigue. While this may not be the definitive cause of chronic-fatigue, a significant proportion of patients who have presented with chronic-fatigue have had associated obstructive breathing difficulties.
Airway obstruction leads to breathing problems and subsequently affects REM sleeping patterns, this has a profound influence on the human body. Breathing problems are a form of stress that impede the body’s ability to handle other physiological and psychological stresses in life. When a person cannot cope with physiological and psychological stresses that were previously not stressful, they are considered to be in survival mode. In this state, a person cannot process or comprehend complex difficult tasks. I believe that if a patient cannot breath properly then they cannot think clearly. On the other hand, if a patient is able to breath properly, then they are able to think clearly and comprehend more difficult tasks. These ideas relate to work by Dr. John Diamond. I have had the privilege to work closely with Dr. Diamond on this topic and we both believe improving the breathing patterns of patients can lead to a cascade of events that improve the overall health status of the patient’s quality of life. By improving oxygenation, one can reduce sub clinical defects which can affect a patient’s physiology. These include responses to allergens, androgen functioning, structure and strength. I am a strong believer that those who have good health are those who posses good maxillary facial architecture, breath well and ultimately sleep well.
There is a long road ahead and we do not know how to get there but we must start somewhere. My aim is to give dentistry greater importance by providing a whole body approach to treatment, thus offering a more effective, preventative health treatment and quality of care to patients.
Dr. Joseph Da Cruz