The only thing harder than watching your children suffer is watching them suffer when modern medicine doesn’t have the answers! Although I have not had to watch my kids in long-term pain, I have had the humbling experience of sitting by and watching them suffer while I am helpless to do anything. It is one of the most horrible experiences you can have!
Unfortunately the profession’s understanding of the issues related to the bite are based on the hard tissues – the teeth and bones. Obviously these are important, however there are a lot of other tissues to also consider and one of the most important is the musculature. It was well documented several decades ago that 90% of the pain in the body comes from muscles, so if there is pain it makes a lot of sense to look at the muscles to help explain what is happening.
In the head and neck there are only a couple moving parts – that would be the jaw and the entire skull complex. Those systems will move dependent on a couple things – one is management of the airway. Airway is absolutely the most critical as we will only live minutes without a supply of fresh air. The other is based on the tooth position and how the upper and lower teeth meet best. The complication is that these two things are intimately related to each other and an airway issue at a young age will alter the growth and development of the jaws and jaw relationships.
Young children with frequent allergic reactions or colds and infections in the head and neck are more likely to develop airway issues and orthodontic issues as older kids. Young children with enlarged tonsils and adenoids are more likely to grow into older children with bite problems because of that. As children and young adults they are generally fairly adaptive and the body doesn’t necessarily hurt, but as they hit the late 20’s and early 30’s it is much more likely to see them start to have pain like migraine or neck aches or numb fingertips.
However, that is just the average. It is entirely possible for even very young children to experience pain as the body works to manage the airway and protect itself. As they develop into their adult teeth and the initial bite, it is absolutely possible to have the body start to kick and rebel against the jaw relationship it is forced to live with. The problem is the mouth is essentially the top of a snorkel and it is through the mouth and nose that we can breathe. If the lower jaw develops into a bite that is back too far, not only could the chin have an unusual and less aesthetic appearance, but also you are very likely to see the consequences of the jaw pushing the tongue backwards and into the airway. Basically what happens is you bend the snorkel. If you have ever been underwater breathing through a snorkel, imagine trying to take a breath while someone bends it!
This will set a growth pattern in motion that is very challenging to the body and can be extremely uncomfortable to the muscles. As they stress and pull to get the jaws into this poor position, they end up getting cramps and set off a reaction that often includes pain.
The most important next step is a comprehensive evaluation. A dentist trained in Neuromuscular concepts can take a look at the system and help to find a better bite relationship. They will utilize a TENS unit that will relax the musculature and help it to find the neutral physiologic position. They may even actually measure the jaw muscle activity and determine if there is a more comfortable way for the muscles to posture the jaw. The first step will be a specially designed Neuromuscular orthotic that will redesign the way the mouth works to determine if the symptoms are totally related to the bite or if there are other factors to address as well. Another important issue to consider is the airway and to make sure that not only is the daytime symptom or symptoms addressed, but is the night-time supported in the optimal physiologic relationship and is the airway protected.
If you or your kids suffer with any frequent or chronic head and neck pain or numb finger tips or tooth grinding or jaw popping – it is important that a dentist trained in Neuromuscular techniques be included in the management of the airway. It is more than just the bones and teeth that help a person be comfortable…