DENTAL POSTURAL THERAPY
Why you might need your bite assessed
The way your teeth fit together gives your body a sense of position. Nerves innervate your teeth giving you a sense of what direction the body is shifted: forward, back, left, or right. The information that your brain receives can dictate your body position.
Sometimes you can alter this just through behavior of how you use your tongue or jaw muscles. Other times you need help from a dentist to make a device to interrupt the previous feedback from poor positioning to help you achieve a normal rest position for your jaw, head, and neck. This allows for automatic processing of movement and posture to improve. For some patients, no matter what exercises they do, they simply do not have access to the movement they need. Their brain and occlusal system will not allow it until it is unlocked by collaborative care from Dr. Brian and a skilled postural therapy dentist.
How to know
if you need
dental postural therapy
Every patient will be individually assessed for their need for dental integration. If your body is able to break free of its old pattern through retraining activities alone, a dentist is often not needed. If you have been consistent with your retraining program and it does not stick for your body, we perform further testing to determine what other influences in your body may be pulling you back into your old pattern.
Frequently patients with dental issues will increase their mobility after one of their activities but after finding their habitual bite they revert to their old patterning and positioning. They may be able to improve motion through their trunk and lower body but their neck is still tight. Dr. Brian will assess jaw position and test body patterning based on bite input or sensory input from the palate to see if a change is induced. He may see that when altering the way your teeth come together or by opening a rotated palate that your mobility improves or your neck tension clears up. If he sees significant differences that you cannot otherwise achieve or maintain he will discuss with you whether an integrated dental appointment is indicated.
Common indicators for needing dental postural therapy:
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Anterior or posterior open bite
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Cross bite
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Missing or worn teeth
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Tongue tie
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Clenching for stability, grinding, temporalis or masseter hypertonicity
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Multiple or difficult treatment plans of orthodontia
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Airway or sleep disorder
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Headaches
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Neck or jaw pain
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Molar fracture
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History of multiple dental interventions
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Occlusal or optic cant
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Significant facial asymmetry
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Hypermobility (over 50 mm of opening)
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Limited opening without a click
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Inability to resolve opening with a click
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History of whiplash, cervical instability, OA lateral flexion > 10 degrees
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Limited lower cervical axial rotation, lateral flexion or extension following restoration of chest wall expansion and shoulder rotation
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Limited horizontal abduction of the shoulder following otherwise neutral thorax
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Inability to achieve neutrality despite optimal mechanics and positioning or neutrality only achievable through interruption of occlusion or with biased occlusion (molar or canine isolation)
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Inability to maintaining neutrality following habitual bite
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History of chronic pain that is not improving with physical therapy intervention
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Narrow infrasternal angle
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Inability to isolate unilateral molar or canine function
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Protrusion causes lateral deviation
How is this different from your regular dentist?
If this were only a dental issue, seeing your normal dentist would be fine. However, we are treating how your neck and body move based on the feedback from your cranial bones, tongue, and teeth positioning in addition to TMD, airway, and occlusal issues. Extensive additional training is required to know how these factors influence body pattern, position, and movement and what appliances or adjustments to an appliance are needed to achieve a specific outcome.
We are not looking at the specific health of a tooth (although your postural dentist may assess this as well). We are looking at the neurological impact to the body that sense of the teeth gives.
Your system can be unlocked by the combination of Dr. Brian (who is specifically trained in how the chains in the body impact each other) and a postural therapy dentist (who is specifically trained to help identify appropriate adjustments).
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Dr. Connie Brester, DDS and Dr. Brian Coleman, DPT collaborating on a patient
How does
dental postural therapy work?
Patients who would benefit from postural dental therapy will typically use one or both of the following devices based on objective testing for their body:
1
Pattern altering dental appliance (splint). A splint can change body position both through mechanical and positional sense of the jaw as well as neurological sense of how the teeth fit. Your body references certain teeth for directional shift in your body. This can be used to your advantage to help guide the body where it needs to go or to prevent it from being directed in an undesirable manner. A splint allows for the occlusal surface to receive different feedback. We desire to allow for unilateral alternating ability for molar contact and canine guidance. This allows for relaxation of muscles of the jaw and neck to achieve normal position and proprioceptive sense from teeth to guide grounding forces through the body.
2
Alternative lightwire functional (ALF). An ALF can give an altered sense to the palate, swallow, and tongue to create similar effects. Dr. Brian and Dr. Brester ensure access to specific contact points through your palate and calibrate the device with additional body testing to make sure you get the desired result of free body movement. This allows for improved sense of swallow and tongue position and decreased cranial strain through light pressure for rotation of the palate. This may allow for decreased neck tension and improve rotational sense of the body.
What to expect at your
postural dental
appointment
Once Dr. Brian has determined you would benefit from postural dental therapy, he may recommend an evaluation with Dr. Connie Brester, D.D.S., at Brester Dentistry in Camas, Washington.
Dr. Connie Brester, D.D.S.
An initial evaluation by Dr. Brester would include an airway and craniofacial exam. If a dental appliance has been recommended, your initial delivery appointment will be with Dr. Brester for fitting the appliance. The next visit will be for calibration of the dental appliance. This would include Dr. Brester and Dr. Brian working together to make specific adjustments to your appliance to ensure freedom of movement through the body.
Additional adjustment appointments may be required as your body changes. If you are able to maintain your movement options, activity no longer produces symptoms, and you have completed your therapy program you may be able to transition out of your appliance or reduce wear time.
How to wear your dental appliance
This will vary for each patient but typically you will want to wear your device as often as possible initially. It may be removed to eat or in situations you feel uncomfortable wearing it.
Over time the goal is to gradually reduce the use of the appliance as your body has learned a new resting position and has new movement strategies on which it can now rely. Transitioning to wearing the appliance only with sleep is common. This process will be guided by assessments performed during your normal sessions with Dr. Brian.
While wearing your device you do not need to have your teeth touching it for it to be effective. Your body will still receive the appropriate feedback. You want a normal resting position with your tongue at the roof of the mouth, lips closed, and teeth slightly apart.