There is a growing trend for dentists and osteopaths to work together, which makes perfect sense because there is a fundamental relationship between proper, balanced movement in the face and mouth and in the rest of the body.
There is also an increasing volume of shared expertise and knowledge regarding cervical, head and jaw pain or discomfort. At its simplest level, sometimes a common toothache may be due to restricted neck movement or the result of a trapped or inflamed nerve which irritates a facial nerve, causing pain.
‘Just as the work and skill of dental clinicians does not begin and end with an open mouth of teeth, osteopaths work with more than muscle and bone’
More and more dental practices now offer access to other health care professionals such as Osteopaths, massage therapists and acupuncturists where patients have a range of diagnosis, clinical treatment and pain management options.
Dr Diane Photay is a firm believer in such collaboration. She says: ‘Our dentists and osteopaths have been working together for several years with successful results. When all other dental avenues have been investigated as to the cause of pain, and there is no dental origin, after a consultation and treatment with our osteopath, we realise the pain is coming from the neck, or even elsewhere in the body.
It never ceases to amaze us how a pain in the mouth could actually come from another part of the body. Each time it happens, we are reminded how well dentists and osteopaths work together.”
Of course, each healthcare professional will take a different approach to diagnosis and treatment; for instance in dealing with TMD the dental practitioner will consider stress levels, bite and possible bruxism before suggesting treatment which could include bite guards, splints and jaw exercises.
The osteopath will also try to establish the root cause of TMD which may be linked to the upper cervical spine or muscular imbalance and treat accordingly, with manipulation, massage or an exercise programme.
There is a clinically recognised connection between occlusion and the patient‘s health, which can lead to headaches, neuralgia and other common complaints.
When a patient presents with headaches, an osteopath will try to establish the cause which could be linked to neck, cranial imbalance, stress, diet and lifestyle, posture, low back pain or an incidental onset.
A dental practitioner will invariably check the bite and perhaps treat with a splint as incorrect bites are a common cause of headaches.
Many problems that confront an osteopath will be developmental, and a contributory factor is often birth trauma.
Dentists are familiar with this and aware of its significance which means they can advise on early preventative treatment when alerted to habits in children such as thumb-sucking, tongue-thrusting, biting the lips, sleeping only on one side of the face, breathing through the mouth and early or late loss of baby teeth.
These are all indicators of difficulties that should be treated as soon as possible and a good example of how osteopathy and dentistry can be complementary.
Trigeminal neuralgia would usually be treated with medication by a dentist or specialist and an osteopath would most probably consider a link with cranial imbalance or hypertonic muscles, having first eliminated a pathological cause.
Early diagnosis, treatment and prevention of recurrence is the main aim of all health professionals and there are clearly excellent reasons why having a range of treatments and therapies under one roof could be of great benefit to patients, practitioners and the practice generally.
Patients are increasingly seeking more natural and holistic treatments and are far more aware of stress-related health problems which can often be effectively dealt with by massage, mobilising joints, relaxation techniques and exercises along with acupuncture and other therapies.
Dental teams are well aware of the importance of diet, oral hygiene and regular checks.
By working with colleagues who can help the process of patient awareness and responsibility , the practice can extend its reach to a wider range of patients and also help ease the anxieties and discomforts of nervous, elderly or very young patients, particularly during a lengthy period of dental treatment.
A young woman came to see Dr Photay complaining of severe pain and pins and needles in the jaw. The examination revealed no dental problems so Dr Photay asked osteopath, Nina Blackstock to come in.
She palpated the neck and found there to be restrictions in the upper cervical complex and a great deal of muscle hypertonicity in the neck.
Following palpation and the responses to her questions, Nina was confident there was no pathological cause or risk of spinal or disc injury but, in order to completely rule this out, the patient was referred to hospital for further investigation.
However, she was in so much pain and discomfort, she could not wait for the hospital appointment and decided to pursue osteopathic treatment.
After the first appointment, the patient noticed an improvement in her symptoms and by the time her hospital appointment arrived, her pain and pins and needles had completely cleared up.
With the use of osteopathic manipulation, deep tissue techniques and exercises the patient carried out between visits, not only did the patient no longer get any pain in the jaw, she also noticed she had more movement in her neck and her headaches had gone.
Just as the work and skill of dental clinicians does not begin and end with an open mouth of teeth, osteopaths work with more than muscle and bone.
Remember the song, about the leg bone’s attached to the thigh bone’s attached to the hip bone and so on?
Just as there’s a body attached to the head, there’s no good reason why dental practitioners could be – if not attached – then at least more closely linked to osteopaths. It could prove to be the backbone of a very successful partnership!
Dr Diane Photay BDS (London) AKC qualified from Kings College Hospital Dental School in 1978. She opened up her own NHS dental practice in Gravesend, Kent in 1986 and within a decade that had developed into a four dentist practice.
In 2001, Diane expanded further, opening a private dental practice, HealthCare Elite, also in Gravesend, with a special interest in cosmetic dentistry. Diane is also a clinical director of CosTech Elite Dental Laboratory where she is able share her experience with technicians and other dentists. Working alongside her daughter Nina, a qualified osteopath, Diane is a leading advocate of collaboration between osteopathy and dentistry.
Nina Blackstock BSc (Hons), D.O., N.D., Diploma in Cranial-Sacral Therapy, GDC-reg. Dental Nurse
Nina grew up in a family of dentists and indeed, worked within the family dental practice from the age of 16. Nina inherited not only the strong family work ethic, but also the desire to help people but when the time came for her to go to university, she did not choose dentistry. Instead, Nina qualified as an osteopath and in 2004 returned to the family business, setting up an Osteopathy clinic within the dental practice. That has proved such a success that Nina took on an associate, which also allows her to manage the family business, HealthCare Elite, a multi-disciplinary clinic.