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resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
Online Marketing Basics: Google Ranking, Part 1
We all know there is so much opportunity with online marketing. And, let's face it, if you don't have a presence online with a website and social media, you are probably not where you want to be.
Medicine as Metaphor
The practice of medicine is both an art and a science. We study and learn the system so that when the time comes to apply it, there is a greater possibility of successfully helping others.
Colon Health and TCM
I still remember many years ago, the loud "Yuck" from my wife at the time when we were together watching the Chinese movie "Last Emperor."
Abdominal Acupuncture for Eye Healing: The Sacred Turtle and Ba Gua Map
Our ideas about western medicine have shifted in recent decades, while the public is asking more from health care providers.
Adding Microneedling to Your Clinic for Results and Profit
Microneedling has taken the beauty world by storm over the last 10 years. Under the names dermaroller, microneedling or skin needling you will see these treatments listed in the services of nearly every fashionable beauty salon and day spa in the country.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
Can Acupuncture Treat Knee Pain?
Recently, an article in the Journal of the American Medical Association concluded that, "neither laser nor needle acupuncture conferred benefit over sham for pain or function" among older chronic knee pain patients.
Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
Melatonin: A Promising Natural Agent in the Prevention of ALS
A number of years ago, experimental studies suggested melatonin could block key steps in the development of Alzheimer's disease, primarily by acting as a brain antioxidant and inhibiting the build-up of beta-amyloid plaque in the brain.
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
The Roots of TCM in Depression Treatment
In traditional Chinese medicine, there is historical precedent for the treatment of so-called "Shen" (Heart-Mind) disorder, or disorder/dysregulation of the spirit, which is also considered as distinct but not separate from the cognitive function of the brain.
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
The Art of Creating a Healing Space
I always advise my graduates to examine their group practice or treatment rooms with fresh eyes after they leave my CE workshops. I tell them, "Ask yourselves - is your space qi filled, welcoming and healing? Or is it cold and clinical?"
The Source-Luo Point Combination, Part 3
Dr. Nguyen Nghi (NVN) was born in Vietnam and is one of the most important scholars, writers, teachers and practitioners of modern time. Many of his theories and applications are the source of modern teachers from Europe and the United States.
The Integrative Medicine Puzzle: Putting the Pieces Together
The conversation is changing in the broader healthcare community with patients actually moving the discussion toward more integrative topics. Patients today want to know their options.
Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
Exploring and Learning from the Gift of Life
I'm grateful to have had the opportunity to teach cadaver dissection classes and workshops with Stephen Cina at the New England School of Acupuncture over the past seven years, first through the Sports Medicine Acupuncture Program and later as a NESA elective course.
Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
July, 2009, Vol. 09, Issue 07
The Progression of Airway Obstruction, Part 2
By Dale G. Alexander, LMT, MA, PhD and Thomas M. Walsh II, DDS
Note from the author: This article is co-authored by Thomas M. Walsh II, DDS. Dr. Walsh is the principal author of these "Airway" articles; feedback, questions, or observations may be sent to him via .
In our last article "The Progression of Airway Obstruction," we illustrated a normal airway, an abnormal airway and described a number of progressive disorders that may evolve from this abnormal growth during childhood. The clear assertion of this article series is that normal development requires that air be able to flow through a clear and unobstructed airway from the nose through the throat and bronchial tree ending in the lungs.
In this article, we are describing more of the anatomy of normal facial and dental growth and identifying the primary factors that alter this progression. The most obvious sign of airway obstruction is mouth breathing. At first thought mouth breathing seems natural. When we exercise heavily we can breathe better through our mouths. However, nasal breathing is a cornerstone of longevity. Nasal breathing warms, moistens and filters the air that we breathe. Further, the tongue can remain in its proper "home," the roof of the mouth.
As massage therapists, we can train to quickly identify people with airway disorders and make a difference. Stop, look and listen. When you see and hear the signs and symptoms of airway disorders explain what you are learning from this article series to your clients. Many of these people have sleep disorders. Refer the person to their dentist, family physician or, to an otolaryngologist, nutritionist or registered dietitian. Finally, explain to them that medicating a structural problem may not be the only option.
Let's review the gross anatomy of the upper jaw (maxilla) for a moment. The maxilla houses all of the upper teeth, sinuses and the nasal cavity. The roof of the mouth is actually the floor of the nasal cavity. The shape and location of the palate defines the amount of nasal and oral volume. The size of the maxilla determines the total volume of air that can be transported down to the lungs via the nose and throat.
Every time we swallow correctly, the tongue compresses against the palate. This upward and outward force directs the upper jaw to expand in a lateral and anterior direction in a growing individual. The maxilla grows properly in both size and direction because of a normal swallow and tongue pressure. In a normal swallow the lips and muscles of facial expression remain passive. The erupting teeth are guided into a proper position by the outward push of the tongue against the inward pull of the facial muscles.
A normal maxilla exhibits the following anatomical features: a wide broad low flat palate, forward protruding teeth, a wide and tall nasal chamber with plenty of room for both filtration and airspace. Individuals with a broad wide smile most likely have a nicely formed maxilla.
If the nasal airway is obstructed or insufficient a person may convert to abnormal mouth breathing. Mouth breathing during childhood development causes the tongue to leave its normal position in the roof of the mouth and posture lower toward the floor of the mouth. Absent tongue pressure against the palate allows the inward pull of the external facial muscles to direct the teeth inward and the maxilla fails to expand outward and forward properly. Open mouth posture (from mouth breathing) requires facial muscles to pull downward on the lower jaw. Consequently the angle of the lower jaw grows more open and the face elongates. The mouth is growing open while the nasal cavity is failing to develop.
Gradually the orbicularis oris muscles will strain to bring the lips together. This pull of the lip muscles to close the mouth then misguides the upper front teeth, gums and bone downward. This can result in a "gummy smile." Many times the upper front teeth are tipped inward. This traps the lower jaw from growing forward gradually squeezing down on the oral airway. It can drive the lower jaw backward and compress the temporomandibular joints which provokes symptoms such as jaw pain and headaches, clicking jaw joints, dizziness and vertigo, and compression of the superficial temporal artery.
Abnormal function has created the abnormal form of the face. The function of constant breathing through the mouth acts to stifle the proper growth of the face and further reduce the airway. Form follows function and function follows form. The beautiful wide broad robust healthy smile is lost.
What are the forces that create a full and robust upper jaw you ask? Or put another way, how can I get a big wide smile? It all starts at birth. Trust Mother Nature. The process of breastfeeding is a crucial one. The suckling action of the tongue pressing against the palate and then pulling downward to draw in breast milk patterns a strong tongue housed in the maxilla. Infants that are nursed for a long time (1-2 years) will have better facial development as they have stronger and properly trained tongues.
Breast milk contains a gift from mother to child, i.e., antibodies. The immune system of an infant will not develop until age 2 at the earliest. Therefore, these antibodies are necessary to protect the infant while the immune system matures. The mouth and nasal cavity house tonsillar tissue which are a vital directive part of the immune system. How will these tissues form if we alter nature's design by denying breast milk and antibodies? Will they be recruited to enlarge beyond their normal capacity? What if we introduce an abnormal diet and allergens too early?
It is Dr. Walsh's speculation that three variables: lack of breastfeeding, altered diet from indigenous to processed food and environmental allergens combine to stimulate the formation of enlarged tonsils and adenoids. These block the normal flow of air through the nose and upper throat. The result is mouth breathing, low tongue posture and you guessed it, a small maxilla, crowded teeth, a gummy smile and a small nasal chamber.
Nature completes the development of the baby teeth around two years of age. This signals the end of the nursing phase when the toddler should alter the nursing swallow and adapt to solid food. Our ancestors and still, many cultures today, eat nuts, berries, vegetables and fruits that require heavy chewing. Chewing such foods stimulate maxillary growth. These people exhibit full faces and broad smiles.
Thumb sucking and other oral habits will progressively alter the normal development of the maxilla and teeth and can contribute to a narrow high-vaulted palate and an open bite in the front teeth. This occurs again because the tongue is displaced and the outer facial muscles squeeze inward and stifle the growth of the jaws.
We now have a formula to identify clients who present with chronic head and neck problems. Look for individuals that were not breastfed, given junk food especially at an early age and that were introduced to an allergy prone environment. These will be the individuals that typically exhibit a small maxilla, crowded teeth, a small and congested nasal cavity, a reduced airway, forward head posture, lips apart posture, mouth breathing, possibly a gummy smile, and a long lower face. They will usually report pain in the muscles of the head and neck, TMJ (temporomandibular joint) disorders, headaches, sleep apnea, atherosclerosis and arteriosclerosis, acid reflux, anxiety, depression and sleep disorders, obesity and the list goes on.
Is there a better way to deal with this you ask? Prevent these problems in the first place and follow nature's design. We can breastfeed infants, eliminate junk and processed foods from our diet and eat real food. We can catch abnormal growing faces as early as possible and redirect facial growth. We can identify abnormal airways and oral muscle function and retrain it as soon as possible.
Waiting until the permanent teeth come in crowded and then extracting teeth and putting on braces fails to address the underlying problems. Treating TMJ problems and getting a continuous positive airway pressure (CPAP) for sleep apnea and taking medications for high blood pressure, headaches, dizziness, sleep deprivation and allergies fails to address the underlying origins of these progressive disorders. Yes, we need to treat people with ailments but we also need to recognize these problems and eliminate the reasons for these progressions. Nature has provided us with a clear first step to follow through breastfeeding our infants.
As massage therapists, we spend time with people. We care about our clients. Our opportunity is to serve them as part of their early prevention team. When you notice that a client is mouth breathing, do refer them to their dentist or family physician.
Click here for more information about Dale G. Alexander, LMT, MA, PhD.
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