resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
A Conversation With Dr. Betty Edmond
This month's column is an exclusive interview with Betty Edmond MD, newly elected CEO/President of the AOMA Graduate School of Integrative Medicine in Austin, Texas.
Qigong for Substance Abuse
It is commonly believed that substance abuse, in addition to harming one’s physiological state, hurts the spirit. There is also a belief that one’s spirit does not weaken due to substance abuse, but rather, the person finds solace in addiction due to an already weak spirit.
Low Back Pain in Running Athletes
After 7 million years of adapting to upright postures, the lumbar spine and pelvis have become remarkably adept at managing ground-reactive forces associated with running.
We Get Letters & Email
Our Country Needs Us Between Elections, Too; Continuing Care: We Aren't There Yet; Our Associations Need to Do More.
An Opportunity & a Responsibility
Nearly 80 Americans die from an opioid-related overdose every day, and spine-related pain is one of the principle drivers of opioid use. This unfortunate situation creates both an opportunity and a responsibility.
True Practice Mobility for the Chiropractic Profession
When natural disasters occur, chiropractors can literally travel to the other side of the world to offer humanitarian relief in less than a day. The chiropractor's license to legally practice, however, can't make it past the state line.
News in Brief
Updated Neck Pain & Whiplash Guideline; Attention, IHS DCs; New VP of Institutional Advancement At Palmer; N.J. DC Interns At U.S. Olympic Training Center; Chiropractic Society Of R.I. On The Front Lines.
Prepare for the End, From the Beginning: Wealth Building and Retirement with the Tao
Yin and yang flow into and out from one another continually. Beginnings become endings and endings become beginnings again. Wholeness and cycles are the nature of Tao.
Five Branches University Has First Hospital TCM Residency
Established in 1984, Five Branches University (FBU) has campuses in Santa Cruz and San Jose, Calif., which serve the communities of Santa Cruz, the Monterey Bay, and Silicon Valley.
Anti-Aging With Dr. Ping Zhang
Jennifer Waters, TCM practitioner and writer of the Acupuncture Today column, "Talking With the Masters" sat down with Dr. Ping Zhang to discuss aniti-aging with acupuncture.
Shoulder Rehab: Start With the Scapula
The scapula is an incredible display of elegance and movement within the biomechanics of human motion. It's evolved for mobility and stability in the scapulo-thoracic region, giving us the ability to do things that are uniquely human, such as throwing with accuracy.
Scar Reduction With Acupuncture & Microneedling (Part 2)
Protocols & treatment Timing
Flirting With Alternative Therapies
There are about as many adjunct therapies being marketed to acupuncturists as there are acupuncturists. While some may remain purist in their application of traditional Chinese medicine, others choose to explore new horizons of treatment.
The Acupuncture Channel System (Part 1)
The earliest Chinese reference to channels is in the Mawangdui Medical Manuscripts,1 which are dated to the Warring States period of the Zhou Dynasty (475 BC-221 AD). The text presents 11 channels. There are no acupuncture points listed in those channels.
The Case Report: A Valuable Tool
Case reports are a valuable form of descriptive research. The most basic form of practice-based research, a case report is a detailed account of the history, presenting symptoms, assessment, observations, treatment and follow-up of an individual patient, discussed in the context of prior and potential future research.
Another Step Forward for Chiropractic
Chiropractic is now available to 86,000-plus Latter-Day Saints missionaries and you are invited to become a provider. LDS membership in not required; our only concern is that our missionaries get the best quality care available.
Crow Like the Rooster
As we welcome in the Year of the Rooster, we look at some of its major characteristics: confidence and communication, which suits the image we have of the Rooster...strutting in the farmyard, crowing to the others that it's time to wake up.
Let's Clear Up the Collection Confusion
This is an often-misunderstood practice swirling with misinformation. First, a few basics: Insurance is a contract between the patient and the insurance company. The insurance company is simply making a payment for services or care on behalf of the patient.
A New Year and Vision for the ACA
Inadequate pain management coupled with the epidemic of prescription opioid overuse and abuse has taken a severe toll on the lives of millions of people in the United States. Every day, more than 1,000 people are treated in the ER for misusing prescription opioids.
The winter season is upon us and offers unique challenges for the clinician and patient alike. To effectively navigate through the winter season there are two main TCM medicinals, Huang Qi and Gan Jiang, to consider, as well as two important formulas which feature these two TCM treasures.
An Education in Gluten Sensitivity
A relatively new syndrome officially documented as non-celiac gluten sensitivity (NCGS) or gluten sensitivity (GS) was officially recognized and published in the new list of gluten-related disorders in 2012.
Nutrition for Menopause: Front-Line Therapy for All Phases
Of all the changes women experience during their reproductive life, there is no doubt the most dreaded are the three phases of menopause. This is not surprising since all of the symptoms associated with menopause are replete with unpleasantness.
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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