Case Study: Dental Integration
Diane was referred to our clinic by another [PRI trained] physical therapist with primary complaints of headaches, neck and low back pain, dizziness, and bilateral hip pain. She had been through a good PRI (postural restoration) physical therapy program with her refering physical therapist but was never able to maintain a state of neutrality in her hips and thorax and never able to reduce tension in her neck. She was referred fro us to consult whether dental or visual integration might be helpful.
Diane had a significant malocclusion or poor tooth positioning where she was missing her first right maxillary and mandibular molars and had a bilateral crossbite with Class 3 (underbite) bite.
After an initial evaluation with a Hruska Clinic PT, Diane recieved an oral device called a Mandibular-Molar Occlusal Orthotic (MMOO) (see Image) with help from Dr Chris Campbell, a local dentist that we often integrate with for cases like this.
Once Diane recieved her MMOO she immedaitely had decreased neck and back tension, improved hip, neck and shoulder mobility (was neutral), and had no hip pain or headaches. See pictures below for some of the objective changes with Diane with and without her MMOO device in between her teeth.
Diane’s Left anterior Crossbite (note how her bottom tooth overlaps her top teeth) this can have a dramatic influence on neck mobility.
Diane’s missing molars on the right side and “open bite” with an inability to feel her teeth touch also has an impact on neck and postural positioning.
No Splint: Limited neck rotation to the right
No Splint: Limited neck Rotation to the left
No splint: Limited left straight leg raise
No splint: Limited left hip adduction (knee should touch the mat)
Following calibration and fitting of her MMOO at the dental office these immediate changes occurred (and were expected)
MMOO fitted: Full neck rotation to the right
MMOO fitted: Full neck rotation to the left
MMOO fitted: Full (90 degrees) left straight leg raise
MMOO fitted: Full left hip adduction (knee to the mat)
When Diane was asked to describe how she felt (without prompting) in the MMOO in her own words she felt…(see video below)
1) Like she wasnt leaning to the right anymore
2) That her body wasn’t in as much pain. Her hip was not sore and her headache was gone
3) She could move her head from side to side without pain
4) She could feel her left foot on the floor and her left leg where before she could really only feel her right leg
This case study does a great job highlighting the impact that someone’s occlusion, or fit and feel of their teeth, has on their entire body in the way it can move and what muscles have to be tense for upright posture. Diane will now be working with her primary PT on learning how to utilize this new posture, orientation and flexibility.
If you have questions please don’t hesitate to contact us!
Diane walking without her splint in.
Notice her leaning to the right, her head tilting to the right and her arm swing with less right forward swing compared to the left.
Diane walking with her splint in.
Notice her body more centered between her legs, more even arm swing and hip shifting.
Diane in her own words!