The importance of the relationship between cranial osteopathy and dentistry cannot be overstated. Conditions affecting the mouth and teeth have a very direct effect on the rest of the body, and a treatment programme can be seriously impeded if these conditions are ignored. The face is a complex bony structure composed of a number of different bones. Some of these bones are very delicate, and they are intricately linked together in a very complex way. All of the bones of the face, like those in the rest of the skull, are free to move very minutely, which they do in a gentle rhythmical fashion. This movement between the bones is important in maintaining free drainage of the sinuses, and permitting the free passage of air through the nose.

Trauma to the face may restrict the normal movement between the bones, and can have very wide reaching effects in the whole body. One of the most common causes of trauma is dental treatment. Common (dental) causes of stress in the face Extraction of Teeth The forces used to extract teeth may be transmitted through to the articulations and joints of some of the delicate bones of the face. This may strain and disrupt their normal movement.

Common Symptoms:- Sinus and ear problems, headache, migraine, neck or lower back pain The immediate pain and tenderness after an extraction can mean that one side of the mouth cannot be used for chewing, thus creating an unequal bite with resultant strain on the rest of the face, head and neck. This situation can persist if there are gaps left between the teeth, particularly if more than one gap exists.

Dentures and Plates An upper plate or denture has the effect of holding the bones of the upper jaw rigidly together, preventing or severely limiting the natural movement between them. Common Symptoms:- Headache, congested sinuses, ear problems, eye strain. Prevention:- Plates and dentures should be removed at night to allow the face to free itself for some hours during each 24 hour cycle. Loss of all the teeth leads eventually to a loss of bone from the face. It is important that the correct distance or height between the upper and lower jaw is maintained. If the height of the teeth is wrong this can cause imbalance in the action of the jaw muscles and a marked degree of tension in the face and jaw. Dentures should be replaced regularly as they wear down, and may have to be built up to allow for bone loss over a period of time. No back teeth Occasionally people have all their back teeth removed leaving just the front incisors. If no dentures are worn, all the biting and chewing is done on the front teeth. This places enormous strain on the structures of the head and neck. It almost always leads to a great deal of neck tension, causing headaches and neck pain

Braces and Orthodontic work Orthodontic treatment has a dramatic effect on the normal functioning of the face, and can have repercussions throughout the whole body. Enormous stresses are imposed through the bones of the face as the teeth are forcibly moved into their sockets. This restricts and disrupts normal motion of the facial bones. Common Symptoms:- Headache, clicking jaw, painful joints particularly the knees, irritability, reduced concentration, neck pain, lowered immunity and increased vulnerability to musculoskeletal strains. After the brace is removed:- The stresses do not always dissipate, and are almost always palpable many years later in adults Osteopathic Treatment is Strongly Recommended Before the brace is fitted, to reduce the underlying stresses as much as possible During the time the brace is being worn, occasional treatments to help the body to accommodate the additional load reduces the secondary symptoms and also helps the teeth to move quicker After the brace is removed, osteopathic treatments to reduce its long term effects.

Bridges Bridges generally cause no problem with the mechanics of the face. The exception is a midline bridge across the two upper front teeth. In this situation the bones of the upper jaw become permanently fixed together, which prevents normal movement between the bones. Common Symptoms:- The stress induced by a fixed midline bridge will highlight any area of weakness in the body. Symptoms can be almost anything – headaches, sinus and ear problems, neck and back pain, even knee or foot pain.

Clicking Jaw Pain and clicking in the tempero mandibular joint is fairly common. There are many causes, one of which may be imbalances and stresses through the face or teeth, and osteopathic treatment can sometimes help. Bruxism (grinding teeth) Many people grind their teeth at night or clench their jaw when they are concentrating or under stress. In children, night grinding may be the result of pressure in the head of face from retained birth compression. Common Symptoms:- Tension, tenderness and irritability in the muscles of the face, head and neck.

How can Osteopathic Treatment help? It may seem after reading this that any dental treatment should be avoided! This is definitely not the case, and much dental work is skilfully performed with the minimum of stress to the mechanics of the face. However, it does highlight the very important connection between stresses resulting from dental treatment, and the types of problems that osteopaths see. The wide subject of facial mechanics is a fascinating one which is often relevant to the patients presenting symptoms. Many of the above problems can be successfully treated osteopathically. Obviously if there is a dental problem that is consistently aggravating and causing stress, it is important to have this dealt with by a dentist. Osteopathic techniques used to treat strains within the face are very gentle.

Text taken from patient information produced by Elizabeth and Clive Hayden