Dentistry’s Standard of Care Unable to Diagnose the Real Cause of Complex Pain Patterns
The following case represents a journey down the rabbit hole when conventionally and even “holistically” trained dentists attempt to solve complex pain patterns.
Dan Tuttle is a chiropractor from Florida. Dan was on a mission to resolve his chronic tooth, neck, and unstable sacroiliac join pain for over a year. After being treated by nine dentists, he consulted with a dentist on the West coast who referred him to my practice. The following is a Cliff Notes version of his treatment journey:
“I have a history of hypersensitivity at #19 (lower left first molar) that started in my teen years and was intermittent and responsive to SOT (Sacro Occipital Therapy) chiropractic or craniosacral therapy. Other interventions including floridation, filling, bite modification had not been helpful.
The problem had resolved itself when the lingual side of 18 (lower left second molar) broke off in 2016. The dentist I was seeing was fine with that, but later found a cavity at 18 and built the tooth back up. When he did that hypersensitivity at 19 (lower left first molar) developed again along with daytime clenching.
I lived with that until August 2018 when I turned 40 and went to a well recommended dentist to get what I believed to be an overfilled tooth at 18 leveled off. That dentist drilled and filled on 18, 19 and 20, leading to constant and increased sensitivity at 19 (lower left first molar). His substitute dentist drilled down more which made it worse and I couldn’t brush my teeth.
A third dentist said there was dentin exposed and put a layer of resin over 18 and 19. However, the sensitivity at 19 continued. I could brush my teeth at least.
Consulted a TMJ specialist who said it was pulpitis and referred to endodontist for possible root canal.
Consulted with 2 more “holistic” dentists. One said adjust the occulsion (dentist #5). The other said do the same (dentist #6). I let #5 do it first and there was some relief. Because of geographical convenience, I let #6 do another occulsal adjustment. He was angry I saw dentist #5 and took it out on my teeth. He drilled down #18 and #19 so that there was NO OCCULSION. This was extremely painful and he just kept doing it anyway in spite of my declarations that it hurt and might not be a good idea.
Outcome of that was nausea, dry heaving, dizziness, disequalibrium and inability to contact teeth with a toothbrush as well as a Category 2 (sacroiliac weakness). I called dentist #5 back who punted to dentist #7 whom she said was good with malocculsion. He was also a holistic dentist. He made me see a massage therapist who was knowledgable about the concept of cranial bones relating to occulusion. After the work was done with the massage therapist the dentist built back up #18 and 19. But he said that the real solution was I needed a daytime and night time splint. The nighttime one was a “micro O2” put out by Prosomnus which has an upper and lower portion and protrudes the mandible, preventing it from retracting at night. The daytime splint was to also hold the mandible in an anterior position. He believed that my posture (anterior head carriage), narrow palate, and retracted mandible at night were interfacing with the atlas vertebra causing the problem and preventing the tooth from healing. He did this splint therapy with nearly all of his patients. I later learned that he ultimately planned for orthodontic work with the DNA appliance (which he also used on many of his patients).
With guidance from Tom Bloink (West coast chiropractor), I requested a lower splint at night to be worn which would have molar contact only of low height (1 mm – GELB splint). It took from November 2018 to March 2019 to get a lower splint of correct height and fit. In the meantime, I wore the Aqualizer at night. When I got the lower split it had contact on all teeth. I made him drill it down to molar contacts only. I wore it at night and he insisted with eating. It broke 2-3 weeks after starting it when I was eating.
The dentist declared that only his way would work and I was at my wits end so I started wearing the micro O2 night splint which had previously be erroneously ordered. That went on for a week or 2 until my dog ate it. Several days later Dentist #7 died of stage 4 cancer.
Shim was placed on tooth #14 (upper left first molar) to stabilize the cranium. Tooth #14 relates to the thyroid and pituitary glands. The patient had an under active thyroid.
Patient had occlusal (bite) interferences on teeth #s 18 and 19 (lower left first and second molars). These two teeth relate to the sacroiliac joint. Chiropractic adjustments to stabilize the SI (sacroiliac) would not hold until the occlusal cranial balance was established.
Dr. Smith is testing the Hip Lock Test to test the occlusal cranial stability. When two sheets of typing paper were placed on the upper left first molar and the patient bit down the Hip Lock Test was strong signifying occlusal cranial balance. Without the paper shims the muscle test was weak.
One of the “Splinters” or initiators causing the thyroid to under function was glyphosate (Monsanto’s herbicide, Roundup, among others).
Dr. Smith is demonstrating his latest research finding, virtual injection. By pulsing an infrared laser beam through the homeopathic remedy into the thyroid, the frequency of the remedy is driven into the tissue and neutralizes the frequency of the glyphosate. By doing this, the toxic effect of the herbicide is erased and the thyroid can function normally.
I continued to wear the aqualizer. This entire time I had been doing various forms of bodywork including:
- SOT chiropractic and craniopathy
- Craniosacral therapy
- Osteopathic Manpulation
- Massage focused on posture modification with neurostimulation technolgies (Dolphin MPS). The same guy who worked with dentist #7.
- Lymph drainage
- Foot Orthotics (I have hypersupinated feet – high arches)
- Bioenergetics ( https://www.neshealth.com/)
The things that helped the most were SOT chiropractic and the massage therapist who understood the relationship of the structure of the cranium to the rest of the body with the occulsion. But I continued to be in pain, I continued to spiral out of control. By the end I was needing to be adjusted EVERY DAY because my SI joint and pretty much every other bone in my body would not hold. I had severe trigger points in my gluteal muscles. I had insomnia. I was developing pain on the right teeth in the back as well. The massage therapist and Dr. Decamp said all this was a result of long term postural and cranial issues and it would get better eventually. But the more I tried to fix it the worse it got.
Dentist #8 said I needed Invisalign which would correct the occulsion and hopefully stop the pain. If it didn’t in 2 years I would need 2 crowns.
Dentist #9 was Ray Silkman who referred me to dentist #10, Gerry Smith.
The rest is history…
Diagnosis of Dan’s Problem:
The primary missing piece of the diagnostic puzzle was a major cranial distortion that involved a reversed motion of Dan’s base of his skull. This placed tension along the entire dural membrane affecting his SI joint. In addition, the bite was distorted by inappropriate restorations and bite adjustments. Also one of his fillings had fallen off on the upper left first molar reducing support for his cranium. Dan also presented with an underactive thyroid and acid oral pH both of which will increase muscle spasm and ligament weakness. A faulty cranial alignment will create occlusal or bite problems which manifest in teeth hitting abnormally causing pain and sensitivity.
Therapy focused on first resetting the abnormal cranial motion. Then a shim (resin restoration on the bitting surface of the molar) was placed to stabilize the cranium, cervical vertebrae, and SI joint. Supplements were also prescribed to support detoxification and his thyroid. In addition minor occlusal adjustments were performed to remove chewing interferences.
By the second day Dan was 95% pain free. His SI joint stabilized as well as his neck. Additional time will be required for his thyroid to normalize and his ligaments to strengthen. Dan was able to eat for the first time in over a years crunchy foods with minimal to no pain. Follow-up conversations reported continued improvement in Dan’s list of symptoms. He stopped grinding his teeth at night, snoring has reduced, and sleeping more soundly. Overall Dan’s recovery was rapid considering his past history.
The key to any recovery must focus on an accurate diagnosis. Without a proper diagnosis, all treatment is faulty. Dan’s case was complex because it involved multiple disciplines. Dental structural imbalances have far reaching effects on the entire body. Unless a practitioner has training and knowledge of functional anatomy and reciprocal muscle interlinks, they will never be able to connect the dots. Unfortunately the standard of care in most professions do not incorporate integration of multiple specialties.