This month we have two very exciting topics to discuss. For the many readers who have ordered the "Curl TMJ Kit" from the LACC library (Mrs. Saab, 310-947-8755) make sure you update your "Kit" with the two articles we are discussing this month.
Today we'll look at two publications by Harvey Getzoff, DC and Albert S. Chinappi, DDS. Both of these articles appear in JMPT under the following citations: AS Chinappi, Getzoff, H. A new management model for treating structural based-disorders: dental orthopedic and chiropractic co-treatment. JMPT, 1994;17(9):614-619. AS Chinappi, Getzoff, H. The dental-chiropractic co-treatment of structural disorders of the jaw and temporomandibular joint dysfunction. JMPT, 1995;18(7):476-481.
If you don't already subscribe to JMPT (shame on you) now is the time to order it. As I have said so many times, our chiropractic literature is packed with great stuff for the hard working clinician.
Is There a Connection?
Drs. Chinappi and Getzoff's first article presents a model for treating structural disorders of the skull through an integrated approach between chiropractic and dental orthopedics. Here, their model requires close cooperation between the dentist and the chiropractor as well as demanding a strong role from the patient. Their model holds that the dental bite, spine, pelvis, and cranium are determining factors in functional health of the body.
Hence, as you would expect, they do not recommend treating isolated segments of the body. Rather they urge that the jaw, cranium, spine and pelvis be approached as interrelated parts of the whole body.
Their co-treatment model entails analyzing the patient from a developmental and postural perspective. Naturally, the dentist and the chiropractor contribute their individual expertise in these areas and it is the summation of their expertise that makes the analysis complete. Here, the authors provide the clinician with detailed road maps on how this analysis is carried out during all the stages of patient care.
The treatment goals of their model is built upon the concepts of improved function, rather than relief from pain. Their operating principle is that if the treatment goals are reached, the patient's symptoms will be diminished greatly, if not completely. At the very core of their strategy is a high degree of integration between the dentist, chiropractor and the staff of each office. Virtually everyone plays a critical role in the management of the patient. Once again, the authors provide lots of detail for the clinician on the treatment goals and objectives.
If you have ever asked yourself, "How can I work with a dentist?" then this article is a must read.
A How-to Approach
Drs. Chinappi and Getzoff's second article presents an actual case demonstrating their concept of integrated dental-orthopedic and chirocranial care for treating structural disorders of the jaw, neck and spine. Here, they present a woman seeking care for headaches and a popping jaw who then develops back pain. Their combined analysis of the patient revealed important dental and chiropractic structural and functional disorders from the head to the toes, so to speak. Once identified, they knew just how to manage the patient's complaints.
Hence, as you would expect, they approached the patient from the perspective that the position of the jaw, head and neck are intricately linked. Through a well-planned co-treatment approach, they eliminated the complaints while improving head, jaw and dental alignment.
The authors state that their co-treatment was the basis for their success. The chiropractic treatments enabled the body to respond better to the changes desired by the dentist. As the body adapted, the dentist was better able to urge the body forward towards proper alignment which is somewhat difficult for the dentist to do all alone.
Their article is packed with information that the busy clinician can use right away in their office. All through the case study, the authors drop wonderful pearls of wisdom.
Best of all, they remind us that the chiropractic-dental team is a valuable one one where the best interests of the patient are well served.
With each article I encourage you to write the questions you may have, commentaries on patient care, or thoughts to share with your colleagues, to me at the following address. Please include your return address.
Darryl Curl, DDS, DC
2330 Golden West Lane
Norco, California 91760
E-mail: doc_curl@ix.netcom.com
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