Patients complaining of pain in tooth bearing regions of the oral cavity may be suffering from a disorder unrelated to pulpal pathology.
Unnecessary dental procedures may complicate the diagnosis and aggravate the underlying disorder. Referral of pain to the oral cavity and teeth may easily be explained by the extensive neurological connections of the trigeminal brain stem complex with other cranial nerves and input from the upper segment of the cervicalspine.
Accurate diagnosis of pain ful disorders can be a complex and time consuming process. The primary responsibility of the dentist in this scenario is to rule out the possibility of arising in tissues that give origin to the teeth. (Canavan D: A dental perspective on headache. Journal of the Irish Dental Association. 50(4):164-6, 2004).
This following study evaluated the effect of changing mandibular position on body posture and reciprocally, body posture on mandibular position. Forty-five (45) asymptomatic subjects (24 males and 21 females, ages 21-53 years, mean age 30.7 years) were included in this study and randomly assigned to one of two groups.
The MatScan system was used to measure the result of changes in body posture (center of foot pressure) while subjects maintained the following 5 mandibular positions: (1) rest position, (2) centric occlusion which is the relation of opposing occlusal surfaces which provides the maximum planned contact, (3) clinically midlined jaw position with the lips aligned, (4) a placebo wax appliance, worn around the lip surfaces of the teeth and (5) right eccentric mandibular position.
The T-Scan II system was used to analyze jaw closing force distribution in two postural positions, with and without a heel lift under the right foot. Total trajectory length of center of foot pressure in centric occlusion was shorter than in the rest position. Center of foot pressure area in right eccentric mandibular position was larger than in centric occlusion.
When subjects used a heel lift under the right foot, occlusal forces shifted to the right side compared to no heel lift (p < 0.01). Based on these findings, it was concluded that changing mandibular position affected body posture. Conversely, changing body posture affected mandibular position. (Sakaguchi K, Mehta NR, Abdallah EF, Forgione AG, Hirayama H, Kawasaki T, Yokoyama A: Examination of the relationship between mandibular position and body posture. Cranio. 25(4):237-49, 2007).
Is this really possible? I received a new AFO brace for my right leg in late December 2008. It includes a built-in foot lift. I wear it unless I am at home. In February I began to experience tingling on the left side of my neck. It progressed to muscle pain on the left side of my neck, and grew into a feeling almost as if I am being choked on the left side. I was also having a great deal of dental work done, including implants on the bottom. I have had an MRI which does not explain the pain. I cannot lift or carry anything without aggravating the pain. Thanks! Jean