I pride myself on my diverse knowledge of biomechanics, anatomy, neurology, adjusting technique (including SOT), and craniopathy but I was truly overwhelmed by the depth and scope of the information offered at SOTO-USA’s “HOT” Conference in Jacksonville in regard to treating the TMJ.

My previous working relationships with dentists consisted of (a) the DDS adjusted the appliance until the patient developed symptoms, then (b) sent them to me to “put out the fire.” I, on the other hand, adjusted the patient’s musculoskeletal and cranial systems until the symptoms subsided, at which point (c) I sent them back to the DDS and the cycle was repeated. There was little attempt at communicating and even less understanding between us concerning our methodologies. Drs. Carlson, Rose, and Walker introduced me to a whole new approach.

On one hand I learned how our two professions share basic similarities (just different points of view). Dr.Carlson demonstrated the relationship between the condyle of the mandible and its point of articulation with the temporal bone (the articular eminence).

The articular eminence forms the anterior border of the TMJ. It defines both the A-P as well as the S-I “glide path”of the condyle as the mandible opens and closes.

He then showed how the slope angle of the articular eminence affects the glide path of the condyle and the way this affects the way the teeth inter-digitate. For the first time, I was able to see from a dentist’s maxilla and ultimately, the TMJ. And I was also able to see how I, as a craniopath, could significantly affect the slope of the articular eminence by directing my attention to the movement pattern of the temporal bone.

        The Effect of Slope on the Articular Eminence and TMJ

        Moderate Angle (Class 1)
        A moderate degree of overbite is found at closure.

        Steep Angle (class 2)
        The steeper the angle, the further the condyle drifts posterior and superior at closure.
        This steeper angle allows the overbite to increase, causing a retrognathic mandible.

        Shallow Angle (class 3)
        The shallower the angle, the further the condyle drifts inferior and anterior at closure.
        This shallower angle allows the overbite to decrease, causing a prognathic mandible.

On the other hand, I learned we have some fundamental differences. The ultimate goal of the dentist is to create an optimized bite pattern (“optimized plane of dental occlusion”) in order to achieve a stable, static relationship between the mandible and the maxilla. In contrast, the craniopath’s goal is to promote free and unrestricted movement of the cranium. That’s like saying that their purpose is get the pudding to set while ours is to keep it liquid.

The Effect of Temporal Rotation on the Articular Eminence and TMJ

The temporal bone rotates EXTERNALLY during the inhalation (expansion) phase of cranial motion and INTERNALLY during the exhalation (contraction) phase.
This has a direct effect on the angle of the slope of the articular eminence.

        TEMPORAL BONE in NEUTRAL
        Moderate Angle (Class 1)
        A moderate degree of overbite is found at closure.

        TEMPORAL BONE RESTRICTED in INTERNAL ROTATION
        Steep Angle (class 2)
        When the temporal bone rotates anteriorly (internal rotation) it steepens the angle of the articular
        eminence, causing the condyle to drift posterior and superior at closure.
        As the temporal bone rotates internally the overbite increases, causing a retrognathic mandible.

        TEMPORAL BONE RESTRICTED in EXTERNAL ROTATION
        (Shallow Angle (class 3)
        When the temporal bone rotates posteriorly (external rotation), it reduces the angle, causing the
        condyle to drift inferior and anterior at closure.
        As the temporal bone rotates exteriorly the overbite decreases, causing a prognathic mandible.

How, then, can we ever hope to work together?  One answer was offered by Dr.Walker and his “Chirodontics” program which is designed specifically to create common ground between our two professions. It stresses that our mutual goals revolve around stabilizing the patient’s biomechanics and not just moving the teeth or cranial bones. It features a unique series of evaluation and correction techniques which dentists and chiropractors can use TOGETHER to treat patients. The schedule for Dr. Walker’s program is available online at Chirodontics.com.