Connect • Contribute • Care

The wagon trains of dental theory are circling and you need to know which ride is going to be the best for you. The dust storm that these two wagon trains are making in the dental profession is intense. The whips are out and the horses are all in a lather.

I will jump into this wild-west dentistry fray knowing full well - my hide might get chapped in the flurry of leather. I am not a dentist - but have tried to do my best to decipher the smoke signals of clinical language these clinicians have presented me with. Hopefully, you and I will be able to move forward without getting trampled.

Centric Relation is an older dental theory that relies on a theory of jaw, head, and teeth relationship (in general). Neuromuscular dentistry, a "newer" theory, tries to achieve the proper resting position for your jaw: muscles being given more prominence in the therapy (in general).

Basically, if you don't start with everything in your mouth region in the best position, pain might ride shotgun on your life journey. Everything should be right before you alter the mastication environment, like building the teeth up with crowns and things. Or so say both sides in this occlusal-wagon-mastership, duel-to-the-death-of-a-theory ride.

(Occlusal function or occlusion is how your teeth come together - in consumer parlance.)

I say in general - because I am only an armchair wagoneer. Or we can all wait a few years and it will be just like the Theory of Evolution - everyone will agree because it is the law of the land. Okay, bad example.

Anyway, Randall Dale, a dentist, is someone that knows his stuff -- or possibly believes I was once a monkey or at least my ancestors were -- but thinks neuromuscular is the way to go.

Randy has one of those articles with actual factual type markings and notations. What is that about anyway? The time it must take to write something with real research notations in it. I like opinions much more.

Sticking with opinions makes life so much easier. Challenge me about wagon train trivia - not my health.

Dr. Peter Dawson (who wears the ten-gallon hat in the CR field) comes down pretty hard on some of wagon master Randy's cohorts. Pete slings quite a few arrows at William Dickerson who is the wagon foreman at LVI - a dental institute in Las Vegas. Bill thinks neuromuscular dentistry is the best way to go. He let Pete's camp know this. Pete thought Bill's ideas were presented in less than neighborly ways.

Pete and Bill are the "masters" of these dental wagon camps. These guys need a new team of horses every few miles in their rowdy trail ride over dental theory land. Watch out for the barbed wire they leave in their dust up.

Honestly, I am not sure who is right. Centric relation has been around for many years - and I am usually wary of the old guard with their ready for the glue factory ideas. Yet jumping on some new wagon just because you saw a few people rhapsodizing about the Kool-Aid being brewed over the campfire can also be an unsatisfying experience.

New theory wrangling is always fraught with some kind of learning curve for all involved. Just because you hear of some people with positive results does not mean every dentist is riding with a firm grasp of the reins.

Heck dental colleges barely know about this Neuromuscular stuff, let alone teach it with vigor - as far as I know. This could mean it is wrong or that the CR people have locked up the wagons.

However, if you have tried the centric relation method and it has NOT worked - you still have pain or other oral issues - should you keep doing the same thing until it works? Maybe the dentist does not have the training to rein in the problem or "perhaps" centric relation is unbridled horse hooey.

Neuromuscular dentistry (ND) could be a seemingly virile equine without a chance to pull his weight into the next generation. Is ND a mule or a horse? ND needs to be able recreate success successively to be accepted by more dentists and new theories do not have decades of deep data to throw around.

So what do we do? First, ask questions of your dentist and a few others. Second, determine your own risk tolerance. Third, ask more questions and make sure your chosen dentist can back it up with experience and examples of their own work and training. The whole concept and process should be carefully explained with proper data that relates to YOUR symptoms and condition.

Finally, realize that ALL health related solutions have some element of theory in them. This does not mean it is wrong - or that it will not work for you - but that each human body is so damned unique in its ability to baffle even people that have lots of "corroborated facts" in their writings and rants.

Think about the cancer treatments that work for just a small percentage of people, but are still offered to most. The clinicians have not nailed down all the boards on these treatments either. Does this mean they should wait until they identify exactly the right cancer treatment even though it might be ten years away? While your dental health going bad is not as scary as cancer, waiting 20 years to solve an oral pain issue can get very close.

My limited knowledge of the exact, clinical things going on in your head, mouth, and face relegates me to an armchair wagon master, but I think Centric Relation works. Incongruously, having traveled around the globe in my armchair wagon I also am bi-polar in my reasoning so I also think Neuromuscular Dentistry works.

Amazing how it works in my head. Talk about scary and painful.

What I am trying to say is that new theories are helpful in moving us forward and opening our eyes. Theory development is fraught with doubt, mistakes and some missing factual links - or at least missing links some of us want to see.

But we need to be challenged or we will always believe that a tooth fairy (in a nice white Stetson hat) anointed the people before us with all the right solutions.

Centric Relation is not wrong because it is OLD. Neuromuscular Dentistry is not wrong because it is NEW. Both might help us in some ways - and hurt us in another - depending on our oral situation.

Bluntly, we consumers need to do a better job of "diagnosing" our own dental care, which we often do to our detriment. We need to find a way to do it in a positive way. Rather than just looking back while riding into the sunset, we need to look into the sun more often and actually move our wagon towards the light.

CR dentists have a theory with facts to back it up. ND dentists have a theory with facts to back it up. This is confusing. But the common cold seems to have stumped a few in the health profession, too.

We can be scared of change OR jump too early on the latest wagon train going by. It is not easy to determine the right one.

I think we need to ask Pistol Pete, Texas Dandy Randy, and Wild Bill why we should believe anyone of them and then take it from there. Step off the wagon - get your feet on the ground and realize it is still up to us to decide and rein in our own care.

We might not have evolved from apes (my legs are very hairy so I am concerned) but maybe we need to evolve beyond fantasyland, wagon rides, and doctors who know it all.

I would also like to thank Dr. Martin (The Mumbo Jumbo Killer) Spiller who drops all this occlusion confusion into a language a wagon train outsider can almost understand. Not that I have drank his Kool-Aid or anything - actually never let a wagon master make you coffee or a dentist make you Kool-Aid.

Sincerely,
RAC

Connect - Contribute - Care
Be part of our community • The consumer needs your input too!