by Felix Liao
How could patients know about these mouth-body connections if their doctors and dentists do not?
We have seen just a glimpse of what can happen to our overall health when the mouth is left off the body map. The traditional medical-dental divide has left many patients with an impaired mouth saddled with missed diagnoses, ineffective or incorrect treatment, and big bills. A more holistic view of how the whole body works is needed.
Integrating Mind-Body-Mouth to Turn On Natural Health
Seeing impaired mouth structure as a source of health troubles is still a very new idea in 2017, even though every patient knows that the mouth is connected to the body. WholeHealth is a “wholistic” way to seeing and integrating the body’s various systems into a more functional and self-renewing whole. The science of oral-systemic links, and sleep medicine in particular, has led us to the new frontier of WholeHealth integration.
The earth is no longer flat, and adults are no longer stuck behind the proverbial eight ball of an impaired mouth and pinched airway. However, to successfully treat these conditions, health professionals must break down their “‘silo mentality” and collaborate seamlessly for high-order health.
An Impaired Mouth comes with predictable consequences baked in, and a diverse set of symptoms will normalize when impaired mouth structures (as a root cause) are corrected. This principle holds regardless of technology or appliances, which will no doubt change with time.
The case outcomes presented in this book do not represent final proof; instead, they are early precedents of what is possible when impaired mouth syndrome is recognized and properly treated with Holistic Mouth solutions. I present them with great humility and deep respect for all the researchers, professors, mentors, and patients whose generous teaching and self-less sharing collectively help make the concept and practice of Holistic Mouth Solutions.
Holistic Mouth Bites
Holistic Mouth is about the role of the mouth in whole body health. Consider getting a Holistic Mouth checkup when natural health goes wrong or does not come back.
An impaired mouth is the start of a domino effect leading to and perpetuating pain, fatigue, and many diseases resistant to conventional treatment, but it is frequently overlooked in health care today.
Behind most puzzling medical, dental, and mood symptoms lurk an impaired mouth and a pinched airway. Recognizing the mouth’s role in total health can help solve many diverse symptoms at the causal level.
Holistic Mouth Solutions is a WholeHealth approach to turn back illness and turn on wellness starting with the mouth’s structural form for supporting overall health through not only food and drink, but also airway and sleep.
Chapter Two
Good Mouth, Bad Mouth
Oral diseases and conditions are associated with other health problems.
– Oral Health in America:
A Report of the Surgeon General (1)
“Holistic Mouth” is a term I coined to put the missing mouth back into whole-body health. The mouth and its owner-operator both play pivotal roles between illness and wellness. Total health has a better chance when the mouth can do all its health-supporting functions with the right form (structure).
What Is a Holistic Mouth? Why the State of Your Mouth Matters
A Holistic Mouth has a sufficiently developed structure to support whole-body health with these essential functions (ABCDES):
Alignment of the head, jaws, and spine to alleviate pain, depression, and fatigue naturally
Breathing without airway obstruction by tongue, day and night
Circulation without dental infections or oxygen deficiency
Digestion without ingesting toxins and causing inflammation
Emotional to maintain or recover health and to feel good every day
Sleep without airway obstruction, snoring, or teeth grinding
Holistic Mouth is about the role of the mouth in whole body health. One simple measure of a Holistic Mouth is whether you sleep well and wake up refreshed consistently. Another is how quickly you recover from illness, injury, or stress.
Mouth breathing, for example, allows bacteria and viruses to get in unchecked, whereas nasal breathing comes with the immune defense built in. Snoring and mouth breathing deprive the body of nitric oxide, a blood-vessel dilator (and the active ingredient for treating erectile dysfunction) made naturally from nasal breathing.
How Your Impaired Mouth Can Harm Your Health
An impaired mouth interferes with the health of the whole body. An impaired mouth can eat, drink, talk, and even smile, but its poor form interferes with its other jobs of supporting ABCDES. An impaired mouth harms your overall health in three ways:
Poor mouth structure: crowded/crooked teeth; bad bite patterns, such as a deep overbite, underbite, open bite, or crossbite; a tongue-tie; a weak chin; a long, narrow face or flat, wide face; and so on, all of which interfere with ABCDES and cause related health troubles
Poor mouth style: misuse and overuse, as in having a sweet tooth or stress eating; neglect as in poor oral hygiene; and unhealthy habits, such as habitual mouth breathing, lip biting, fingernail or pencil chewing, tongue cushioning between the teeth, and tight-lipped swallowing that results in mouth wrinkles and “sad smile” lines around the mouth
Both
America’s health-care bills show that most mouths today are not only overused, but also structurally impaired.
Frequent symptoms of an impaired mouth can include:
Pain in the head, jaws, neck, shoulders, or back that persists despite treatment
Chronic fatigue, depression, anxiety, excessive weight gain
Snoring, tiredness upon waking up, daytime sleepiness
Teeth grinding, jaw clenching, dental sensitivity to hot and cold
Sweet tooth, bleeding gums, diabetes, brain fog
High blood pressure, heart attacks, stroke, dry mouth from medications
Increasingly crowded front teeth, mouth wrinkles forming “sad smile” lines
Broken back teeth needing crowns, root canals, extractions, or implants
Malocclusion: crowded/crooked teeth or mismatch of upper and lower jaws
Impaired Mouth Syndrome
A patient with impaired mouth can have a diverse set of medical, dental, and psycho-emotional symptoms called Impaired Mouth Syndrome. Different patients can have different combinations of the symptoms listed above, which are rarely integrated in medical, dental, or hospital assessments. For example, malocclusion has been linked to obstructive sleep apnea in a 2008 Japanese study. (2)
In 2017 America, sleep apnea patients do not get evaluated for malocclusion, nor do patients with bunched up teeth and underdeveloped jaws get evaluated for sleep apnea risk. This is the inevitable outcome of artificially dividing the body into parts and classifying treatment into medicine, dentistry, chiropractics, osteopathics, naturopathics, acupuncture, etc., when no such departmental lines exist inside the body.
WholeHealth is the holistic way of seeing symptoms as reactions to causes, and Impaired Mouth Syndrome is the collection of subjective symptoms connected to deficient jaw structure. Many symptoms go away naturally when impaired mouth structure is recognized and treated, as the case studies in this book will show.
Malocclusion: Why Dental and Skeletal Alignment Matters
A Holistic Mouth has good jaw structure, which means that there’s bone volume for all teeth to align naturally and enough space between the jaws for the tongue to stay out of the throat.
Crowded teeth come from deficient jaws, which is a cardinal feature of impaired mouth. The bite—occlusion in dentistry—is where the upper and lower teeth come together. When they don’t fit together peak-to-valley and/or when the jaws do not align with skull bones, we call it malocclusion (mal- means “bad” in Latin).
So malocclusion comes in two types: dental (teeth to teeth) and skeletal (jaw to jaw or jaw to skull). Dental occlusion refers to how upper and lower teeth fit into each other while skeletal maloc
clusion is the orthopedic (bone to bone) mismatch: How does the upper jaw fit into the head? How does the lower jaw fit into the upper?
Both dental and skeletal malocclusion come in three types—Class I, II, and III—named after the frequency of occurrence in the population. In general, Classes II and III are abnormal and often come with more medical and dental problems, but Class I is not immune.
Drawing courtesy of Dr. Je-yang Jau of Taiwan
In my opinion, a dental malocclusion is secondary to a skeletal malocclusion diagnosis because skeletal malocclusion is a bigger source of the “three-foot cage.” Skeletal malocclusion can affect dental occlusion, facial appearance, snoring, and sleep apnea.
Viewed from the side, a jaw is protruded when it is positioned forward relative to the forehead, as in gorillas or early humans. A jaw is retruded when it is positioned toward the back of the head. Weak chin and flat midface are features of an impaired mouth and frequent findings in patients with sleep, pain, and fatigue issues.
Because it has a greater effect on the airway, skeletal malocclusion should be treated before dental malocclusion. My patients find the following distinction useful: orthodontics (braces) treats dental malocclusion by moving teeth like boxcars on a railroad, whereas jaw orthopedics (oral appliances) develops rail beds to correct skeletal malocclusion.
Illustration courtesy of Dr. Je-yang Jau of Taiwan
While crooked and/or crowded teeth are often a sign of malocclusion, perfectly straight teeth are not necessarily a sign of good occlusion. Straight teeth in skeletal malocclusion qualifies as impaired mouth. I often see this type of “three-foot cage” in adults who had teeth extracted for braces in their teens. Symptoms of Impaired Mouth Syndrome, such as neck pain, jaw-joint clicks/pops/locks, snoring, sleep apnea, teeth grinding, and chronic fatigue are frequent in these patients.
“Life-Changing” Impaired-Mouth Correction: Sheila’s Story
Sheila’s jaw would lock up, and she had lots of neck and back pain when she woke up in the morning—“As if I’d been doing yard work all day.” That was six years ago.
“I used to have MS (multiple sclerosis),” she says, “and now it’s all behind me. The neck pain is now a 0 on a scale of 10, and I have no dental complaints. My energy is up, and I regained my balance after oral appliances corrected my bite and widened my palate. I started running again, which is huge for me. This has been life changing.”
Sheila was a model patient, doing her part in treatment by wearing the appliances twelve to sixteen hours a day, seeing the recommended health professionals for necessary support, making the needed diet and lifestyle changes, and doing self-healing exercises. In my experience, most patients can comply with wearing oral appliances, but many slack off with integrative care and fail to sustain the necessary lifestyle changes.
Sheila’s results are powerful proof of her commitment to following through.
Holistic Mouth Bites
A Holistic Mouth facilitates whole-body health with alignment, breathing, circulation, digestion, energy, and sleep (ABCDES) while an impaired mouth interferes with ABCDES and blocks whole-body health.
Can Sheila’s “MS” happen be an overlap with Impaired Mouth Syndrome? I believe it is.
Even though crooked, crowded teeth are often a sign of jaw underdevelopment, straight teeth inside jaws in skeletal malocclusion still constitute an impaired mouth.
Straighten jaws before teeth because it has a greater effect on airway size, skeletal malocclusion of the jaws should be treated with oral appliances if possible before dental malocclusion is corrected with braces.
Chapter Three
Your Mouth-Body Connections: The Science of Oral-Systemic Links
Disease enters by mouth, and disaster exits by mouth.
– Chinese Proverb
Intuitively, we know that the mouth and body are connected. Now science has weighed in. Besides through nutrition and diet, the mouth can impact our overall health in many ways, including gum inflammation, sleep, snoring, sleep apnea, teeth grinding, mouth breathing, malocclusion (bad bite) and their related medical, dental, and mood symptoms.
Oral-Systemic Links is a growing compilation of scientifically established mouth-body connections that join the dental and medical spheres.
“Oral,” of course, means the mouth, which is far more than just an opening in your head. It includes the upper and lower jaws that form two-thirds of the face, as well as the teeth, gums, jaws, jaw joints, muscles, tongue, tonsils, soft palate, ligaments, salivary glands, nerves, blood vessels, lips, skin over the jaws and face, and fascia, the fibrous and loose tissues under the skin and around and throughout all muscles, organs, and joints.
“Systemic,” on the other hand, refers to the rest of the body: the brain, head, neck, spine, limbs, torso, internal organs, and all the physical tissues in, around, and between them, including bones, joints, muscles, fascia, blood, nerves, cells, and genes.
“Links” encompasses all the connections between the mouth and the whole body, including all systems governing posture, breath, circulation, digestion, and elimination—blood, lymph circulation, saliva, hormones, the immune system, neurotransmitters—everything that keeps the body functioning. The connections also include experience, memory, emotions, vital energy such as chi (qi), and the body’s energetic meridians.
The Surprising Science That’s Been Hiding in Plain Sight
Oral-systemic links are two-way phenomena. Mouth symptoms can have systemic causes, such as the left-sided jaw pain associated with angina and heart attack. Conversely, medical symptoms can have dental sources. Below are a few recent research findings that illustrate the mouth-body connections:
A 2016 study in PLoS Medicine showed the link between periodontitis (gum disease) and memory decline: “The presence of periodontitis at baseline … was associated with a six fold increase in the rate of cognitive decline.” (1)
Bacteria from the mouth have been shown to spread to the rest of the body. For instance, people with periodontal disease have double or triple the risk of having a heart attack or stroke, (2), (3)
Oral bacteria have been found in heart-attack clots. “Dental infection and oral bacteria, especially viridans streptococci, may be associated with the development of acute coronary thrombosis,” says a 2013 study in the journal Circulation.(4)
The DNA from endodontic (root canal) bacteria was found in 56 percent of thirty-six samples of heart-attack clots in another 2013 study. Periodontal bacteria were found in 47 percent of those samples. The authors concluded that “dental infection could be part of pathophysiology in intracranial aneurysm disease [stroke].”(5)
The mouth is where stress often shows up, according to one study published in Brain Research. Overeating may be a stress-driven reaction.(6)
Sleep apnea has been shown to be a significant contributor to both Alzheimer’s disease and diabetes.(7)
A study in Heart Failure Reviews suggested that sleep apnea should be seen as “the new cardiovascular disease.” (8)
In light of such evidence, leading doctors and integrative health professionals now recognize the mouth-body connection. In fact, in 2011, dentist Dr. Richard H. Nagelberg said, “The oral-systemic connections are accepted at this point by the medical and dental connections.”(9)
“I am constantly amazed at how powerful a predictor of health your teeth are,” says Dr. Joseph Mercola of Mercola.com. “When I have seen chronically ill patients with nearly cavity-free teeth, I am encouraged that they will likely get well quickly. If, on the other hand, their mouths are full of fillings and root canals, the prognosis is not as good.” (10)
Dr. Jerry Tennant, the author of Healing Is Voltage, concurs: “Chronically ill patients need an informed dentist more than a medical doctor.” (11)
The problem: while most people know that the mouth feeds the heart, the brain, and the body, and more and more doctors are aware of the perio-cardio connection, far fewer know about the impaired mouth-pinched airway connect
ion. Naturopathic and chiropractic doctor Louisa Williams does:
In my 30 years as a holistic physician specializing in dental issues, if a patient presents with a major malocclusion, then the treatment of this is truly sine qua non before (or at least in conjunction with) any other therapies. That is, positive dietary changes, nutritional supplementation, structural treatments (craniosacral therapy or spinal alignment), and even the most curative treatment—constitutional homeopathy—will never have a truly satisfying effect in the case of an impaired airway and the reduced oxygen delivery created 24/7 by a significant orofacial dysfunction. This issue must be addressed by an orthopedically trained biological dentist utilizing functional appliance therapy. (12)
The mouth-airway connection is even more foundational to health and survival than food and water, and oxygen level is a pivotal factor in chronic infections and periodontal-heart disease inflammation, in my opinion.
Mouth-Airway Connections
“Go to sleep” is the standard advice when you get a cold or come down with an illness. How fast you recover depends not only on the quantity but also the quality of your sleep. This is where having a wide-open airway is an asset and having an airway occupied by the tongue is a liability.
If the airway behind the soft palate and tongue is narrow, the risk of airway collapse goes up because an obstruction by the tongue creates a vacuum.
A narrow airway can be objectively documented with a 3-D cone-beam computed tomography (CBCT) scan: “3- dimensional CBCT airway analysis could be used as a tool to assess the presence and severity of OSA.” (13)
A color scale is used to show the risk of airway collapse leading to obstructive sleep apnea. Red means high risk; white means low risk. Green is somewhere in the middle—not horrible, but hardly ideal.