The Hazards of a Bite out of Balance
If your teeth meet imperfectly, your chewing muscles stay active twenty four hours a day, seven days a week.
Where do Excessive Forces go?
Bite balancing, or “occlusal equilibration,” is not a skill taught in dental school but requires many hours of post-graduate training from institutions of higher dental education such as The Pankey Institute and the Dawson Academy After taking training from both of these institutions and after equilibrating well over a thousand patients over the past 38 years I continue to be amazed at how much difference it makes in the comfort and function of my patients and for that reason it remains one of my very favorite dental procedures as, within a typical 90 minute equilibration session, I am able to give a patient an entirely new experience of just how comfortable their mouth and jaws can be.
Recently one of my patients from New York City, Lese Dunton, the journalist and editor of The New Sun Newspaper recorded our interactions during her equilibration session and was kind enough to transcribe it so that it might be useful as an educational tool. So here, below, is a transcript of that treatment visit and while it can’t convey they dental procedure itself, it does a very good job addressing what goes on in the process of chewing and in the process of bite balancing:
Dr. David Shuch: …I don’t think I’ve been taped before, and hopefully I’ll be educational.
There’s an organic choreography that happens when someone whose bite is balanced, when the teeth come together.
What that choreography is about is…then when all of the teeth come together at the same time – the back teeth, the front teeth are a separate matter – but from here by the canines and back, simultaneous and even contact (demonstrates). When that happens, it creates what I call an “off switch.”
It’s a switch that synapses from the proprioceptors, which are located along the roots of all of the teeth, that when you tap your teeth together it allows you to feel the quality of how they touch. It’s when you bite down and squish into a jelly bean you get a proprioception of that, like I’m squishing into something like a jelly bean versus if you bit into a raw carrot and it kind of, it compresses slightly and then it gives when it cracks.
All of these kinds of things that have different textures, and these all require a different chewing choreography, depending on what they are, they give signals to a set of nerves that basically live in the skin of the roots of your teeth. The ligaments that anchor the roots of your teeth to the bones in your jaws. Those ligaments they are proprioceptors. They sense pressure and tension and vibration.
When a bunch of them, all at the same time, signal that your teeth come together, and they all hit at the same time – it’s a natural signal for all of these big, strong, clenchy kind of muscles to shut off because the nature of these proprioceptors is simply to sense a discrepancy that happens when you put food in your mouth, that signals – pay attention, there’s something in the mouth that needs to be chewed.
The mouth and the teeth and the jaws are all designed to feel that there’s something there that doesn’t belong there, such as food that was placed there, and it needs to be chewed until it gets so small and smushy that you can swallow it. And then what’s supposed to happen — all the teeth meet together because there’s no more big pieces of food in your mouth, and then the muscles shut off.
What happens when you have bite interferences, you never get to that off switch. It never shuts off.
Lese Dunton: And it could send less than great signals that could cause other matters.
DS: Well, we can subjectively say that it’s less than great, but they’re just doing their job. If you think about it, if you just took a hair on your head and put it between your back teeth on one side and bite down, you could easily feel that there’s something as thin as a hair on that one side. So the bite doesn’t have to be off by much, in terms of height. It can be off by just the slightest bit, but if it’s off, those muscles, they’re going to be busy, and sometimes they’ll be busy 24/7, 365.
So, what we’re trying to do with Part 1 of the bite balancing, is just get you to a point that when you are just closing your jaws without moving them from side to side or front to back, but just closing and contacting your teeth like a door closing into a door-jam—that everything hits so simultaneously and so evenly that you can’t tell me that you are able to sense any discrepancy. From my point of view, I look and at the marks left by my bite paper and if they look all even and once I see that…then I listen to the sound that comes from when your teeth contact. I can tell by sound, as you’ll experience shortly, the resonant sound that comes from the skull when all the teeth hit together all at the same time (claps)…
DS: When you can’t tell me where you’re hitting…that there’s no spot that’s raising its hand and going, I’m hitting here first, I’m hitting here first – but everything fills in at the same time – then we’ve reached a point where, in your case for the first time in I don’t know how long, you actually have an off switch when we bring the teeth together.
DS: And that’s going to help you a lot to have at least a chance of not waking up with all this business going on. The way that this wisdom tooth was positioned back here, by itself, it was creating an interference and there was no way to fix it, and it prevented me from doing this (equilibration). It meant that there were inflammatory nerve signals that were in and of themselves setting things up to be extra tense, which you don’t need.
LD: A lot going on.
DS: So that’s why you said, it “turned the volume down” a bit. [Getting the wisdom tooth out prior to this second appointment.]
[Gets working on equilibration.]
LD: You mentioned Step 1. This needs to happen before anything else.
DS: Well, in my view, for my patients, if they’re coming in with some clear and obvious symptoms…as long as they don’t have a tooth with a cavity that’s a mile wide that if we don’t get to it right away they might need root canal, I will always say, “Let’s do this first.” That way, I’ll know how high, how wide to build whatever. Whether it’s a single filling or it’s a mouth full of crowns and porcelain work. This is a place to start.
LD: Like a foundation in a way.
DS: It’s a foundation. I’ve often said, I like to use the phrase that I learned from a cabinet maker, a carpenter who did fine cabinetry. He said, if you’re going to hang a window in a house or a door, you always have to establish what is “level, plum, and square.” If you don’t, the windows won’t open and close right, the doors will hit on the ground. Everything has to be with, in terms of gravity, it has to be level. And it can’t be canted in one way or the other. So, this is like level, plum and square.
LD: That’s great.
DS: Okay, clench again, and grind-grind-grind. Yeah, hey, see that? Isn’t that nice.
LD: See now I’m showing off.
DS: I know. Alright so tap-tap-tap-tap-tap-tap. Nice and hard. Yeah, you’re finding that spot every time. Every single time. You’re finding the same spot where everything comes into simultaneous contact. This allows the chewing muscles to set up a simple muscle memory, like how your leg muscles know exactly how to walk up a flight of steps that you’ve walked up a thousand times before—they just know where to go without getting tripped up. When all the teeth hit at the same time the muscles have no guess-work, they can rely on this position and fall into a consistent habitual pathway.
[Sound of device – plus more tapping and testing.]
DS: Tap-tap-tap-tap-tap-tap-tap. Yeah, you have no trouble finding the spot now. No hunting at all.
[Sound of device.]
DS: Clench. Grind-grind-grind. Ah, yes indeed. Okay, good. That’s plenty.
[Sound of device.]
DS: Clench. Grind-grind-grind. You are showing off. (Laughs.) You couldn’t do that before!
LD: I didn’t even know. Unintentional showing off.
DS: Yeah. Alright, tap-tap-tap, let me know. Okay, yeah, you’re good.
[Sound of device.]
DS: Ahh! Tap-tap-tap. Loud. That’s it. Anything stand out?
LD: Not really.
DS: It should sound really loud in your head.
LD: It sounds really loud.
DS: One of my patients from many years ago, she’s passed since, her first language was Hungarian, so her use of language was always a little interesting, how she chose words. So when I balanced her bite she goes, “Oooo, it sounds like a skeleton!” Yes! It’s your skeleton.
LD: That’s a good way of saying it. It’s not a familiar sound.
DS: I call that the ripe cantaloupe sound because it’s like rapping a ripe cantaloupe and it echoes in a certain way.
What you’re hearing is the resonance of the skull. The lower teeth are acting as a hammer, the upper teeth are acting as an anvil, and as you’re percussing that way – when everything hits at the same time – there’s a pressure wave that goes from the maxilla up into the bones of the head. If you imagine how strong that percussion is, that force has to be dissipated. The way that it’s dissipated is that the cranial sutures, the little squiggly lines in a dry skull that you see, they’re actually slightly mobile. What happens is when you (claps) bring your teeth together like this, they go this way and they go that way, and that pumps the cerebral spinal fluid.
DS: Had this conversation with John Upledger, many, many years ago, who was the founder of Craniosacral Therapy.
LD: That name sounded familiar.
DS: The Upledger Institute down in Florida. He was the first to identify that there was a mechanism that caused the cerebral spinal fluid to circulate. He identified that mechanism as the cranial bones and as the cranial bones move, they’re like pumps. I brought to his attention that when the bite was equilibrated, the pressure wave would cause all of the cranial bones to expand, and then drop back down.
LD: In a good way.
DS: In a good way. It’s like if a rock musician sitting at a drum set hits the base drum thing with their foot and the drum skin goes out and comes back from that – it’s like that. You’re creating a percussion wave and it’s causing the pressure wave to go out and then come back. That action, out and back, you do it again. It’s pump…pump.
Many, many years ago, when I was studying Tai Chi Chuan in Soho, back in the early and mid 80s, my teacher, Don Ahn taught us that in Traditional Chinese Medicine there was a folk remedy for longevity. To tap teeth hard – 10 times in the morning and 10 times at night. There was no explanation at the time – I was in dental school at the time – and it took me to years to integrate that and say, ohh!, because it’s circulating the cerebral spinal fluid!
LD: That’s amazing.
DS: Yes, I think so.
LD: Such a breakthrough.
DS: And people who have jammed cranial bones, which frequently brings migraines and other things like that, they usually see a cranio-sacral practitioner and then they get their cranial bones adjusted. Cranio-sacral practitioners love working with me, or other dentists that adjust bites because often when the bites’ off, it jams the cranial bones. They get jammed. The same way the subluxated cervical vertebrae get jammed when people’s bites are off. And they’re constantly going to the chiropractor and having their necks cracked, again and again and again. But when we the balance the bite, the adjustments hold better.
LD: It’s so exciting.
[Discuss process of “rebooting your operating system,” of your jaw muscles. They’re reestablishing what the feedback loop is between when the teeth hit and what the muscles are supposed to do.]
[More testing and discussion, including about recent bonding of front tooth.]
LD: (mentions how the pain is the worst in the morning, perhaps after a full night of dreams, and gets better as the day goes on).
DS: Let me give you my post-equilibration talk and homework…it will take time to adjust…stay away from hard crusty bagel for the first couple of days…focus on smaller bites and softer things…2-day rebooting process…you’re become hyper aware as you chew foods of your canines…It’s going to feel to you as though I moved your canines in, you’re going to be bumping into them all the time…that’s because I made it so that you have canine guidance, when you chew, the canines are the teeth that shape the arc of opening, and capture the bottom the jaw coming together and closing…before, it was a mess. It was everywhere all in the back, all places that were just serving as triggers.
The canines are wired neurologically to have that function, so this is the best of all possible worlds is when we can get canine guidance – fortunately you have nice canines, so we were able to get the guidance – but in the beginning, you’re going to hit them all the time [like new furniture in a dark room]. Ignore it. Just be aware that that’s part of the process of rebooting. It’s just going to go away.
After a while, the bottom jaw is going to learn to move in an envelope of function, we call it, where it’s not going to be pounding because it has to learn where the furniture is, and the canines are part of the furniture.
DS: So that’s the second thing. The third thing is that the lower jaw is suspended by muscles and ligaments the way a marionette is suspended on strings, and for people who have been clenching and grinding for years, the muscles and the ligaments are like a clenched fist. Typically, in an equilibration like we did today, they already start to melt. Your jaw moves freely, easily, comfortably, but it’s possible over the next few weeks, it’s possible that the muscles and the ligaments will relax more.
So think of a marionette puppet, the lower jaw is a marionette puppet – if they relax a little bit more, they may not relax perfectly symmetrically. If you find, after about two weeks, that you’re consistently hitting first again, it will be subtle, it’s a 5-minute visit and you could come back.
You asked about dreams, waking up in the morning and feeling worse then. There are three things that cause the jaw muscles to do this –
- Dento-genic stress – teeth-caused interferences, which we’ve eliminated today.
- Psycho-genic stress – which is like the stress of living in a stressful world that, as the Bible said, can cause “wailing and the gnashing of teeth.” I have nothing to do with that. If you’re in a psychic bind, you may do that. You’ll do it evenly now, but you won’t do it because of your teeth any more.
- Parasites – we see that more in third world countries with little kids that have ground their baby teeth down to nothing because they got bugs in the belly.
Those are the three things that tend to be factors. It’s usually the first two. At least we peeled away that dentogenic layer.
LD: My dreams are 95 percent positive and awesome, but it’s just busy at night, you know? And because of the bite stuff I wake up like, aaaahhh, ohhhh, ugggh.
DS: Did we talk about sleep hygiene? (We talk again about side and back sleeping and what to do with pillow, etc.)
Re books –
The first two books, the one you’re reading (Letters of a Young Healer) and the one before it implicitly describes a system of healing. There is an implicit discussion of what’s behind the scene; they give a view of an internally consistent understanding of healing. The book you’re reading now is told through story. In The Charm Carver it’s taught through parables, essentially. What I’m doing now is a non-fiction, it’s taught explicitly. It’s a theory-and-practice book. It’s more of a non-fiction. That’s called Healing Presence: A Science of Spirit.