DentalMechanics

Proprioceptive Stimulation. An Effective Tool for Reversing Postural Distortions and Eliminating Chronic Pain

Prof/Dr Rothbart's Research Website

Your Subtitle text

Dental Imbalances Driven by the Foot

Reversing poor posture (postural distortions) in children over the age of 8-9 may require a multi-disciplinary approach even when the postural problem is initiated by abnormal foot motion.

In order to understand the inherent limitations of treating the foot only (e.g., Rothbarts Foot or PreClinical Clubfoot Deformity), a brief discussion of the pathodynamics engaging the feet and teeth is presented below.

I. Ascending pattern. Postural distortions occur sequentially, from bottom to top.

Rothbarts Foot will drive the innominates anteriorly (externally)

Anterior rotation of the innominates can drive the temporal bones into an posterior (external) rotation, the more pronated foot being ipsilateral to the more posteriorly (externally) rotated temporal bone (Rothbart, 2008).

Posterior (external) rotation of the temporal bones can force the sphenoid bone into an extended and side bent position (unleveling the pupils).

This can unbalance the maxilla resulting in a:

Loss of vertical facial dimension

Narrowing of the Curve of Spee (dental arch) (See Photo Left below), which can crowd the teeth and, if severe enough

'Block out' the emergence of the primary cuspids (See Photo Right below)

Narrowing of the Curve Blocked out teeth
of Spee

Posterior rotation of the temporal bones can place the sphenoid in extension which can narrow the Curve of Spee and push the maxilla forward (Class II Malocclusion)

In some cases, Structural malocclusion can be corrected using postural therapy (Guaglio, 1990)

Type II and Type III Malocclusions

The Pure ascending postural distortional patterns that result in Type II and Type III Malocclusions are due to the locked extension or flexion of the sphenoid bone resulting from either the Rothbarts Foot or the PreClinical Clubfoot Deformity (See Rothbarts Triad below).

Rothbarts Triad

Rothbarts Foot:

Posterior Temporal Rotation
Extension Sphenoid Bone
Type II Malocclusion

PreClinical Clubfoot Deformity:

Anterior Temporal Rotation
Flexion Sphenoid Bone
Type III Malocclusion

Caricature (Bert and Ernie) demonstrating

the Sphenoid bone locked in either

(Cranial) Flexion, or (Cranial) Extension.

II. Descending Pattern. Postural distortions occur sequentially from top to bottom

Pure Descending Postural Distortional Patterns Resulting from Dental Pathomechanics

Frontal Plane Distortions (Maxilla Roll)

My current research (August 2011) suggests that a roll in the maxilla (maxilla distortion on the frontal plane) results in an Atlas Roll (C1 distortion on the frontal plane). An Atlas Roll can destabilize the entire spine on the frontal plane (e.g., augmenting the scoliotic curves). The sacrum tilts, unleveling the spine (observed as a functional leg length discrepancy when the patient is in the supine position). Frequently pain is felt in the pes anseranus (medial compartment of the knee) and lateral ankle (Peroneal muscles).

Transverse Plane Distortions (Maxilla Yaw)

My current research (August 2011) also suggests that a yaw in the maxilla (maxilla distortion on the transverse plane) results in an Atlas Yaw (C1 distortion on the transverse plane). An Atlas Yaw (suspected when one observes asymmetrical head rotation) can destabilize the entire spine on the transverse plane, resulting in a transverse plane slippage or rotation of one vertebrae on top of another. This is most commonly occurs at the level of the sacral thoracic vertebrae (e.g., Spondylolisthesis). The sacrum yaws, generating a shearing motion in the sacraliliac articulation. In time, this can lead to a sprain of the SI Ligament, clinically manifested as moderate to severe pain in the SacralIliac Articulation.

Sagittal Plane Distortions (Maxilla Pitch) – pathomechanics needs to be clarified

Note: Distortions in the occlusion (maxilla) can occur in one plane or multiple planes concurrently.

III. Mixed Pattern. Postural Distortions resulting from both Ascending and Descending Patterns occurring concomitantly

Multi-disciplinary approach is required to: (1) stabilize the foot pathomechanics and (2) stabilize the occlusal imbalances.

If treatment is only directed towards stabilizing the foot (i.e., Rothbarts Foot or PreClinical Clubfoot Deformity) or only directed towards stabilizing the malocclusion (and resulting Atlas Roll), rotational distortions in the sacrum (and innominates) may persist.

Orthodontic Intervention

Braces should never be used until the posture is stable.

If the teeth are straightened in the presence of a forward head position, the forward head position or cervical curve may become locked in place and intractable to postural therapy.

Terminology

Correlating Terminology used by Orthopedists and Podiatrists to the Terminology used by Dental Orthopedists (and airplane pilots):

Frontal Plane Motion = Roll
Transverse Plane Motion = Yaw
Sagittal Plane Motion = Pitch

Correspondence from Dentists in North America

References:

Rothbart BA 2008. Vertical Facial Dimensions Linked to Abnormal Foot Motion. Journal American Podiatric Medical Association, 98(3):01-08, May.

Rothbart BA 2008. Malocclusions Linked to Abnormal Foot Motion. Positive Health, Vol 151, October.

Rothbart BA 2006 Cranial Lesions Initiated by Abnormal Foot Motion. Health and Healing Wisdom (Price-Pottinger Nutrition Foundation Journal) Vol 30(1):6-7.

Kieser JA 1997 Basicranial flexion, facial reduction and temporomandibular joint dysfunction. Medical Hypotheses, Vol 49:5, 409-411.

Oleski SL, Smith GH, Crow WT 2002. Radiographic Evidence of Cranial Bone Mobility. Cranio, 2:1, 34.
Observations (Oleski Et al, 2002): The mean angle of change measured at the atlas was 2.58 degrees, at the mastoid was 1.66 degrees, at the malar line was 1.25 degrees, at the sphenoid was 2.42 degrees, and at the temporal line was 1.75 degrees. 91.6% of patients exhibited differences in measurement at 3 or more sites, (pre vs post therapy). This study concludes that cranial bone mobility can be documented and measured on x-ray.

Prof/Dr Brian A Rothbart
Chronic Pain Elimination Specialist
Discovered the Rothbarts Foot Structure and the PreClinical Clubfoot Deformity
Developer of Rothbart Proprioceptive Therapy
Inventor and Designer of Rothbart Proprioceptive Insoles
Founder of International Academy of Rothbart Proprioceptive Therapy
Author of Forever Free From Chronic Pain