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Orofacial Myofunctional Therapy

20/9/2015

This is for people who like to read...there is a lot of information....

So I am going to do a sideways jog and change the subject for this post. I was going to post a blog on Central Sensitization, but this topic has been occupying the better part of my waking hours since I took the course at the end of August. I wanted spend some time organising my thoughts around this topic, and decided to create a new page on the HeadWorks website. Please feel free to head over to this page and have a read. It's interesting stuff. Sorry it's real wordy. I'll add some pictures later.

Orofacial Myofunctional Therapy is an exciting, emerging field of therapy that is involved in the neuromuscular retraining of the oral and facial muscles. It was actually first introduced in the 1900s by an orthodontist (Dr. Alfred Rogers) who experimented with facial muscle exercises.

Brief overview of history:

In 1918, Dr. Rogers published: "Living Orthodontic Appliances", in which he cited that muscle function alone would correct malocclusion with no need for retention. (Can you imagine the controversy?)
In the early 1900s, Dr. Benno E. Lischer first coined the term "Myofunctional Therapy" after studying with Dr. Rogers.
In 1907, Dr. Edward Angle, an orthodontist, wrote articles on the effects of habits. He is responsible for classifying occlusion (Class I, II, III malocclusion).
In 1925, Dr. Harvey Stallard studied 7000 children on sleep position and malposed tooth buds and concluded that, "Sleeping on the face during a child's formative years could create malocclusion."
1924-1940: Truesdell and Truesdell were the first to understand the relationship between swallowing anomalies and dysmorphosis. They advised patients to swallow in occlusion. They also felt that atypical swallowing was related to hypertrophy of the tonsils.
An orthodontist, Dr. Klein is often quoted: "Living bone is extremely susceptible to the guidance and influence of pressure and stimuli.” (Klein, 1951)
In the 1950s, speech therapists began to look at nasal obstruction, oral habits, swallowing, and how they affected speech.
In 1960, Dr. Walter Straub had a theory that bottle feeding caused the "perverted" swallow. He developed a series of exercises to correct the swallow, and lectured with 500 cases on record. Dr. Straub wrote many articles published in the American Journal of Orthodontics.
There are several other pioneers who developed exercises for successful therapy.

The past helps us understand the present and look to the future.

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Descending Inhibition

2/9/2015

4 Comments

So the cannibal tribe is chasing you, and you trip, fall and sprain your ankle. We know that sprained ankles are extremely painful, but if you stop to deal with your sprained ankle, the cannibals will catch you and eat you.

Your brain is going to decide that staying to nurse your sprained ankle will reduce your overall probability of survival, so it shuts the pain off. How does it do that?

1)      Your brain decides that pain is going to reduce your survival rate, so it tells the hypothalamus, “Let’s not have any pain.”

2)      The hypothalamus communicates with the Peri-Aqueductal Gray Matter (PAGM), which is the gray matter surrounding the cerebral aqueduct in the midbrain. The PAGM coordinates the body’s analgesic system. (When the PAGM is electrically stimulated, pain is shown to be eliminated or reduced).

3)      When the PAGM is activated, it sends analgesic impulses down through the brainstem, through the raphe nucleus, which synapses with a descending neuron that goes down one side of the spinal cord (dorsolateral tract) to influence analgesia at the appropriate level of the spinal cord.

As previously described in earlier posts, a nociceptive impulse comes into the dorsal horn of the spinal cord and synapses with a second order neuron to go in the spinothalamic tract to the brain for pain to be recognised/registered.

If it is inappropriate to feel pain, analgesic impulses come down the dorsolateral tract, and at the appropriate level of the spinal cord, a neuron (analgesic neuron) will project from the dorsolateral tract into the area of the synapse between the axon of the sensory neuron and the start of the second order neuron (which would take the nociceptive impulse to the brain).

This analgesic neuron contains chemical transmitters which fit into the pre- and post- synaptic receptor sites. When these chemical transmitters bind with the pre- and post- synaptic sites, they cause pre- and post-synaptic inhibition respectively, resulting in the whole synaptic area being turned off, inhibiting ongoing propagation of nerve impulses. Therefore, pain is not felt, as the impulse going to the brain has been blocked.

Interesting to note: these chemical transmitters are opioids. The body produces its own opioids, endorphins, enkephalin substances. Also interesting to note that the seed of the poppy plant has the same chemical properties as your body’s endogenous opioids. Morphine, when injected, will have the same effect of pain inhibition as these endogenous opioids.

So, when it is not appropriate for you to feel pain in order to ensure your survival , your body activates its own analgesic system, releasing its own opioids, blocking off pain. All this happens outside your awareness.

This is your amazing body.

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Orofacial Myofunctional Therapy

Descending Inhibition

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