From Spring 2008
Suzanne Taylor first went to Dr. David Clark because she’s afraid of needles and pain. A colleague called him the “gentle dentist,” so she made an appointment to see him for a broken tooth.
Clark found that Taylor was grinding her teeth. She also slept terribly and suffered from frequent headaches around her temples. Often her shoulders were hunched up by her ears.
What Clark and a minority of dentists know is that all of Taylor’s symptoms are related. It’s a case of the jawbone being connected to the neck bone, and the neck bone being connected to the—well, you get the picture. To get to the root of these symptoms and how they’re linked, a practice called bioesthetic dentistry has emerged. It’s complicated, but to put it simply, many of our jawbones are out of alignment. And that makes bad things happen: temporomandibular joint (TMJ) disorder, migraines, neck pain, back pain. From a vanity standpoint, this also affects our smile, eyes, and cheeks.
As of February, 229 dentists and 45 lab technicians had been trained in bioesthetic dentistry, according to the OBI Foundation for Bioesthetic Dentistry in Keizer, Oregon, the only training facility for dentists interested in the field. Four of those doctors are in the Dallas-Fort Worth area: Dr. Hal Stewart of Flower Mound and three dentists in Plano—Clark, Dr. Joseph Hidalgo, and Dr. Steven Thompson. These dentists, who have taken hours and hours of classes and spent a lot of money doing so, are taking dentistry to a new level.
“I was an expert at doing fillings, root canals, and crowns,” Thompson says. “I’d done more than 50,000 cosmetic restorations alone. But I’m not interested in just being a repairman. I wanted to be able to look at the system, fix the system. It’s more meaningful than just filling cavities all day long.”
The Science
In the 1970s, the late Dr. Robert L. Lee, co-founder of the OBI Foundation, coined the term “bioesthetics,” defining it as “the study or theory of the beauty of living things in their natural forms and functions.” When the former biologist switched to dentistry, his experience in the study of living systems parlayed quite nicely into his new career.
“He noticed people coming in with broken teeth, worn teeth,” Thompson explains. “The biologist in Bob said, ‘Let’s take a look at healthy teeth and healthy systems that are pain-free and not worn. Let’s take a look at the ones that are working right.’”
Lee found that people with healthy, pain-free joints and mouths had three principles in common:
A stable condylar position, meaning the jaw joint is in its most physiologically stable position. A stable jaw is the foundation for a beautiful smile.
Proper anterior guidance, meaning the front teeth are contacting in a way that directs the rest of the teeth as you chew. “If the front teeth are not providing proper guidance,” Thompson says, “then the back teeth are crashing into each other in a way that’s not healthy for the bite or for the joint.”
Proper genetic tooth form, meaning the teeth are not worn and have the proper contour and shape. “The teeth have to relate to the opposing teeth in a precise way to send the proper signals to the brain,” Thompson says. “If the brain is receiving improper signals from the teeth, the brain gets confused, and that’s what typically triggers clenching, grinding. The brain reacts with muscle spasms, pain, clicking.”
The Treatment
Many of Clark’s bioesthetic patients, who complain of migraines or jaw, neck, and shoulder pain, are referred by chiropractors or neurologists. “More than 93 percent of patients who have migraines have them because of muscle spasms and muscle tension,” Clark says. “Those muscles are the ones associated with the bite.”
Most dentists and doctors address these symptoms with medication or a nightguard, which buffers teeth during grinding. Clark and Thompson say this isn’t enough anymore. “We can go in and find out why people are having the pain, identify the specific cause, and then treat the root cause of their pain,” Thompson says. “That is life-changing for people.”
Generally the first step is to fit the patient with a maxillary anterior guided orthotic (MAGO). The MAGO is made of clear, hard plastic and is worn 24-7, sometimes for several months. It takes a couple of weeks to get used to, but many patients say their pain stops almost immediately. The MAGO tracks the joint back to its original, stable position. Remember, the brain is going to get as many teeth together as possible. If that means destabilizing the jaw, so be it.
Some patients need the MAGO and a few crowns. Others need all of their teeth restored—even jaw surgery. “The whole goal is to establish harmony between the jaw and the teeth,” Thompson says.
This harmony isn’t quick—or cheap. MAGO therapy runs between $3,000 and $5,000. If you don’t need much restorative dentistry afterward, your bill might be less than $7,000. If you need, say, 12 crowns and 12 bondings, you might spend $20,000. Getting crowns on all your teeth could cost up to $40,000.
Dental insurance often maxes out at $1,000, and the majority of bioesthetic dentistry falls out of the scope of what insurance will cover. Still, patients who have experienced it are sold on the process.
The Results
After three days of wearing the MAGO, Suzanne Taylor’s headaches started fading. She went weekly to have the MAGO adjusted, and within a few months, Clark started restoring her bite so it wouldn’t get off-kilter again. She needed her front teeth bonded and 10 crowns.
Taylor’s headaches are gone, as is the tension in her neck and shoulders. One of her eyes is open more than it used to be, her top lip is fuller, and her smile is straighter.
“It’s made a big difference in my face,” she says. “Some people call it a facelift through dentistry.”
John Schick of Plano had been a patient of Dr. Thompson’s for many years before the dentist—fresh from his bioesthetics training—asked him about his teeth grinding. He made a mold of what Schick’s mouth looked like and what a properly aligned mouth looks like to show Schick the difference. When Thompson went to work on Schick’s teeth, they were ground down by more than 50 percent. “I wasn’t really happy with my smile,” Schick says. “It just didn’t look right.”
“So many people are seeking cosmetic dentistry to fix their smile,” Thompson says. “In reality, that’s just another example of putting a Band-Aid or treating a symptom and not addressing the underlying problem. Doing cosmetic dentistry without doing the bite stabilizing is throwing your money away because you’re going to have the same problems all over again.”
Schick started wearing the MAGO in August 2006 and has had 28 crowns since then. The process was arduous, yes, but Schick feels great about it. “Now I don’t hesitate to smile,” he says.
