The Use of Acupunture in Dentistry

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The Use of Acupunture in Dentistry

• YEHIEL ALPERN D.M.D A.C

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The History of Acupuncture

• Acupuncture, or needle puncture, is a European
  term invented by Willem Ten Rhyne, a Dutch
  physician who visited Nagasaki in Japan in the
  early part of the seventeenth century.
• The Chinese describe acupuncture by the character
  'Chen', which literally means 'to prick with a
  needle', a graphic description of this
  therapeutic technique.

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Early History

• Acupuncture has a clearly recorded history of
  about 2,000 years, but some authorities claim
  that it has been practiced in China for some
  4,000 years. The Chinese believe that the
  practice of acupuncture began during the Stone
  Age when stone knives or sharp edged tools,
  described by the character 'Bian', were used to
  puncture and drain abscesses..

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APPLICATION IN DENTISTRY

• SEDATION-PREOPERATIVE
• PAIN CONTROL-POSOPERATIVE
• GAG REFLEX CONTROL
• CONDITIONS in oral medicine
• TMJ DIS -FUNCTION,BRUXISM
• RECURENT APHTOUS STOMATITIS
• Facial paralysis ,Trigeminal neuralgia
• Modified taste sensation, Burning mouth
  syndrome,xerostomia.

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YIN YANG

• The Yellow Emperor said ''The principle of Yin
  and Yang is the foundation of the entire
  universe. It underlies everything in creation. It
  brings about the development of parenthood it is
  the root and source of life and death it is found
  with the temples of the gods In order to treat
  and cure diseases one must search for their
  origins.

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CHINESE PHYLOSOPHY

• YIN
• DARKNESS
• MOON
• REST
• WEST
• MATTER
• COLD
• LOWER
• INTERNAL
• BODY

• YANG
• LIGHT
• SUN
• ACTIVITY
• EAST
• ENERGY
• WARM
• UPPER
• EXTERNAL
• MIND

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PHYSIOLOGY

• THE VITAL SUBSTANCES
• THE VITAL ENERGY ,LIFE FORCE CHI
• MOVEMENT, WARMTH, SPIRIT,ORGAN FUNCTION,
  WEI PROTECTION(IMMUNITY)
• JING -life essence (genetics)
• BLOOD
• BODY FLUIDS
• YIN AND YANG ORGANS

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PATHOLOGY

• THE EIGHT PRINCIPLES
• DEFICIENCY YIN
• EXCESS YANG
• INTERIOR HOT
• EXTERIOR COLD
• TCMS SYNDROMES

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LI 4

• Chinese Name He GuEnglish Name Union
  ValleyDescription In the middle of the 2nd
  metacarpal bone on the radial side.Any problem
  on the face - sense organs, mouth, teeth, jaw,
  toothache, allergies, rhinitis, hay fever, acne,
  eye problems, etc.
• Tootache use both LI 4 ST 44 - LI for the lower
  jaw ST for the upper jaw.
• Headache, especially frontal a/or sinus (yangming
  area).

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• ST7  XiaguanStomach 7   Meeting point of the
  Stomach and Gall Bladder ChannelsLocation With
  mouth closed, in the depression at the lower
  border of the zygomatic arch, anterior to the
  condyloid process of the mandible.Benefits The
  Ears, Jaw And TeethActivates The Channel And
  Alleviates PainCheek And Facial Pain   Cheek
  Pain And Swelling   Deafness   Ear Pain   Jaw
  Dislocation   Jaw Lower And Gums Swollen  
  Mouth And Eye Deviation   Purulent Discharge And
  Itching   upper Teeth And Lower Jaw   Tetany
  Facial   Tinnitus   Toothache   Visual
  Dizziness   Yawning  

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• ST5  DayingStomach 5   Great WelcomeLocation
  Anterior to the angle of the mandible, on the
  anterior border of masseter muscle, in the
  depression that appears when the cheek is bulged.
  CautionAvoid the Artery!Eliminates Wind And
  Reduces SwellingAdenopathy   Chills   Edema
  Face And Lower Cheek   Eye Pain With Inability
  To Close Eyes   Facial Swelling Wind
  Obstruction   Fever And Chills With Neck Pain  
  Frequent Yawning   Lips Twitching   Mouth
  Deviation   Mumps   Stiff Tongue With Inability
  To Speak   Toothache Lower Jaw   Wind Tetany
  With Lockjaw  

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THEORETICAL EXPLANATIONS FOR ACUPUNCTURE

• TRADITIONAL
• THE
• MERIDIANS
• 14 MAJOR
• 8 EXTRA

• SCIENTIFIC
• GATE CONTROL
• Melzack and wall 1965
• NEURAL MECHANISMS
• Stux and Pomerants 1987

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Gate control theory Melzack Wall 1965

• Small diameter nerve fibers carry pain stimuli
  through a gate but large diameter nerve fibers
  going through the same gate can inhibit
  transmission of those pain impulses
• The brain also appears to influence whether the
  gate is open or closed

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• Acupuncture excites the pain inhibitory nerve
  fibers for a short period of time, thereby
  blocking pain, but the effects of acupuncture can
  last for some months after the acupuncture needle
  has been removed, and nothing in the Gate Theory
  really explains this prolonged effect.
  Acupuncture is a valuable treatment in a variety
  of non-painful diseases and the Gate Theory makes
  no attempt to explain the mechanism of
  acupuncture in the treatment of these diseases.

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NEURAL MECHANISMS OF ACUPUNCTURE ANALGESIA STUX
POMERANTZ
AA is initiated by stimulation of small diameter
nerves in muscles which sends impulses to
Spinal cord
midbrain
Pitutary hypotalamus
Endorphins and
Monoamines
ANALGESIA
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Endorphins

• Endorphins are released into the nervous system
  by the action of acupuncture and the effects of
  acupuncture anaesthesia can be reversed by the
  use of anti-morphine drugs.
• From some recent research work it would seem
  that not all types of acupuncture are blocked by
  anti-morphines
• The endorphin theory again only deals with pain
  and makes little attempt to explain the use and
  effects of acupuncture in non-painful diseases.

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Suggestibility

• Acupuncture has been criticized for being no more
  than a complex form of 'hypnotic suggestion'.
  Available research work shows that those gaining
  benefit from acupuncture treatment are no more or
  less suggestible than those for whom acupuncture
  does not work. It would therefore seem that
  acupuncture does not depend on suggestibility. At
  the same time, acupuncture does have a certain
  amount of 'magic and mystery' surrounding it.
  Almost certainly this creates a small amount of
  benefit although it does not fully explain the
  dramatic and significant therapeutic effects of
  acupuncture.

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Other Ideas

• Some research workers, particularly in Russia,
  have suggested that fields of biological activity
  exist around all living objects. The concept of
  'biofields' has little hard scientific evidence
  to support it, but there are people in both
  Russia and America who are suggesting that
  acupuncture may work through these 'fields. At
  present there are no good grounds for accepting
  or rejecting these theories.

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Dr. Nogier's pulse reflex may possibly be part of
the effect of such 'biofields'
Auriculotherapy is a therapeutic intervention in
which the auricle of the external ear is utilized
to alleviate pain, dysfunction and disease as
represented and manifest throughout the body
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KIRLIAN   PHOTOGRAPHY Kirlian Photography
is a process that uses high frequencies
and electron streams to take a
picture of invisible radiating
energy fields that surrounds all
living things

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Graphically illustrate the difference in presents
of CHI (Life) energy level before and after
acupuncture, massage, raiky, Qi Ging, exercise,
polarity, or any other body work.
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No Real Answer?

• The fact of the matter is that acupuncture does
  work, and has been shown to do so, but the exact
  answer as to how it works is unclear. The current
  scientific explanations give a logical and
  supportable basis for stating that it does have
  an effect on the nervous system, but it is
  difficult to draw any more definite conclusions.

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MethodsTRADITIONAL AND MODERN

• ACUPUNCTURE
• MOXIBUSTION
• HERBS
• ELECTRO ACUPUNCTURE
• SOFT LASER
• BIORESONANCE AND HOMEOPATHY

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ACUPUNCTURE NEEDLES
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Moxa
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Modern Acupuncture Techniques

• Both Chinese and European firms has produced
  small electrical stimulators that allow small
  amplitude pulsed electrical currents to pass
  between sets of paired acupuncture needles. In
  China these electrical machines are used to
  replace prolonged manual stimulation of
  acupuncture needle in activities such as
  acupuncture anaesthesia. In the West electrical
  stimulation is often used as part of standard
  acupuncture therapy. The voltage used is small
  and painless and passed between acupuncture
  needles that have already been inserted into the
  skin.

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LI 4

• Chinese Name He GuEnglish Name Union
  ValleyDescription In the middle of the 2nd
  metacarpal bone on the radial side.Any problem
  on the face - sense organs, mouth, teeth, jaw,
  toothache, allergies, rhinitis, hay fever, acne,
  eye problems, etc.
• Tootache use both LI 4 ST 44 - LI for the lower
  jaw ST for the upper jaw.
• Headache, especially frontal a/or sinus (yangming
  area).

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• ST7  XiaguanStomach 7   Meeting point of the
  Stomach and Gall Bladder ChannelsLocation With
  mouth closed, in the depression at the lower
  border of the zygomatic arch, anterior to the
  condyloid process of the mandible.Benefits The
  Ears, Jaw And TeethActivates The Channel And
  Alleviates PainCheek And Facial Pain   Cheek
  Pain And Swelling   Deafness   Ear Pain   Jaw
  Dislocation   Jaw Lower And Gums Swollen  
  Mouth And Eye Deviation   Purulent Discharge And
  Itching   upper Teeth And Lower Jaw   Tetany
  Facial   Tinnitus   Toothache   Visual
  Dizziness   Yawning  

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• ST5  DayingStomach 5   Great WelcomeLocation
  Anterior to the angle of the mandible, on the
  anterior border of masseter muscle, in the
  depression that appears when the cheek is bulged.
  CautionAvoid the Artery!Eliminates Wind And
  Reduces SwellingAdenopathy   Chills   Edema
  Face And Lower Cheek   Eye Pain With Inability
  To Close Eyes   Facial Swelling Wind
  Obstruction   Fever And Chills With Neck Pain  
  Frequent Yawning   Lips Twitching   Mouth
  Deviation   Mumps   Stiff Tongue With Inability
  To Speak   Toothache Lower Jaw   Wind Tetany
  With Lockjaw  

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Effects of Electro Acupuncture
LOW FREQUENCY(2-4 hz)HIGH INTENSITY
ENDORPHIN SYSTEM---THREE CENTERS
---slower onset and long duration
--- cumulative ---called
acupuncture like TENS produce CHI
---given frequently (more than daily)tolerance

( morphine like)
) HIGH FREQUENCY
(50-200HZ), LOW INTESITY SPINAL CORD AND
MIDBRAIN (by pass endorphin
---conventional TENS (gate theory)
system)- ---rapid onset and short
duration ---no cumulative
effects
TREATMENT FAILURE deficiency of endorphines
or deficiency of opiate receptors
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Electrical stimulation on periodontal
regeneration in experimental 4wall bony defects
in dogsKaynak ,JP 2005 ,2194
Quality of new bone fill and mean value of
cementum were significantly higher than control
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Herbal Remedies

• Herbal medicine is itself a powerful method of
  healing. Western drugs often control symptoms,
  but do not alter the disease process (
  antibiotics eliminate bacteria but do not improve
  a person's resistance to infection diuretics fid
  excess fluid without improving kidney function).
  Chinese herbs treat the underlying condition as
  defined by traditional diagnosis, and rarely
  cause unwanted side-effects.

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Literature of effects in dentistry

• Acupuncture induces an increase in the local
  blood and salivary flux in xerostomia patients
  j.oral rehab.1993 Blom et al.

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Trigeminal neuralgia

• ACUPUNCTURE treatment is useful in management of
  trigeminal neuralgia j .of anest.and pain in
  density Beppu et al 1992

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TMJ

• Acupuncture is useful in Tmj disorders
  psychological related but not due to occlusal
  interference . Raustia et al
• J.prosthet.dent 1986 nov ,56(5)

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Bacteria

• Shimura et al., (1980) showed that acupuncture
  reduced the number of cavity-causing bacteria in
  rats even after the rats were fed a sugary diet

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Gag reflex

• PC6 an efficient acupoint for dealing with gag
  reflex .Yugin. Special care in dentistry jan-feb
  1989

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The use of acupuncture in dentistry a review of
the scientific validity of published paper Oral
Dis. 1998 Jun4(2)100-4

• Acupuncture in 11 out of 15 studies proved
  effective in the treatment of temperomandibular
  dysfunction (TMD) and as analgesia

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A Randomized Controlled Trial of Tai Chi for
Tension Headaches Ryan B

• Tai Chi seems to directly affect stress and
  tension that contribute to the pain associated
  .In addition, Tai Chi may affect other symptoms
  that arise from stress such as tachycardia,fatigue
  ,anxiety, insomnia, etc..

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LI 4

• Chinese Name He GuEnglish Name Union
  ValleyDescription In the middle of the 2nd
  metacarpal bone on the radial side.Any problem
  on the face - sense organs, mouth, teeth, jaw,
  toothache, allergies, rhinitis, hay fever, acne,
  eye problems, etc.
• Tootache use both LI 4 ST 44 - LI for the lower
  jaw ST for the upper jaw.
• Headache, especially frontal a/or sinus (yangming
  area).

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• ST7  XiaguanStomach 7   Meeting point of the
  Stomach and Gall Bladder ChannelsLocation With
  mouth closed, in the depression at the lower
  border of the zygomatic arch, anterior to the
  condyloid process of the mandible.Benefits The
  Ears, Jaw And TeethActivates The Channel And
  Alleviates PainCheek And Facial Pain   Cheek
  Pain And Swelling   Deafness   Ear Pain   Jaw
  Dislocation   Jaw Lower And Gums Swollen  
  Mouth And Eye Deviation   Purulent Discharge And
  Itching   upper Teeth And Lower Jaw   Tetany
  Facial   Tinnitus   Toothache   Visual
  Dizziness   Yawning  

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• ST5  DayingStomach 5   Great WelcomeLocation
  Anterior to the angle of the mandible, on the
  anterior border of masseter muscle, in the
  depression that appears when the cheek is bulged.
  CautionAvoid the Artery!Eliminates Wind And
  Reduces SwellingAdenopathy   Chills   Edema
  Face And Lower Cheek   Eye Pain With Inability
  To Close Eyes   Facial Swelling Wind
  Obstruction   Fever And Chills With Neck Pain  
  Frequent Yawning   Lips Twitching   Mouth
  Deviation   Mumps   Stiff Tongue With Inability
  To Speak   Toothache Lower Jaw   Wind Tetany
  With Lockjaw  

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THE ODONTOMES

• PAIN may be associated with health disturbances
  in areas remote from the teeth and periodontium .
  Clin.prev.dent nov-dec 1991 Horowitz et.al
• Eastern cultures base health upon meridians in
  the human body. Everything that passes along
  these meridians affects the major organs of the
  body, such as the liver, heart or kidneys. All of
  the meridians run through the teeth. Dr.Voll

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