In line with alignment

May 15, 2014
The message in this column is twofold. I am celebrating while singing the praises of chiropractic care -- both a personal and professional impact.

By Eileen Morrissey, RDH, MS

The message in this column is twofold. I am celebrating while singing the praises of chiropractic care -- both a personal and professional impact.

Chiropractors focus on musculoskeletal and nervous system disorders, and the effects of these on general health. Chiropractic care is used most often to treat neuro-musculoskeletal complaints, including (but not limited to) back pain, neck pain, arm and leg joint pain, and headaches. Chiropractors use a hands-on, drug-free approach to health care that includes patient examination, diagnosis, and treatment.

The most common therapeutic procedure performed by chiropractors is known as spinal manipulation (generalized) or chiropractic adjustment (specific). The purpose of manipulation is to restore joint mobility by manually applying controlled force into joints that have become restricted in their movement -- as a result of tissue injury. Such injuries can be caused by a single traumatic event, such as improper lifting of a heavy object, or through repetitive stress, such as sitting in an awkward position with poor spinal posture for an extended period of time. (Is this ringing any bells for our beloved dental hygiene profession?) In either case, injured tissues undergo physical and chemical changes that can cause inflammation, pain, and lessened function for those afflicted. Manipulation or adjustment of the affected joint and tissues restores the mobility. The pain and muscle tightness is alleviated, and the tissues can heal.


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My exposure to chiropractic medicine was personal, ancient, and extremely limited -- more on this later. Fast forward to the present day. Over the past year, I have had three patients present with severe TMJ symptoms. My dentist employer had referred one to a TMJ dental "specialist," who was not able to help her. (Understand that this woman had gone to the emergency room at one point because she could not close her mouth.) She was terrified. Somehow, through her own support network, she sought out the care of a chiropractor who specialized in TMJ disorders. After one adjustment, she is on a maintenance schedule with her chiropractor and is completely comfortable. Her TMJ symptoms vanished after one manipulation; she sees her chiropractic physician on a continuing schedule because she has come to appreciate the integration of this treatment into her own overall sense of health and well-being.

A short time after, another patient in our practice had experienced the same symptoms. She too had been referred to the dentist who was a TMJ specialist, but to no positive outcome. At her recare visit, I found myself sharing the story about the aforementioned client, and told her I would email her the name of the chiropractor who had expertise with TMJ distress. It turns out that this second patient did indeed visit a chiropractor; however, it was one of her own choosing. But she had the same satisfying ending. It took only one adjustment and her TMJ symptoms (which had also included a complete inability to close her mouth) disappeared altogether. At this point, I was officially impressed!

I cannot begin to tell you how gratifying this is to me. Fast forward to my present-day life, which involves a newfound relationship with a gentleman who happens to be a chiropractic physician. Dr. David Kutschman practices in Shrewsbury, N.J. Since I have known him, I have learned a great deal more about this approach to care and have gained even greater appreciation. Dr. Kutschman explains that some (not all) chiropractors practice a manipulation technique known as the pterygoid stretch, which is used in treating TMJ disorders. This certification involves postgraduate training. This is important to know if we are seeking out practitioners who may be well able to help our patients. How is it, I wonder in angst, that I have been so unaware all these years as to how my TMJ patients could be better served?

On a personal level, while I now use loupes and make every effort to be ergonomically correct when I practice clinically, my years of pretzel-like postures have taken their toll. There are times when I get a burning knot under my left shoulder blade that seems to be a chronic malady. I have written in the past about my efforts to "self-treat."

My personal experience with chiropractors historically was limited and unsatisfying, taking place a long time ago. I was under the incorrect impression that all chiropractors wanted you to become a staple in their practices weekly for a lifetime. I am ashamed and can say only that I have become enlightened. My own knotty shoulder blade is a distant memory -- something that rears its ugly head on rare occasions thanks to some simple adjustments.

My education on the topic came in the form of Dr. Kutschman's simple analogy. He said, "If your body is not in the shape that it should be, you would not expect to work out one time and have an immediate result, would you? You would continue to exercise and eat healthy until you reached a point where you could maintain. Correct?" (Yes!) "It is no different with chiropractic. Once you are properly aligned, you maintain." This is serious food for thought for hygienists.

When I asked Dr. Kutschman why the pterygoid stretch seems to help TMJ distress with one adjustment only, he explains that such relief will not necessarily always be the immediate case. Yes, there will be improvement, but the patient may require follow-up manipulation as time passes. Perhaps this information will be useful to you in your efforts to serve your patients.

EILEEN MORRISSEY, RDH, MS, is a practicing clinician, speaker, and writer. She is an adjunct dental hygiene faculty member at Burlington County College. Eileen offers CE forums to doctors, hygienists, and their teams. Reach her at [email protected] or 609-259-8008. Visit her website at

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