Wednesday, June 5, 2013

More Similarities Than Differences

In the 70s, it was common for middle class kids growing up in Toronto to go to summer camp. I attended four different summer camps over the years, spending eight weeks away from home. The lakes in southern Ontario were great. They warmed up enough to swim comfortably on hot days when nothing could beat being near and in the water. Those camps were mostly all the same, getting kids outside and active all summer long. I wasn’t crazy about it then, but I sure miss those days now.

Today, summer camps are different. There are still the traditional camps I attended, but so many are specialized. There are sports camps, music camps, acting camps, etc. They run for one, two, or three weeks, but rarely the whole summer. The more I look at today's camps, though, the more similarities I see. These camps are simply trying to address a broader set of needs and to get kids outside and engaged.

Just short of 19 years ago, I married my wife and best friend, Tina. It was an interesting union of a Hindu family with a Jewish one. We live in a world with some amazing faiths and expressions of those faiths. The number of varieties of Christianity is wide and varied, not to mention Jewish and Muslim worship, Hinduism, Buddhism and more. We live in a fascinating world. But the more deeply I look, the more similarities I find. We are citizens of one world.

In the 1980s, the Faculty of Dentistry at the University of Toronto taught occlusion from the classic gnathological standpoint. Centric relation (CR) was the focal point for rebuilding worn or deficient occlusions and in denture fabrication. I really struggled with it and, in the end, avoided it altogether.

I worked conservatively, restoring teeth to the best of my ability, in habitual occlusion. I have been mostly successful for my now 26-year career. But I do see worn teeth, deficient dentition, collapsed bites and more. I knew that there was a way to do this and sought to learn more about occlusion. Over those 26 years, I studied the methodology of Pankey and Dawson, learned about OBI, Kois’ and Spear’s methodologies, and more. But as I stumbled upon neuromuscular approaches to dentistry, I found something that resonated with me. I studied this intensely, first at the Las Vegas Institute, and then directly with Myotronics, and finally, more recently, with Dr. Clayton Chan.

Occlusion has had considerable amounts of coverage in popular dental media. And now, better peer-reviewed publications as well. I continue to be amazed at the passionate discussions that are being held, as well as with the unfortunate animosity that has been associated with it.

I have had successes and failures in the pure gnathological CR approach, and I have had successes and failures in the pure neuromuscular approaches. But as I have studied and learned more, particularly with Dr. Chan, I have found there are more similarities than differences in the various occlusion camps. When I apply both the neuromuscular and the gnathologic approach, as I learned from Dr. Chan, I achieve the success in conservative treatment that I was not getting before, especially with patients who are in pain. I am a dentist in one profession of dentistry.

The best advice I have ever heard on this subject is from one of my prosthodontic colleagues in Calgary, Dr. Donald Reikie, during one of the local debates on occlusion. He said, “Choose the methodology that resonates for you. Learn it well and apply the principles diligently and meticulously and you will have success.”

Let’s use these words to apply our learned principles well and diligently and celebrate the similarities we have in finding healthy solutions for the patients we have the privilege to treat.

Thanks for reading.

Larry Stanleigh, DDS

2 comments:

Dr. Andy said...

Larry, Oh yes, the heated arguements over occlusion.

I would follow the advice you shared on picking a methodology that resonates with you. However, I would add a second part. "Remember that each system works on most of the people most of the time."

Does Gnathology work? Yes, on most people most of the time.

Does Nueromuscular Dentistry work? Yes, on most people most of the time.

Furthermore, as I explain to patients, do root canals fail? Yes, but they work on most people most of the time.

You can say the same about implants, sealants, etc.

So when I hear that a certain method or product works miracles I say to myself, "Yes, it works on . . . "

Andy Alas, D.D.S.

Dr. Lawrence M. said...

Andy, I mostly agree with you. However, in my more recent studies (last 5 years) with Clayton Chan at Occlusion Connections, he demonstrated how if you combine the Neuromuscular approach with the Classic Gnathological approach, you can address the 30% of cases that each approach on their own could resolve. I'm getting resolution and stability in cases I was failing before.
pretty neat stuff.
thanks for staying connected.
warm regards,
Larry Stanleigh

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