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Cranial Osteopathy in Dentistry

Editor’s note: Having just submitted a major grant on Friday and then having had to turn around and head to an NIH study section meeting today in Bethesda, I just didn’t have the time to produce something up to the usual standards of SBM for today. (And, being managing editor, I should know what’s up to the usual standards of SBM; what I started to write wasn’t it. Trust me on this.) Fortunately, Dr. Grant Ritchey and Dr. Steve Hendry, two skeptical, science-based dentists, did submit something up to SBM’s usual standards. Even better, since we’ve been having a number of requests for posts involving dentistry, it seemed like a perfect time to publish their first contribution to SBM and see how our readers like it. Maybe next time around, I’ll have them update the “state of knowledge” regarding amalgams.

Form follows function, as the old saying goes. Nowhere in the human body is this adage more fitting than in the oral cavity.  In less than two generations, the practice of dentistry has evolved from basic pain relief and function-based procedures (such as extractions and fillings), into today’s practices of complex cosmetic rehabilitation, orthopedic and orthodontic management of the teeth, jaws, and facial structures, replacing missing teeth with dental implants, and treatment of sleep apnea and temporomandibular joint (TMJ) disorders, to name but a few.   With such rapid progress, it is to be expected that for every science based advance made in our field, there are just as many claims that are either dubious in their evidential support or outright pseudo-scientific or anti-scientific nonsense.

In this article, we’ll be taking a look at the roles that health care practitioners such as chiropractors, osteopathic physicians, and physical therapists, are attempting to play in the dental field.  We will also see how well-meaning dentists have been trained in and apply their pseudo-scientific principles in their dental practices. In particular, we’ll be examining Cranial Osteopathy (also known as Craniosacral Therapy or Cranial Therapy) in the management of the dental patient, the purported benefits claimed by practitioners of cranial osteopathy, and the quality and quantity of evidence for this type of treatment in the scientific literature.

Basic Skull Anatomy

The human skull is made up of some eight cranial (head) bones and fourteen facial bones.  These bones help protect the organs of vision, hearing, taste, equilibrium, and smell. They also provide attachment for muscles that move the head, control facial expressions and chew our food.  At birth, the spaces between the cranial bones- called fontanelles – are wider and more elastic, allowing the infant to pass through the birth canal and later permitting brain growth in the first few years of life.  In humans the lateral fontanelles close soon after birth, the posterior fontanelle generally closes several months later, and the anterior fontanelle may remain open for three years.

By early childhood, the cranial bones become tightly interlocked in a zig-zag, zipper like pattern (illustrated nicely here) that renders them immovable in a macroscopic sense, although each suture (called a synarthrosis if you want to impress your friends at parties) has a very slight amount of flexibility- 10-30 micrometers on average (1 micrometer = 1/1000th of a millimeter or approximately 4/100,000ths of an inch).  These sutures fill the minuscule space between the cranial bones, essentially stitching them together with dense, strong connective tissue fibers called Sharpey’s fibers.

Tenets and Scope of Cranial Osteopathy

Cranial Osteopathy was invented by William G. Sutherland D.O. around 1900 when, while viewing a disarticulated human skull, he noted the way some of the skull bones were:  “…beveled… like the gills of a fish… indicating articular mobility… for a respiratory mechanism.”   Note that we said “invented” rather than “discovered,” as this discipline was indeed invented from whole cloth, based upon the happenstance similarity in the appearance of a skull bone and the gills of a fish, which he then superimposed on his 19th century osteopathic ideology.  (Imagine what he would have come up with had he instead noted the similarity between the uvula and the male genitalia!)  Sutherland claimed, and adherents of Cranial Osteopathy hold, that the cerebrospinal fluid (CSF) has an inherent rhythmicity, which he likened to the tides of the ocean.  He called this the “Primary Respiratory Mechanism (PRM)”, often referred to today as “Craniosacral Rhythms.”  According to Osteopathic principles, the PRM underlies all of life’s processes and begets vitality, form, and substance to all of a person’s anatomy and physiological processes.  Any disturbance in the natural flow of CSF could cause illness and conversely, practically any illness could be prevented or cured by the physical manipulation of the cranial bones, “freeing up” the functional flow of the CSF.   Towards the latter part of his life, Sutherland believed that he could sense a “power” which allowed corrections to occur from inside his patients’ bodies without having to provide any physical manipulations.  This has come to be known as “biodynamic craniosacral therapy” or “biodynamic osteopathy”.  See this overview of the scope of Cranial Osteopathy (“The Cranial Concept”) in their own words.

Of course, none of this imagery would be of any use without a therapy to sell, and osteopaths assert that they can fix what ails you through hands-on manipulation of your skull bones. As one practitioner’s website puts it:  “As incredible as this may seem, we feel the bones move, the membranes pull, the fluids fluctuate, and even the brain undulate”.  And woe unto the poor sap who suffers from a rigid-boned, lax-membraned, fluid stasisy, un-undulating brain!  Practitioners of Craniosacral Therapy or Cranial Osteopathy claim that they can detect this secondary CSF pulse with simple palpation and distinguish them from a regular vascular pulse.

Cranial manipulations are performed in a variety of different ways depending upon the condition being treated and the philosophy and training of the practitioner.  (See an overview of some of the techniques.)  Some of them include range of motion therapies similar to what a physical therapist would do; others involve the supposed manipulation and movement of the cranial bones, using only digital (i.e. finger) pressure with a very light force.

The Cranial Osteopathic Academy, a component society of The American Academy of Osteopathy (AAO), described it thus:

Treatment is typically very gentle. Tissues are supported and allowed to change. Usually very little force is used during treatment, but at times some force may be necessary. Diagnosis and Treatment are said to blend into one another. As tissues change the physician learns more about their nature. As the nature of the tissue dysfunction is better understood, the therapeutic response deepens.

Each patient’s experience is unique. Some patients sense only a gentle touch, while others feel their body change immediately. Some patients simply feel a deep sense of relaxation, and others feel nothing at all. Most patients feel a distinct change following the treatment.

Though Cranial Osteopathy is very gentle, patients can occasionally experience some discomfort during certain stages of the treatment. When this occurs, it is simply a part of the healing process. As the treatment progresses, the discomfort subsides.

Although physicians practicing Osteopathy in the Cranial Field will work anywhere on the body, they may find it important to diagnose and treat the head. Though styles of treatment may vary, the osteopathic physician will primarily focus on the body’s “mechanism” – the body’s natural striving for health and normal function.

According to Dr.Sutherland, within each patient there is great wisdom, an inner physician, a wise all-knowing force that is the source of all healing. In his own words: “Allow physiologic function to express its own unerring potency rather than apply blind force from without.”

Cranial Osteopathy and its variants make a number of imaginative leaps from histological starting points to therapeutic endpoints.  From the slight (micrometer) flexibility of cranial sutures, and the slight-but-measurable fluctuation in CSF pressures, practitioners infer that the brain and spinal cord undulate rhythmically “like a jelly fish, coiling and uncoiling” which is critical for health.

Dental Applications of Cranial Osteopathy

Gradual movement of teeth within bones, and gradual orthopedic movement of facial bones themselves, are familiar to all dentists who do orthodontics.  Dentists performing orthodontic treatment utilize various appliances to expand the palate (palatal sutures don’t normally fuse until adolescence) and move teeth within the jawbones.  Further, the treatment of TMJ disorders has typically been in the realm of the dentist, involves the articulation of cranial bones in the scope of treatment (the mandible and the temporal bone), so the Osteopathy belief system would seem a natural fit to dentistry, especially in these areas.  And sure enough, Osteopathy has colonized the dental profession. We’ve seen expensive dental continuing education courses with “Cranio-”, “Sacro Occipital Therapy” and “Chiro-” in their names that graft Osteopathic principles onto dentistry to create whole new, untapped disciplines to market.

Websites promoting these dental applications of Cranial Osteopathy claim to teach amazing new skills to dentists, including how to “free up” and move facial bones around, by hand, in minutes using only fingertip pressure.   Additionally, in almost every case, these dental courses provide a gateway to other, more garden variety forms of CAM: nutritional supplements, detox, immune system boosting,  nervous system balancing, and so forth. For the dentist, taking one of these courses is the first step in going “down a rabbit hole” into CAM-land – a metaphor that devotees enthusiastically embrace and frequently use.

An important point to reiterate here is that the emphasis in the dental application of cranial osteopathy is not merely to treat illness or facilitate the flow of the CSF as in “regular” osteopathy; it claims to actually bodily move the facial and cranial bones to more ideal positions to improve orthodontic and TMD outcomes.  Cases are shown where overall changes in facial structure and the occlusion (i.e. the bite) are alleged to have been changed by as much as a half of an inch or more by cranial manipulation alone.  Of course, these are case studies with little to no supplementary documentation (radiographs, CT scans, etc.) available for an objective reviewer to confirm the claims. We have yet to see a well-documented, objectively presented case study in the medical or dental literature which adequately demonstrates the validity of the treating practitioner’s claims, although one would think that after decades of the existence of their treatment modalities, such evidence would be plentiful, substantive, and readily accessible to the health care community.

Credibility as a Dental Treatment

For Cranial Osteopathy to be viable treatment, there needs to be good evidence anatomically and histologically that the sutures are indeed movable (by hand, no less) to a significant degree, and evidence that doing so is therapeutically beneficial.   Neither appears to exist. Although Cranial Osteopathy can provide a modicum of basic research to support its claims, it falls far short of what is needed to establish a scientific foothold in the dental-medical community. Osteopathic applications are woefully lacking in any substantive research but instead rely on anecdotal evidence as the foundation of its validity and applicability.  See the excellent overview of Cranial Therapy at Quackwatch.org.

Evaluating the literature, minute movements of the cranial bones appear to be possible (in the micrometer range as stated above) — but not the large rearrangements of bones that practitioners claim to make with hands-on manipulation.  It is dubious that a practitioner can feel distortions in cranial bones that the most sensitive neurophysiological instruments cannot.

Moreover, even if an Osteopathic therapist could detect abnormalities in the skull, there appears to be no credible evidence linking small movements at cranial sutures to beneficial health outcomes.  As a scientific principle, this is nothing more than wishful thinking and resembles faith healing more than evidence based medicine. The therapeutic claims, research protocols, treatment goals, and definitions of what constitutes solid medical evidence are as flexible as the cranial bones they purport to manipulate.

Cranial Osteopathic adherents predictably scold their critics as being closed-minded and unwilling to learn, or worse, a shill for the Dental Industrial Complex.  But we like the old adage about staying open-minded, but not so open that your brain falls out.  The really surprising (and disturbing) thing to us is the number of bright, conscientious, and highly-trained dentists we see being drawn to courses in Cranial Osteopathy, and in many cases buying into the smorgasbord of alternate-medicine courses offered as side dishes at the cranio-dental table. If there’s harm in the Cranio-dental movement, besides a lot of money wasted by dentists on dubious courses and by patients on dubious treatment, it may be that it seems to be a particularly attractive gateway to more bizarre alternate treatment philosophies – one that seems to appeal to surprisingly smart and educated dentists.   By granting dentists a license to practice, the public trusts us to apply evidential knowledge to the management of their dental problems. This implies that we must critically examine new hypotheses, decide if there is rational evidence for them, reject the pseudo-science, and apply the knowledge that sifts through for the benefit of the patients we serve.

 

Post Script:  This is our first article in what we hope will be many to come on dental-related topics.  We would love to hear from you, the fine readers of the Science Based Medicine Blog.  If there are topics you would like to see addressed, or if you have any questions, comments, or critiques, please feel free to email us at  HYPERLINK “mailto:skepticaldentist@gmail.com” skepticaldentist@gmail.com.

 


 

Dr. Grant Ritchey received his Bachelor’s degree in Human Biology from the University of Kansas in 1982, and his Doctor of Dental Surgery degree from the University of Oklahoma in 1986. He lives in Kansas City, is married, and has two grown daughters. Since 1986, he has maintained a general dental practice in Tonganoxie, Kansas, and was awarded a Fellowship in the Academy of General Dentistry in 1998. Currently, he is working toward his Masters in Education Degree from the University at Buffalo in the Science and the Public program, with an emphasis on the prevalence of alternative medical practices in dentistry.

Dr. Steve Hendry, BSc DDS FAGD, completed an honours degree in Genetics at the University of Western Ontario before deciding to be a dentist when he grew up. He spent summers working in a corn cytogenetics research lab through dental school. Since graduating in 1981, he’s maintained a general dental practice. Steve has always been fascinated and appalled at the scarcity of critical thinking skills in society and, increasingly in his own profession. He is particularly proud of having attained the status of “closed minded” in the eyes of some of his woo-friendly peers.

Posted in: Chiropractic, Dentistry, Science and Medicine

Leave a Comment (32) ↓

32 thoughts on “Cranial Osteopathy in Dentistry

  1. Harriet Hall says:

    Thanks for this!
    Craniosacral therapy brings back fond memories, since it was the subject of the first article I ever published, in Skeptical Inquirer, entitled “Wired to the Kitchen Sink.” http://www.quackwatch.com/01QuackeryRelatedTopics/cranial2.html

    SRAM had an interesting article on interexaminer reliability, showing that different practitioners couldn’t agree on the frequency of the rhythmic CSF fluctuations they thought they were feeling: http://faculty.une.edu/com/shartman/sram.pdf

    I hope to see many more dental topics covered in a similarly lucid manner. Welcome to SBM!

  2. egrrrl11 says:

    Very enjoyable piece!

    I would LOVE a piece on amalgam. I know quite a few people who have spent $$$$ having amalgam fillings removed for reasons that strike me as very, very woo.

  3. I’m glad to see some more dentistry coverage here. I’m a skeptic who isn’t a dental professional but works in an administrative capacity at a dental nonprofit, and have absorbed a lot of info over the years.

  4. Scott says:

    Quite nice. Definitely count me as looking forward to hearing more from Drs. Ritchey and Hendry.

  5. Woody says:

    Nice article. As a child of a dentist and the spouse of an orthodontist, I definitely plan to share this and hopefully lure my family members fully into the skeptical fold.

    I am surprised that orthodontists as a profession have not been aggressively denouncing this practice ( or maybe they have?). If practitioners claim to move bones in a single appointment with simple finger pressure, why would anyone opt for the costly, time-intensive orthodontic procedures? I predict the response – because they actually work!

  6. TsuDhoNimh says:

    (Imagine what he would have come up with had he instead noted the similarity between the uvula and the male genitalia!)

    One of you two owes me a new keyboard!

  7. DBonez5150 says:

    Outstanding piece! Enjoyable, well thought-out, and likely to irritate sCAM devotees – all qualities I’ve come to love here at SBM! I would certainly welcome and enjoy further contributions on dental-related topics from either/both of you Drs. It’s also interesting (disturbing?) to see an expanding list of science-based industries impacted by the intrusion of such nonsensical, faith-based garbage. Even the hobby I love so dearly, high-end audio equipment, is fraught with similar pseudo-scientific, absolutely un-provable nonsense (magical electrical outlet covers, sound improving jars of rocks, $10,000 speaker cables, directional wires, etc.). Sigh; it’s everywhere.

    I’ll be sure to send a link of this to my dentist. We’ve had a number of science-based discussions (well, he spoke and I mostly gurgled and slurred) and his ideals, and practice from what I can tell, seem quite grounded in science and reality.

  8. Quill says:

    Thank you both for this article. Count me in among the people who would very much like to read more on SBM about dentistry subjects. I was especially pleased with this piece as I’d not heard of this particular CAM practice in the dentist’s chair. I suppose I’m fortunate to go to a “closed-minded” dentist.

    Also count me in as someone who wants to hear more about the whole amalgam filling “controversy.” I had seven replaced years ago for the excellent reason that three were fractured, two were looking dodgy and all had been put in over a three year period decades ago by a dentist who, to be kind, had not done his best work on my teeth. I am happy to have barely-noticeable, tooth-colored fillings and to be pain-free. However, when I would mention to some people having had this upgrade-replacement I was treated to a wide range of responses, from “The new ones look great!” to “I’m so glad you got rid of the poison in your mouth! Did you know amalgam fillings were originally developed by the military to track people?”

    So you can surmise I’d love a well-written piece based on science instead of The Great, Hidden, Mysterious Secrets That Will Improve Your Live, Cure All Disease and Remove You From the Clutches of BigBigScaryStuff. :-)

  9. Jann Bellamy says:

    Interesting post — I’m grateful for everyone out there exposing this nonsense. Here in Florida, we have one of the “premier” cranio-sacral therapy institutions, the Upledger Institute. http://www.upledger.com/. It astounds me that proponents never have to demonstrate plausiblity or have any evidence of effectiveness yet are able to sell these “services” to the public.

  10. tmac57 says:

    Thanks to both Dr’s Hendry and Ritchey.Great article,and I look forward to other dental related subjects,such as anti-snoring devices,amalgam,and TMJ (TMD).And hint to Dr. Ritchey, It’s probably not a good idea to talk about the ‘Dental Industrial Complex’…you know,living in Kansas…Just sayin’.

  11. BillyJoe says:

    “well, he spoke and I mostly gurgled and slurred”

    Similar experience with my recent dental encounter:
    First she disables my mouth and then she asks me a question!

  12. Chris says:

    Once upon a time there was a small plaque on the wall at my dentist: “Blessed be those who engage in lively conversation with the hopelessly mute.”

  13. nybgrus says:

    It took me a while to actually get to this article, but I enjoyed it. I don’t know too much about dentistry so learning more about the actual science of the field is very interesting to me. I also am particularly curious about TMJ disorders since that not only seems to be a very popular think in the mass media but also amongst people I know. It also seems like an excellent area for much nonsense to be injected.

  14. bluedevilRA says:

    Thank you for covering this! As a D.O. student, I often have to swallow my SBM/skeptical nature to avoid offending some of the nuttier faculty, but cranial is just one of those things I cannot stomach.

    The basic science faculty absolutely hate it. In anatomy lab, we can see how the bones of the skull are fused together and interlocked with sutures. To me, this is no different than Reiki and other magical altmed nonsense.

    Dr. Hall, thanks for posting that NECOM (New England College of Osteopathic Medicine) study. The authors of that study, along with other NECOM faculty, started a petition to have cranial osteopathy removed from the curriculum.

    Also, cranial osteopathy does not stop at dental complaints. The advocates of cranial insist it can be used to treat psychiatric and neurological conditions too. It is for this reason that if I enter either psych or neuro for residency, I will be doing an ACGME residency and joining the AMA rather than the AOA.

  15. Ed Whitney says:

    @ bluedevilRA:

    Correct me if I am mistaken, but I thought that the AOA was not particularly affiliated with cranial osteopathy, which was more associated with the American Academy of Osteopathy (which sponsored the Cranial Academy, for example). If I recall correctly, the AAO and the AOA were not particularly great buddies because of differences of perspective on the cranial model and other issues.

    I am curious about one thing in your curriculum, namely with respect to how you are taught about embryology. Blechschmidt and Gasser’s “Biokinetics and Biodynamics of Human Differentiation” was a favorite of the cranial folks and was promoted by the Sutherland Cranial Teaching Foundation. This book reminds one of D’Arcy Wentworth Thompson with its structuralist approach to the development of form. It has some suitably nebulous things to say which lend themselves to a semi-mystical approach to the human organism and therefore to the cranial model. In the first chapter, for example, it says, “There is good reason for the assumption that every cell represents a field that is called a metabolic field (Stoffwechselfeld). The concept of a metabolic field is very important. It shows that no cell should be thought of as a rigid unity but rather as a momentary aspect of spatially ordered (submicroscopic) metabolic movement (Stoffwechselbewegungen).”

    Well, if you can’t even understand the concept of Stoffwechselbewegungen, then why the hell should I waste time listening to you? Serious science, this. Have you been taught any of its concepts? It supports the idea that external physical forces involving the biodynamics of altered reciprocal tension motion can influence physiological processes. Any of that sound familiar?

  16. Thanks for the interesting article. Like nybrgus I would also enjoy hearing about TMJ, under diagnosed, over diagnosed?

    Cranial sacral therapy for children seem to be gaining popularity in our area. A couple years ago I heard from friends who were having their infant treated with CS for motor issues. Recently I heard from a mom who told me that her son was having trouble learning to read until the “neuro-chiropractor” started giving CS therapy.

    I don’t understand how people get lured by stuff like that. A quick search on crania-sacral therapy will reveal how questionable it is.

  17. Mike says:

    Sadly, lots of things would be questionable after a quick search, but people do them anyway. Just look at tooth-whitening treatments, aka dental bleaching, which cause chemical burns, erode enamel, and cause sensitivity, or else be ineffective, and also be only temporary and cost a lot. Yet folks still go for it.

  18. bluedevilRA says:

    @Ed, can’t comment on the relationship between AOA and AAO aside from the fact that we definitely have cranial as part of our OMM course. It is required at all DO schools and is tested on the COMLEX (the DO-equivalent of the USMLE), I believe.

    As far as embryology goes, our systems courses have integrated embryology. So during our Cardiovascular system course, we learn the embryonic development of the heart. This is all taught by basic science faculty, mainly anatomists. What we were taught corresponds with books that are used for USMLE board prep like BRS Embryology and First-Aid for the USMLE.

  19. inconscious says:

    Like bluedevilRA I am also a DO student. However, I am also a PhD student and obviously a reader of SBM. As such I was quick to become uneasy when it came to some OMM techniques that didn’t seem to have an easy to understand and intuitive (from a biological perspective) biomechanical basis – which is exactly what cranial DOES NOT have. It’s especially frustrating to have to pass standardized board exams with some of this garbage on it.

    Reading this article actually lead me to the Quackwatch article on the “dubious” components of osteopathy. I posted it to the facebookz and even my SBM-ish DO-student friends seemed to be a little hypersensitive to any sort of attacks on osteopathy (particularly from an MD). I would suggest any DO students that read SBM also take a look at the Quackwatch post. I think there are some sweeping generalizations and non-nuanced claims that Dr. Barrett makes, but overall the portions on cranial are spot on. These articles definitely capture the feeling of discomfort many of us modern DO students (and many DOs in general) feel toward some of the quacky aspects of our professional past and present.

    @Ed I can also second bluedevilRA’s mentioning of embryology – ours is integrated across the first two years of basic science training and is very much not quacky. In general the basic science years for DO education are VERY well taught, with few exceptions.

  20. @Mike, True, but CST must be up there in the questionable department, a simple google of cranioscacral therapy and most of the links are wiki, quack watch and cancer.org saying the evidence does not match the claims, the rest are clinics who preform the therapy, selling the therapy. Seems that should raise the eyebrows of anyone with a tiny grain of critical thinking ability.

  21. Mike says:

    @micheleinmichigan, I know, you can’t help but wonder why people don’t do any research. I’m appalled at the number of smart people who don’t. A friend of mine was astonished at how his father, a normally smart and skeptical person, was taken in by a pyramid scheme and lost tens of thousands of dollars. Even the smartest of us can fall in the trap of believing what sounds good.

  22. tmac57 says:

    Micheleinmichigan- I did a Google search on ‘craniosacral therapy benefits’ and then ‘craniosacral therapy risks’,and most results tended to be positive surprisingly. So unless a person really took a critical eye toward their investigation,a superficial look at it might be misleading.

  23. JPZ says:

    Excellent and well-written article! Thank you for your contribution.

  24. @Mike, yes. I did not mean to suggest that a lack of intelligence was the issue. Since one of these couples have been good friends for a number of years, I just kinda struggle to see how they’ve gone in this direction. Upon reflection, I don’t really think they’ve changed direction. I think that, due to my son’s special medical/educational needs, I’ve become much more likely to question interventions.

    @tmac57, I think you are on the right track. I google craniosacral therapy children and none of the sites that wrote on the questionable nature of CST came up, also there was a positive review on the La Leche site, so I can see why folks might miss the information that I found.

  25. lilady says:

    I thoroughly enjoyed reading this article and hope that we can expect more articles from these dentists.

    Your article dealing with cranio-sacral therapy was very informative and I thought back on the occasional times I post under “lilady” when a particularly bogus theory is blogged about by a “practitioner” on the Huffington Post website:

    Juliet Linley “Cranio-Sacral Therapy for Kids” (March 4, 2011):

    “What utter nonsense! I visited the University of Wisconsin website and they do offer courses in radiothera­py..for cancer radiation treatments technician­s and for engineers who are designing machines and setting up radiation treatment facilities­. Even if Rimmington graduated with a “degree” in radiothera­py, it has nothing to do with her “internati­onal certificat­ions of the highest levels in biodynamic craniosacr­al therapy. BTW which universiti­es here or abroad have undergrad or graduate programs that qualify a personal for certificat­ion in “biodynami­c craniosacr­al therapy” and what are the names of the certifying “boards.”

    I googled “Biodynami­c Craniosacr­al Therapy” and lo and behold, found a website with an “interesti­ng” article by Michael Shea about “getting permission from the infant…b­efore you provide therapy” and other pseudo-sci­ence.

    New parents, save your money and don’t let any quack therapists near your precious infant.”

    I think I thoroughly debunked the credentials of the quack therapist who was doing this “therapy” on newborns.

    Just today, I spoke to our family dentist about the two adjacent tooth extractions that my husband required, which will require implants for replacement. I had looked at some reputable internet sites for advice about the use of a moistened tea bag, placed gently over the sutured surface of the gum for treatment of any ongoing bleeding and my dentist confirmed that it may prove of value due to the tannic acid in the tea.

    My husband is S/P triple cardiac drug eluding stents placements this past February and is required to take Plavix and ASA for at least two years. He is very sensitive to these anticoagulants and has had spontaneous gum bleeds and other spontaneous capillary bleeds as well as some large purpora/echymoses…in addition to being a world class klutz. We are already at Plan B…decreasing ASA from 325 mg. to 81 mg…and their is no plan “C”.

    So, would our latest SBM bloggers care to comment about moistened tea bags to stop seepage bleeding following tooth extractions?

  26. tmac57 says:

    lilady-re moistened tea-bags for bleeding after tooth extraction.I had to do this a couple of times when I accidentally disrupted the blood clot after having a wisdom tooth pulled.My anecdotal evidence is that it does work,but the taste is quite nauseating.I, however, was not on any blood thinning medication,and it sounds like special care should be taken in that circumstance.

  27. lilady says:

    @ tmac57: I am delighted to report on the “patient”. No bleeding and no need to try the tea bag treatment, yet. Yes, we do at times, omit the 81 mg. ASA, as per his cardiologists instructions and he only skipped the dose yesterday and resumed it today.

    Thanks again for your comment.

  28. tmac57 says:

    lilady- Glad to hear it.I am sure that they cautioned about this,but I will just add,that it is very important not to form any kind of suction (using a straw,drawing up saliva to spit etc.) as this can cause the blood clot to come out,and it will bleed like you won’t believe.It seems easy,but I found it somewhat challenging,and on two occasions,I did cause it to happen,so beware,especially for the 1st couple of days.Good luck!

  29. lilady says:

    Tmac57…he had cabin fever today so he met his buddy for their usual weekly luncheon and continued with soft nourishing diet. A small spike (less than 101 F) in body temperature, but here is on 2 grams amoxicillin/daily for the next few days.

    Still no spontaneous bleeds beneath the gum sutures, so he is on the mend.

    Dentists all worry about treating patients on anti-coagulant therapies…especially Coumadin and demand “medical clearance”. I read an interesting article in a cardiology journal that the risks of throwing a clot by removing Coumadin as treatment for atrial fibrillation or S/P cardiac ablation for the purpose of dental procedures are far greater than the risk of excessive bleeding following dental extractions. Life is so much fun and never dull when you’ve had those procedures…but then I think about the “alternatives”.

  30. tmac57 says:

    lilady-I see that he had sutures.That probably made a big difference in his case.All of my extractions (I’ve had 6 at different times),
    were done without suturing afterward,which left a gaping hole in my jaw,protected only by a blood clot.They tend to heal amazingly fast,but I really had to be careful for the first couple of days.
    Yeah, it sounds like the doctors are doing quite a balancing act in his case.Lifesaving medicines can have a double edge sword for sure.
    Glad everything is going well.

  31. niclucas says:

    Greetings all. As the editor of the International Journal of Osteopathic Medicine, I’m pleased to be able to direct interested people to a collection of articles we have published on the topic of osteopathy in the cranial field. Unfortunately, the journal is a subscription based publication and so the articles may not be available in their entirety – however, much can still be gleaned from the abstracts.

    Here is the link:

    http://www.sciencedirect.com/science?_ob=ArticleListURL&_method=list&_ArticleListID=1833567937&_sort=r&_st=13&view=c&_acct=C000228598&_version=1&_urlVersion=0&_userid=10&md5=5da28a5d582825fedebc927fa0d11909&searchtype=a

    If this doesn’t work, simply search the journal using the keyword ‘cranial’ at:

    http://www.sciencedirect.com/science/journal/17460689

    My background is in biomedical science, pain medicine and clinical epidemiology – and I am also a qualified osteopath. I take the same view about unproven surgical procedures as I do for esoteric faith based healing systems. One has the veil of ‘authority’ and the other the veil of ‘belief’ or ‘spirituality’.

    I want both to justify themselves as worthy by demonstration under appropriately controlled conditions.

    My experience at the emergency ward the other night with my child left me appalled at the clinical skills of the doctors, who wouldn’t have passed the 3rd year neurological assessment exams I used to oversee. So, on the one hand, we have reliable and accurate clinical examination skills that are based on sound biology yet are not performed correctly by staff who are poorly supervised, and on the other hand we have practitioners who are passionate in their belief about osteopathy in the cranial field (or other such concepts) and demonstrate exceptional ‘care’ for their patients, yet these tests and treatments are biologically implausible, have proven to be unreliable, and have no evidence of their effectiveness.

    Both situations are disappointing and I’m sure apply to dentistry as much as they do medicine, allied health and CAM. As the comedian, Tim Minchin notes “alternative medicine that has been proven to work, is called … medicine”.

    Another favourite quote from Tim is “every mystery, every solved, in the history of the world, has turned out to be … not magic”.

    Best regards,

  32. Bacteriophile says:

    Interesting article. I am another who would be interested in an article on the science of amalgam.

    Also, one time my wife tried out a new dentist who told her that her wisdom teeth had gotten stuck or something and might eventually induce the growth of tumors. The dentist also made numerous disturbing and seemingly excessive other suggestions for treatment, so he seemed pretty sketchy and unreliable, but I wondered if the thing about wisdom teeth causing tumors was true (especially since I still have my wisdom teeth). How important is it really to get wisdom teeth removed?

    Thanks again for your contributions.

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