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The Use of Acupunture in Dentistry. YEHIEL ALPERN D.M.D A.C. פניה לרפואה משלימה. בסקר מקיף שנערך בארה"ב וכלל מעל 30 אלף מרואיינים, נמצא כי 36 אחוז מהמשתתפים מעל גיל 18 פנו לשירותי הרפואה האלטרנטיבית בזמן מחלה. ומה קורה בישראל?.

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the use of acupunture in dentistry

The Use of Acupunturein Dentistry

YEHIEL ALPERN D.M.D A.C

slide3

פניה לרפואה משלימה

בסקר מקיף שנערך בארה"ב וכלל מעל 30 אלף מרואיינים, נמצא כי

36 אחוז מהמשתתפים מעל גיל 18 פנו לשירותי הרפואה האלטרנטיבית בזמן מחלה.

slide4
ומה קורה בישראל?
  • בסקר עם יותר מ- 2000 משתתפים בשנת 1993 ובשנת 2000, נמצא כי בשנים אלה היתה עליה של קרוב ל- 70% במספר הפונים לרפואה משלימה
  • הגישות הטיפוליות הפופולריות ביותר היו הומאופתיה ואקופונקטורה
  • נשים ותושבי ערים גדולות נטו יותר לטיפולים אלטרנטיביים וסה"כ בשנת 2000 דווחו 75% מהמטופלים שהטיפול עזר להם
slide5

107. Acupuncture

National Institutes of HealthConsensus Development Conference Statement 3-5,1997November

the history of acupuncture
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.
early history
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..
application in dentistry
APPLICATION INDENTISTRY
  • SEDATION-PREOPERATIVE
  • PAIN CONTROL-POSOPERATIVE
  • GAG REFLEX CONTROL
  • CONDITIONS in oral medicine:

TMJ DIS -FUNCTION,BRUXISM

RECURENT APHTOUSSTOMATITIS

Facial paralysis ,Trigeminal neuralgia

Modified taste sensation, Burning mouth syndrome,xerostomia…….

yin yang
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.
chinese phylosophy
YANG=

LIGHT

SUN

ACTIVITY

EAST

ENERGY

WARM

UPPER

EXTERNAL

MIND

YIN=

DARKNESS

MOON

REST

WEST

MATTER

COLD

LOWER

INTERNAL

BODY

CHINESE PHYLOSOPHY
physiology
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
pathology
PATHOLOGY

THE EIGHT PRINCIPLES

DEFICIENCY YIN

EXCESS YANG

INTERIOR HOT

EXTERIOR COLD

TCM’S SYNDROMES

slide17
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).
slide18
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 • 
slide19
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 • 
theoretical explanations for acupuncture
TRADITIONAL

THE

MERIDIANS

14 MAJOR

8 EXTRA

SCIENTIFIC

“ GATE CONTROL”

Melzack and wall 1965

“NEURAL MECHANISMS”

Stux and Pomerants 1987

THEORETICAL EXPLANATIONS FOR ACUPUNCTURE
gate control theory melzack wall 1965
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
slide22
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.
neural mechanisms of acupuncture analgesia stux pomerantz
NEURAL MECHANISMS OF ACUPUNCTURE ANALGESIA STUX & POMERANTZ

AA is initiated by stimulation of small diameter

nerves in muscles which sends impulses to:

midbrain

Spinal cord

Pitutary & hypotalamus

Endorphins and Monoamines

ANALGESIA

endorphins
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.

suggestibility
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.
other ideas
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.
dr nogier s pulse reflex may possibly be part of the effect of such biofields
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

slide28

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

slide29

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.

no real answer
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.
methods traditional and modern
MethodsTRADITIONAL AND MODERN
  • ACUPUNCTURE
  • MOXIBUSTION
  • HERBS
  • ELECTRO ACUPUNCTURE
  • SOFT LASER
  • BIORESONANCE AND HOMEOPATHY
modern acupuncture techniques
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.
slide40
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).
slide41
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 • 
slide42
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 • 
effects of electro acupuncture
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

slide44
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

herbal remedies
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.
literature of effects in dentistry
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.
trigeminal neuralgia
Trigeminal neuralgia
  • ACUPUNCTURE treatment is useful in management of trigeminal neuralgia j .of anest.and pain in density Beppu et al 1992
slide50
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)

bacteria
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

gag reflex
Gag reflex
  • PC6 an efficient acupoint for dealing with gag reflex .Yugin. Special care in dentistry jan-feb 1989
slide53
The use of acupuncture in dentistry: a review of the scientific validity of published paperOral Dis. 1998 Jun;4(2):100-4
  • Acupuncture in 11 out of 15 studies proved effective in the treatment of temperomandibular dysfunction (TMD) and as analgesia
a randomized controlled trial of tai chi for tension headaches ryan b

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..

slide58
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).
slide59
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 • 
slide60
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 • 
the odontomes
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