The Other Foot and Mouth Disease
Abstract: While the epidemic of “foot and mouth disease” in Britain will leave long term scars, the term could also be used for the disorders resulting from a lack of balance within the postural chain in humans …
Abstract: While the epidemic of “foot and mouth disease” in Britain will leave long term scars, the term could also be used for the disorders resulting from a lack of balance within the postural chain in humans linking the mouth (jaws) to the feet. The concept is reviewed as being a potential cause of signs and symptoms not always easy to pin-point.
The ‘Foot and Mouth Disease’ epidemic.
In 2001, the UK experienced an outbreak of ‘Foot and Mouth Disease’ which brought the country to a standstill and affected Agriculture and Tourism there dramatically, leaving a legacy and an unforgettable scar.
Over two thousand cases were reported and over 6 million cows were killed, the viral epidemic was estimated to have cost the UK economy the equivalent of over US$16 Billion dollars.
Clearly a disease whose significance cannot be overstated – yet there is a more insidious and equally debilitating disease involving the human body which it is estimated eclipses the above disease both in significance and economic burden.
Such a disease has great ramifications due to its effects, but it is the variation of signs and symptoms that cause not only its stealth, diagnostic difficulties, but its ineffective management too.
So what is the “Other Foot and Mouth Disease”.
It is the disease process which acts both between each end of the postural chain. That is from the feet to the jaws – the postural chain. This so-called, “postural chain” reaches from where the foot touches the ground and to the mouth, as the teeth touch one another (hence the title “foot and mouth”).
Why should this be of concern to us?
If you consider the body as beautiful, complex but efficient car – you’d likely agree that ensuring it was put together correctly, checked on during assembly to ensure that chassis, body panels and engine/gear-box components were working synchronously, and checking it afterwards in use was a necessity. A test drive by a skilled and experienced test driver ensures this.
The human body is of course much more than that, but it too requires structural integrity. Everything that’s supposed to be aligned should be so, in order that maximum efficiency is achieved (we call it health). Postural integrity involves that this “postural chain” be as effective as possible.
In actual fact however, this disease is not restricted to either end of the postural chain but may cause structural incongruity through-out the body, often related to dysfunction, failure and pain in many affected areas, along with physiologic (tissue and organ) disorders related to these structural issues too. Consequently, the true cause of these is rarely seen!
The balance mechanism system
“The feet are important as they provide the base upon which man stands upright – homo erectus)”. It seems reasonable therefore that the static and dynamic function of the feet will influence this postural chain.
The ankles and all joints above them, including the knee, hip, pelvis, lower back, shoulders, neck and cranium may all potentially be affected. Tissues, organ systems, musculoskeletal and neural, as well as hormones and neurotransmitters may be affected secondarily. Equally, when the human stands upright, it requires feedback to maintain this upright, erect stance.
Correct sensory input from the eyes, muscles, tendons, joints, along with the vestibular system (balance mechanisms of the inner ear) allow calculation and correction in this postural stance.
This balance mechanism system is therefore only correct and accurate when the head is on straight and the feet recording equal balance (from gravity, through the body). It is the teeth that help to regulate this.
The brain stem is the most primitive area of the brain and controls basic survival functions such as heart rate, breathing, digestion, etc. It keeps us prepared to react to incoming sensory information. Information from the balance mechanism system are all directed to the brain stem.
The brain stem also receives information from the cerebellum which controls body poise, balance, position and spatial awareness. The higher levels, the cerebral cortex, (including previous experiences that have affected previous and presenting balance) are also fed there.
The Occipital lobe behind these, (controlling visual processing), the parietal lobe (controlling movement and orientation) and the Temporal lobe (controlling responses to sound, speech and recognition) are all connected, as are the Frontal lobes where problem solving, planning and thinking is located.
This neural network controls the complexities of posture, so incorrect feedback will affect it.
The balance mechanism system can therefore control balance by using the most appropriate information for a particular situation. In the dark, when visual information is absent, reduced or impaired, the system will use more information from joint proprioception, the feet and the inner ear.
Walking on a sandy beach or uneven surface during the day, the information coming from joint proprioception and the feet will be less reliable and your brain will rely on information from the visual and vestibular components of the system.
All of these aspects of the act of balance requires the head to be upright in order to hold the cranial sensory organs of balance.
“The information conveyed from the periphery by the sensory components of spinal and cranial nerves is destined to reach the cerebral cortex or the cerebellum.
You will be conscious of sensory information that reaches the cerebral cortex, but mostly unaware of information that does not travel to the cortex.
However, this does not mean that sensory information that does not attain cortical levels is of no value.
For example, sensory neurones or their collateral processes form the afferent limbs of many reflex arcs. We simply could not function efficiently without proprioception informing us about the state of muscles and joints—another source of information that does not reach consciousness. “– Pocket Dentistry an excellent dental practitioner / student resource.
A bit heavy but it indicates how much feedback the teeth have unfortunately dental courses teach teeth as instruments of chewing, or needing fillings, etc. Their role as sense organs is not considered.
The teeth as organs of balance.
Swallowing requires a” braced position” (teeth together – you can’t swallow with your teeth apart) for the muscles from which the swallow starts (up to 1800 times a day).
Each time you swallow, the teeth contact and depending on the level of the biting surfaces of the teeth, the position of the teeth and the integrity of the ‘dental arch of teeth”, the contact can be felt falling on certain areas of different teeth.
The body generally seeks to achieve and maintain maximum efficiency maximum efficiency in whatever it does and in order to achieve this, the muscles are provided an innate memory, called ‘muscle engrams’. (You can see how people need to lift their feet only a little when running up stairs.)
So that your body doesn’t have to work unnecessarily the upper and lower jaws are held only slightly apart (this is called freeway space – the small space maintained between the teeth at rest). The body can adapt and maintain this gap (freeway space) to the commonly seen 2mm – even if it’s far greater. This alas not in the undergraduate dental school curriculum, yet.
If this is a space greater than it should be then the body must hold the lower jaw higher (closer to the upper teeth) to decrease the movement necessary each time you swallow, saving energy. he system can often be seen to be compensating, i.e. at swallow the jaws may be braced by the soft tissues of the tongue and cheeks.
The tongue is often seen to have scalloped sides and the cheeks felt to have ridges – this is because the body is using the tongue to brace the jaws – there’s no support from the teeth as they’re not where they’re supposed to be!.
At this time, to wrap up this post I want you to try something. First gently tap your teeth together a few times – this sets the muscles (even if the bite is wrong normally, its set now to a specific bite where most teeth touch – that’s OK)
Now, tip your head to one side and tap your teeth quickly but gently, where do they touch first? Now try with your head back, now the same thing head forwards. Head back, they touch on the back teeth first, head forwards, they hit on the front teeth first.
Coupled with the very frequent act of swallowing (let’s face it you don’t have to swallow that many times to clear your mouth) in which your teeth touch – the resulting feedback, as different teeth touch, his is how the head knows where it is. In the next post (part II) we can investigate what can go wrong, how it affects other things and how it can be corrected.
Dr Stephen Bray 2019