Welcome to Holistic Happenings in Orthodontics!
In Harmony Orthodontics - Dr. Catherine Murphy, DDS, MSD
This month’s topics:
- Tuesday’s Tooth Tips
- Chicago Midwinter Meeting
- Breastfeeding Solutions
- In Harmony Featured in The Times
- Book Club News
- We’re Hiring
Tuesday's Tooth Tips
In honor of Children’s Dental Health month, I shared a weekly tooth tip on social media each Tuesday and was thrilled with the feedback! Here are the tips shared this month:
First Dental Visit
A child’s first visit to the dentist should be within 6 months of his/her first tooth or by age 1. Appreciate Northwestern Hospital helping to support this important recommendation! Need more collaborative care like this. Physicians and dentists can better care for patients when working together. Simple reminders on both ends help busy families stay on track with appointments and care.
Question: When do kids need to use a sippy cup?
Answer: Never! A bit of a trick question.
Sippy cups are EVERYWHERE and so it is often thought sippy cups are needed. Actually sippy cups can cause problems with your child’s teeth and swallowing patterns.
🦷 According to the American Dental Association (ADA) the valves within the sippy cups do not actually allow the child to sip. Instead, the child has to suck to get the liquid out of the cup, like when using a baby bottle 🍼 This actually defeats the training aspect of the “sippy” cup ☹️ Additionally, many kids are allowed to walk around with these cups in their mouth because they don’t spill 💦. However, this can cause injury 😳.
🍼Have you heard of baby bottle cavities? Well sippy cups can lead to this too depending on what is put in the cup. 😢 Before bed, the cup should only be filled with water. 💧 During the day, when filled with anything other than water, it can lead to cavities because the child is more likely to sip the drink over a longer period of time. When any liquid other than plain water it sipped, it can cause decay because of the prolonged exposure to sugar and/or acid. ☹️
So children do not actually need a sippy cup. Babies can practice drinking from a cup as young as 6 months! 🧼 Yes, life can be messy with kids! However with a few rags to help clean up, avoiding sippy cups can help prevent cavities, injury, and bad swallowing patterns. 😃
Next time you reach for the bottle of mouthwash, ask yourself why.
Think it’s required?
Don’t have time to brush?
For most of us, mouthwash is NOT a required part of our routine. (If it is prescribed, follow your doctor’s advice.) Otherwise, for fresher breath, brushing gives the best results even if you don’t have the full 2 minutes to brush!
Some mouthwashes can actually dry out the mouth which can lead to further concerns. Dry mouths are more prone to bad breath and cavities.
Additionally, some mouthwashes are so powerful in killing bacteria that the balance of good bacteria gets negatively affected. 🦠
What should be routine? Drinking water! Water will help keep you and your mouth hydrated and healthy.
See your dentist if bad breath is common and or if your gums bleed. Your dentist will help you find the underlying cause.
🦷Baby teeth, aka primary teeth, contribute to your children’s facial development. Your child’s teeth provide structural support for the developing muscles of the face. These muscles give shape to your child’s face.
This is one of the many reasons baby teeth are extremely important, despite their limited time in the mouth.
Fruit snacks are not fruit. The marketing though is genius, especially when the label “organic” is added. If the marketing has helped give you the impression that gummy fruit snacks are a healthy snack alternative to candy, you’re not alone. Many are surprised to hear that fruit snacks are really more like candy than fruit, especially in added sugar content. The World Health Organization states that children should have no more than 3 teaspoons (tsp) of added sugar per day. (1tsp = 4 grams). One pouch of fruit snacks typically has about 8 grams of added sugar! Yikes, double the amount recommended for entire day!
Additionally, treats like fruit roll ups, raisins and other dried fruit stick to the teeth longer than other treats (like dark chocolate) and stay in the mouth longer leading to more possible tooth decay.
My recommendation is that when kids want a treat, make it something they know is special, like ice cream. When kids want a snack, fresh fruit or nuts are great options. **Of course, you must take allergies into consideration! **
Breastfeeding Challenges & Solutions
Last month we began a new series on breastfeeding challenges and solutions. Continuing my open book about my own struggles to breastfeed and its affect on my career, I share with you my recent challenges and solutions with my daughter.
Why? Well, I understand that nursing is a mother’s choice and either way she needs support. Breastfeeding requires a support system along with a lot of patience and understanding. Breastfeeding also positively affects the growth and development of the child’s face.This positive impact may lessen the need for orthodontics in the future! (Yes, it seems like I’m trying to put myself out of a job.)
Pain. Yes, the day my daughter was born was painful because of the labor but also painful because of her poor latch. However, I thought I could power through it. Well, I couldn't despite my desire. I can now fully empathize with the many mothers who shared with me that they stopped nursing due to the pain.
Thankfully, I had a lactation consultant at the hospital who helped me with some options. While in the hospital, I nursed as much as I could handle and then pumped. I was so thankful her tongue tie release was set for our first day out of the hospital, followed by chiropractic appointment the same day.
The second part in this series by Dr. Trish Hammett is discussing the effect of the hyoid bone and a baby’s latch. Yes, the hyoid, that funny bone that is not attached to another bone! Oh, the things we learn as moms, right?!
Stay tuned next month for the next part in the series with Dr. Charlie Beck, osteopathic physician.
The Hyoid Bone: A Silent Roadblock to Successful Nursing
By Dr. Trish Hammett
The benefits of nursing almost cannot be numbered, and yet so many mothers continue to struggle to nurse. Many are still told their babies are “lazy nursers” or that mom just isn’t “producing enough milk.” The incentive to help these mothers has appeared to be next to zero.
It has been a great pleasure to watch the growing recognition of the importance of a proper latch in successful nursing. With a proper latch, babies are able to empty the breast completely and stimulate additional milk production thus ensuring a proper supply. With a proper latch, a baby can nurse efficiently and receive sufficient calories without wearing themselves out, thus ensuring a strong nursing session in which baby doesn’t doze off halfway through their meal.
So what contributes to a correct latch and how can health professionals aid mothers in achieving their nursing goals? This article will address a little known cause of improper latch and one that happily can be corrected manually without cutting or discomfort to baby.
This little known cause is hyoid dysfunction and misalignment which leads to a functional limitation of the tongue and mimics the symptoms of a posterior tongue tie. The functional anatomy of the hyoid bone and musculature of the tongue, the causes of hyoid misalignment and dysfunction as well as the mode of correction will all be discussed.
First, let’s begin with a brief functional anatomy discussion. The majority of the muscles of the tongue (genioglossus and hyoglossus muscles) attach to the hyoid bone which is located just below the chin. These muscles are responsible for drawing the tongue forward and protruding the tongue as well as depressing the tongue respectively. Also attached to the hyoid bone are the suprahyoid muscles (digastric, stylohyoid, mylohyoid and geniohyoid). These muscles are responsible for depressing the mandible (opening the jaw) and elevating the base of the tongue.
Let’s look at how this relates to a proper latch and tongue motion during nursing. In a proper latch, the tongue rises, extends past the gums, wraps around the nipple and “milks” the nipple. During the latch, both baby’s jaw and tongue should follow a smooth elliptical motion analogous to a horse’s cantor. Without proper tongue motion, a baby’s latch will be choppy and clamp-like and moms will complain of extreme pain throughout the nurse and often experience blisters and cracking of their nipples.
Because this motion and latch is inefficient in drawing out milk, babies will tire easily during the latch and will have a tendency to pop on and off the nipple as well as to fall asleep mid-nurse. As a result of not efficiently draining the breast, moms will experience decreased supply and may struggle to produce milk. With proper motion of the tongue during nursing, the hyoid bone must move freely. A dysfunctional misalignment of the hyoid will result in restricted tongue motion, especially the ability to extend the tongue anteriorly and will contribute to a shallow latch.
So what can cause a dysfunctional misalignment of the hyoid? The major causes occur during the birth process. These causes are perpetrated by the doctor, by the natural birth process and often by the baby himself. The first cause is by the doctors and their birth protocols. The protocols taught in Williams Obstetrics require using the head as a lever to pull babies out of the birth canal. It has been published that this maneuver applies 45 to 90 pounds of pull pressure on the infant’s head and cervical spine. If during this maneuver, the obstetrician applies the pressure more to the side of the face and jaw the hyoid bone can be compromised.
The second cause is due to a natural occurrence during the birth process, which happens when a cord is wrapped around the neck of the infant. As the baby descends and the cord tightens the hyoid bone is compromised.
The final cause is perpetrated by the baby himself. This occurs when babies have their hands up by their face during the birth process and/ or are sucking their thumb/hand during the process. The equivalent effect is that with the every contraction the baby is basically “hitting themselves,” forcefully pressing into their jaw and throat over and over for up to 24 hours or more. It is important to note that all of these effects also cause a dysfunction of the TMJ which also adds to the disordered tongue movements and latch after birth.
The wonderful news is that correction of a hyoid dysfunction is obtainable from a properly trained pediatric chiropractor. The treatment involves an extremely gentle craniosacral and myofascial release utilizing about 5 ounces of pressure and generally resolves the issue in 1 to 3 visits.
Testing the strength and proper motion of the suck reflex before and after the adjustment will show a marked change and mothers almost always report improvement and decrease in pain during nursing after the adjustment. The only mothers who do not notice an immediate decrease in pain are often those who have already reached the point of blistering, cracking and even vascular damage. In these cases the cessation of pain during nurse is only delayed by the time required for mom’s healing.
How can other practitioners recognize the signs of a dysfunctional hyoid bone? Begin by looking for risk factors within the case history, e.g., a cord wrapped around the neck, baby was born with hand near the face (these babies tend to keep their hand up around their face or in their mouths after birth as well), or a doctor who had to “really work to get baby out” which could indicate excessive force.
Secondly, examine baby’s suck reflex looking for a tongue that doesn’t extend all the way and doesn’t go through normal motion during nursing. Thirdly, examine for signs of tongue-tie. In the absence of a visible tongue tie a short trial (3 visits) of chiropractic cranial-sacral is definitely the next step before treating for a posterior tongue tie. As the old saying goes, “First do no harm.” And a non-surgical therapy should definitely be attempted first.
If you’re having trouble nursing or have concerns, talk to your pediatrician. If necessary, ask for a referral to a pediatric chiropractor.
In Harmony Featured in The Times
Thank you to Marc Chase of The Times of Northwest Indiana for the second year of “Innovations in Health Care” special feature. It is a wonderful way to inform our community about the many practitioners here who are offering new therapies, treatments, and options to their patients. I was honored to be asked to submit again this year.
Thank you to my patients Jakob and Melanie for their willingness to share their stories in order to help others.
Additionally, thanks to Stacy Lashenik, LDH and Tracy Biggs, CCC-SLP, CLC for their contributions to articles, but more importantly to the patient care.
Lastly, it is such a pleasure to bring such wonderful health care providers together through my book club. The sessions have been so inspiring and motivating. I am truly grateful for each member.
In case you missed them, here are links to the articles:
Doing more than straightening the teeth by treating the whole child
Innovative planning for better oral health
Orthodontist creates unique book club to treat whole patient
Book Club News
On March 6, 2020, Maria Janik will share her knowledge with the Connections Book Club. Maria co-founded Indiana Biomedical Kids (IBK) online support group for families in Indiana and surrounding areas who seek alternative and traditional therapies to help improve the quality of life for their children with autism. She also co-founded the National Autism Association of Indiana. Her organizations not only bring awareness, they bring hope and treatment options to parents including the latest in scientific research.
The book we are reading is Healing the New Childhood Epidemics: Autism, ADHD, Asthma and Allergies by Dr. Kenneth Bock, MD.
For more information, visit Dr. Bock's website:
Join the In Harmony Orthodontics Team!
We’re looking for a part-time assistant to help out in the afternoons. No previous dental experience is required. The ideal candidate enjoys working with people and has excellent critical thinking skills.
- Office and laboratory duties
- Preparing patients for treatment
- Obtaining records
- Working chair-side as the dentist examines and treats patients
If this sounds perfect for you or someone you know, contact us! Send resumes to: firstname.lastname@example.org.