The Use of Acupunture in Dentistry

1. The Use of Acupunturein Dentistry YEHIEL ALPERN D.M.D A.C

3. 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.

4. 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

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

6. 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.

7. 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..

8. 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…….

9. 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.

10. YANG= LIGHT SUN ACTIVITY EAST ENERGY WARM UPPER EXTERNAL MIND YIN= DARKNESS MOON REST WEST MATTER COLD LOWER INTERNAL BODY CHINESE PHYLOSOPHY

11. 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

12. PATHOLOGY THE EIGHT PRINCIPLES DEFICIENCY YIN EXCESS YANG INTERIOR HOT EXTERIOR COLD TCM’S SYNDROMES

17. 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).

18. 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 • 

19. 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 • 

20. TRADITIONAL THE MERIDIANS 14 MAJOR 8 EXTRA SCIENTIFIC “ GATE CONTROL” Melzack and wall 1965 “NEURAL MECHANISMS” Stux and Pomerants 1987 THEORETICAL EXPLANATIONS FOR ACUPUNCTURE

21. 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

22. 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.

23. 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

24. 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.

25. 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.

26. 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.

27. 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

28. 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

29. 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.

30. 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.

32. MethodsTRADITIONAL AND MODERN • ACUPUNCTURE • MOXIBUSTION • HERBS • ELECTRO ACUPUNCTURE • SOFT LASER • BIORESONANCE AND HOMEOPATHY

33. ACUPUNCTURE NEEDLES

34. Moxa

35. 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.

40. 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).

41. 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 • 

42. 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 • 

43. 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

44. 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

47. 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.

48. 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.

49. Trigeminal neuralgia • ACUPUNCTURE treatment is useful in management of trigeminal neuralgia j .of anest.and pain in density Beppu et al 1992

50. 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)