Dr. David E. Lawler | 
820 South Auto Mall Road | Bloomington, Indiana 47401
 | 812-339-4499

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Oral Systemic Balance

Stop and think about it…… breathing is our most important body activity. As important as the heart is, its function is secondary to breathing since the heart circulates the life-giving oxygen throughout the body that is first acquired by breathing. With this as the starting premise, Oral Systemic Balance, a technique developed by Dr. Farrand Robson, supports breathing. While traditional oral appliance therapy supports breathing during sleep, Oral Systemic Balance supports breathing during BOTH sleep and awake time.

Note: for a more simplified introduction to Oral Systemic Balance go to our other website, drugfreepainhelp.com.

Another extremely important body function is swallowing. Obviously, swallowing is critical to our survival allowing us to intake life-sustaining food and water. While we rarely are consciously aware of it, we swallow over a thousand times a day. When we think about swallowing, we usually think about the intake of food and water, but the swallowing function occurs 24 hours a day as we swallow our own saliva. Oral Systemic Balance supports both breathing and swallowing by using removable oral appliances (orthotics) to improve jaw and tongue function and by doing so is able to quickly and dramatically provide relief of pain.

Because this concept of pain relief is not commonly recognized or understood, throughout this site I have used edited video clips of patients that we have worked with in order to enhance the awareness of the power of this form of therapy. The results of Oral Systemic Balance (OSB) are typically so dramatic that, unless these videos are viewed, the full appreciation of this form of pain relief is really not possible. I am most grateful for these patients consenting to have these videos of their treatment process made public. Their willingness to have these videos exhibited in this manner is a reflection of their wish to have others receive the relief of pain that they have experienced.

For those of you without a high speed internet connection to easily see videos or who prefer to read about someone’s experience from their own words, one of my patients who had experienced significant pain relief, after suffering from migraines for years, started a fascinating discussion about OSB here on the internet site sleepguide.com. This online discussion went on for 3 months before I was aware of its presence.

To see more clearly the effect of an OSB orthotic on the swallow, look at the following video. Notice that the first swallows without the orthotic in place have the sound of a “gulp” when the water goes down. With the orthotic in place, the swallow is much quieter.

To see the strong connection between breathing and swallowing and how OSB can support both of these vital functions, watch the following video clips of patients that we have helped with this therapy. It is important to understand that the comments about improved breathing and swallowing occur at the initial appointment when the OSB orthotic is first placed in the mouth and that these patients are speaking with the orthotic in their mouth so speech is rarely effected by the orthotic.

While all of the patients in the above video were consciously aware of swallowing difficulties and shallow breathing, many people who can be helped with OSB therapy are unaware of any problem with either breathing or swallowing.

The patient in the following video was not aware of any difficulty with her swallow. While she had difficulty in swallowing large pills, she had not associated this difficulty with a swallow dysfunction. It was not until my questioning of her breathing at our initial consultation that she paid any attention to the possibility that her breathing was shallow. She had experienced her debilitating pain and muscle tension for years and had tried many, many different approaches to pain relief before being treated in our office. The video starts out with a review of the symptoms of pain that she is experiencing at that moment. She comments that her “massaters are tight”. Massaters are the muscles that are used to clench the jaws. Throughout this and other videos of the treatment process, you will hear a beeping sound made by a critical care monitor that is used to monitor vital signs. Vital signs are monitored throughout the treatment process as a “window” into the body to assess the therapeutic result.

The patient in the following video had an awareness of occasionally choking on certain foods and some difficulty swallowing large pills but had absolutely no awareness that there was any restriction in her breathing. This appointment starts out reviewing the symptoms that she is experiencing. After reviewing her present symptoms, the OSB orthotic was tried in the mouth and the ease of swallowing water was compared with the orthotic in and out of the mouth.

Another example of the power of OSB therapy is shown in the following video. This fibromyalgia suffer lived a life of pain prior to being treated with an OSB orthotic. The first part of the video is a review of the symptoms that she is experiencing at that moment. The second part of the video takes place at the same appointment, but minutes after the placement of an OSB orthotic on her lower teeth. The later part of the video shows her symptom relief at the end of the first appointment. Pay particular attention to her comments about her swallowing and her breathing before the orthotic was placed and after orthotic placement.

Because OSB is a relatively unknown therapy and because the results of this therapy are so profound and immediate, it is really important for anyone wanting to understand its potential to watch the videos that are present on this blog. Other videos that have not been included here can be seen on our YouTube channel.

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In order to help understand OSB therapy, let us start with the concept represented by this cartoon character known as the homunculus man. This image is drawn with the body parts drawn in proportion to the innervation that each receives from the brains cerebral cortex. Obviously, the hands are quite large representing the innervation necessary for us to do intricate tasks requiring great dexterity. Notice the enormous size of the jaws and tongue. This is due to this area’s important function of speech and taste, PLUS swallowing and breathing. As we will later discuss, due to the extreme importance of this part of the body, when there are disturbances in this area the nervous system goes into a high state of alarm.

At the back of the throat there is a common hole or tube, as shown in this drawing. Through this passageway goes food, water, air and saliva. The air goes to the trachea which leads to the lungs and everything else goes to the esophagus leading to the stomach. It is CRITICAL that the air is separated from food, water and saliva or we will either choke to death or drown. The epiglottis, a tiny flap of tissue positioned slightly below the base of the tongue and above the vocal cords, has the all-important role in this duty as shown in the following animation courtesy of Hank Grebe of mediaspin.com.

A real-life demonstration of epiglottis function can be seen in this video done with video-fluoroscopy:

An amazingly intricate interrelationship exists between swallowing (tongue function) and epiglottis function. This is easily understood by looking at the close anatomical proximity of the tongue base and the epiglottis as seen in this cross-section drawing of the human head and neck.




















To understand why the tongue can be the trouble maker in causing much epiglottis dysfunction and be the source of a vast number of physical symptoms that can literally arise from head to toe, we must first look at the tongue and its housing, the lower jaw. In this drawing we see a schematic drawing of a well shaped lower jaw with the tongue placed in its normal position. It is important to understand that a well-shaped jaw is necessary for teeth to come in straight with no crowding.

This drawing shows an underdeveloped jaw with crowded lower teeth. The teeth are crowded because the lower jaw did not develop to its full genetic potential and there was inadequate room for the lower front teeth. Notice that there is less room for the tongue in this jaw. Xs are shown in teeth that are commonly extracted prior to orthodontics in an attempt to relieve the crowding of the front teeth.

This drawing shows the lower jaw after the bicuspids marked with red Xs above were removed to create space for the lower front teeth to be straightened with braces. As a result of this procedure, there is dramatically less room for the tongue.






To illustrate this more fully, the tongues from the 3 examples above have been enlarged and superimposed on one another. The tongue outlined in black is from the fully developed jaw, the tongue outlined in red is from the jaw with the crowded front teeth and the jaw in blue is from the jaw that had 2 teeth removed prior to orthodontic treatment. It is most important to understand that, even though there is less physical space for the tongue to reside, the physical size of the tongue does not become smaller.

This reduced room for the tongue has HUGE significance!

Because the tongue does not fit in the mouth it positions itself further back in the throat. In addition to tongue function being altered by inadequate space in a jaw with crowded teeth, tongue function can also be seriously altered by missing teeth. When a tooth is not present, the tongue looses its bracing support in the area formerly occupied by the now missing tooth.

Remember that the function of the tongue and the epiglottis are intimately related. When the tongue function is altered because of lack of adequate room, epiglottis function is effected.

Because the function of the epiglottis is so very critical, the body does what is necessary to assist its proper closure. This can happen in many ways. Some people will hold their head further forward as seen in this patient. Other people will tense their jaws or elevate their shoulder position. Any of these compensating actions can result in headaches or neck and shoulder pain. All of the body’s compensating activities take constant attention and engages the sympathetic nervous system. (The sympathetic nervous system is that branch of the autonomic nervous system that functions in fight or flight response.) This constant nervous system activity runs continually in the background without our conscious awareness, but can have a tremendous impact throughout the body as is seen in the young man shown in the video below.

To see follow up videos of this patient after treatment go to our video library. It is interesting to note that in the follow-up video, he mentions that the numbness that he described and attributed to “poor blood flow” is no longer present. If you watch all of the videos in the video library, you will see that having numbness in hands and feet disappear after correcting impaired oral function with an Oral Systemic Balance orthotic is a common event.

Another video, done at the conclusion of the first appointment, shows the immediate effects that can be noticed after placing an OSB orthotic. This particular patient is speaking in this video with both an orthotic placed on his lower teeth as well as an orthotic on his upper teeth that is designed for primarily for night-time wear. Notice that his speech is not effected by wearing the orthotics.

This same patient came back for his one month post treatment evaluation and agreed to have his and his wife’s comments about OSB therapy recorded. I am truly grateful to this couple for sharing their experience with the results of OSB therapy. In addition it is impossible for me to adequately express my gratitude to Dr. Farrand Robson for his guidance as I continue to learn to provide the therapy that he developed.

It is important to note that a subsequent home sleep study done with a Watch PAT home sleep monitor confirmed that this patient did indeed have dramatically reduced snoring. However, the home study did reveal a significant number of respiratory events where breathing was compromised and blood oxygen levels dropped. This shows the importance of not relying totally on subjective patient feedback. If this patient chooses, the next step can be taken utilizing an Oral Systemic Balance mandibular advancement appliance. This type of appliance blends the OSB concept of managing swallowing dysfunction with the more traditional oral appliance concept of moving the jaw forward during sleep to more fully open the airway. This would build on the benefits of what he has already accomplished in the improvement of his health.

To see more pre and post treatment videos of patients who have been helped with OSB therapy, go to our video library.

There are a wide range of symptoms that are commonly reported by people who can be helped by Oral Systemic Balance therapy. Some people experience many of these symptoms while others manifest only a few. They are as follows:

  • Head pain. This pain can originate in many places such as, behind the eyes, temple, jaw joint (TMJ), at the base of the skull, etc. They often suffer from headaches or migraines. It is very common for them to wake up with a headache.
  • Clenching and grinding of teeth. They may be unaware that they clench or grind their teeth, but evidence of significant tooth wear is often seen in their mouth. Clenching and/or grinding of teeth during sleep is actually a survival mechanism since this activity stimulates the tongue and moves it out of the airway during sleep and allows breathing to occur.
  • Popping and cracking in the jaw joint often leading to temperomandibular joint pain (often called TMJ).
  • Neck and shoulder pain. They often can turn their head farther to one side or the other. Pain may radiate to the back of the shoulder or to the front of the chest.
  • Tightness in the throat. Patients will often report that wearing clothes that put pressure on the neck, such as a turtleneck sweater, is extremely unpleasant. They may report that they often feel a lump in their throat.
  • Difficulty swallowing. This difficulty swallowing may be very subtle or extreme. People with this problem may notice that they have to drink a large volume of water to swallow a pill. They may have a difficult time swallowing certain kinds of food. They may occasionally choke on their own saliva.
  • Difficulty breathing. This can be extreme or merely a feeling that their breathing is shallow. They will sometimes report that they sometimes have to remind themselves to breathe. Quite often, they are not even aware that their breathing is shallow since shallow breathing is all they have ever known.
  • Gastric (Acid) reflux or heartburn
  • Panic attacks. These may be full blown panic attacks or merely a periodic feeling of being tense for no apparent reason. This occurs because the sympathetic branch of the nervous system must be overactive (producing adrenaline) to ensure proper swallowing and breathing.
  • Irregular heart beat.
  • Sleeping problems-multiple awakenings during the night. Awakening feeling unrefreshed.
  • Bed partner reports of snoring and/or pauses in breathing.
  • Daytime sleepiness or fatigue.
  • Hand or foot pain/numbness.

    Oral Systemic Balance is, as of now, a relatively unknown therapy. There are countless people who suffer from the above symptoms that can often be easily eliminated with OSB therapy. It is important to emphasize that no OSB practitioner can predict the downstream effects of correcting a swallowing dysfunction. In other words, OSB practitioners do not set out to provide relief of foot pain and numbness as was experienced by several patients in our video library of case studies. We merely treat a diagnosable swallowing imbalance and the body does the rest. (More videos of patients who have had foot pain/numbness eliminated can be seen in the video library case study link below.)

    Go here to see the entire video library of patients talking about their symptom relief with Oral Systemic Balance Therapy.

    Even more videos of patients experiencing almost immediate relief of long standing pain can be found here .

    To here a radio interview with Dr. Robson, the developer of Oral Systemic Balance, and his cardiac nurse Renee, go here.

    For those wanting to know more about Oral Systemic Balance therapy, read an excerpt from the book, Snore-No-More by James L. Mosley.

    For information on finding a qualified Oral Systemic Balance practitioner, contact Dr. Farrand Robson’s office at 800-977-1945.

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