The structure and function of the human body is extremely complex. It’s composed of many organized systems that interact to perform vital functions. Each system is a combination of interactive bodily parts forming a functional unit. Some systems of the body consist of interactive neuromusculoskeletal parts that perform motions such as walking, running, kicking, throwing, grasping, chewing, and swallowing. All these movements of the human body are designed to function in harmony with one another as an integrated unit, a closed kinetic chain. Chewing is performed by the masticatory system, sometimes referred to as the stomatognathic system. The structure and function of the stomatognathic system is also extremely complex. It’s composed of the cranio-maxillary complex, mandibular complex, temporomandibular joints, hyoid bone, cervical vertebrae, atlanto-occipital joints, tongue, lips, cheeks, and surrounding soft tissues, all 28/32 teeth as a complete unit, and the skeletal muscles and motor and sensory nerves that control the function of these structures. Sometimes the system functions well and sometimes it doesn’t and becomes dysfunctional. At times the dysfunctions are caused by malformation and/or malalignment of its structure due to abnormal embryonic or fetal development and at other times it’s caused by structural deformation due to mechanical forces that have distorted its otherwise normal size, shape, alignment, and position. In many cases these are abnormal ascending internal muscle contraction forces caused by faulty posture and body biomechanics.

I had an excellent dental education. But, after a three-year tour in the US Navy Dental Corps and ten years in private practice I became aware that there is more to practicing clinical dentistry than providing basic dental care. There was the bigger picture that included caring for various structural and functional components of patients’ stomatognathic system when they become a big problem.  To provide comprehensive care for many of these patients I began studying with a number of experts from in and outside of the field of dentistry. Slowly my clinical practice changed from being a solo dentist to one involved as part of integrative interdisciplinary health care, co-treating patients along with other healthcare practitioners such as chiropractors, medical physicians, and craniosacral, physical, and massage therapists.

To effectively accomplish the task, I realized I needed to consider and analyze the health status of the condition of patients’ stomatognathic system, both its structure and its function. I learned that to effectively treat its disorders depended on how well I analyzed the condition of all its components. I use the term analyzed because it means to examine methodically by separating into parts and studying their interrelations, instead of to evaluate or assess which means to form an estimate, idea, or opinion of the condition of. I found it was far better for me to know rather than to guess. I found there are many dental patients who have disorders of components of their stomatognathic system that required more comprehensive care in lieu of basic dental care to effectively and successfully treat them. Just as disorders of the stomatognathic system differ from dental disorders, the method of examining, testing, analyzing, and diagnosing each differs as well. Since most dentists, and nearly all other healthcare practitioners, as well as patients, are unaware of the differences, I attempt to clarify the distinction between a comprehensive oral-craniofacial patient analysis and a traditional basic dental analysis.

Dentists who practice traditional basic dental care essentially provide examinations, tests, and treatments for patients’ simple conditions involving their teeth and gums.  However, patients who have disorders involving components of their stomatognathic system in addition to disorders involving their teeth and periodontal tissues have complex conditions. These are people who have disorders involving the structure and function of their cranio-maxillomandibular-cervical-dental system, skeletal muscles, and the motor and sensory nerves that control these structures in addition to problems with some or all of their teeth. These are patients who may have some type of dentition design disorder such as worn out and badly broken-down teeth, teeth with cracks, attrition, chipping, abfractions, abrasions, wear facets, malocclusion, possibly missing some, most, or all of their natural teeth, and patients with a bad bite or no bite.

I also found that some of these patients may have had disorders involving the structure and function of their cranio-maxillomandibular-cervical-dental system, tongue, and the nerves that control these structures in addition to problems with some or all of their teeth. It’s the bigger picture. I found some of these patients had more complex multifactorial disorders with side effects that included chewing and swallowing dysfunction, bruxism, headaches, airway and tongue disorders such as abnormal breathing patterns, snoring, and obstructive sleep apnea, tongue thrusting and lisping, temporomandibular joint dysfunction and pain, craniofacial-cervical neuromuscular pain and dysfunction, occlusal trauma, and chronic traumatic brain and cranial nerve injuries. I believe these types of disorders of the stomatognathic system affect at least 25% of the dental population in America and Canada. That’s close to 75 million people.

The information and knowledge I have provided is based on my clinical experiences and the advanced knowledge and clinical skillsets I acquired during a span of over twenty years at times treating patients collaborating with other healthcare practitioners as member of an integrative interdisciplinary healthcare team. The book contains a summary of various methods, technological procedures, and biometric instrumentation that can be used to test and analyze the condition of components of the stomatognathic system that form the basis of diagnosing and treating oral-craniofacial design disorder, and dentition design disorders. This is a what to do and how to do book that outlines the way to acquire the necessary information about the health status of the condition of its structure and function to help dentists determine the diagnosis and formulate effective treatment plans.

At the time that this book is written, the accepted use of subjective and objective methods in most dental circles, including the dental schools, to examine, test, analyze, and diagnose patients who have complex conditions involving their stomatognathic system is quite limited. One of the reasons I had in writing this book was to help change that situation. The purpose of introducing biometric instrumentation and methods is to expand healthcare practitioners’ awareness of what is currently available to determine a definitive diagnosis of condition of the stomatognathic system based on objective data, not on vox populi -popular opinion or clinicians’ gut feelings and opinions. It provides a broad view of the structure and function of the stomatognathic system and much of the current technology available to test, analyze, and diagnose the condition of its various components. The examples included herein are neither exclusive nor comprehensive. I realize that newer technology is constantly being developed, and that some or all of the examples presented in this book will eventually become obsolete. However, the biomechanical principles of physiological function of the stomatognathic system will endure the test of time.

The book is 226 pages long, contains over a hundred illustrations, and is divided into four sections with a bibliography of 79 references.

• Comprehensive Patient Care

Comprehensive Analysis, Craniomandibular Somatic Dysfunction, Physiological Adaptive Range (PAR), Analyzing Patients’ Cranial Structure & Function, Stomatognathic System, Structural Alignment, Nutritional & Organ Systems, Psychological & Spiritual Condition

• Subjective Analysis

Medical/Dental Health History, Screening Appointment, Clinical Observation & Assessment

• Objective Biometric Analysis

Orthocranial Study Cast Analysis, Orthocranial Craniofacial 3D CT-Scan Structural Analysis of the Craniofacial-Cervical Bones, Analysis of: Craniofacial-Cervical Muscle Activity, Mandibular Movements, TM Joints, Occlusal Forces, Cervical Range of Motion, Body Posture, Mandibular Intercuspal Position, & Emotional Status.

• Treating Complex Conditions

Determining the Diagnosis & Implementing Comprehensive Oral-Craniofacial Patient Care

My purpose in writing the book is to share what I have learned to benefit clinical dentists, other healthcare practitioners, and the patients they care for. – Dr. Carlson