by: Ara Elmajian D.D.S.
Understanding and influencing the regulation of our homeostasis amidst our constantly changing environment, has been the main objective of my dental/medical practice since the early 1980’s and is still the basis for most of our tests and treatments. Homeostasis is the state of equilibrium of the internal environment of the body that is maintained by the dynamic processes of feedback and regulation between our internal and external terrains.
In this context it is the regulation of the body via the autonomic nervous system (ANS) that we are talking about. The ANS is part of our nervous system that regulates essential functions such as breathing and heartbeat, functions that occur without conscious involvement.
The ANS consists of two branches named the sympathetic and the parasympathetic nervous systems whose functions are antagonistic. In simple terms and for the purpose of comparing, we can say that stimulating sympathetic fibres usually produces vasoconstriction in the part supplied accompanied by a accelerated heart rate, depression of gastrointestinal activity, erection of hairs (goose flesh), a general rise in blood pressure, pupilllary dilation, and secretion of thick saliva. In other words, activities that occur in emergencies or trauma, commonly known as “the fight or flight response,” are produced by the sympathetic nervous system. Conversely stimulating the parasympathetic nerves generally produces vasodilation of the part supplied with slowing of the heart rate, increased gastrointestinal activity, a fall in blood pressure, contraction of the pupil, and secretion of thin saliva.
The central structure in the brain stem that regulates the ANS is the hypothalamus. The hypothalamus is a sophisticated sensor of our environment, monitoring both our internal and external milieu by analyzing the blood running through it. It is of great importance in controlling certain metabolic activities, such as the regulation of body temperature, mineral concentration of the blood, maintenance of water balance, sugar and fat metabolism and secretion of releasing and inhibiting hormones.
The hypothalamus is the chief region for the integration of sympathetic and parasympathetic activities. Therefore it regulates the action of both of the branches of the ANS. Based on its analysis of the many different factors occurring in the blood, we can understand that the hypothalamus carries out many varied functions. It can send messages to other glands, such as the pituitary, to release hormones that are necessary. It regulates our defense mechanism of “fight or flight” (as mentioned above) by decreasing blood flow to internal organs and increasing blood flow to the muscles most needed at the time. On the other hand, during digestion it regulates blood flow back to the internal organs involved in digestion and assimilation of food. It also regulates the hormonal balance during reproduction and pregnancy. The hypothalamus with all its checks and balances is our bodies’ major regulating center.
The hypothalamus is programmed by the limbic system, which is largely associated with our emotions. It is a set of brain structures involved with feelings, instinctive behaviour, learning, memory and motivation. The limbic system helps us to remember events that caused strong emotions and is activated by motivated behaviour and arousal. It is that part of our brain that influences our social behaviour and whether or not we are judgmental. As we learn not to fear an action, such as swimming, the limbic system reprograms the hypothalamus to act appropriately, replacing the fear with confidence.
The ANS (autonomic nervous system) relays pain or dysfunctional signals from the mechano- and chemo- receptors in our joints, joint capsules, ligaments, tendons, visceral organs and vascular system to the limbic/hypothalamic region of the brain. It also sends signals to modulate the smooth muscles of our blood vessels, cardiac muscles of the heart, digestive tract, respiratory system, reproductive system and urinary system.
Chronic illness, infection, toxicity and emotional tension all alter the signals sent from the hypothalamus to the organs and structures as well as the feedback from those organs and structures back to the limbic system and the hypothalamus. This alteration or disruption in the signals sent in either direction is due to changes of the membrane potential of the ganglia and nerve fibres caused by exhaustion and toxicity, such as the toxicity produced by heavy metals. This maladaptation resets the base line of the hypothalamus resulting in over or under stimulation of the glands, organs, and structures affected.
The ganglia can be described as the junctions outside the nerve track that relay the impulses back and forth to the organs and structures. These ganglia (nerve structures) are also referred to as mini-brains or computers in that they need to be rebooted when overload occurs due to overuse and toxicity during periods of stress and injury of the organs or structures connected to that particular ganglia.
To make matters even more complicated, many of these ganglia do not communicate directly with the central nervous system. Science has shown that ganglia can maintain some visceral organ functions, even though communication with the central nervous system is severed. In this situation the organ responds to the changing internal stimuli but is unable to respond to the changes in the external stimuli. It is crucial at this point to be able to diagnose which ganglia is involved and have knowledge of the technique of utilizing neural therapy by injecting the vicinity of those specific ganglia. The purpose of the injection is to reboot the computer and thereby revitalize the ganglia and in turn the corresponding organ.
It is understandable how chronic conditions can wreak havoc on this very sensitive feedback and regulatory function of the nervous (or electrical) system.
Structurally our bodies are interconnected through the fascia, a fibrous membrane covering, supporting and separating muscles as well as uniting the skin with underlying tissue. In osteopathic literature the fascia surrounding each muscle group is connected to the fascia of other muscle groups and organs. This is known as the “fascial continuity theory”. A classic example used in osteopathy is that, when we tug on a bed sheet in one direction, we will create wrinkles on the periphery of that same sheet.
Physical scars in tissue are an example of the above and can disrupt our fascia in many ways. The normal electric potential of a cell wall is measured at 80 millivolts. A scar cell wall electric potential can go up as high as 1.5 volts. This increase in electric potential can affect the regulation of the ANS causing a disturbance in distant parts of the body that may manifest in pain or decreased range of motion. This situation has been seen numerous times in our practice and can also be corrected in most cases with neural therapy. By injecting a scar with a solution of 1% procaine and normalizing the electric potential of the membrane, we can positively affect the related pain or limited range of motion in a distant part of the body. For example: injecting an appendectomy scar increased the range of motion in the shoulder of one patient, indicating that the disturbance caused by the scar was creating the problem with his shoulder.
Chronic, low grade infections, such as those often seen in the bone next to a root canalled tooth, chronically affected structures like a leg length discrepancy or compromised dental occlusion (bad bite) all have the ability to disturb the ganglia of the ANS or reset the hypothalamus to over or under react. Chronic emotional stress, prolonged anger, other psychological factors, nutritional discrepancies and hormonal imbalances also disturb the normal functioning of the ANS.
In a pain management practice it is the clinician’s obligation to identify the foci or irritation in a particular patient that initiated the chronic illness and disregulation of the ANS. It is not always obvious and it could be complicated by the fact the illness or pain may be a result of a combination of structural, functional, biochemical, electromagnetic and /or emotional stresses.
One of the major tools we have in medicine and dentistry that addresses disregulation of the ANS is neural therapy. It has been successfully implemented in countless situations in our clinic and, when combined with other modalities, has proven to be very helpful in dealing with a myriad of acute and chronic pain and illness situations.
There are several techniques used in neural therapy. Injecting scar tissue as mentioned earlier, segmental injections into the skin surface representing the neurological segment of an affected organ and injecting the autonomic ganglia related to the affected organ or the epidural space (also mentioned above) are all powerful neural therapy techniques. Another indication for neural therapy is injecting lymphatic tissue, such as the tonsils and adenoids, to widen lymph tissue thereby increasing lymph drainage, relieving congestion and reducing or eliminating pain.
Empirical observation over centuries has demonstrated the energetic connection of teeth to organs. For example, central and lateral incisors are connected to the genital urinary tract and wisdom teeth are related to the heart. A chronically infected wisdom tooth can create a disturbance field in the heart in the form of palpitations or other symptoms. A form of neural therapy I discovered called intraosseous neural therapy (I.O.N.T.) has many applications in the oral cavity. (See article on I.O.N.T for more detailed information on this subject.) We can test suspicious teeth by utilizing intraosseous neural therapy and injecting in the vicinity of the tooth to see if the symptoms with the corresponding organ subside or change temporarily. In the example of the infected wisdom tooth it would be advisable to extract the tooth and cavitate or clean the infected ligament and bone tissue surrounding the tooth to prevent further disturbance to the heart.
Utilizing the intraosseous neural therapy technique as a diagnostic tool in the mandible or maxilla can expose suspected foci of irritation or interference fields such as a chronic infection of an old dry socket or a hyperemic tooth that may be impacting the health of the related organ in a negative fashion.
There are many other applications of I.O.N.T both in medicine and dentistry and it is one more valuable diagnostic and treatment tool in the management of pain and chronic illness.
Understanding the delicate balance between the ANS and our bodies is a significant piece of the puzzle when attempting to assist and offer some relief to those patients who have multiple chronic health complications. Neural therapy is one very useful and effective method of both calming and revitalizing the intricate system of feedback and regulation of the ANS and the balance it endeavours to maintain.
It is also very important to keep in mind that the complicated human body and its many intricate systems – digestive system, immune system, nervous system etc. – do not function alone or independently. They all impact each other, with a few exceptions. One very powerful and often forgotten puzzle piece in healing is the psyche, the emotions, the affect receiving and giving joy can have on recovery. This often underestimated determinant can influence and cause shifts in the whole body in a positive direction. Feelings of happiness positively affect the ANS which in turn sends positive messages to the organs and correspondingly receives positive signals back from those organs producing even more positive messages and thus more happiness. In this cycle of happiness many superlative changes can occur. As a clinician, we can utilize our entire arsenal of treatment options and skills certain that we have hit the nail on the head only to find the patient not responding or only partially responding. It has been my observation that when the recovery comes to a standstill or hits a plateau, there is almost always an emotional issue/s blocking the complete success of the treatment protocol. In neural therapy this is called “blocked regulation”.
In these situations it is our obligation to assist these patients in recognizing and dealing with the emotional baggage that is affecting their recovery, referring them when indicated and helping them to understand and participate in their own healing. Of course this is a huge topic of discussion – one that we will investigate another time.
Comprehensive neural therapy courses are offered through the American Academy of Neural Therapy to medical and dental practitioners who wish to expand their knowledge and treatment skills in this field.