Welcome And Why Bite Matters

SPEAKER_00 0:44

Welcome, welcome to another Beauty of Breathing Podcast recording. How's everybody doing today? It is Tuesday over here in Maya Moves, and you guys get to listen to this live with us. I love whenever we do these recordings live because you guys can interact with her, with us different than any other podcast out there where you're just listening in. It was recorded a long time ago and you don't get to participate. So if you're listening to us live, uh, I have you guys on my Maya Moves Instagram. You guys are welcome to ask any questions uh you would like. So let me go ahead and introduce our speaker to you guys. Today we're diving into a topic that has been studied for decades, but is still evolving: occlusion and the way we understand the bite. My guest is Dr. Robert Kirstein, a prosodontist educator, researcher, and one of the leading voices in objective occlusive analysis, with more than 40 years studying occlusion, TMD, and restorative dentistry, and decades of work with computerized occlusive analysis and T-scan. He's been at the forefront of moving byte uh analysis from what we think we're seeing to what we actually can measure. But what makes this conversation especially interesting for our audience is the bigger picture because the bite doesn't exist in isolation. How we think about occlusion can intersect the jaw function, muscle activity, airway, sleep comfort, and the way we approach comprehensive patient care. So today we're going to talk about how our understanding of the bite has evolved, what objective data can actually tell us, where occlusion fits into airway and whole body care, and what clinicians may be missing when they simply, simply look at the teeth. Welcome, Dr. Kirsting.

SPEAKER_02 2:39

Yes. Thank you.

SPEAKER_00 2:40

Okay, so welcome to the video breathing. We're so excited to have you. And I absolutely love today's

Dr Kirstein And The T Scan Origin

SPEAKER_00 2:46

topic, the evolution of occlusion for that case of transforming byte analysis. So tell us a little bit about you.

SPEAKER_02 2:54

Well, I um when I was graduating dental school at Tops, I had a preponderance to be, I love prosthetic dentistry. And remember as a little kid, I used to make build ships and models, and so I ended up making tea. But my my specialty had the first T-scan program in it. It was actually built by my teacher. Yes, by William Manis and five engineers from MIT. They made the first T scan. And so I was exposed to it as a young person. I was 25 at the time. And um I saw that it was even in its infancy, it was still better than what we were doing with bite paper and ink and mounting stone models. And anyways, I started studying it way back then and found it had tremendous capability to see inside the bite. Just what you mentioned in the introduction, that how the bite looks is necessarily not how it functions, and what you can see by measuring is really amazing. So, my past 42 years actually have been studying how the T-scan can help dentists um in all kinds of disciplines. TMJ, sleep is a new discipline, but it can help in that. Uh, prostodonics, implants, but also how it um improves human physiology and how centrally tied to human physiology it actually is, because like brain directly, and it influences a lot of PEMS.

SPEAKER_00 4:16

Oh my gosh, I feel like in the dental field, we're missing such a big component uh of what we're doing. And I remember that I used to say this to my patients. I had so many patients, of course, they used to grind at your teeth. And for some reason, I started telling them that you know, your teeth are like a puzzle. The upper and the lower teeth are supposed to fit perfectly. God made everything perfect and with a purpose, right? So things are supposed to fit perfectly whenever your teeth are not aligned properly, whenever you get a new feeling, or you have a crown, and there's any changes, or you're missing a tooth, and there's any changes to the bite, it's almost like your brain is all night long trying to figure out where that puzzle fits because it no longer fits. Um, talk to us a little bit about why it is important for the upper teeth and the lower teeth to come together.

SPEAKER_02 5:11

Well, in general terms, obviously patient comfort and their bite is extremely important. As you pointed out, you can't get distracted. You know, people are overwrought by bite problems and TMJ problems. It affects their emotions. And it's it's actually not really about the fitting. Teeth fit together, they look like they fit together often in people that have bite problems. So alignment is not the main issue. The main issue is actually friction on the teeth that is actually a flaw in God's design. So not to kiss mud, but it's because the teeth actually hyperfire the nervous system and enter the brain with extra electricity that is meant to tell the brain how to help us chew, eat, and swallow and not choke on our food. But the teeth often promote too much of it, and the way they fit can even ideally can do that. And so ultimately what happens is the teeth tell the brain how to control chewing, eating, and swallowing, but they can do it excessively. And it works the system too hard. And it wears, for example, in terms of the teeth, an example would be wearing the system too hard would be to wear the teeth down while clenching and grinding, as opposed to just clenching and grinding and the teeth stay intact. Another way the teeth um hyperfunction the system is to tighten up all the muscles of swallowing and constrict the airway, which is an unknown uh um thing to the patient. They don't know their airway is getting smaller because their teeth for years and years and years have been tightening up their airway musculature and

Friction Beats Alignment In Occlusion

SPEAKER_02 6:46

they cause TMJ because of this flaw in the ideal design. So um uh the point I want to make just so to finish this uh uh question is that ideal alignment does not guarantee the neurophysiology of the occlusion will operate well. So fitting together in a mechanical way is not as important as fitting together in a neurophysiologic way, and that can only be optimized with the T skin technology.

SPEAKER_00 7:13

Very interesting. And also, what makes your jaw open and close? It is the muscles. We cannot ignore how important proper orofacial muscle function is for all of the functions of the orofacial structure to be able to work properly. The muscle always wins. I always tell my patients that uh people uh, you know, most people not in this field, they don't know that in order for the skeletal structure to grow, you need the push and pull of the muscle. And if the muscle is weak, so if the baby didn't breastfeed long enough, if they drank from a bottle, if they didn't chew hard enough, if they just have low tone on those muscles, then it doesn't really matter what the skeletal structure looks like because you know you're going to try to uh adapt to be able to eat, to swallow the things that we have to do for essential uh survival. But why do you think that people are bruxing?

SPEAKER_02 8:12

Well, again, bruxing is a function of the teeth. It's a very good question. There is a there is an emotional element to it, but it's actually triggered by the teeth rubbing together while the person is sleeping and not separating within a very small distance. We actually have studied bruxing and have studies where we've stopped bruxing in many people without night guards, without appliances, without psychotherapy, because of correcting the way the teeth rub together, removing this friction, actually. So when someone is sleeping and they're under stress, for example, and they are a potential clancher grinder, let's say they're having trouble at work and um they come home at night and they're trying to sleep and they're thinking about that, and they start grinding their teeth. Because their teeth keep rubbing together in small distances, it self-perpetuates the mechanism. And when we treat the bite to very high tolerances, we actually interrupt that process. And the person who clenches often says, Yeah, I can't clench my teeth anymore, meaning they can put them together, they can fit them, bite down, but they can't engage the muscles of their head like they did before. And that inherently breaks the cycle, not only physically, but also psychologically. The stimulus isn't there when they put their teeth together, even if they're under stress, they stop clenching and grinding, and they can't do it. In other words, the teeth don't do it to the person. So again, it's this excess electrical output that is the player, because it talks directly to the muscles of the mandible and uh the maxilla. And in this direct connection, a person who's crunching and grinding is tightening up all these muscles, teeth are rubbing together, and they're having all this head stress. When you correct the bite with the T scan in specific ways, the person can engage that system. What goes off the teeth, the electricity that enters the brain is far less, and what comes out is far less. We've been studying this for a long time. So with less contraction instructions, the muscles don't engage anyway near as hard. And the person doesn't have to do anything. That's the beauty of this management. It just does control the problem in most people without the person thinking about it, doing anything, taking anything, wearing anything, seeing a therapist, trying to have stress management. No, it just stops. So it's a major advance for patient care to be able to mechanical.

SPEAKER_00 10:30

Could we say, though, that it was God's perfect design instead of a flaw? Because if we're doing these things to destroy our teeth, couldn't that be a red flag? Couldn't that be smoke letting our body know that there's something wrong? Because years and years and years ago, maybe we did not have the same issues. Right?

SPEAKER_02 10:53

Yeah, clenching and grinding in TMJ has been a big problem for a long time. I mean, evolutionarily, uh I'm not talking about, I'm talking about in the modern era. But the the flaw is the amount of electricity that comes up the teeth. It's a beautiful system in that it controls how you swallow food safely so you don't choke and die. It operates in an incredible uh series of physiologies that the teeth direct directly into the brain. The first synapse the back teeth make is in the center of the brain, where there are five uh different systems or six different systems that talk to the teeth, which are circulation, respiration, or as I say, breathing, swallowing, blood flow, hash, sexual activity, and digestion. And all of these things are being influenced by teeth making excess electricity going into the brain. And the output then influences those systems. So that's the flaw. The design is beautiful, but in each person, one can't control the amount of electricity that comes off their teeth, and then it does different things to different people. Some people do nothing, and some people it wears the teeth down. You ask that as a red flag. Yes, that would mean that there's too much friction and the teeth are sanding each other away. You use in other patients, it causes TMJ and muscle pain. In other people, it causes earaches. Some people get ticks, facial pain, like trigemal neuralgia. That comes from the same electricity, excess electricity. So that's what is controllable with high precision um computer guided accusal adjusting. And because of that, we treat a lot of things that people struggle with that they they can't resolve despite management, like, for example, getting Botox four times a year, you know, or going for facial massages, or having chiropractic or physical therapy. Those therapies help people manage their problem, and the therapists try real hard, but they can't override what the teeth are doing neuroelectronically. This is major misunderstanding in dentistry. You can only see this information with computers. You can't see it by looking at someone's bite in their mouth or, you know, scanning their teeth, you know, making bulges of their teeth. No, you need to measure between the teeth, and you also need to measure the muscles at the same time.

SPEAKER_00 13:13

Wow. I do believe there are many different reasons why um people clench and grind. You know, some people out there will say it's just stress, um, but we don't really define stress. So immediately people, listeners, you know, the public listening to this would think, okay, stress could be something

Bruxism Without Night Guards

SPEAKER_00 13:36

at work. It could be something that's happening at the house, personally, an argument with somebody, a difficult situation, financial issues. But when is your body under stress? Let's say that you're not breathing very well. You're either snoring at night or you have a nasal obstruction or some airway obstruction with some sorts. Whenever there's a lack of oxygen that goes to your brain, that also is stress. And there are certain things that your body will do to keep you alive and healthy and well. Uh, and maybe, you know, this grinding is the is the attempt of uh getting the tongue out of the airway because whenever you move your mandible forward, the tongue is attached to the mandible, it's gonna come forward also. And it just may be a survival neck mechanism to some of these patients. So it's so important for us to collaborate with each other and listen from each other and see what amazing technology is out there to give us more answers, also. Um, explain to us a little bit more how this eye uh T scan works.

SPEAKER_02 14:41

How the T scan, yes.

SPEAKER_00 14:42

How the T scan works.

SPEAKER_02 14:44

Well, first, I just want to say stress is additive, it's not causative. Biocyclopsocial theory has never been founded in science. There's no research that shows people grind their teeth because they're under stress. But if they put their teeth together and their teeth create excess electrical activity, it stimulates its own output in order to cause the teeth to grind and clench. This is why we can stop it in many people. So we've also shown, again, because you brought up stress, and then I'll answer your question. We've also shown that by using the T scan, which I'll show you in a second, to control the bite, we can reduce cortisol, which is the stress hormone dramatically. Catch is incredible. Yes, it takes stress the stress response in the brain, like you mentioned, the lack of oxygen would induce stress in the brain. This excess electrical activity coming off the teeth stresses the brain. And in a study we just published in in um 2026, cortisol was was reduced, excuse me, 50% in patients that had their bite adjusted to high precision metrics with the T scan. So there's no pill you can take, there's no yoga class you can do, there's no diet you can go on that's going to reduce your cortisol by 50%. But adjusting your bite to high precision if you have chronic pain or if you clench and grind your teeth, or if you have sleep issues, there's no question it can help you.

SPEAKER_00 16:05

So that's incredible. Tell us a little bit how it works. What does it look like if I'm a patient I come to your office and I'm having this done?

SPEAKER_02 16:12

Well, this um, I'll try to hold it in the non-blurred part of my background. You can see the T-scan handle, and there's a sensor that I've actually used to record on myself. So it has some tooth imprints. It connects to a computer via USB. And the sensors are used all over the world. There are sensors used same components in automobiles. In um in um uh, for example, your brake pads are machined by this same technology, and your um uh engine your seats are contoured around you by sensors that they use to see how you when you move in curves and what happens when you speed up or slow down. These same sensors that you bite on uh are used to control things in your car. So they're extremely precise, and they're used by companies like Michelin and Amazon. And so they what they are is a tactile pressure sensor. When you bite on this, it it's being scanned 3,000 times a second, and it records how your teeth come together, how they chew across each other, how what pressures they exert as they do those things, and then it gives it back to you in a movie form that you can um observe changes in someone's bite or bad things in their bite, where there's too much pressure, where there's uneven timing of teeth, and then make intelligent corrections about where these problems exist. And that optimizes the neurophysiology. And so these computer enhancements, I mean, I'm sorry, these computer guided adjustments are high precision, high tolerance. It can't be done with ink and paper to stop someone from clenching and binding. You need the precision of the T-scan. And this is something that we've studied again for many years. There are publications about many of these things. The newest ones are actually looking at sleep and opening the airway from relaxing the constrictor muscles, again, with high precision bite adjusting. So it's an amazing tool. And uh patients, the only caveat I would say before I take your next question is patients would be looking for trained T-scan doctors, not someone owns one. Owning one doesn't make someone a good user. They have to be trained in how to record, how to read the information, and how to then use it to optimize someone's bite. And that's not uh something inherent in uh buying one or having one in your office.

SPEAKER_00 18:33

It's so the company does the company offer training whenever you purchase it?

SPEAKER_02 18:38

The company offers onboarding, which is not training. Onboarding is learning how the software works and how the buttons work and how to, you know, ba in basic ways put it in someone's mouth and use it. They're not they're not dentists, they're not, they're not um uh trained in how to use it to improve a denture, how to make better implant case, how to solve TMJ. Those things the dentist has to learn. And those protocols are well defined and in uh now published many years. So the technology is available to the profession to use it in many ways. Sleep is an area that is emerging, and it's a wonderful thing to see. Um, because um, as I said earlier, the uh high precision adjusting can often open the airway 30%, uh, sometimes gaining 50 millimeters of area. Let's say a typical one might be 140 um square millimeter area, and it might become 210 after a month or two. All right, it's amazing. It it does it automatically. Again, the beauty of the T-scott manage these conditions, like a sleep apnea appliance manages

Stress Cortisol And Tooth Electricity

SPEAKER_02 19:46

the condition. But in the morning, the person doesn't wake up with 70 more square millimeters of airway. They wake up and their airway goes back to the same place, and their teeth are usually affected by wearing that sleep appliance. Whereas with T-scan guided high precision therapy that relaxes muscles, the person gets a new airway. It opens up and they don't have to wear anything or do anything. So it's amazing, right?

SPEAKER_00 20:11

So is it moving their teeth in any way?

SPEAKER_02 20:14

No, it's just refining the amount of electricity that's coming off of them and limiting it so it doesn't tighten all the muscles of the head and face. It works, all the swallow mechanism muscles are affected by the teeth rubbing together and throwing off this electricity. And it does it um while you are using your teeth. It's not because you clench and grind, it's not because you um uh uh you know uh have trouble chewing, or when you're chewing, you're rubbing your teeth. It occurs when you're chewing, when you're swallowing. And it happens thousands of times a day because you swallow and your um back teeth have to come together to do that.

SPEAKER_00 20:50

So Alex is saying, love the T scan. I agree we need more to measure, or it's just a guess. Still don't understand. Oh yeah, go ahead. Come here, go ahead. Still understand how dentistry hasn't brought this up to standard as the industry is all about having data a hundred percent. I mean, can you imagine if every dentist started actually checking people's occlusion and and doing a sleep study? We would see so much uh better dentistry coming out of these offices because people have so many issues with um restorations breaking. Is this something that if somebody constantly has to get restorations redone, is this something that a T-Scan can help with?

SPEAKER_02 21:38

Yes, absolutely. It's a very good question. So breakage of teeth or rebreaking of teeth or cracking of cusps is a friction problem that's inherent in the bite. And it doesn't go away because you get a filling put back or you get a clown put on, you could still break off a cusp. And again, it has to do with the same mechanics. When when people's teeth don't operate well, they often, as we've been talking about, hyperfunction all these muscles, which means they load their teeth with more force than they have to. And the person doesn't know it. They're not saying, oh, I'm gonna bite down hard now. They're just using their system, and their system neurologically controls how much muscle activity is being applied to their teeth. So breaking of restorations is a huge problem that the T scan has been shown in studies to limit. Uh, one published paper um specifically on dental implants showed T scan reduced the complication rate in the treated population from from um compared to not using T scan, uh, it was one in four. So 25% complications are breaking porcelain, chipping teeth, screws loose now. T-scan was 1.8%. And both groups treated about 150 to 200 implants. And this is the kind of difference that's been out in the literature. There's many advantages using T-scan in the literature. There are scientific studies that go back a long way. My first ones in 1990, 1989, 1990, and then other people collaborating with me in the in the 2000s and onward, hundreds of papers about the benefits of T-scan. But dentistry has not wanted to adopt the benefits that the public would gain. And it's it's its own commentary on the profession being, you know, unwilling to see the value of something that's proven and quite effective. And most important thing, this sensor is used all over the world in industries that deal with friction, pressure mapping, timing, force. I mean, you're driving cars that

How T Scan Measures The Bite

SPEAKER_02 23:37

all kinds of parts with T-scan centers and rake pads, engine gasket seals, springs, you can't imagine, steering wheel, art, all kinds of things. And then in other industries. So dentistry surely should be adopting this technology.

SPEAKER_00 23:50

Amazing. So this is an assessment tool. Somebody would come into the office. Do you use it on every patient? Do you usually only use it on people who have symptoms? How does that work?

SPEAKER_02 24:00

Well, you can use it uh on as a diagnostic tool and as a treatment tool. So, yes, you can certainly schedule yourself to scan every person, and that would require the person doing the scanning to be good at it. It doesn't just work because someone bought it, like I said. So if you're going to scan every patient and you want valid data, uh as a dentist, you'd want to be trained in how to use it. And then you can make very intelligent decisions about what's wrong with their bite and how to improve it. And that could be for a TMJ patient, a patient with symptoms, someone who has painful teeth after getting new dentistry done. Um, you know, there's a lot of different ways to use it to diagnose common occlusal problems like wear and recession and cold tooth sensitivity. But it's also a treatment tool. It's used to deliver the sophisticated dentistry. You know, people spend $40,000, $50,000 on fancy implant restorations, uh, top and bottom, and then the dentist basically guesses at ink and paper to deliver it. And it's been shown in four separate studies that the dentists are guessing at the ink and paper and that they don't do it well. We don't do it well, and it's a real sort of hidden thing that the public doesn't realize. It's often why the public goes to the dentist and then comes home with a bite problem. And it is it's so it's solely because two elements to this problem with using paper and ink without computer analysis. The paper and ink doesn't measure bite force, timing, pressure, mapping. It doesn't give the dentist any information except for where the teeth touch. And that's if it marks well. It doesn't always mark that well. The other piece of it is when the dentists look at the marks, they're taught that the size of the marks shows the pressure and the force. And that's completely untrue. That it's the only correlation that's been found scientifically was 20% correlation, meaning 20% of the time a big paper mark would be high force, 20% of the time a little paper mark would be low force, the other 80% of the time there's no correlation. And so that's yes, and so when the dentists look and choose, it's been shown in four studies, they choose wrong often 90% of the time. And then that means they destabilize the person's bite, or they leave high forces on an implant case, and then three months later, a chunk of it comes off because the high forces weren't detected. So the paper and ink method is really a compromise that the profession has continued to perpetuate in lieu of adopting the T-scan. And the the dentists that have the T-scan, they should be credited for moving forward beyond ink and paper. It's really a benefit to their patients. So it would be a very big change in dentistry if people started acquiring the T-scan B, the standard of care, not guessing at ink and paper doesn't care about the bike.

SPEAKER_00 26:46

I love that. Because and it does show everything because what we're used to, it's usually just localized to that specific that we're working on. Um what this treatment looks like with a T-scan?

SPEAKER_02 26:59

Well, that's an excellent question. So essentially, you have data drawn from the patient making certain specific movements that apply to their problem. For example, if someone came in and said to me, Well, Dr. Kirsten, ever since I last two days I can't bite on this tooth over here on my left, I would ask them, is it only if you bite on it or do you have to chew on it? And they would say, Well, no, I can bite on it, but if I chew on it, it hurts whenever I'm eating. So then I would record with the T-scwing movements. And I would then look at that tooth for the highest force that shows up on that tooth, not necessarily the highest force in the mouth, but on that tooth in the middle of the chewing movement, because the T-scords a movie of your bite, and then you can play it back incrementally and see, you know, into the detail, amazing detail you can see. And then you adjust um, you know, the problem contact and see if the patient can grind around and go home and chew and eat and the tooth doesn't hurt. I had one woman recently who had an implant put in, a single implant, and a few months later she couldn't chew on it. So she had gum in her um in her pocketbook. So um she said she had been trying to chew gum that morning and the tooth, the implant tooth was bothering her. So we said, okay, let's fix it for you. Let's find out what's wrong. We used the T-scan and isolated the implant and looked at some of the friction on the chewing motion, and we adjusted the places that were frictional, and um uh they only lasted like seven tenths of a second, which does is how just to give you an idea of like what the T-scan show you. Well, a pressure overload for seven tenths of a second. That's easily findable in the hands of a knowledgeable T-scan user. And then we marked the tooth the same way we recorded. So she chewed on the she did the same action on the paper. We found the spot, we adjusted the area which was the problem located by the T-scon on the tooth, and then we had to chew gum again. And, you know, she was able to sit in the chair and chew gum and say, you know, it doesn't really hurt me now. I think it's still a little sore, but I can chew. And I said, well, go home and wait a few hours and then have dinner and see if it's different for what you've known the last few weeks. So this is the kind of immediate response you can get out of the patient that's positive. And then in terms of treating bigger picture items

Restorations Implants And Hidden Overload

SPEAKER_02 29:11

like treating the full bite after Invisalign, you can optimize the uh fitting together that you talked about, and also the chewing mechanics that create the X friction after someone's teeth are moved, and that stops them from getting headaches and facial pain after Invisalign. Um, and you can also use it to install big implant cases like we were talking about. So there's many ways to use the T-skin, and and the essence of it is you record data, mark the teeth with the carbon paper, and only use the carbon paper to locate where the T-skin says there's a problem. So instead of looking at the paper marks and saying, oh, I think it's that one, I think it's that one because it's big, or that one doesn't count because it's too small, which is what the dentists are taught to do, which is hard to believe, it's still being taught. Um instead of doing that, you read the data and you say, okay, the canine tooth on the back side near the near the chewing edge has to have some force removed. And you go in and you mark the teeth, and then you adjust only the areas the T-scan shows you. And that's how you optimize under high precision. Um it's it's called computer guided microadjusting, high precision microadjust.

SPEAKER_00 30:21

Do you notice any more bite issues on people who had their premolars extracted?

SPEAKER_02 30:30

Their premolars. Actually, it's an interesting question. So uh I'm not sure I have the correct uh the total answer, but I see it very differently than dentistry does. They believe this is a big problem. I see it as four less teeth that aren't throwing muscle activity off into the brain. And it's again the lack of control over the friction that remains that causes most of the bite problem. So in this instance, it's very possible, it's nothing I've studied, but it's very possible that first premolar extraction patients um have an exaggerated response neurologically that gives them more problems because they're missing some teeth in the middle. It's hard to say I know that. I'm I can't I can't say I know that, but I've treated many to to talk in the reverse. I've had many orthodontic first premolar extraction patients that uh came to me for TMJ treatment, and they did extremely well. It had nothing to do with their being first premolar extraction patients. They, I mean, they had symptoms like others. They had the same jaw pain and they had the same headaches, and they clenched and grinded their teeth, and their teeth were cold sensitive, and they had braces, obviously, or invisalign because they were missing extractions. Yeah, excuse me. They were missing premolars. But they solved their TMJ extremely well by the, again, using high precision microadjusting to control the friction. And so um I don't believe they're any different than any other patient who has teeth. And just to tell you, I'm an example of a survivor of first promolas.

SPEAKER_00 32:11

But no snoring, no sleep apnea, no tension in the neck, anything like that.

SPEAKER_02 32:17

My orthodontist did a very nice job and actually did minimize the friction. You know, I've measured my many times, and so yes, but she didn't do it by microadjusting, she did it by alignment. So there are alignments that can optimize the friction, and there are alignments that can maximize the friction, and that really influences the neural output. So my orthodontist must have done a good job. So I don't have too much friction.

SPEAKER_00 32:39

Good. Uh someone is asking uh on Instagram, so the Invisalign itself is not enough to correct the bite. T scan is still needed after the procedure or before is better.

SPEAKER_02 32:51

Oh, it's a very good question. Um, Invisalign can do a beautiful job correcting the alignment, but alignment alone does not optimize the occlusion. That's why we see a lot of like well-aligned, beautiful teeth. Um the best example is, you know, 30-year-old female who had braces and has TMJ, and you know, and you look in her mouth. We actually just treated one in this weekend in a course that I did in Las Vegas, uh perfect teeth. I mean, you know, perfect alignment, and still had TMJ and trigeminal neuralgia. So the answer is no. The answer is yes, you need the T-scope to optimize the occlusion after creating the macroacclusion. So the macro occlusion is the aligning of the teeth. And that in an invisalign is moving the teeth. In prostanotics, that would be crowning all the teeth, or an implank, that would be installing all the teeth. That and you make all the teeth fit and align. That doesn't finish the case in any predictable way because you need the human to, you know, chomp their teeth together and grind around. And, you know, no matter what you do in the lab or what you do on the computer screen with like invisalign showing how the teeth line up, that doesn't play out in the mouth with the pressures and the chewing and the friction. And so the line alone cannot solve the end of Invisalign. You definitely need the T scan. And again, a trained operator to optimize it for the patient.

SPEAKER_00 34:17

That's amazing. I'm gonna have to get one done now. I really think that my uh friend Dr. Bush did have one in his office. I might have to go visit him. Um, can someone have significant occlusal dysfunction without pain?

SPEAKER_02 34:31

Yes, absolutely. An example would be that their gums are receding, their teeth don't hurt, and they're um, you know, not complaining of TMJ, and they're using their teeth day to day and they don't have cold sensitivity, even though their gums are receding on some teeth. Or another example would be wearing their teeth down uh usually doesn't hurt the patient. Even in the worn state, patients who have wear and exposed inner tooth often don't complain of their teeth hurting or their teeth being um sensitive. So, and then the reverse is true. The teeth can be perfectly aligned and gorgeous and create dysfunction. So um there are the effects of the friction are many, and depending on the individual's constitution, it's how they exhibit or not exhibit those effects of the friction.

SPEAKER_00 35:22

Wow, this is really like opening my mind to so many many other questions. Um we are hearing more about whole body dentistry and the relationship between the mouth, the muscles, the posture,

Why Articulating Paper Misleads Dentists

SPEAKER_00 35:36

breathing, and physiology. Where is that connection well supported? And where should clinicians be cautious?

SPEAKER_02 35:45

Well, that's an interesting question. It's it's very well supported, actually, because of what we talked about already. So the teeth, the bite specifically, and oral function, chewing, eating, swallowing, is brain-centered control. And in that tooth feedback, that you know, when you eat lunch after we talk, you're not going to be thinking about chewing and swallowing. You just kind of do it. It's all done for you. And you don't die because food goes down your throat. And that matters because it could go down into your lungs, which is where you would die. And this is the beauty of the system. So uh, once in the brain, the five systems we talked about: posture, circulation, respiration, sexual activity, digestion, swallowing, they're all tied up with the teeth. And it doesn't appear that way to the human. But we see influences. For example, a very nice study that was published showed uh 90 patients who had forward head posture as a problem in their spinal alignment, who had their bite corrected in specific ways, high precision computer guided microadjusting, their head posture aligned. And the study showed that the day of treatment, the head posture began to align. And that was using posture metrics and posture analyses, standing in front of scales and plates and doing all these things that, you know, closing your eyes and doing sway analysis. And it's amazing. So the whole body connection is there from the oral cavity. Who it affects, how it affects them ranges from things like getting brain fog to having vertigo and then having shoulder misalignment, like you can have one shoulder higher than the other one, even though the rest of you is well aligned. And I'm and I'm magnifying it, you know, it'd be more something like this, right?

SPEAKER_00 37:35

And yeah, we see that all the time with our patients. They're completely misaligned. You change the bite and they and you put the tongue in the right position, and all of a sudden the posture is better.

SPEAKER_02 37:44

Yes. Well, again, it's oral function. So, and the the the main player is the teeth. Like we see these things without training tongue posture, without making appliances, without intervening in a standard uh non-bite therapeutic approach. And I don't mean non-bite, like someone might make an appliance and that can realign the spine because of the same mechanics and improve bite on the appliance. But we see these changes directly from the teeth. And you don't need to train the person to do anything, they just begin living. And one of the great ones is again opening the airway, because that really is a fantastic um uh thing that the person, you know, can have done without needing to wear an appliance that throws their bite off when they wake up in the morning.

SPEAKER_00 38:34

Yeah, so I'd love to understand a little bit more about how that works and what was used to measure before and after uh for that research.

SPEAKER_02 38:43

So the the way it works um is simply the teeth are connected to the center of the brain, as I said, and four cranial nerves that leave the brain, all use these tooth, the same nerve to get to their end structure. So, in other words, the trigeminal nerve, which the teeth are part of, also is used by the oculomotor nerve, which controls how your eye moves, your facial nerve, which controls your muscles of facial expression, and your glossopharyngeal nerve, which controls the base of your tongue and your upper airway. And so when the teeth throw out all this extra-electrical activity that goes into the brain and comes out on the trigeminal nerve, it also shows up in these other areas. So the glossopharyngeal nerve controls the constrictors of the some of those nerves that work with the glossopharyngeal nerve, which is the ninth cranial nerve, control the constrictor muscles and um of the throat that aid in swallowing. And they just tighten up around the airway and they just squeeze the airway just from swallowing, day after day after day, just from chewing and eating, not because the person's punching and grimming. So that's how it works. That's why there are so many tooth-related emphases. Even the vagus nerve, which is feeds your lungs and your heart, has some tooth-related uh connection, which I'm I'm not so sure about. So, what was the second part of your question? Because you asked how it works.

SPEAKER_00 40:08

I don't remember anymore. Because I already have another question in my mind.

SPEAKER_02 40:12

I spoke to you on, but that's the neuroflujo I think. Okay.

SPEAKER_00 40:18

Well what would need to happen for objective? Oh, I did ask um uh how I was just trying to understand a little bit more um about how it works.

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SPEAKER_00 40:27

Oh, how did you guys measure the airway that got is that 30 or 40 percent?

SPEAKER_02 40:31

Yes. So thank you for reminding me. Yes. It's done by volume and area computation from CT images of the airway, sort of from the side of the head where you see the mouth, the tongue, see down to the upper airway, the throat, and um calculating the volume using you know software tools, uh having the patient reperform the same radiographic position. That's a balance. Yes. But again, if someone's gaining, let's say, 50 square millimeters of airway, it isn't because their tongue was in a different position in the in the x-ray by a dramatic amount. People, you know, that my tongue is slightly against my teeth and then it's just below my teeth, it's not going to gr grow the airway 50 square millimeters.

SPEAKER_00 41:20

So well, if the tongue is low, it is more, it's it is constricting the airway more. Whenever we bring the tongue forward and up, it frees the airway by a whole bunch. We do see that. However, the patient is awake, the patient is not laying down, they're not asleep, and for every, I think it's five degree of forward head movement during the scan, it opens up the airway by 25%. It's something crazy. So I know that it's very difficult to really look at the the C BCT airway. They always tell us we can't diagnose. I understand we can diagnose. It gives us a great picture of the anatomy and what's going on in there. And we know that if we see something, you know, bad on the C BCT, it's just going to be worse at night. Um, but I was just wondering how how that research was done. Um, what would need to happen for objective occlusive analysis to become a more routine part of comprehensive care in a dental office?

SPEAKER_02 42:19

Well, dentists would have to be informed that it's an important advance for them to uh adopt. And this has been um not the focus of dentistry on the bite world and the and the occlusion world. They've turned away from it. So that's a major thing. And one one way to change that would be if patients demanded it, because you know, as I said, patients don't realize the dentists are guessing at ink and paper. They go to the dentist, they don't realize they're at risk for developing a bite problem after having fillings done or having a crown put in. It's actually very common. I get contacted fairly regularly about people who have readistry done and their bite is thrown off and they're not able to get it resolved. So dentistry has to make the T-scan matter to the public and uh and face the truth about using carbon paper and shim stock as a method to adjust being highly flawed and completely inaccurate compared to using high precision sensors that are used all over the world in airplanes and aerospace and robotics and uh you know engine gaskets. Like I said, these sensors are incredible and it's a uh it's a strange resistance. I mean, I faced it all these 42 years. So um, despite publishing

Airway Posture And Cranial Nerve Links

SPEAKER_02 43:37

much more about the T-scan than there is about the value and accuracy of carbon paper and shim stock. In other words, there are hundreds of papers showing the T-scan treats all kinds of things because the studies are actually studies. People who had problems were treated with precision computerized byte analysis adjusting, and their outcomes were measured statistically in many different ways. And bike paper has none of that. Carbon paper has none of that. And the studies on the carbon paper essentially show that it doesn't really measure anything about the bike except we have the teeth touch. So to answer your question simply, dentistry has to adopt it. But the public can demand it. And the public can go to a dentist who has it. They can ask their dentist if they have a T scan, if they don't have a T scan, they might want to rethink spending those $25,000 on all that implant dentistry.

SPEAKER_00 44:29

Yes. Yes. And if they're about to invest any amount of money into their the health of health of their teeth, it's so important to make sure that it's going to hold, it's going to last. It's not going to bring them any future problems. So thank you so much for sharing with us about the T scan. Um, this is great information, and I hope more and more dentists um seek uh for Disney technology. Not new, it's been around for a long time, but Disney Technology should actually practice. I have a fun, quick, rapid fire myth or fact you have to answer.

SPEAKER_02 45:06

Okay.

SPEAKER_00 45:07

You ready?

SPEAKER_02 45:08

I'll do my best.

SPEAKER_00 45:09

All right. Articulating paper tells you everything you need to know.

SPEAKER_01 45:15

A high spot is always a problem.

SPEAKER_02 45:21

Not always.

SPEAKER_00 45:23

A perfect looking smile means a balanced bite. Occlusion and TMD are always directly connected.

SPEAKER_01 45:36

Everyone has an ideal bite position. Can I clarify that?

SPEAKER_02 45:46

Yes. So many different bite positions can be very uh comfortable for patients if their bite is optimized. Finding the perfect bite position is not uh will not solve many problems that people suffer with. It's it's not the answer. Again, that's an alignment issue. So that's a myth.

SPEAKER_00 46:07

And before we go through our finish a sentence portion, I'm gonna start a sentence and you just finish with the first thing that comes to your mind. Do you mind telling everybody how they can find you?

SPEAKER_02 46:19

Uh, they can find me on um the internet at my website, www.drrobertkirstein.com, which has a lot of dentist information mostly, but patient information about computerized bioanalysis and what's available uh in terms of help. Um they can find me uh on Facebook, although I'm not the world's greatest social media. And um and they can certainly look at the tech scan website, www.techscan.com. They'll find me there to some degree. And in um another website of providers, this is actually the important one, of trained T scan providers, www.digitalacclusion seminars.com.

SPEAKER_00 47:04

Perfect. We'll make sure that we add all that to our show notes. And to finish our uh beauty of breathing episode tonight, I have a few finish the sentence, uh, a little game that we do. Are you ready?

SPEAKER_02 47:17

Yes.

SPEAKER_00 47:18

All right, occlusion is really about neurophysiology. The best thing clinicians miss when looking into bite is the neurophysiology.

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SPEAKER_00 47:33

If you only look at where the teeth touch, you're missing a tremendous amount of information that will help patients live far better if you understood it. The future of occlusal analysis is the T scan technology. Well, thank you. Thank you so much, Dr. Robert. This was such an incredible talk. I appreciate you sharing your time with us. Any last words before we go?

SPEAKER_02 48:02

Just to thank you for uh exploring this information with me. I hope your um listeners, you know, gain some information that will help them in their seek for dental comfort and gay comfort and sleep comfort.

SPEAKER_00 48:17

Yes, I mean there's there's more out there that we can do to help our patients. It is really the patients have to become their best advocates to go search for these answers on their own. Don't, you know, just believe the first opinion you get, get more than one opinion. And if you're having trouble, if you're having pain, if you're having symptoms, you need to become your best advocate and go after it because there are people out there that care enough to go the extra mile to help you out. So thank you so much. Have a wonderful day, everybody, and we'll see you soon. Bye bye. Next Tuesday.

SPEAKER_02 48:51

Thank you.