לחץ כאן

483 views
398 views

Published on

0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
483
On SlideShare
0
From Embeds
0
Number of Embeds
3
Actions
Shares
0
Downloads
9
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

לחץ כאן

  1. 1. The Use of Acupunture in Dentistry YEHIEL ALPERN D.M.D A.C
  2. 2. ‫משלימה‬ ‫לרפואה‬ ‫פניה‬ ‫וכלל‬ ‫בארה"ב‬ ‫שנערך‬ ‫מקיף‬ ‫בסקר‬ ‫מעל‬30‫כי‬ ‫נמצא‬ ,‫מרואיינים‬ ‫אלף‬ 36‫אחוז‬‫גיל‬ ‫מעל‬ ‫מהמשתתפים‬18 ‫האלטרנטיבית‬ ‫הרפואה‬ ‫לשירותי‬ ‫פנו‬ .‫מחלה‬ ‫בזמן‬
  3. 3. ?‫בישראל‬ ‫קורה‬ ‫ומה‬ -‫מ‬ ‫יותר‬ ‫עם‬ ‫בסקר‬2000‫בשנת‬ ‫משתתפים‬1993 ‫ובשנת‬2000‫היתה‬ ‫אלה‬ ‫בשנים‬ ‫כי‬ ‫נמצא‬ ,‫של‬ ‫עליה‬ -‫ל‬ ‫קרוב‬70%‫משלימה‬ ‫לרפואה‬ ‫הפונים‬ ‫במספר‬ ‫הומאופתיה‬ ‫היו‬ ‫ביותר‬ ‫הפופולריות‬ ‫הטיפוליות‬ ‫הגישות‬ ‫ו‬‫אקופונקטורה‬ ‫לטיפולים‬ ‫יותר‬ ‫נטו‬ ‫גדולות‬ ‫ערים‬ ‫ותושבי‬ ‫נשים‬ ‫בשנת‬ ‫וסה"כ‬ ‫אלטרנטיביים‬2000‫דווחו‬75% ‫להם‬ ‫עזר‬ ‫שהטיפול‬ ‫מהמטופלים‬
  4. 4. 107.Acupuncture National Institutes of Health Consensus Development Conference Statement 3-5,1997November Ample clinical experience research data, suggests that acupuncture option for a number of clinical cond postoperative pain and myofascial and low ba
  5. 5. 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.
  6. 6. 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..
  7. 7. APPLICATION IN DENTISTRY  SEDATION-PREOPERATIVE  PAIN CONTROL-POSOPERATIVE  GAG REFLEX CONTROL  CONDITIONS in oral medicine: TMJ DIS -FUNCTION,BRUXISM RECURENT APHTOUS STOMATITIS Facial paralysis ,Trigeminal neuralgia Modified taste sensation, Burning mouth syndrome,xerostomia…….
  8. 8. 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.
  9. 9. CHINESE PHYLOSOPHY YANGYANG== LIGHTLIGHT SUNSUN ACTIVITYACTIVITY EASTEAST ENERGYENERGY WARMWARM UPPERUPPER EXTERNALEXTERNAL MINDMIND YIN= DARKNESS MOON REST WEST MATTER COLD LOWER INTERNAL BODY
  10. 10. 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
  11. 11. PATHOLOGY THE EIGHT PRINCIPLES DEFICIENCY YIN EXCESS YANG INTERIOR HOT EXTERIOR COLD TCM’S SYNDROMES
  12. 12. Toothache Key Diagnostic Points: Toothache is a common symptom. It can be involved in acute or chronic pulpitis (inflamm of the dental pulp), dental caries (tooth decay), periodontal abscess and pericoronitis (inflammation of the gingiva, surrounding the tooth). Differential Diagnosis: 1) Toothache due to Stomach fire. Severe toothache accompanied by foul breath, thirst, constipation. Tongue:Yellow coat Pulse: Rapid, flooding 2) Toothache due to wind-fire. Acute toothache with gingival swelling accompanied by chills and fever. Tongue:Thin white coat Pulse: Superficial and rapid 3) Toothache due to Kidney Yin deficiency Dull pain on and off. Loose teeth. Tongue:Red body Pulse: Thready and rapid
  13. 13. Treatment Principle: Clear away fire, stop pain. Point and Technique Prescription: L.I. 4: One of the four key points, this one for face and mouth. It's also the Yuan Source point for the L.I. channel. L.I. goes into the lower gums. St 6 and 7: (reduce) Local points found on the stomach channel. Stomach channel enters the upper gums. For use with Stomach fire and wind fire, the above three points should be reduced. For Kid Yin Deficiency, the above three points should receive even stimulation. For Stomach fire, add: St 44: (reduce) Ying spring point of Stomach channel is used to reduce the stomach fir as Ying spring points are used for heat/fire. For Wind-fire, add: SJ 2 (reduce) The Ying spring point of the San Jiao. Ying Spring for heat/fire, This poi clears fire and dispels wind. SJ 5 (reduce) Luo connecting point of San Jiao, and the confluent point for the Yang Wei Mai especially effective for exterior syndromes. Dispels wind and heat. Du 14: (reduce) Clears away fire because its the meeting point of all yang channels and a nape location, many of which are effective on wind attacks. For Kidney Yin deficiency, add: Kid 3: (reinforce) Nourishes Kidney Yin. Tai Xi, "Great River" the deep and low collecting point of water on the body.
  14. 14. LI 4  Chinese Name: He Gu English Name: Union Valley Description: 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).
  15. 15.  ST7 • XiaguanStomach 7 • Meetin g 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 •
  16. 16.  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 •
  17. 17. THEORETICAL EXPLANATIONS FOR ACUPUNCTURE  TRADITIONAL THE MERIDIANS 14 MAJOR 8 EXTRA  SCIENTIFIC “ GATE CONTROL” Melzack and wall 1965 “NEURAL MECHANISMS” Stux and Pomerants 1987
  18. 18. 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
  19. 19. 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.
  20. 20. NEURAL MECHANISMS OF ACUPUNCTURE ANALGESIA STUX & POMERANTZ AA is initiated by stimulation of small diameterAA is initiated by stimulation of small diameter nerves in muscles which sends impulses tonerves in muscles which sends impulses to:: Endorphins and MonoaminesEndorphins and Monoamines Spinal cordSpinal cord midbrainmidbrain ANALGESIAANALGESIA Pitutary & hypotalamusPitutary & hypotalamus
  21. 21. 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.
  22. 22. 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.
  23. 23. 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.
  24. 24. Dr. Nogier's pulse reflex may possibly be part of the effect of such 'biofields' Auriculotherapy is a therapeuticAuriculotherapy is a therapeutic intervention in which the auricleintervention in which the auricle of the external ear is utilized toof the external ear is utilized to alleviate pain, dysfunction andalleviate pain, dysfunction and disease as represented anddisease as represented and manifest throughout the bodymanifest throughout the body
  25. 25. KIRLIAN PHOTOGRAPHYKIRLIAN PHOTOGRAPHY KirlianKirlian Photography is a process thatPhotography is a process that uses high frequencies anduses high frequencies and electron streams to take aelectron streams to take a picture of invisible radiatingpicture of invisible radiating energy fields that surroundsenergy fields that surrounds all living thingsall living things
  26. 26. 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.
  27. 27. 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.
  28. 28. Methods TRADITIONAL AND MODERN  ACUPUNCTURE  MOXIBUSTION  HERBS  ELECTRO ACUPUNCTURE  SOFT LASER  BIORESONANCE AND HOMEOPATHY
  29. 29. AACUPUNCTURE NEEDLESCUPUNCTURE NEEDLES
  30. 30. Moxa
  31. 31. 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.
  32. 32. Toothache Key Diagnostic Points: Toothache is a common symptom. It can be involved in acute or chronic pulpitis (inflamm of the dental pulp), dental caries (tooth decay), periodontal abscess and pericoronitis (inflammation of the gingiva, surrounding the tooth). Differential Diagnosis: 1) Toothache due to Stomach fire. Severe toothache accompanied by foul breath, thirst, constipation. Tongue:Yellow coat Pulse: Rapid, flooding 2) Toothache due to wind-fire. Acute toothache with gingival swelling accompanied by chills and fever. Tongue:Thin white coat Pulse: Superficial and rapid 3) Toothache due to Kidney Yin deficiency Dull pain on and off. Loose teeth. Tongue:Red body Pulse: Thready and rapid
  33. 33. Treatment Principle: Clear away fire, stop pain. Point and Technique Prescription: L.I. 4: One of the four key points, this one for face and mouth. It's also the Yuan Source point for the L.I. channel. L.I. goes into the lower gums. St 6 and 7: (reduce) Local points found on the stomach channel. Stomach channel enters the upper gums. For use with Stomach fire and wind fire, the above three points should be reduced. For Kid Yin Deficiency, the above three points should receive even stimulation. For Stomach fire, add: St 44: (reduce) Ying spring point of Stomach channel is used to reduce the stomach fir as Ying spring points are used for heat/fire. For Wind-fire, add: SJ 2 (reduce) The Ying spring point of the San Jiao. Ying Spring for heat/fire, This poi clears fire and dispels wind. SJ 5 (reduce) Luo connecting point of San Jiao, and the confluent point for the Yang Wei Mai especially effective for exterior syndromes. Dispels wind and heat. Du 14: (reduce) Clears away fire because its the meeting point of all yang channels and a nape location, many of which are effective on wind attacks. For Kidney Yin deficiency, add: Kid 3: (reinforce) Nourishes Kidney Yin. Tai Xi, "Great River" the deep and low collecting point of water on the body.
  34. 34. LI 4  Chinese Name: He Gu English Name: Union Valley Description: 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).
  35. 35.  ST7 • XiaguanStomach 7 • Meetin g 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 •
  36. 36.  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 •
  37. 37. Effects of Electro Acupuncture LOW FREQUENCY(2-4 hz)HIGH INTENSITYLOW FREQUENCY(2-4 hz)HIGH INTENSITY== ENDORPHIN SYSTEM---THREE CENTERSENDORPHIN SYSTEM---THREE CENTERS ---slower onset and long duration---slower onset and long duration --- cumulative--- cumulative ---called “acupuncture like TENS” =produce “CHI”---called “acupuncture like TENS” =produce “CHI” ---given frequently (more than daily)=tolerance---given frequently (more than daily)=tolerance ( morphine like)( morphine like) (( HIGH FREQUENCY (50-200HZ), LOW INTESITYHIGH FREQUENCY (50-200HZ), LOW INTESITY SPINAL CORD AND MIDBRAIN (by pass endorphinSPINAL CORD AND MIDBRAIN (by pass endorphin ---conventional “TENS” (gate theory)---conventional “TENS” (gate theory) system)-system)- ---rapid onset and short duration---rapid onset and short duration ------no cumulative effectsno cumulative effects
  38. 38. Electrical stimulation on periodontal regeneration in experimental 4wall bony defects in dogs Kaynak ,JP 2005 ,2194 Quality of new bone fill andQuality of new bone fill and mean value of cementum weremean value of cementum were significantly higher than controlsignificantly higher than control
  39. 39. 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.
  40. 40. 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.
  41. 41. Trigeminal neuralgia  ACUPUNCTURE treatment is useful in management of trigeminal neuralgia j .of anest.and pain in density Beppu et al 1992
  42. 42. 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)
  43. 43. Bacteria Shimura et al., (1980) showed that acupuncture reduced the number of cavity- causing bacteria in rats even after the rats were fed a sugary diet
  44. 44. Gag reflex  PC6 an efficient acupoint for dealing with gag reflex .Yugin. Special care in dentistry jan-feb 1989
  45. 45. The use of acupuncture in dentistry: a review of the scientific validity of published paper Oral Dis. 1998 Jun;4(2):100-4  Acupuncture in 11 out of 15 studies proved effective in the treatment of temperomandibular dysfunction (TMD) and as analgesia
  46. 46. A Randomized Controlled Trial of Tai Chi for Tension Headaches Ryan B Tai Chi seems to directly affect stress and tension that contribute to the pain associated .In addition, Tai Chi may affect other symptoms that arise from stress such as tachycardia,fatigue,anxiety, insomnia, etc..
  47. 47. Toothache Key Diagnostic Points: Toothache is a common symptom. It can be involved in acute or chronic pulpitis (inflamm of the dental pulp), dental caries (tooth decay), periodontal abscess and pericoronitis (inflammation of the gingiva, surrounding the tooth). Differential Diagnosis: 1) Toothache due to Stomach fire. Severe toothache accompanied by foul breath, thirst, constipation. Tongue:Yellow coat Pulse: Rapid, flooding 2) Toothache due to wind-fire. Acute toothache with gingival swelling accompanied by chills and fever. Tongue:Thin white coat Pulse: Superficial and rapid 3) Toothache due to Kidney Yin deficiency Dull pain on and off. Loose teeth. Tongue:Red body Pulse: Thready and rapid
  48. 48. Treatment Principle: Clear away fire, stop pain. Point and Technique Prescription: L.I. 4: One of the four key points, this one for face and mouth. It's also the Yuan Source point for the L.I. channel. L.I. goes into the lower gums. St 6 and 7: (reduce) Local points found on the stomach channel. Stomach channel enters the upper gums. For use with Stomach fire and wind fire, the above three points should be reduced. For Kid Yin Deficiency, the above three points should receive even stimulation. For Stomach fire, add: St 44: (reduce) Ying spring point of Stomach channel is used to reduce the stomach fir as Ying spring points are used for heat/fire. For Wind-fire, add: SJ 2 (reduce) The Ying spring point of the San Jiao. Ying Spring for heat/fire, This poi clears fire and dispels wind. SJ 5 (reduce) Luo connecting point of San Jiao, and the confluent point for the Yang Wei Mai especially effective for exterior syndromes. Dispels wind and heat. Du 14: (reduce) Clears away fire because its the meeting point of all yang channels and a nape location, many of which are effective on wind attacks. For Kidney Yin deficiency, add: Kid 3: (reinforce) Nourishes Kidney Yin. Tai Xi, "Great River" the deep and low collecting point of water on the body.
  49. 49. LI 4  Chinese Name: He Gu English Name: Union Valley Description: 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).
  50. 50.  ST7 • XiaguanStomach 7 • Meetin g 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 •
  51. 51.  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 •
  52. 52. THE ODONTOMES  PAIN may be associated with health disturbances in areas remote from the teeth and periodontium . Clin.prev.dent nov-dec 1991 Horowitz et.al  Eastern cultures base health upon meridians in the human body. Everything that passes along these meridians affects the major organs of the body, such as the liver, heart or kidneys. All of the meridians run through the teeth. Dr.Voll

×