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Should Your Patient Consult a Dentist?
I am responding to the comments from Joseph Niamtu III, DMD, about a procedure I perform for prefacial and postfacial cosmetic surgery patients (PSP, September 2006, page 12). As mentioned in the article, I perform noninvasive rehabilitative treatments and exercises that control or eliminate clenching and bruxism.

The smallest change in the balance of the lower jaw as it relates to the temporomandibular joint has a profound effect on the musculature, vascular, and lymphatic systems, which in turn will start deteriorating the temporomandibular joint. I focus on bringing this situation under control—minimizing and, in some cases, removing the causes and effects of clenching and bruxism.

It is important to note that the connective-tissue matrix is distorted in patients with inadequate dental support—vertical dimension, missing teeth, and ill-fitting prostheses—and those who are undergoing dental reconstruction. Using a series of treatments, I intervene presurgically to help restore muscle tone and improve the connective-tissue matrix, and postsurgically by aiding lymphatic drainage and removing swelling—thereby providing better, faster healing. This is essential because any elective surgical intervention will always be more successful and heal better in a healthy environment than in a scenario in which inflammation, spasm, and discomfort already exist. Because facelifts affect the musculature’s connective tissue and the skin overlying it, if the muscle fiber is healthy and not stressed or in a damaged state, it is reasonable to expect a successful result.

Dentists are the practitioners who can permanently affect the oral-facial system. By practicing integrative dentistry, they can create the ideal substructure environment: healthy teeth, adequate occlusion and vertical dimensions, an efficient lymphatic and circulatory system, and a robust masticatory muscular system. When plastic surgeons and trained dentists work together, patients are better medically served and more content with their facial surgery.

New York City