About us

Richard Dean has been in general practice for more than 40 years and has pursued a particular interest in dental occlusion, precision restorative dentistry and full mouth rehabilitation. As a result of increasing experience in restoring complex dental problems, it became clear that the most difficult restorative cases had underlying jaw misalignment. Making up for lost dental tissue required building up the teeth to the correct heights and this could only be done by correcting the jaw misalignment first.

As a result of an underlying jaw misalignment, many patients have symptoms of muscle and joint pain. These symptoms can spread by ‘knock on’ effects to other musculo/skeletal groups affected by the derangement within the TMJ. Knowing how to solve the problem in the adult TMJ patient begs the question ‘How do you avoid the problem in the first place’?

Recent research on children with malocclusion requiring orthodontic treatment found more than 70% had pre-existing compromised jaw relationships with internal derangements of the joints. knowing the underlying cause of any problem suggests the promise of a solution. As long as treatment is aimed at symptoms, the patient may well feel better but the underlying cause lies unrecognised and hence is not considered in making the diagnosis. ‘The Elephant in the Room’. It has been stated that ‘Malocclusion is a postural problem’ and there may well be some truth in the statement.

The association of general posture and certain malocclusions (e.g. class II with protruding incisors) is documented and recognised. Also recognised is that dysfunction in the joints in the form of disc displacement can lead to symptoms of pain in or around the joints, pain in the muscles of the head and neck, headaches, dizziness and a whole host of symptoms remote from the jaw joints.

Perhaps the human body, in its amazing complexity and balance, functions as a whole and if one part is out of alignment, the rest of the body adapts. When a structure is sufficiently out of alignment, the adaptive capacity of the individual is superseded and tissue strain and damage can occur and give rise to symptoms.

In the example of the protruding incisors, it is often not the fault of the upper teeth so much as the underdevelopment of the lower jaw, which is in a receded position to the maxilla. Correct mandible/maxilla relationships are only possible if the joints and muscles are functioning in a symptom free fully functional system. Orthopaedics is the practice of ‘straightening children’ and should precede the tooth straightening or orthodontics. This requires an overall assessment of the body posture and its treatment to stabilise and balance the whole system in conjunction with the dental orthopaedics.