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Getting to the root cause of a problem that seems to stem from the mouth is a little like being an investigator scrutinizing a crime scene. The role of the investigator is to trace events back to what led up to the crime—what was the victim doing, where were they, what were they exposed to, and so on. It’s the same with the mouth—crowding, gum recession, worn or broken teeth, or other issues are clues as to what’s been happening with a patient.

Since teeth are the hardest substance in the body, a broken tooth (the crime) is a clue that needs further investigation. In many cases, the culprit for such a “crime” is clenching—the damaged tooth occurred as a result of constant grinding at night. And that may be a sign of obstructed breathing, since clenching occurs as an automatic reaction to open a closed airway. When the airway is cut off during sleep, the body launches into survival mode. At that point, the jaw muscles clench to the point of destroying the body’s hardest substance—the teeth—in trade for saving a life.

At the Julian Center, we don’t repair a broken tooth without looking for a cause of the problem. If it turns out to be clenching, then we want to know what caused the clenching. Was it misaligned teeth, or was it indeed an airway obstruction? By tracing back from the “crime scene” to the root of the problem, we often find that the culprit is a sleep disturbance that is on the verge of robbing the person of their health.

As an oral physician, when I see crowding, gum recession, fractured teeth, and many other issues, my professional experience tells me to keep investigating.

I became an “oral investigator” of sorts after seeing what happened with a pair of twins who were patients of mine early in my career. While one twin came in regularly for cleanings and was great and following recommended treatment, she always had a problem with either her teeth or gums. The other twin rarely came to see me, but even when she did, she rarely had issues needing to be addressed. Since they were twins, it would seem that their genetic and environmental situations would be similar, but that clearly wasn’t the case.

Their situation made me realize that the healthiness of the mouth was related to something else in the body, something else in each patient’s life. As it turned out, with the twins, it was nutrition. The twin who had impeccable oral hygiene ate an unhealthy diet, while the twin who had terrible oral hygiene ate a healthy diet. That is when I realized that focusing solely on the problems in the mouth was missing a bigger picture—and not fully serving patients.

Since then, I have spent years researching the role of nutrition and lifestyle in oral health. And that’s why today, resolving problems of the mouth at the Julian Center takes a comprehensive and holistic approach to diagnosis and treatment.