Acupuncture in dentistry: what’s the point
Having spent the past 12 years working in dental hygiene at O’Brien & Molloy Periodontics in Dock Rd, Galway, I know the value of effective pain management dentistry.
Acupuncture is an effective equivalent to local anaesthetic (LA) for in-chair pain management, but time constraints during dental treatment leaves LA as a more popular method. Primarily as a TCM (traditional Chinese medicine) practitioner, I can use acupuncture to treat the following conditions:
• TMJ disorders
• Trigeminal neuralgia
• Facial pain
• Bell’s palsy
• Apthous ulcers
• Cold sores
• Uncontrolled gagging
• Post-operative pain
• Sweet cravings.
It is also shown to be effective in smoking cessation, which benefits those patients with advanced periodontal disease, who must quit. While most of these treatments have not been supported with good quality research, the results from a TCM viewpoint are still quite significant.
Acupuncture in Ireland
The use of acupuncture as a treatment option in dentistry is a relatively new concept in Ireland. Dental acupuncture is an extension of medical acupuncture and uses TCM, concepts and dental/medical landmarks to achieve a therapeutic effect. It has been used widely in Britain for the past 10 years. The British Dental Journal has published many articles on the use of acupuncture in dentistry, such as those by Johanssson A et al (1991), Rosted P (2000; 2006) and Rosted P and Warnakulasuriya (2005) to name but a few.
In recent years, interest by members of the Irish dental profession in the use of acupuncture in dentistry has increased, partly because of these published results showing its efficacy.
However, due to the limited number of good quality randomised controlled trials to date and the fact that more studies are required, the chance of referrals from the dental profession to the acupuncturist has been limited. Currently most patients attended for acupuncture through self-referral, with the exception of those who have been referred by well-informed dental pain management specialists who have found acupuncture to be an excellent first line of treatment when little pain relief is gained from medication and rehabilitation.
Dentistry has advanced greatly in the past 25 years and I have been fortunate enough to be part of that within dental hygiene. These advances and changes in dentistry were well discussed in the recent 10-year celebratory issue of Irish Dentist by Dr Brendan Flanagan in his article ‘Dentistry: past, present and future’. He also identified that the expectations of patients have changed greatly over that time. However, those patient expectations extend well beyond the topics discussed in that article.
Patients now expect a more holistic approach to their care. Most want the dental profession to be aware of alternative options that can manage their dental related problems should they not respond to conventional treatment.
I suppose it was with this in mind, while I was training in acupuncture, that I became interested in how acupuncture is being and could be used in dentistry. So began my journey of using acupuncture as an adjunct to dental pain management, xerostomia management, apthous ulcer treatment and as an aid to smoking cessation for patients.
Qualification and experience
Over the past year I have been fortunate enough to have worked with and been mentored by Dr Dermot Canavan in the area of orofacial pain management. This collaboration provided me with a valuable insight into the medical management of orofacial conditions.
My employers allowed me great flexibility while I undertook my training in Ireland and especially during my study time spent at Schugang Hospital, Shanghai, and with Dr Chang in Hong Kong.
In May 2007 I spoke at the IDHA summer meeting and included an article in our dental hygiene magazine. It has been empowering to have such support in my quest to raise dental awareness of the benefits of acupuncture.
Personally, I feel privileged to be at the forefront of this new era that sees patients getting the option of acupuncture as a means of treatment, which has long since been available and used within the medical profession since its recognition by the World Health Organization in the 1970s. It is also recognised by insurers such as VHI, Quinn Healthcare and Garda Medical Aid.
Acupuncture has been a major part of primary healthcare in China for the last 5,000 years. It is used extensively for a variety of medical purposes, ranging from the prevention and treatment of disease to relieving pain and anaesthetising patients for surgery.
As in many acupuncture practices, the emphasis of acupuncture is on prevention. In TCM, the highest form of acupuncture is given to enable you to live a long and healthy life. Acupuncture is only one part of TCM, which also include moxibustion, herbs, cupping, shiatsu massage, diet and exercise advice.
Diagnosis and practise
Acupuncture diagnosis is based on the taking of a thorough medical history, which looks at the body from a holistic viewpoint. The examination also looks at the tongue, which is considered one of the most reliable indicators of health in the individual. The pulse is another vital diagnostic tool.
Acupuncture involves the insertion of fine needles into various prescribed points along channels (meridians) of the body.
In traditional acupuncture these needles are thought to affect Qi (vital energy), blood, yin (fluid) and yang (movement) when deqi (tingling, needle grab) sensation is achieved. In medical acupuncture the needles are known to activate myleniated nerve fibres in muscle that send impulses to the spinal cord and then activate the midbrain and pituitary hypothalamus (Rosted P, 2000).
The insertion of the needles seem to increase the blood flow in the surrounding area and this supplies nourishment to tissues, removes toxic substances, eases pain and reduces inflammation.
Reported risks and complications associated with acupuncture are extremely rare and the procedure is considered very safe. The main risks may include an increased risk of superficial bleeding or bruising at the needle sites.
What can this mean for you?
Acupuncture does have a scientific background and the efficacy has been tested in a number of clinical trials including pain management, facial pain, TMD, therefore it is a viable treatment option for dental patients.
Finally, acupuncture can treat you, the dental professional, for neck pain, low back pain, carpal tunnel syndrome pain, repetitive strains, muscle spasms, wrist pains and even TAT (tired all the time).
I believe that through education and awareness of acupuncture’s role in dentistry, the dental profession will be able to meet with the broader expectations of our patients and will align us with our medical counterparts.
I have been witness to so many amazing results with acupuncture that it continues to reaffirm, for me, that acupuncture does have a place in modern dentistry.
Flanagan B (2007) Dentistry: past, present and future. Irish Dentist 10(8): 46-47
Johanssson A, Wenneberg B, Wagersten C, Haraldson T (1991) Acupuncture in treatment of facial muscular pain. Acta Odontol Scand 49: 153-158
Rosted P (1998) The use of acupuncture in dentistry: a systematic review. Acupuncture in medicine 16(1): 43
Rosted P (2000) Introduction to acupuncture in dentistry. BDJ 189(3): 136-140
Rosted P, Warnakulasuriya S (2005) A survey on the use of acupuncture by a group of UK dentists, BDJ 198: 139-143
Rosted P, Bundgaard M, Fiske J, Pedersen, AML (2006) The use of acupuncture in controlling the gag reflex in patients requiring an alginate impression. BDJ 201: 721-725