Fibro Friends

Oral Systemic Balance - The Second Chapter

Oral Systemic Balance is a therapy that has provided an important part of my recovery from years of chronic illness. Developed by a TMJ dentist named Farrand Robson, the therapy employs oral appliances to help patients breathe better and restore balance to the autonomic nervous system. I was a patient of Dr. Robson's for two years beginning in 2007 and as a result pulled out of the downward trajectory that my health had been on for over 20 years. One of the reasons I started my blog was to share information about this therapy with others. I estimate that I got initially 30% better with this therapy and since wearing my appliances I have suffered no relapses. I wrote about OSB and my treatments in the post "Oral Systemic Balance" http://fibrofriends.typepad.com/fibro_friends/2010/02/oral-systemic-b.html I spent the following years pursuing a variety of other therapies with some moderate benefits which I documented in subsequent posts.

In the spring of 2013 I learned that Dr. Robson had made significant advancements in the "science" of Oral Systemic Balance since I was in treatment. This was due largely to the addition of a heart ultrasound machine to his diagnostic tools. Along with technology that measures heart rate variability and an electrocardiogram (EKG) Robson ascertained that the heart compensates for restrictions in the air passage or throat that can improve by wearing oral appliances. Robson discovered new adjustments to the contours and position of his appliances that produce positive changes in the heart as observed on the ultra sound and EKG. As a result of this he is now able to achieve even greater results with his patients especially the more difficult cases like mine.

In the spring of 2013 I went to Dr. Robson's office for an evaluation of my heart function with an EKG. This was not the typical examine done by a cardiologist. The test took about fifteen minutes. My heart was observed in various positions while wearing my balance appliance: sitting, lying and standing, and while breathing deeply, speaking and swallowing. Dr. Robson's assistant, a nurse who formerly worked for a cardiologist explained that the test showed considerable cardiac stress manifesting as flattened T waves, a very slow pulse (48 beats per minute) and low blood pressure (80/40). My oral appliances were then completely redesigned and I embarked on a whole new series of Oral Systemic Balance adjustments. Over the course of the next six months I had three long (4 hours) appointments with Dr. Robson, his nurse and an ultra sound technician while being monitored by a roomful of equipment including heart ultra sound, EKG, heart variability, oxygen and carbon dioxide saturation, pulse, etc. Dr. Robson observed  imbalances between the sides of my heart and the size and position of the atrium and ventricle. The right side of my heart was very compromised. He also observed a back flow of blood in the jugular vein, something that is common in people with multiple sclerosis and chronic fatigue syndrome. He made changes in the contours of my appliance especially ones to the the upper palate, which he associates with CFS that improved my heart function. My treatment also included a dozen follow up appointments of adjustments with Dr. Robson's assistant.

Oral Systemic Balance is not a quick fix. It is a process that takes many appointments and adjustments as the body adapts and changes. At the beginning I experienced what felt like set backs and a return of symptoms but these diminished over time. My cardiovascular function as measured by blood pressure and pulse, EKG and ultra sound made slight improvements which I witnessed first hand in the diagnostic equipment. My resting blood pressure lying down is now 90/50 and my pulse is in the upper 50's. I no longer get a heavy, light headed feeling when I walk up stairs or a hill. As a result of this second round of Oral Systemic Balance I estimate my health has improved another 10%. Meanwhile I continue to pursue other avenues to complement my recovery. I believe that CFS is a multifaceted condition that demands a variety of treatments for full recovery. That being said I cannot imagine truly healing without this key therapy.

I believe that the cardiovascular abnormalities associated with Chronic Fatigue Syndrome and many other chronic conditions are actually coming from a compromised air passage. Dr. Paul Cheney now diagnoses his CFS patient with heart ultra sound equipment and no doubt sees the same features as Robson, he just doesn't know what causes them. This may be a difficult thing for many people to get their heads around and it is definitely not what's taught in medical school but innovation sometimes come from unexpected places. The development of the "science" of Oral Systemic Balance just may be the key to health for those of us with chronic health conditions like CFS and FMS.

Unfortunately OSB treatment is very expensive and time consuming costing thousands of dollars and multiple appointments. Patients travel from other parts of the country and the world to be treated by Dr. Robson. Many get good results while others do not improve or only improve a small amount. In my opinion OSB is in its infancy as a medical science and patients are paying a premium for a therapy that is not efficient or accurate. Those that are desperately ill will hang in there and get benefits while many others will discontinue treatment due to the cost. Dr. Robson has made some significant discoveries but he practices essentially in a very small circle. In my opinion it is time for Oral Systemic Balance to be turned over to a larger research institute that has the resources to refine this therapy and make it less expensive and easier to replicate. 

Oral Systemic Balance

Oral Systemic Balance is a patented therapeutic system that employs oral appliances or orthodics to facilitate greater ease of oral function, particularly breathing. The system was developed Dr. Farrand Robson, a TMJ dentist whose clinic is located in Tacoma, Washington. This groundbreaking system put me on a slow and steady path of healing. I believe it may address the root cause of many chronic health conditions including chronic fatigue and fibromaylgia syndromes, chronic Lyme disease, TMJ, sleep apnea, insomnia and anxiety disorders.

I was referred to Dr. Robson in February of 2007 by a Bowen Work therapist named Cathy Kruse. At that time my body so severely stressed that I was unable to tolerate any body work including Bowen Work. I related my health history to Cathy and described how I had struggled with severe fatigue and an adrenaline like state for over thirty years. Cathy said that Dr. Robson had developed a treatment that addressed these issues.

My initial appointment with Dr. Robson was very unsettling. I was in a state of complete exhaustion and could just barely manage the one and a half hour drive alone to Tacoma from my home on Bainbridge Island. After taking x-rays, impressions of my teeth and a heart rate variability test that measures the sympathetic nervous system Dr. Robson talked to me at length. He told me that I had a very large tongue and a relatively small mouth and that my tongue was restricting my air passage and this fact was the cause of my long term exhaustion and the stress on my nervous system. I was highly skeptical of his diagnosis because I had no awareness of breathing difficulties. Furthermore the estimated cost for my treatment was $23,000 which seemed exorbitant. (Cost for treatment varies with each patient). I decided instead to go to the Fibromyalgia Relief Center in South Lake Tahoe, California where I was a patient of Dr. Paul Whitcomb's for the next three months. (See my post "Paul Whitcomb - Friend or Foe" www.fibrofriends.typepad.com/fibro_friends/2008/08/paul-whitcomb---friend-or-foe-1.html). 

I got relief from some of my fibromyalgia symptoms during my stay at Tahoe but when I returned home my symptoms returned and within six weeks I was in a severe state of decline. I started thinking about Dr. Robson and wondered if in fact his diagnosis was correct. I found two articles that Robson had written about the link between chronic fatigue, fibromyalgia and TMJ syndrome. Since the maintenance of the throat is essential for survival (breathing and swallowing) difficulties in this area according to Robson result in greater muscle contraction, jaw pain and stimulation of the sympathetic nervous system. Improving oral function and the ease of maintaining an air passage in the throat results in a reduction of muscle contraction, a balancing of the Autonomic Nervous System and a lessening of physical stress on the entire body. Intellectually this theory made a lot of sense to me but I was still weary about pursuing OSB because I did not personally know of anyone who had done this treatment. I called Cathy Kruse and asked her about Dr. Robson. She said he was legitimate and that medical miracles were happening at his office everyday. Cathy asked me if I had been a thumb sucker and I said yes, a very avid one until the age of nine. Thumb sucking is a way that children can accommodate for a restricted air passage because the thumb moves the tongue out of the way. I tried sucking my thumb and discovered to my amazement that I got twice as much air with my thumb in my mouth than without. This was the real turning point for me. I consulted my naturopath and holistic medical doctors. They both said they had heard Dr. Robson speak but were turned off by his manner and the cost of his treatment so they had not explored it further. My family doctor referred me to a TMJ dentist whom he respected and this dentist was very familiar Robson and Oral Systemic Balance. He told me that Dr. Robson was a genius, totally dedicated to his work and that I would most likely benefit from the treatment.

When I began Oral Systemic Balance treatment on September 17, 2007 my health was in the worst state ever or what I refer to as “the black hole” and I was struggling with the will to live. I had trouble walking or standing for any length of time. When I walked to the top of the stairs I felt light headed and weak. I had constant abdominal pain and a dry mouth. My muscles hurt all over and were sore to the touch and my sleep was very disturbed with 15-20 awakenings each night. Dr. Robson fitted me with a balance or “night time” oral appliance that consists of acrylic upper and lower shelves that fit over the teeth which are connected by hardware made out of titanium with a hinge that brings the lower jaw forward. Within 24 hours of wearing the appliance I noticed a substantial improvement in my health. My abdominal pain went away and never returned and my muscles hurt less. Dr. Robson said because of my initial response to the appliance his diagnosis was correct and that I would do very well with the treatment.

I had appointments at Dr. Robson’s office every three to four weeks each appointment lasting two to five hours. I was treated by one of his assistants named Preston whom I liked very much. One of my appliances was adjusted and contours were changed or reshaped at each appointment. The changes to my appliances were made very gradually so that my body could assimilate them. Basically each adjustment brought my lower jaw and tongue a little farther forward and allowed me to breath better. People who have restricted breathing problems often have a forward head position to help them breath better. My posture and head position as measured in x-rays and photographs improved within the first month. At the beginning of my treatment I noticed that I got more air in my belly, then I started getting expansion in my ribs, then in my back and finally in my upper chest. I really had no experience of what it is like to breathe fully. The difference is amazing and it takes no effort on my part. 

Oral appliances take a little bit of time to get used to but are pretty comfortable to wear especially at night. When adjustments are made the hardware can cause sore places inside the mouth but these toughen up within a week. Over the course of two years I had my balance appliances completely redesigned and fabricated at least six times. I alternated between two "night time" or balance appliances, one which was most recently adjusted and a “backup” appliance which was worked on previously. I wore my balance appliance all day and night for one year except for when I was eating to facilitate the fastest progress. This made me look a little like a chipmunk or a character from "Planet of the Apes" as the hinges on the balance appliances protrude into the cheeks but I was beyond vanity when it came to my health. After one year I began to wear the balance appliance only at night.

At the beginning of my treatments I basically noticed a lessening of stress on my body. After several months I could walk to the top of the stairs without feeling light headed and my muscles were no longer sensitive to the touch. Chronic mucous in my throat went away after six months. After two years I had two well fitted balance or night time appliances that optimize my ability to breathe. I was also fitted with a day time lower appliance but I did not notice any benefits so I have discontinued wearing it. Oral Systemic Balance improved the quality of my life and I have maintained all the improvements I made with it however there are additional symptoms that did not resolve with this treatment. These included delayed onset muscle soreness that prevents me from exercising, severe food and drug sensitivities and reactions, and insomnia. Dr. Robson and his staff were optimistic that these symptoms would resolve with OSB. Because of their dedication to their work and the results they observe in others with many chronic health conditions they had difficultly accepting that I did not get completely well with OSB and this caused some feelings of tension. 

I believe that Oral Systemic Balance addressed one of the root causes of my health condition.  It did not however resolve most of my symptoms but it made it easier to live with them.  Resolving my remaining symptoms has required pursuing additional therapies. Currently I am pursuing Low Intensity Neurofeedback System or LENS that treats dysfunctions of the Central Nervous System.

Dr. Robson trains and certifies dentists who practice Oral Systemic Balance. He oversees these dentists and the appliances which are patented and fabricated at his laboratory in Tacoma, Washington. He continues to make developments in his system which he refers to as a science. There are now over 30 Oral Systemic Balance certified dentists in various parts of the country. Some of them have very informative websites which one can find on the Internet.  Unfortunately the cost of treatment is very expensive and not covered by health insurance.  I personally know of many patients who spent thousands of dollars and did not benefit from the therapy or only improved slightly. To get more information and to see if there is an OSB dentist in your area call Dr. Robson’s office TMJ Diagnostics at (800)977-1945.

 

Here is a photograph of my balance appliance which I wear at night. Notice how the lower piece is forward. This brings my jaw  forward so that my tongue does not restrict my air passage. Plastic contours place my tongue in an optimal place for breathing. 

 

Here is a photograph of my day time appliance which I wear on my lower teeth. The plastic contours of the appliance remind my tongue to stay forward and in an optimal place for breathing. 
  

P.S. In the spring of 2013 I learned that Dr. Robson had made significant advancements in the 
science of Oral Systemic Balance since I was in treatment and that he was getting even better results with his patients. I embarked on another series of treatments where my appliances were completely redesigned and adjusted and experienced as a result another significant leap forward in my recovery. For more on this read my post "Oral Systemic Balance - the Second Chapter".

http://fibrofriends.typepad.com/fibro_friends/2014/01/oral-systemic-balance-the-second-chapter.html