Every top competitive athlete regardless of sports venue want their bodies to perform, function and respond optimally (at its ultimate best) during any training or competitive event. Hours of training, discipline, rigorous exercises day in and day out, proper diet and mental discipline are placed on the trained human body, soul and spirit (the whole body) to perform at its best. A disciplined and measured approach is also required by the sports dentist to use methods, techniques and technology that will help produce objective and quantifiable results that effect his/her athlete’s performance.
Objectively Measured K7 Chan Optimized Bite™ Position and Athletic Performance
Dentist who use the K7 Kineseograph with low frequency TENS (Myotronics-Noromed, Inc, Kent, WA) to objectively measure and determine their athletes physiologic mandibular relationship with their TMD patient’s as well as their elite athletes have discovered performance and functional differences between other bite recording techniques and the K7 Chan Optimized Bite technique. The K7 Chan Optimized Bite™ has exceeded neuromuscular dentists expectations who have been trained in standard K7 bite taking protocols, but have not learned and experienced the differences with their athletes. When comparing the habitual bite positions, centric relation, MORA (mandibular orthopedic repositioning appliance) positions including other neuromuscular K7 techniques, they have discovered consistently that the Chan Optimized Bite™ protocol as taught by Dr. Clayton Chan at Occlusion Connections (the Leader in Optimized Bite Training and Education) has been the one bite finding technique that actually optimizes and enhances the physiologic jaw relationship of the elite athlete without manual intervention during various resistant kinesiologic muscle tests and cross training exercises. The Chan Optimized Bite™ technique is a calibrate and measured protocol use FDA and ADA approved computerized instrumentation with low frequency TENS to objectively measure and identify the most optimal mandibular relationship that positively effects an improved trigeminal neuro-muscular response of the human bodies alignment for optimal function and response.
Performance Optimization
Optimization is a term used to distinguish itself different than the classical neuromuscular jaw positioning. It is a technique and protocol that uses a systematic bite finding protocol using jaw tracking instrumentation (Myotronics K7, Scan 4/5) to “Optimize the Bite”. It is a bite recording protocol that goes beyond classical TENs bite, modified TENS bite techniques, classic scan 4/5 bite protocols and “modified Scan 4/5 bite” taking protocols developed and pioneered by the originator Dr. Clayton Chan. The Optimized Bite® technique and protocol is scientific and can be measured to within 0.1-0.3 mm accuracy.
To read more: What is Bite Optimization?
Chan, CA (2003-2007) and has identified and developed a protocol using the K7 to consistently and reproducibly determine a mandibular position that is more optimal using the Chan Optimized Bite™ protocol to improve his TMD and orofacial pain patients as well as elite athletes mandibular function and performance. Other dentist who have been trained by Dr. Clayton Chan have also discovered in their use of the Chan Optimized Bite protocols that their TMD patients and athletes function and performance improved even better that standard neuromuscular K7 techniques. Studies have shown repeatedly that performance athletes have increased isometric strength, balance, flexibility, function and endurance using performance mouth orthotics that have been established with the Chan Optimized Bite protocol using the K7 and TENS. These optimized bite athletes have reported a difference in their performance and execution of their athletic activity better than other performance enhancing mouthguards, splints or protection guards.
Dentists who are also a part of the elite athletes support community and team realize that they too must be disciplined, trained and at their ultimate best in providing the best jaw position and relationship for the head, neck and postural system. The K7 Optimized Bite which has been internationally recognized by world class (Olympic) professionals, trainers and competitive elite athletes as the ultimate in optimal bite positioning for the best strength, balance and body performance. For years the dental profession and sciences have realized that mouthguard appliances, such as a mandibular orthopedic repositioning appliance (MORA), and neuromuscular orthotics enhance athletic performance. Scientific studies have been aimed in their design, controls, periods of time, double blindness, and the placebo effect to investigate their effect on the human body and athlete performance. Although it would appear that designing a study to please both clinician and researcher would be a difficult task, studies have been performed to meet the “gold standard” of meeting the criteria of a physiologic and objectively measured bite – the K7 Chan Optimized Bite™ Scan 4/5 protocol with instrumentation. These results favor the premise that jaw repositioning can enhance muscular strength and athletic performance.
For several years dentists have been treating patients with temporomandibular disorders (TMD) and orofacial pain have reported an increased strength and performance with their patients as a result of changing their maxillomandibular jaw relationships (l-3). The primary goal of proponents for mouthguards was to provide universal protection of the teeth and jaws from trauma. Although much has been said and published in the literature on this subject over the past 40 years, the idea that mouthguards, mouth “protectors,” or bite appliances could also provide some increment of increased muscle balance, strength, and/or improved coordination when it surfaced 18 years ago seemed to be an intriguing idea is now becoming a reality through present day research, measuring technology (K7 Kineseograph and TENS) and the Chan Optimized Bite™ Scan 4/5 protocols.
More information on: The K7 Chan Optimized Bite Science and How It Works – Part 1
Retrospective Literature Review: Jaw Positioning and Athletic Performance
Early published articles by late Smith (1978), Kaufman (1980), Fuchs (1981), Forgione, et al. (1991) reported improved muscle strength and athletic performance when using mouthguard appliances and mandibular orthopedic repositioning appliances (MORA) to enhance athletic performance. These double blind studies aimed to evaluate any placebo effect of various bites and jaw positioning effects to meet the “gold standard.” Studies performed during the mid-1980s, and to which the scientific community refers to continually, on closer examination were flawed according Tukey’s multiple comparison technique which showed no significant differences among mouth open, acquired centric, and placebo conditions. Fuchs then concluded that with no exception, the strength means were greater and the standard deviations lower in the K-MORA position than in any other position. Fuchs replication of Smith’s research helped answer the unchallenged placebo criticisms in the literature that tend to obviate Stenger’s and Smith’s seminal findings prematurely. The results favored the premise that jaw repositioning can enhance appendage muscular strength and athletic performance.
Smith (1978) reported on a sample study on professional football team players which emphasized temporomandibular joint and associated musculature. It was determined that there was a correlations between a corrected jaw posture and the ability to give a stronger muscle contraction response after comparing teeth together in habitual occlusion and a wax bite position which was taken by bringing the player’s lower jaw from habitual rested position to a speaking space with midlines evenly aligned.
Forgione, et al. (1991) reported significant isometric strength differences of the deltoid muscles between varying jaw positions. Increased strength while biting on the unadjusted mouthguard was significantly greater than while biting in acquired centric occlusion position.
In 1980, Kaufman fabricated and positioned several splints for the United States Olympic luge and bobsled teams. He discovered that headaches previously reported by luge athletes during their runs, were alleviated to varying degrees in some of the athletes by use of these appliances. Some of these athletes also indicated an increase in strength when pushing off at the start. Further double-blind randomized study(6) were conducted to observe the effects of the mandibular orthopedic repositioning appliance (MORA) on football players on the 1982 C.W. Post College football team compared the MORA(7) and the conventional mouthpieces (CM) among 40 tested candidates(8). Test results showed less severe injuries, decreased numbers of knee injuries, and greater strength in favor of the MORA in performance, number, type and severity of injuries, as well as on physical strength, jumping ability, and balance and agility over the conventional mouthpieces to football players.
Other studies have shown positive correlation between changes in jaw relationship and significant increases in strength and muscle efficiency (power) of athletes during vertical jumping (five percent increase) and a 17.3% increase in the grip test (9). Tested athletes comparing three different mandibular positions with muscle strength of arms and legs showed considerable variability of muscle strength and mandibular positions (10).
Another double-blind study, performed at the University of Illinois, involved 20 randomly selected volunteer undergraduate students.(11) Two appliances a MORA, which repositioned the mandible three dimensionally, as described by Gelb,(12) and a placebo appliance that did not alter the occlusion. Centric occlusion, centric occlusion with the placebo splint inserted, and the position with the MORA inserted were tested using the Cybex II Dynamometer resulting in statistically significant differences between the MORA and normal bite conditions for shoulder extension, peak torque; shoulder extension, average torque; and external rotation, average torque. No statistical differences were observed between the placebo and the normal bite condition.
Fuchs (1981) (13) unpublished dissertation compared isometric strength of 40 females divided equally into five groups; TMJ patients, athletic TMJ-symptomatic subjects, sedentary TMJsymptomatic patients, normal athletic subjects, and normal sedentary subjects. But unlike Smith’s research design, a disoccluded and a placebo condition were both included.
Posturometric and Stabilometric Analysis Using a Computerized Footboard Comparing Different Jaw Relationships on Body Posture
Bracco, Deregibus* and Piscetta (2003) investigated the effects of different jaws relations on body posture in a sample of 95 subjects. All subjects underwent a posturometric and stabilometric analysis using a computerized footboard. Tests were performed in three mandibular positions: centric occlusion (maximum intercuspidation ICP, cotton rolls (rest position, REST) and orthosis (myocentric position, MYO) , respectively determined by teeth engagement, joints position, and muscles contraction. All subjects showed variations of body posture in the different mandibular positions. Statistical analysis (analysis of variance for repeated measures) confirmed that postural variations in different jaws relations were significant: in particular, the SKN multiple comparison test showed that myocentric (classic neuromuscular K7 with TENS) position improved postural balance on frontal plane with respect to the other jaw positions considered.
The results seem to support the observation that different jaws relations imply differences in body posture. In fact, there was a strong relation between mandibular position and body posture: 91 out of 95 (95.8%) subjects showed variations in load distribution closing mouth either in centric occlusion or in centric relation or in myocentric position. Furthermore, 92 out of 95 (97.9%) subjects showed changes also in the distance between theoretical and real barycenter on x axis, and 95 cases out of 95 (100%) showed changes on y axis. Similar results were observed by the authors in previous experiences (14).
Statistical analysis showed these variations were significantly relevant. Temporo-mandibular disorders are principally a pathologic condition of masticatory muscles and head and neck postural muscles or, at least, a combined pathologic condition of muscles and temporo-mandibular joints. Altering trigeminal afferences and proprioception, those disorders can provoke, with a descending action, an unbalance of the whole postural muscles chains and finally posture alterations. Since an occlusal therapy could induce a re-equilibrium of masticatory muscles, this re-equilibrium could influence, with a descending action, the whole body postural muscles, resulting in an improved posture. Considering tests performed in centric occlusion, that is an habitual position, as a control group, the sample showed that myocentric position (which is a right-left muscular
equilibrium position) seemed to improve postural balance on the frontal plane in about a half of the subjects with respect to other jaws relations considered: in 45 out of 95 subjects myocentric position improved the asymmetry index and in 44 out of 95 subjects it reduced the x distance. Statistical analysis showed that posture on the frontal plane was significantly different in myocentric position with respect to centric occlusion and rest position. A good balance of masticatory and head and neck muscles seems to be an important factor of postural stability. On the sagittal plane, neither myocentric position (classic neuromuscular trajectory with K7 and TENS) nor rest position improved posture with respect to centric occlusion. It must be said that the methodic presents some limitations: stabilometry reduces all human posture to a single point, the center of foot pressure, which is assumed to be the gravity center(15).
The K7 Chan Optimized Bite neuromuscular trajectory (and advancement beyond the classic K7 neuromuscular trajectory) in both AP and frontal/ lateral domains has been shown through studies with elite athletes to significantly improve strength, speed, agility, recovery enhancement, balance, flexibility, stability, endurance and cognitive enhancements. Further studies and research is being done to further confirm and substantiate these findings.
References:
15. P.M. Gagey, B. Weber, Posturologie. Regulation et Dereglements de la Station Debout, Masson, Paris, 1995, pp. 138–174, 325–327.
© 2009 Clayton A. Chan, DDS. All Rights Reserved.
