Physiologic Rest — A Key Solution to Dental Health

Lotus on still water photographed by Dr. Clayton A. Chan — visual representation of Physiologic Rest, the foundation of GNM diagnosis at Occlusion Connections, Las Vegas

Occlusion Connections - Center for Orthopedic Advancement

What Is Physiologic Rest Position — And Why Is It the Starting Point for Every GNM Diagnosis?

Before a dentist can determine where the bite should be, they must first establish Physiologic Rest — the position where the masticatory muscles want to rest. Physiologic rest position is that precise mandibular position where all elevator and depressor muscle groups achieve minimal electrical activity, balanced tonus, and anatomic resting length simultaneously. It is not an estimated position — it is a measurable, objective reference point that GNM uses as the foundation for every diagnostic and treatment decision. Without it, occlusal treatment is built on assumption.

“We see the evidence in nature; the goodness of health.”

PHYSIOLOGIC REST – SOLUTIONS TO HEALTH, NORMALCY and STABILITY

Body health is a state which all living individuals desire and want to achieve and maintain. Any condition outside of “normalcy” is considered unhealthy leading to signs, symptoms and concerns that must not be ignored in today’s environment. The human body needs to have both resting states (homeostasis) to recover from those active states during the day. Maintaining a “physiologic” resting state is something that the body requires daily to stay healthy. When the bodies biological cell are no longer functioning within its balance and equilibrium the structures of the body deteriorate into a state of unrest, sickness, strain, anxiety, degeneration, unbalance, unhealth, which triggers concerns and awareness about our physical conditions that are not normal.

Physiologic rest is defined as follows:

normal repose after exertion
not pathologic
conforming to the normal functioning or state of the body or a tissue or organ;
physiological
A state of homeostasis
A place to start where the problem begins.
A reference point

” Is that position in space where all the masticatory muscles including all antagonistic muscle groups such as elevators and depressors are in the state of minimal electrical activity necessary to maintain postural rest.”

A Starting Position – To Begin Your Assessment
The position in which the muscles surrounding the mandible are at their anatomic resting length.
Balanced muscle tonus is maintained.
A state of minimal contracture, strain, compression and constriction is achieved when at physiologic rest.

Physiologic Rest Position

It is that mandibular position in which the various mandibular muscles are simultaneously at their resting length and in balanced tonus with one another.
It is always defined from (and only valid from) the upright postural position.
It is the reference point for all diagnostic and treatment procedures involving restoration of the occlusal position.

A state of neutrality…where physiologic health and recovery begins.

Why Physiologic Rest Is the Foundation of GNM Diagnosis

Before a clinician can decide how to treat, they must first establish where neutrality lives. Physiologic rest is that neutral — the position where the masticatory muscles want to rest, at their anatomic resting length, in balanced tonus, with minimal electrical activity. Not estimated. Measured.

The body knows this position. It is the state it would settle into if released from compensation, strain, and the proprioceptive memory of years of habitual closure.

In this state, the mandible is at rest. The condyles are postured without tug or pull. The disc is in its neutral relationship with the condyle. The cervical chain releases. No compression, no torque, no compensation — only stillness.

For the dentist trying to determine the optimal bite, this matters profoundly. A bite cannot be built on a foundation that has not been measured. Before the building, the foundation. Before the treatment, neutrality – homeostasis.

The K7 Evaluation System aids the dentist in finding this neutral position and making it visible. sEMG verifies muscles at minimal activity – physiologic rest. ESG records joint sounds free of internal derangement – Quiet. CMS jaw tracking captures functional movement in full range of motion – Quality of health, freedom of movement. The K7 Evaluation System is developed and manufactured by Myotronics-Noromed →

What the body achieves quietly at rest, the instrumentation records objectively. The foundation, once measured, becomes the place from which everything else is decided.

Defining the Terms:

The term “physiologic” refers to “healthy”; a state of optimal physical, mental well-being, absent of disease, that takes into account the whole individual.

Physiologic health can be tested. It indicates clinically that the patient is able to show high amplitude EMG recruitment patterns (this is good, healthy) vs. low amplitude EMG recruitment patterns (weak, unhealthy, pathologic) when a patient clenches. Science and literature has documented this fact well. Additionally, the healthy/physiologic recruitment muscle patterns should be balanced and specifically allow the mandible to close along an “isotonic” path of closure to a terminally balanced contact position.

Isotonic denotes the solution within the body of cells showing the flow of water across the semipermeable cell membrane at a tonicity where other solutions are not showing a net gain.

An “isotonic” mandibular closing path is clinically determined and recognized when the involuntary muscles produce a closing path that equals and coincident with the voluntary closing path as observed from a sagittal (side view) jaw tracking data and frontal/lateral views. This is what is consider “Normal” healthy or “physiologic”. Mandibular K7 jaw tracking technology combined with low frequency J5 Dental TENS are the devices of choice to record both voluntary habitual mandibular closure paths versus voluntary mandibular closing paths relative to CO (habitual centric occlusion/ MIP).

When there is a different involuntary mandibular closing path from the habitual voluntary closing path clinicians around the world have recognized these diverging patterns as pathologic/unhealthy (in other words, an antero-posterior mandibular slide exists, occlusal skids and or abnormal jaw closing pattern can exist, thus the mandible and occlusion are deemed unstable. Abnormal tooth wear, abnormal vector of forces will influence hyper muscle activity inducing strains, torques and skews to underlying boney structures, thus “abnormal, unhealthy, and a pathologic condition would exist.

Resting muscle activity is considered healthy and “normal” when muscles EMG patterns are showing microVolt readings 2.0 mV +/- 5% at rest. Resting activity above these values would be considered pathologic, unhealthy, and not normal.

A Reflective Thought

Physiologic Rest goes beyond a dental neuromuscular concept, but rather it is a life style that the student in time will recognize as an important part of his/her life. Without homeostasis (physiologic neutral) within one’s spirit, soul and body one will only appreciate this aspect as a dental teaching, but should take it to its next level of reality as a means to experience life as inner healing and relaxation.

Written by Clayton A. Chan, D.D.S. — Founder and Director, Occlusion Connections | Las Vegas, Nevada

6170 W. Desert Inn Road, Las Vegas, Nevada 89146 | Telephone: (702) 271-2950

http://www.occlusionconnections.com

Occlusion Connections