From book, Snore No More, third edition by James L. Mosely
Oral Systemic Balance® Therapeutic Systems provides a new, noninvasive therapy that is based on major scientific advances resulting in a better understanding of how the body mechanisms keep the airway open and the consequences of this system breaking down.
Snoring and Obstructive Sleep Apnea (OSA) are the result of a breakdown in the body’s ability to keep the airway in the throat open. When this occurs, the tongue is able to fall back into the throat (pharynx) and either obstruct or partially obstruct the air passage which can result in snoring, OSA or a multitude of other concerns. How the tongue maintains its position in the mouth so that it does not go back into the throat is critical.
These new findings reveal more about the normal protective mechanisms of the body keeping the throat airway open so that we can easily breathe swallow and speak. The recruitment of this biologic system by Oral Systemic Balance® therapies allows snoring and OSA to be managed along with a wide variety of other symptoms including “TMJ” and many other pain conditions and agitation states. This new knowledge and therapy is the result of the work of Doctor Farrand C. Robson and is now available through certified Oral Systemic Balance® (OSB) practitioners.
This system uses oral devices that have some similarities with the dental orthotics that have been used in the treatment of snoring and OSA, however OSB therapy is quite different in that they do not solely rely on alteration of jaw position to keep the tongue from falling back into the throat. OSB Therapies address snoring and sleep apnea at the level of their origin. In doing so it also impacts other symptoms associated with the underlying system problems. Oral Systemic Balance Therapies applies new knowledge of the effect that the shapes and contours of the teeth and other oral structure have on the tongue and throat airway. In this way, snoring and OSA are better managed as breathing, swallowing, and speaking are made easier.
The magnitude of the impact of this therapy on the body can be understood when we realize that keeping the throat open is the most important body function. The physiological changes that occur as breathing, swallowing and speaking are restored are so significant that a unique and specialized evaluation and monitoring process is needed to manage the treatment and allow each person greater awareness of their symptoms and a more active role in their care.
The throat is kept open by a variety of body compensations. The most basic of these is the underlying tightness or tone of the tongue muscle when we are fully relaxed which determines how the tongue sits in the mouth, as well as the throat. There must be enough tension in tongue muscle to hold the tongue forward so that it does not fall back and block the throat airway when we are relaxed. This has important implications in the cause of snoring, OSA, and other conditions. This has not been understood prior to Doctor Robson’s work.
The modification of this muscle tone with Doctor Robson’s patented orthotics allows greater ease of the primary oral functions such as swallowing, speaking, and breathing. OSB Therapy directly alters this muscle tone by the tongue’s contact with the teeth and other structures in the mouth. This management of the muscle activity in the tongue muscle has direct application to the treatment of snoring and OSA.
OSB Introduces Daytime Therapy
Day time therapy is part of OSB Orthotic Therapies since maintenance of an open throat is not just a night issue, even though treatment of OSA and related symptoms has up until now been focused on nighttime concerns. There are many serious day symptoms associated with snoring and OSA. If there is obstruction of the throat when we relax at night, it is to be expected that day time problems will also exist. The structure and form of the throat are present 24 hours a day, we are just not able to adapt to these problems at night as well as we do in the day. Specially designed unobtrusive day time orthotics have had marked benefit for many OSA and other sleep disordered breathing patients.
Clinical Results Of OSB Therapy In Snoring And Obstructive Sleep Apnea
Doctor Roy Hakala, a certified OSB practitioner in St. Paul Minnesota, provided OSB Therapy for a surgeon who was so severely affected by snoring and OSA that he was falling asleep during surgery! CPAP use actually made his condition worse and his sleep clinic referred him for OSB Therapy including an OSB oral sleep orthotic. The surgeon summed up his results of OSB Therapy in the simple phrase, “This has changed my life!”
Another example of success is from Doctor John D. Walsh, a certified OSB practitioner in Anchorage, Alaska who provided OSB Therapy for a local physician, Doctor Sandra Denton. She has stopped snoring and reports that she “noticed a number of health benefits immediately.” Doctor Denton states, “I am thrilled with the results of the Robson OSB appliance and have encouraged many of my patients to get it. One 78-year-old patient no longer requires her CPAP machine, which she had been using for two years. She also no longer snores.”
Richard Simpson of Rialto, California also experienced beneficial effects as he shares, “A desire to eliminate sleep apnea brought me to Doctor Robson. Upon starting to wear a dental device I felt that my tiredness was gone. . .overnight that twenty year old pain from a right knee injury was gone. . .also gone were the pains in my lower back and under my left shoulder blade. . .I’ve regained that three-quarters of an inch in height that I had lost.” Even greater for Richard, “Mornings, I awake feeling refreshed and able to accomplish something worthwhile, which wasn’t the case before. I’m really feeling great!” Anyone who has, or is close to someone who suffers with snoring problems can appreciate these remarks.
Introduction To A New Science
Oral Systemic Balance® Therapy is innovative and scientific, developed from over twenty-five years of work by Doctor Farrand Robson of Tacoma, Washington. OSB Therapy helps people with snoring, sleep disordered breathing, muscular pain problems, and other concerns by recruiting normal body mechanisms that restore or maintain normal function.
All the air you breathe goes over the back of the tongue and through the throat. Any disturbance in the normal muscle reflex mechanisms that maintains muscle tone and tongue position will result in some level of interference with the primary oral functions of breathing, swallowing, and speaking. Many of these muscular reflexes that keep the throat open are the result of the shape and position of teeth and are modified by routine dental procedures. When the tongue is properly positioned and airflow is unrestricted, oral functions are effortless and effective and sleep is restful and pleasant.
Difficulty with breathing, swallowing, and speaking often can be traced to the configuration of the mouth. This is most often related to problems involving muscle tone of the tongue. An excessively narrow or broad mouth, crowded teeth, loss of teeth, bulky dentures or partial dentures, and other oral conditions all can interfere with tongue space as well as interfere with the normal reflex mechanisms that maintain muscle tone. In such cases, the only place the tongue can go during oral function is backward, into the throat. Lack of appropriate tongue space can be apparent when observing the tongue, and is obvious when the tongue is scalloped or when tongue thrust is present.
Disordered breathing is usually caused by tongue obstructing airflow down the throat. In this situation, every inhalation requires extra effort and puts negative pressure (suction) on the soft tissues of the throat. The chest wall works harder than normal to draw air in, and the resultant forceful and turbulent airflow over these enlarged tissues produces snoring. The continued effort of the chest wall that is required to maintain breathing interferes with normal cardiovascular dynamics and interrupts and/or prevents deeper and more restful sleep stages. People who snore often sleep lightly or fitfully, awakening at the smallest disturbance, and often blaming their awakenings on the need to empty the bladder. They still feel tired on rising and often can sleep for ten or more hours without feeling fully rested.
There are several systems that aid in the body’s adjustment to keep the throat open. One of these compensations is clenching and grinding of the teeth which causes a reflex called the Jaw Tongue Reflex (JTR) that actually opens the throat more and makes breathing easier. This is a frequent cause of Jaw pain and headache pain in the temples and behind the eyes. When severe, many people can have nausea and be very sensitive to light and sounds.
Forward head posture, which changes the posture of the whole body, is another compensation that lets us breathe more easily. Like the clenching of teeth, forward head posture may be associated with muscular pain as muscle contracts to maintain breathing. The weight of the head in a forward position puts an enormous strain on the body, especially muscles of the neck, shoulders, and back. This can result in pain anywhere in the axial skeleton. People with this posture may experience difficulty and have less stability with Physical Therapy and Chiropractic care since restoration of normal head posture makes it more difficult to breathe freely. The head and body will again move forward to reopen the throat. OSB Therapy can reduce or eliminate the need of these posture alterations and allow the body to self correct. In this way, OSB Therapy complements these other therapies.
Another major compensation that the body makes for an obstructed throat is to activate the sympathetic “fight or flight” component of the Autonomic Nervous System (ANS), releasing neurotransmitters such as adrenaline. Adrenaline facilitates muscle function, allowing stronger and more rapid muscle contraction, which helps the body adjust to maintain an open throat. This is the reason that we feel more on edge at the same time we are experiencing muscular pain. Adrenaline also raises the heart rate, which is one reason people with nighttime breathing problems, also known as choking, may wake with the heart racing. There are many other effects from this adrenaline release, including digestive and stomach acid concerns.
The adrenaline that is needed to maintain breathing is often associated with diagnoses of anxiety, depression, and even panic attacks. As Doctor Robson of OSB frequently says, “My patients who are`viciously choking’ appear to be anxious, depressed, and on edge.” The on edge feelings are often thought to be “stress,” “anxiety,” or other psychological concerns but in reality are a survival “fight or flight” response.
The OSB Therapeutic Systems Approach
Oral Systemic Balance® Therapy is a process that occurs over time and starts with a specific diagnosis. A comprehensive history, as well as a highly specialized interview process, physical examination, radiographs (x-rays), pulse oximetry, heart rate variability testing (HRV), postural analysis, and diagnostic dental casts are combined with the patient’s own account of their chief complaints and health concerns. Treatment is designed to establish a more open throat that allows for greater ease of swallowing, speaking, and breathing. Once the ease of these primary oral functions has been established, the sympathetic nervous system no longer needs the fight-or-flight reaction. The patient often feels safer and more relaxed than they remember ever being.
HRV is a measure of the level of physiologic function and adaptability that quantifies the activity of the sympathetic and parasympathetic nervous systems. It is a predictor of cardiovascular disease and stroke. The National Heart, Lung and Blood Institute has acknowledged the increased risk of stroke for patients with jaw related muscle pain (TMJ) problems and sleep disordered breathing (SDB). Use of HRV provides a special level of safety for the patients, especially those with multiple systemic disorders.
The OSB treatment system uses intra oral orthotics, patented devices that look a little like orthodontic retainers and that fit comfortably over the teeth, usually the lower teeth. The OSB laboratory individually designs and fabricates the orthotics. Shapes and forms are built into and added onto these orthotics that trigger reflex changes in the tone of the tongue so that the tongue has a place to rest in the mouth and prevents the tongue from falling back into the throat. The jaw is held at the most appropriate vertical and horizontal dimensions to support ease of the primary oral functions. Once a patient takes a few easy, deep breaths with a fully adjusted orthotic, head posture improves, healthy and vital facial skin tones appear, head and neck pain fades and leaves, and the patient is free to enjoy the relaxed and peaceful, whole-body effects of effortless breathing.
Follow-up radiographs are taken to be sure that the OSB orthotic is providing optimal improvement in jaw position, tongue posture and opening of the throat.
A variety of OSB orthotic designs are available to allow for individualized treatment. Some of the orthotics prescribed fit on the lower and/or upper teeth, whereas others fit both upper and lower teeth at the same time and have either a rigid or a mechanical connection between the upper and lower components. Orthotics designed for daytime wear are inconspicuous and often enhance the clarity and tone of the voice. Many patients with snoring or OSA will require separate nighttime orthotics, like the one pictured, that stabilize the jaw and tongue position One of several orthotic designs dependably during sleep. available through OSB laboratories.
Many people have difficulty tolerating standard dental appliances that do not support the reflex patterns to maintain appropriate muscle tone. Some appliances can be bulky and can steal space from the tongue. Such appliances can actually increase nighttime clenching and aggravate morning headaches, cause Temporomandibular Joint (TMJ) pain, and excessive salivation. OSB appliances do just the opposite: They provide appropriate tongue space and provide normal neuromuscular reflexes that support normal muscle tone. This results in decreased clenching and improved breathing.
Doctor Arthur Strauss, an OSB practitioner in
Patient Participation In Treatment
The OSB interactive interview and diagnostic testing allows the patient to understand the source of their symptoms so that they actively can participate in their care and know that they can be well. When a patient is finally able to relax and experience the feeling of well being, they become aware of what it feels like to breathe, swallow, and speak more freely. Once this occurs, they can assess the benefit of any orthotic and actively participate in their treatment. They no longer have to maintain the same intense behaviors that they had previously needed to maintain adequate ease of breathing, swallowing and speaking.
What Is Being Said About OSB Therapy
“This therapeutic approach is nothing short of an historic medical breakthrough,” says Doctor Rusty McDougal, a certified OSB practitioner, following the provision of OSB care for a number of his patients.
Virginia Stull of
After receiving treatment from OSB certified practitioner, Doctor Gordon D. Wagoner of Flora, Indiana, Nancy S. Cripe wrote, “I can honestly say that as long as I wear my OSB (orthotic) every night, I am totally pain free. I cannot remember the last time I took anything for pain. Previous to that day (of receiving the orthotic), I took Advil on a daily basis. I sleep much better at night and wake up feeling more rested, I do not snore, and rarely have a headache.”
Doctor Stephen Levine of
E.J.O. from the
After receiving OSB Therapy from a certified OSB practitioner, Doctor John Laughlin III, of
Doctor Michael Alvarez of
Doctor Robert J. Rowen heard about the life-changing results that were occurring with OSB therapies and made a point of personally and critically evaluating these reports. He recounted his first visit to Doctor Robson’s office, where his best friend, Ronald MacDonald had been suffering for over thirty years from OSA. Doctor Rowen shares that, when Ron received his orthotic, “Instantly, (Ron) became more relaxed, his blood-oxygen saturation jumped five points to normal, and he exclaimed, `I can breathe!’” Additional information regarding Dr. Rowen’s evaluation of OSB Therapy can be read in previous issues of Second Opinion Newsletter at www.secondopinionnewsletter.com.
Doctor Brian J. Smith of
Is It For Me?
Although evaluation by an OSB-certified dentist is needed to determine if any specific person is a candidate for this therapy, most people suffering with snoring or other sleep-related disorders and chronic head and neck pain problems will benefit from OSB therapy. One quick self-test involves body posture: If it is easier for you to breathe (swallowing and speaking may also be noticed) when you slouch, letting your head drift forward, than when you are standing tall like a soldier with your back to a wall, you will probably benefit from OSB therapy.
The OSB diagnostic and therapeutic system was developed by Doctor Farrand C. Robson over twenty-five years of dedicated work. He evaluated jaw dysfunction and jaw related pain conditions in order to more fully understand the relationships between the jaw, teeth, throat, and the rest of the body and establish the origin of these conditions. The primary focus of Doctor Robson’s work is to provide a systematic therapeutic system that can be broadly used by other practitioners to benefit the millions of people who suffer with these problems. OSB currently trains doctors around the country in this therapy and updates them on the continuing scientific and technologic advances generated by Doctor Robson.
Doctor Wayne Whitley of Fredericksburg, Virginia, a certified OSB doctor, stated that, “The innovative and original work of Doctor Farrand Robson of Oral Systemic Balance® has connected the dots for those suffering with these and related maladies and the healthcare providers seeking to assist them in their journey. My health has been optimized and I can now optimize the health of those that seek care at my office.”
Doctor Robson explains the extraordinary results that doctors and patients are seeing with OSB therapies as “the closer we are to the cause of a problem, the better and more rapid are the results of treatment.” Treating the cause, instead of just the symptoms, and partnering with other practitioners including chiropractors, optometrists, neurologists, psychiatrists, and others produces profound results. Specialists are continually impressed by the way their treatment results are enhanced by OSB therapy that addresses the underlying anatomical conditions. It has always seemed unlikely that the broad list of symptoms many patients have would be the result of several independent disorders, all striking a single person at one time. OSB diagnosis helps get to the root cause of many of these disorders and OSB therapy helps resolve a whole spectrum of symptoms at once.
Doctor A. Joseph Williams III of
Contact Information For Patients And Doctors
Patients who want to locate a licensed OSB dentist or want more information on OSB Therapy may call 1-800-977-1945.
Doctors can become certified as OSB practitioners after a series of courses and upon meeting specific educational and practical requirements. Those interested in receiving OSB training may call 1- 800-977-1945 for additional information.