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Something that most people would not think about in relation to their dentist and the things a dentist thinks about is posture ... body alignment, but as someone who treats people with headaches, jaw joint problems, sleep breathing disorders, this is something that I find to be of utmost importance.


When I look at photos of people who lived a few generations ago, I see people who had very good posture. Today most of us work at jobs where we sit all day, look at computer screens for a good portion of the day, and one of the most common scenes that I see is people looking at small hand held screens (smartphones, tablets) and reading emails, or sending text messages. If you observe the posture of someone "texting" you will see what some call "texting neck", forward head posture, or "turtle neck". The effect of these scenarios on posture is that our head ends up postured ahead of our body. When the body is aligned, and a person is standing or sitting straight, the ears, shoulders, hips and knees line up (when looking at someone from the side). For every inch that the head is forward of the shoulders, it is as if we added 10 pounds of weight to the head. This puts tremendous strain on the muscles of the neck and back leading to pain in both those sites. This stress and strain and pain can put the body in a "stress" mode leading to the release of cortisol and putting us in a state of "fight or flight". This can lead to hormonal imbalances in the body. Forward head posture has also been shown to lead to a decrease in the strength of the muscles involved in breathing which can reduce lung capacity. By straining the neck musculature it can also contribute to Sleep Apnea and snoring which I have talked about in previous posts. What does this have to do with dentistry? "Forward head posture" is actually "Forward neck posture" with a "backward head posture". This has the effect of pulling the lower jaw backward and altering the "bite" over time. This can lead to TMJ disorders, headaches, ear pain, ringing in the ears, and a host of other symptoms which I have also talked about in previous blog posts.


There are specialized excercises that one can do to help improve this condition. These involve strengthening the back, the core musculature, the neck. It may also require that the bite be stabilized with a dental orthotic which creates an optimal relationship between the lower jaw, the base of the skull, and the neck and spine.

The postural compensations and deviations from normal alignment that result in forward head posture can over time lead to deterioration of the body and our overall physiology. It may feel normal and not very obtrusive when we are young, but as we get older, our bodies are less able to adapt to the strains and stresses placed on it and things can start to break down. Joint pain, muscle pain, degenerating discs in the spine, ... these are just a few of the conditions that can result from poor body alignment.

A chiropractor friend of mine gave a great analogy the other day. Imagine you have new tires put on your car, but the tires are not balanced. The car will drive and it will feel OK at first. Over time there will be wear on the tires and additional stress places on the bearings and axles. This could lead to premature wearing out of the parts of the car. If the wheels were balanced to begin with and maintained, I think we could agree that the car would perform much more effectively for a much longer time with fewer problems.

If you suffer from back pain, sleep disorders, TMJ pain, respiratory distress such as Asthma, Emphysema, neck pain, headaches ... I encourage you to look into getting a postural assessment at your chiropractor, osteopath, or personal trainer and start taking steps to correct your overall body alignment.

Yours for better health,

Dr. Marty Frankel - Smiles by Design
3080 Yonge Street, suite 3030
Toronto, Ontario M4N 3N1


GINGIVITIS - What is that really?

Translated into English, GINGIVITIS means gum (Gingiva) inflammation (itis). What is the significance of this, why does it happen, and how do we take care of it? 


According to Webster's Dictionary, INFLAMMATION is a "local response to cellular injury that is marked by capillary dilatation, leukocytic infiltration, redness, heat, and pain and that serves as a mechanism initiating the elimination of noxious agents and of damaged tissue". So what does this mean? Our bodies in their innate wisdom become inflamed as a response to injury, or local irritants, in order to get rid of whatever is causing the injury or irritation, so that it (our body) can heal and become healthy again. We get an increase in blood flow to the area (which is why it gets red), heat in the area, and it also becomes painful, and often swollen. One thing that we know about inflammation in the body is that inflammation somewhere equals inflammation everywhere.


Gingivitis is gum inflammation. It is one of the early forms of gum disease and is most often caused by a build up of bacteria on the tooth surface near the gum line. Our mouths are full of bacteria, probably one of the "dirtiest" places in our body. Over the course of approximately 24 hours some of that bacteria will stick to the tooth surface and start to irritate the gumline. This sticky bacteria is called dental plaque. If we don't remove it or disrupt it on a daily basis it can stay there and start the process which becomes known as GINGIVITIS. Our gums get red, swollen, sometimes sore, and they tend to bleed easily when touched, brushed, or flossed. Gingivitis can be mild, moderate, or severe depending on how much a person neglects to remove the plaque. GINGIVITIS can also lead to BAD BREATH.

Did you know that GINGIVITIS is completely reversible? That means with the proper care, you can get rid of it and keep it away.


Because the bacteria that cause GINGIVITIS are present in our mouths all the time we can never totally eliminate the risk of developing it without some effort. There is no magic cure. I often think of the manangement of gum disease much like the management of Diabetes. If a person with Diabetes takes their insulin or medication every day as prescribed, watches their diet, excercises regularly, they can live a normal healthy life. If that same person does not take care of theses things, their Diabetes will get worse. Diabetics must take personal responsibility for the success of their treatment. Similarly with GINGIVITIS, there are things that we can do in the dental office to help maintain healthy gums, but perhaps of even greater importance is the personal homecare routine that a person must develop to help maintain their gums in a healthy state with no inflammation. Dedication to good homecare on a consistent daily basis is essential.

Studies done over the last 15 years show a very strong connection between inflammation in the body and other medical diseases such as heart disease, stroke, diabetes, respiratory illnesses, low birth weight babies, and even cancer. This is why we as dental professionals "NAG" our patients to floss and brush daily. The key word here is DAILY. I have had patients come to my office and tell me how they floss religiously every other day. These people never quite get on top of the inflammatory process because on the "off" day they are allowing the plaque bacteria to do some damage. On the other end of the spectrum, some people come in and tell me that they floss 4 or 5 times a day. ... Every time they snack, drink, sneeze, speak, ... they are flossing. I don't discourage this, but it is really not necessary to floss that often. I hope that I have helped to clarify the condition called GINGIVITIS, and created some understanding as to its importance.

Dr. Marty Frankel - Smiles by Design
3030 - 3080 Yonge St.
Toronto, Ontario M4N 3N1