Orthodontist explains how the body has evolved in adapting to change
Non-communicable diseases in dentistry and medicine include sleep apnea,
malocclusion, and caries. Dr. Mark A. Cruz, a Dana Point dentist, and
his colleague, Dr. Barry Raphael, are committed to taking a closer look
at the root causes of these diseases to help in diagnosing and treating
patients effectively. Dr. Raphael is an orthodontist in New Jersey who
has 33 years of experience in treating patients with a variety of dental
and orthodontic concerns. Dr. Cruz and Dr. Raphael developed the Airway
Focused Dentistry Mini-Residency to educate doctors from multiple
disciplines about the significant role the airway plays in dentistry.
Dr. Raphael explained the difference between competencies
and compensations during one of the sessions. There are natural
balancing acts that occur in the body such as the balance of blood
sugar. When the body is working properly, it is able to maintain
homeostasis and good function. This is called a competency, a function
that maintains homeostasis. If there is a change in the context or
physiology, and the body is no longer able to perform competently, then
it is a compensation. This means the body will find another way to
achieve the same goal.
“Competence is the things we are able to do, and the things
we inherited from evolution . . . compensations are things we are
choosing to do or that we are passing on as behaviors, often through
cultural evolutions. Competencies are physiologic functions.
Compensations are parafunctions, meaning they are ways of trying to
accomplish the function,” Dr. Raphael said.
When there is chronic stress or a mechanical flaw in a
system, the rest of the body will adapt, to cope by compensation. There
are three ways that compensations can work:
- Pain and paresthesia – The body’s way of warning us that something is wrong, and alerting us to take action.
- Parafunction – A function that is intended to create the same result as the function, but often may not.
- Anatomic distortions – Created from functions that do not work.
Dr. Raphael then quoted Gavin James, a well-respected mentor
of orthodontists and dentists. “All parafunctions, even when
destructive, are serving a purpose for [compensation]. Every pattern of
wear tells a story. Every malocclusion tells a story. Our job is to
understand what it is. We are the Sherlock Holmes of the mouth.”
Dr. Raphael tied Dr. James’ words to the purpose of the
mini-residency, adding, “So that is what we are going to create in you.
We are going to create for you the ability to be a Sherlock Holmes, a
detective trying to figure out when you see a symptom and when you see a
result of that compensation, what is that . . . a sign of? And, what is
the body trying to do there?”