ZONE THERAPY--MAINLY FOR DENTISTS.
There are four reasons why zone analgesia--as we call the
pain-relieving properties of zone therapy--are not more generally used
by dentists. One is that the dentist doesn’t wish to put himself in the
embarrassing position of suggesting such a foolish-seeming thing to his
pain-racked patient. Another is that the patient herself thinks she’s
conferring a favor upon the dentist by permitting him to spend five or
ten minutes’ valuable time in attempting to alleviate her sufferings,
and make the ordeal of cavity preparation or scaling comparatively
painless.
Also, to press over the roots of a tooth for three, four, or more
minutes--exerting, after toleration is established, all the force of
which the operator is capable--is hard work. It’s much quicker and
easier, and less likely to numb the dentist’s thumb and finger, to
“slap” a gas cone over the patient’s nose, or inject cocaine around
the gums--which, to my mind, hurts almost as badly as having the tooth
extracted.
There is yet another reason, however, which partially justifies
the previous three. The analgesic results of zone pressure are not
sufficiently uniform to “bank” on. In other words, a dentist, led by
previous successes, might be tempted confidently to assure a patient
of the painlessness, under zone analgesia, of a certain operation. But
when he commenced to work he might almost lift the top of his victim’s
head off. To obviate this do not limit the pressure to three minutes
only, and do not attempt to operate or extract until a puncturing test
with a sharp instrument shall prove the part to be desensitized.
Also, I would here emphasize that there is no use in attempting, with
zone analgesia, to relieve pain if it is desired to remove a nerve. We
do not pretend to explain why it is possible, for instance, to work
thirty-five minutes, (as demonstrated before the Mass. Dental Society
by Dr. B. A. Sears, of Hartford) and cut the jaw bone all to pieces in
order to remove an impacted wisdom tooth, while we are unable to thrust
a nerve broach into a root canal. But the fact remains, and some time,
when pathologists and other experts have studied these problems, we
may know why. But for the present, we must be content to be guided by
dearly-bought experiences.
There is no known way of telling in advance, just what degree of
analgesia success is assured. Dr. M. W. Maloney, of Providence, R. I.,
and Dr. Wm. J. Hogan, of Hartford, Conn., claim successful results with
about 80% of their cases. Dr. Everett M. Cook, of Toledo, Ohio, writes
that he is easily successful in 75% of his cases. Dr. Thomas J. Ryan,
of New York, is quite uniformly successful in desensitizing the gums
for pyorrhoea treatment. While other dentists range on down to as low
as 50% of successes, or even to zero.
There are probably very definite reasons for this, although it may be
difficult to convince the average dentist that such exist. First, it
requires a fine technic to find the various dental nerves, and, by
commencing gently, and gradually increasing pressures, to anesthetize
them without hurting the patient more than the operation might have
hurt him. In which case he has the pain of the operation plus the pain
of attempting to analgesize his unresponsive nerve points.
Next, when pressures are made over the fingers, especially where no
clamps or rubber bands are used, there is a tendency to skimp on the
time devoted to the finger squeezing. The dentist or his assistant will
give the job a “lick and a promise”--and let it go at that. They don’t
use sufficient time or sufficient force really to accomplish anything.
And third, they won’t take the time properly to learn the zones and the
teeth relations, and apply in a serious way the knowledge so acquired.
However, for the benefit of those dentists who may be interested in
learning how to desensitize cavities in sensitive teeth, or do some
of the necessarily painful scaling of tartar and other deposits in
pyorrhea, and for the particular benefit of several million of their
patients throughout the country, I would say that pressure by an
assistant exerted over the joints of the thumb (the assistant would
do better completely to “cover” the joint, using thumbs and fingers
of both hands for this purpose), will mitigate or quite control the
pain in the incisor and occasionally the cuspid teeth of the side
corresponding to the finger being squeezed.
Never let the patient do this for himself, unless you provide him with
clamps or wide rubber bands for the purpose, as he cannot be trusted
to make the pressures long enough or strong enough to accomplish
satisfactory results.
Pressure exerted over the first or second joint of the first finger
will control pain in the cuspid and bicuspid teeth. The second finger
is related to the two molars, but sometimes the third (or ring) finger
must also be employed for this region.
In other words, pressure upon the thumb, fore-finger, middle, and
ring fingers of either hand will control correspondingly pain in the
incisors, cuspids and bicuspids and the two molars on either side of
the median line, providing that there is no great inflammation or no
abscess in the vicinity of the corresponding teeth.
Occasionally the “control” over-laps, in which case it is necessary to
use also the finger next to the zone finger, and in the case of wisdom
teeth, to get the best results it is sometimes advisable to use both
the third and the little finger--as the fourth and fifth zones merge in
the head.
A very successful method practiced by some experts--particularly where
extraction must be done--is to grasp the offending tooth as near the
apex of the root as is practicable, and with the thumb and finger make
firm pressure for three, four, or more minutes--by the watch. This
usually produces a degree of anaesthesia lasting about one half hour,
although pressure can, if necessary, be reapplied at any time.
Other dentists and oral surgeons get excellent results by pressing on
the “heel of the jaw”--the point directly back of the wisdom tooth,
ponderously known as “the tuberosity of the superior maxillary.” This
produces a very complete and lasting anaesthesia of the entire jaw of
the side affected, and permits of the painless extraction of teeth
living in the immediate neighborhood.
[Illustration: FIG. 25--Pressure at I, Fig. 4, with thumb and finger
will anesthetize both thumb zones, inasmuch as the pressure is brought
directly on the median line and to the right and left of it.
Pressure at II (pressure on inferior dental and lingual nerves) will
anesthetize not only entire jaw on side compressed, but to a greater or
less extent the entire half of the body.
Pressure at _a_ with thumb and finger will often anesthetize that
zone sufficiently for painless extraction. Any tooth may be prepared
similarly.
Pressure at _b_ with thumb and finger anesthetizes bicuspids and
occasionally molars.
Pressure at III will aid materially in anesthetization.]
With the lower front teeth, it has been found that to press or hold
the inferior (or lower) dental nerve, where it enters the ramus (or
groove) of the lower jaw, gives good anaesthesia. Also pressure with
the finger on the inferior dental nerve, where it exits from below the
bicuspid tooth (called by doctors the mental foramen) will usually
anesthetize that half of the jaw.
Many operators, the better to “focus”, prefer to use the blunt end
of an instrument (the handle of an excavator is excellent) upon this
inferior dental nerve.
The proper application of these principles cannot fail to be of immense
value to the dentist and oral surgeon in their daily practice. In
relieving toothache and neuralgia, in removing deposits, in extracting
teeth, and in fact in most painful operations which dentists are called
upon to perform, this pressure technique should prove invaluable, as
many dentists are learning every day.
And further, the application of these principles will inevitably
encourage public interest in dentistry, and will materially diminish
the sum total of pain and suffering that humanity is called upon
to endure. Indeed, it is common--and highly gratifying--among many
dentists now using zone analgesia--to have sensitive patients--those
upon whom, because of past exhausting and nerve-racking experiences,
they have always dreaded working--say “Well, Doctor, if you never hurt
me any more than you did today I shall never again fear to come to you.”
[Illustration: FIG. 26--Pressure at IV will not only anesthetize the
third and fourth zones, but frequently also that half of the upper jaw.
Pressure at V with finger covering the median line and counter pressure
with the thumb on the outside of the jaw, or even on the lip directly
opposite the finger, will usually anesthetize the incisors sufficiently
for painless extraction.]
Mothers will find this method a safe and certain means of relieving
themselves and their children of an immense amount of pain and
discomfort. For, while they cannot, of course, hope to possess the
technical knowledge enabling them to find and exert pressure upon the
nerves themselves, it is a comparatively simple matter for them to
rigidly grasp the roots of an aching tooth between their thumb and
finger, and temporarily relieve pain--at least until they can take
little Alfred or Alice to the dentist.
If this may not seem feasible, they can, by remembering the fingers
that correspond with the particular zone it is desired to influence,
do much to relieve distressing conditions in that zone until such time
as the doctor or dentist can be visited, by squeezing, or by applying
rubber bands around the proper fingers.
For example: At a dinner party the other night one of the guests
complained of severe pain in the right upper first molar. I told her to
squeeze firmly the joint of her second or middle finger, which advice
she considered a very ill-timed and pointless joke. Insisting that I
was serious and helpfully disposed, she obeyed instructions, and in a
very few minutes beamed complete relief from her dental anguish.
Another instance in which toothache was relieved in what might be
called an _outré_ manner was reported by Dr. J. F. Roemer of Waukegan,
Ill., who operated with a pair of rubber bands upon the aching teeth
of a young traveling man. Dr. Roemer writes that this man came to
the office with an extremely painful and sensitive condition,
chiefly affecting the incisor teeth. As the knight of the leather bag
explained it his teeth were so “sore” that he could not eat any solid
food whatever, and he didn’t much relish the food he drank. It was
impossible for him to close his teeth together without causing great
distress. A dentist who had examined the salesman could find nothing
wrong with the teeth, from the dental standpoint.
Dr. Roemer, however, examined him in a characteristic zone therapy way.
He searched the patient’s fingers with a metal comb to find out what
was the matter with his teeth. This search disclosed the presence of
“spots” on the insides of the thumb and first finger which were acutely
sensitive to pressures from the teeth of the comb.
The diagnosis established, the treatment was simplicity itself.
Commencing with light pressures upon these sensitive areas the doctor
gradually increased the force applied to the comb, at the same time
engaging the owner of the thumb and teeth in conversation relative to
his business, and to the political situation--this latter a perennial
source of interest-absorbing conversation in the West.
After about ten minutes of this operation the doctor looked up
and asked his victim “how the teeth were getting along.” After
cautiously testing their sensitiveness by means of various biting
pressures, the patient responded that “while they were still a little
‘sore’ the pain had entirely left.”
The doctor then issued instructions as to how to apply rubber bands
in order to make the proper pressure, which is to use one-fourth
inch bands about two inches in length, bind them around the first
joint--counting from the tip--of the thumb and first finger, leave them
on until bluish discoloration appeared, then remove, and re-apply after
a few hours.
The traveling-man reported the following day that he had enjoyed a good
night’s sleep--the first for many nights--and after forty-eight hours
of this treatment he telephoned that all pain and sensitiveness had
completely disappeared.
In neuralgia and other painful conditions of long standing, where
there are no decayed teeth--or other dental causes for the pain--many
permanent cures have been effected by pressure treatment. Almost it
would seem that whatever tends to reduce the pain would also help
remedy its cause, no matter how remote.
As illustrating, in detail, the successful “home treatment” of
neuralgia, another case of Dr. Roemer’s is most interesting. The
Doctor says “I saw recently a patient with tri-facial neuralgia of two
years’ standing. Nothing had relieved permanently. The attack which
brought him to me was of four or five days’ duration. During this time
he had been unable to eat. Even the attempt to speak would bring on
an acute paroxysm of pain of a sharp piercing nature, which radiated
over the entire left side of the face, extending from the lower and the
upper jaw, and up into the left eye. These paroxysms left him as ‘limp
as a rag.’
“He had been advised to have the nerve cut, as offering the only relief
for his trouble.
“I applied rubber bands on the joints nearest the tip of the thumb and
forefinger of the left hand. In less than ten minutes my patient was
talking and laughing, and we had quite a visit.
“I told him nothing about what was being attempted with the bands, so
he wasn’t ‘hypnotized.’ After we saw results, however, I instructed him
to apply the bands every half hour if the pain continued, and as it
decreased to lengthen the interval of the applications.
“When next I saw him, several days after, he laughingly said, ‘Oh, I
apply the rubbers once a day now, as I don’t want that pain to come
back.’ He is now enjoying life better than he has for years, thanks to
‘those fool rubber bands,’ as his daughter called them.”
Many dentists secure a very satisfactory degree of
analgesia--sufficient for excavating or treatments--by compressing
firmly the lip or cheek immediately over the tooth that is to be worked
upon. (See Fig. 27.) But as a rule, for extraction purposes, they
prefer pressure over the roots, or directly upon the various branches
of the dental nerves. (See Figs. 25 and 26.)
[Illustration: FIG. 27--Patient anesthetizing the left jaws in the
first zone, by firmly pressing the lip directly opposite, between the
thumb and index finger of left hand, indicating the area with the right
index finger.]
[Illustration: FIG. 28--Stickpin firmly imbedded in a section of the
anesthetized area shown in Fig. 27.]
One of the most significant facts in connection with zone therapy is
the intimate relation between morbid dental conditions and pain or even
pathological changes in practically every section of the body. It has
been demonstrated beyond a shadow of doubt, that points--or foci--of
infection within the mouth, or in the teeth, frequently manifest
disturbances most remote from their point of origin.
This is one reason why many physicians and surgeons, using the method,
make a routine practice of sending every patient, in whom dental
disease is even suspected, for a thorough overhauling by a competent
dentist.
Another reason for striving to keep all our original teeth in their
places is that nature intended to preserve the continuity--if it
may be so termed--of our various nerve zones. Sound, healthy teeth
and roots in their normal occlusion, seem to assist in the normal
functioning of the entire zone chain of which they are important links.
Asthma, congestions, headaches, neuralgia, conditions affecting
the nerves of the head or the ears, or even partial deafness, have
been materially improved, and many times completely cured, by the
application of a galvanic cautery around the necks of the teeth, by
pressure on the teeth themselves in the zone affected, or even by
having the patient “grind” the particular teeth related to those areas
which it is attempted favorably to influence.
In several instances, chronic frontal headaches in children have
been cured by correcting faulty occlusion of the front teeth by that
branch of dentistry known as “Orthodontia.” When after several months’
treatment, the teeth were restored to their normal alignment, and
continuity of the nerve zone was re-established, the headaches cleared
up, and there has been no return of them.
[Illustration: FIG. 29--A prominent Connecticut dentist anesthetizes
the entire left half of his body through pressure on left inferior
dental nerve. See following cut.]
[Illustration: FIG. 30--We might have covered the left side of the body
with stick-pins without his knowledge, as far as pain was concerned,
during the period of fifteen minutes of anesthesia which followed his
pressure of one minute with the finger on the left inferior dental
nerve. Note the stick-pins in ear, finger and leg.]
Occasionally it happens that a patient will go to a physician who
uses zone analgesia to be prepared for the services of a dentist
who doesn’t. Only recently a man suffering from indigestion and
rheumatoid arthritis (rheumatism of the joints with progressive
stiffening) was advised by his physician to have his teeth removed, the
doctor insisting that because four wisdom teeth were the only teeth
he had that were not decayed and completely broken down, nothing else
would cure his indigestion and rheumatism.
His heart action was such that it would have been dangerous to
administer cocaine--much less a general anesthetic.
Therefore, for the removal of his 27 teeth and stumps, the pressure
method was decided upon. His physician accompanied him to the dentist,
and doctor and dentist, for the next twenty minutes made the proper
pressures on the fingers and on the inferior dental nerves.
All the lower teeth were then removed--without a particle of pain.
Pressures were then repeated on the fingers and the palatine nerves,
and the teeth in the upper jaw were likewise removed.
Of the entire 27, only two gave much pain on extraction, and these
were most strongly attached to the bony processes (the sockets and
attachments by which teeth are held in place). Bleeding following this
wholesale extraction was very slight.
It may be interesting to know that after the gums had healed and the
patient had worn artificial teeth for a few months, his appetite and
digestion improved, he began to gain in weight, and there was an almost
complete relief from the rheumatic symptoms and the joint stiffening.
In some instances physicians have applied the pressures in their own
offices, and have then sent the patients--with rubber bands bound
tightly around their finger joints in order to maintain the analgesic
influence--to the dentist, where their extraction or cavity preparation
has been painlessly done.
And occasionally great pleasure and satisfaction is afforded both
patient and doctor when some sufferer calls up on the ’phone at two
or three in the morning and inquires what finger to press to relieve
the pain of a certain tooth, especially when the advice given has been
followed by relief.
[Illustration: FIG. 31--Hand and arm, left eyelid and chin, decorated
with stickpins after the patient has anesthetized the left side of the
body by pressure on the left inferior dental nerve.]
[Illustration: FIG. 32--A lighted match is held beneath patient’s right
great toe, anesthetized through pressure on the inner surface of the
jaw in the first zone.]
It has been for many years a quite general piece of knowledge among
dentists that the application of menthol to the mucous membrane of the
nose, on the same side as an aching tooth, would very frequently stop
the toothache. If dentists will now apply a slight elaboration of this
bit of zone analgesia technic they may possibly save themselves many
gray hairs. What their patients will save in agony, apprehension, and
the drain on their vitality cannot be even estimated.