Taking Care of Teeth & Treating Trauma #281

Dr. Jon Ryder:

You know, I think a lot of people that go on to healthcare want to have this concept of helping people, but I really did. You know, I felt the idea of going to places that were underserved and in need. It's always been an underlying passion, I guess, of mine and interest.

Dr. Gregory Nevens:

And the other confounding variable has a lot to do with, I think one of the issues that we're struggling with now in terms of how to do research with integrative medicine, and that is in the act of looking at light as energy, you change what you see.

Dr. Lisa Belisle:

This is Dr. Lisa Belisle and you're listening to Love Me radio show number 281, taking care of Teeth and Treating Trauma. Airing for the first time on Sunday, February 5, 2017, Maine is becoming known for its highly trained healthcare providers and innovative healers. Today we speak with Dr. John Reiter, Dean of the University of New England College of Dental Medicine, which will be graduating its first class of dentists in 2017. We also discuss groundbreaking techniques for re patterning the brain and nervous system in cases of trauma and chronic pain with health psychologist and integrative practitioner Dr. Gregory Nevins. Thank you for joining us.

Dr. Lisa Belisle:

In the studio, we have Dr. John Reiter, who is dean of the University of New England College of Dental Medicine. He has served in leadership roles at the college since its opening, including assistant dean for Academic affairs and executive associate dean. Plus, you have a long and esteemed history in dental medicine.

Dr. Jon Ryder:

Yeah, that's right. I don't know about esteemed, but thank you.

Dr. Lisa Belisle:

Well, I think it's pretty interesting what you've been doing. You've made your way from the middle part of our country and really gone around the world from what I can tell.

Dr. Jon Ryder:

Yeah, it took me a while to get to Maine, but now that I'm here, I'm extremely happy to be here. And what a beautiful place.

Dr. Lisa Belisle:

I completely agree. Tell me about why dentistry.

Dr. Jon Ryder:

Well, I don't know how far back you want me to go. You know, I was born on a Thursday, but I actually used to play in rock and roll bands. And one of the players, one of my bandmates, was a dentist. And I got to know him well and appreciated the lifestyle that he led and also got to hear a lot about his stories of helping people and going on mission trips and things like that. So I think that inspired me. And. But actually going back even further than that, when I was a child and going to the dentist, I used to get little rubber animals as a reward. And I think maybe that was the very first time I was inspired to go into dentistry. I had quite a collection as well. But I think that idea of, you know, I think a lot of people that go into healthcare want to have this concept of helping people, but I really did. You know, I felt the idea of going to places that were underserved and in need, that's always been an underlying passion, I guess, of mine and interest. And I think that's what drove me outside of the country as well and into some of the adventures in Southeast Asia and other places, and eventually to Maine, because Maine is actually not that much different from a lot of the Neets in Southeast Asia and other places. Places.

Dr. Lisa Belisle:

Well, tell me about that.

Dr. Jon Ryder:

Well, I spent time in Cambodia, and I was helping with the Curriculum development and with the dental schools there and addressing the access to care issues in Cambodia. Cambodia is a very rural area, which is similar to very rural country, which is actually similar to Maine. And many ways there's a couple of larger metropolitan areas that you might compare, maybe Portland and Bangor and so on. But the rest of the country is very rural. And the problem with distribution of healthcare professionals is again very similar. So when I was in Cambodia and working with the dental schools, we were actually looking at the, at the new dental schools that were developing in the United States and what was their mission and how might we borrow some of those ideas and apply them there? So that's what got me kind of alerted to the new school that was opening in Maine, University of New England, as well as some of the others I had known about, the founding dean in the, that he had opened another school in California, a dental school. But the dental school curriculum is basically the same as any other dental school. But this was the largest geographical area left in the United States, if you consider Maine, New Hampshire and Vermont without a dental school. And definitely the needs in this area were or are great. So this idea of building a traditional dental school with a little bit of bent on adding more public health in the curriculum, having the fourth year students going out into community based educational sites to start immediately, addressing the access to care issues and also the benefits of being trained in a, in a real life environment like that, this was different and it's somewhat of a departure from a traditional training program or educational program. So I liked that idea when I first heard about it being in Southeast Asia and I bought into that idea. I guess it does really work. So we tried to apply some of those things in Cambodia, some of those concepts which are being implemented now. And then when the opportunity came up to come to Maine and be involved with a school that had these same philosophies, then what a great opportunity. So I only wish that I would have been able to come 10 or 20 years earlier.

Dr. Lisa Belisle:

Well, all good things take time, right?

Dr. Jon Ryder:

Right, that's right.

Dr. Lisa Belisle:

I'm thinking about dental school and medical school and I know what the curriculum for medical school is because I've been through it. I don't think that I'm very well. I know I'm not familiar with the dental school curriculum and I'm guessing that a lot of people who are listening are also not familiar. Can you explain that?

Dr. Jon Ryder:

Yeah, I think a dental school curriculum is arguably the most or one of the most difficult programs to go through. It's very similar to A medical school program in the first two years, where they're. Often dental schools and medical schools will combine courses and classes. For the first two years, Harvard, for example, the medical students and the dental students attend the same courses and the same classes. And even where I went to school at Iowa, we spent a lot of the same courses with the. Or attended many of the same courses with medical students. But what happens when the medical students go off when they're done with the course or with the class time and then they go off and study? The dental students have to go into a lab or a simulation clinic and start cutting plastic teeth and doing procedures. So we're learning how to develop those hand skills and that mind to eye to hand coordination. At the same time, you're cramming all this biomedical science information and other types of information in your brain. So it can be very difficult. The average number of credit hours per semester in a dental school is about 35 credit hours for one semester versus a typical undergraduate program, which is a about 15 or 16. So easily double the time and effort that it takes. And then beyond that, the first two years, then we start concentrating more on seeing patients and doing these mini residencies for the last two years. So it's not an easy time. It can be very stressful for students.

Dr. Lisa Belisle:

Do you do training these mini residencies? Do you learn about periodontia or do you learn about other types of dental specialties? Or where does one do these trainings?

Dr. Jon Ryder:

Yeah, again, there can be different philosophies and methods of training. At Iowa, for example, in the third year, we spent 12 week rotations going around to each specialty. So there's oral surgery and perio and, and root canals and pediatric care and so on and so on. So that was an interesting way to learn where you would kind of focus and immerse yourself in these different specialties. And it's similar to a medical type of training. And then in the fourth year, we would go into family, what we called family dentistry, which is more comprehensive care. In our program at une, we think that we like to emulate the way one would practice after you get out. So we have what we call a group practice model of training. So in the beginning of the second year of dental school, you're indoctrinated into one of these groups, group practices. It's kind of like Harry Potter where you get your Slytherin or whatever.

Dr. Lisa Belisle:

Is there a hat? Does somebody pick out?

Dr. Jon Ryder:

Yeah, it's a magic hat that we pull the name out of.

Dr. Lisa Belisle:

Well, there's a selling point Right there.

Dr. Jon Ryder:

Exactly right. There's a lot of magic in dental education, but once you're in this group, the practice group, you're in that group for three years, for the remaining three years and you team treat the student, team treat the same patient base for that three year period. So the benefits are student helping student within, within the group, but also maintaining this comprehensive and continuity of patient care. You get to know your patients very well, they get to know you and then there's this trade off of the new ones that come in and the congratulations to the old ones that move out. So we feel that that's a very patient centered especially and also student centered way of learning and approaching patient care.

Dr. Lisa Belisle:

You started this in 2013, the school did. So you now have a group of fourth year students who are getting ready to graduate this year, 2017.

Dr. Jon Ryder:

Right.

Dr. Lisa Belisle:

Tell me what usually happens once one has a dental degree. Do you go right out into practice? Do you do additional training? What's the general approach?

Dr. Jon Ryder:

Well, historically, dentists, when they graduate, tend to go straight into practice. The numbers statistically tend to be about the opposite from medical school where 80% of physicians graduating would go into specialty programs, 20% into primary care. And with dentists it tends to be about 80% that go into directly into primary care and another 20 or 25% that would go into specialties. That number has been increasing a little bit, the specialty numbers in the last few years, but it's stayed relatively steady. Dentistry is still very much this cottage industry where you see one dentist in a 800 or thousand square foot practice in a community and, and they become the community dentist. It is changing a little bit with, you know, I think the hands being forced by, you know, changing issues in medicine and medical care in general. Affordable Care act definitely has some influence on that. So we are starting to see the rise of corporate dentistry. Whereas a corporation may own several different practices or manage practice, manage practices in states, a variety of states, but I think we're still looking at single or partnerships kind of an industry out there. There are several specialties that dentists can go into and oral surgery, orthodontics are probably the most famous that people know and the most popular. But there's also pediatric dentistry and endodontics, specializing in root canals, periodontics, specializing in the gums and surgeries and things like that. And public health is another area. While we don't have specialty training programs in our dental school, we, we definitely train our dental students to be very competent in those areas and prepare them to go out into the world and practice those procedures.

Dr. Lisa Belisle:

It seems to me that I've seen different sets of initials behind dentists names. So even though everybody comes out and they're all called doctor, I've seen dmd, dds, probably many other alpha type of initials. What's the basic difference in what people come out with?

Dr. Jon Ryder:

Well, the first dental school in the United States was Maryland. And they created a degree called the Doctor of Dental Surgery, which was the DDS program. Harvard came not too much longer after, and Harvard being Harvard, they created their own program called the Doctor of Dental Medicine. And so then that's where the DMD came from. And the training programs were slightly different in the early days. But as time has gone on, there's really essentially not that much difference. We can say that the Doctor of Dental Medicine degree, which is the one that we have at une, is maybe has more emphasis on the medical philosophy and the medical model as opposed to a surgical model or a surgical approach toward care. But essentially they're the same thing. And then you'll often see dentists with master's degrees or PhDs. The training, specialty training programs are not unlike medicine. And again, where you do a residency and you could either come out of that program with a certificate or board certification, that's the primary objective. But often those training programs will have a master's incorporated with them or potentially a PhD. And then there's fellowships to throw in the mix as well.

Dr. Lisa Belisle:

So it sounds like you could just keep getting educated for a really long time.

Dr. Jon Ryder:

Oh yeah, it takes a long time to get to this point. And you can certainly keep on going, which is good. I think there's continuing education that's required, whether you want to continue your education or not, to maintain your license in most states. But I think it's good that people continue and stay on top of what the. There's just too much happening in medicine too quickly. You have to read the journals and maintain your, you know, this continuing education idea.

Dr. Lisa Belisle:

I know we've heard a lot about the importance of oral health in physical health. We've heard a lot about gum, bacteria and heart disease. And I've. Every time I go to the dentist now, even though I'm not a. I don't chew tobacco, they pull my tongue out, they look on either side, they palpate around, they make sure I don't have any oral cancer. And it seems like the specialties are becoming more and more integrated. Where it used to be teeth on one side, rest of the body on the other side, it seems like there's this Growing understanding that they're all connected.

Dr. Jon Ryder:

Yeah, Hallelujah. They've discovered that the mouth is connected to the body. Right. So that's a great epiphany in revolution. I think that's happening now. I don't know why. I guess you have to go back in history and try to figure out why dentists have lobbied to stay somewhat separate from medicine. But, you know, medical training has very little training in the oral cavity or even really the head and neck region. The medical students are typically. And I'm not slamming medical education, I'm just saying, in my experience, medical education or medical students tend to look past the teeth and at the back of the. Of the throat, and then that's where diagnosis starts and interest starts. But the concept of interprofessional education, I think, is very, very important and significant now. And not only is the research showing that the mouth is connected to the body, but other areas, other medical areas, ally specialties are also realizing that from their perspective, you know, from their perspective back toward the mouth. Even programs like occupational therapy or physical therapy are involved with dental students, and I mean dental patients, and vice versa. You know, a patient that has Parkinson's, Parkinson's disease, for example, and maybe has trouble taking care of their teeth or can work with an occupational therapist to devise different kinds of toothbrushes or devices to assist them with that. Physical therapist working with patients with jaw or TMJ issues and so on. And pharmacy students, we have pharmacy students and pharmacists that interact with the dental students, for example, on medical adherence issues and polypharmacy issues that dental patients will have as well. Social workers, dental patients. Sometimes when there's something, again, magical about laying them back in the chair and they start to kind of open up about their personal issues and issues. But it's often a time where you can, you know, diagnose or maybe not diagnose, but suspect domestic violence issues or suicidal tendencies and things like that. So the dentist today has to know how to work with other healthcare professionals, recognize problems and get their patients to the proper areas and proper healthcare professionals. So I think the idea of interprofessional education is again, extremely important. And at une, to give UNE a plug, we have four doctoral programs, six master's programs, and four bachelor's programs, all in health care. And the opportunity for these students to interact is tremendous.

Dr. Lisa Belisle:

Hasn't dental medicine always been somewhat on the forefront? Because it seems as if it's really a team approach. It's the doctor that I see at the end of the visit. I see him for very short periods of time, thank goodness, because I have nice teeth, thanks to my parents who brought me to the dentist all the time when I was younger. But I spent a lot of time with a dental hygienist and there's like no separating it. You couldn't have one without the other. And it always, at least in my lifetime, it seems like it's always been the case. Case.

Dr. Jon Ryder:

Yeah, that's a really good point. And I think that dentists do feel approach patient care in a team way, a team effort, and I think that that's going to increase. I wouldn't be surprised if, of course, I need to finish my sentences. I wouldn't be surprised if we see multi specialty types of health care care practices in the future that would include dentists, hygienists, but also some of these, maybe physicians or specialty areas in dentistry, whatever. In Maine, we have FQHCs, Federally Qualified Health care centers, especially in the rural areas. And these FQHCs often employ a variety of healthcare professionals as well as inviting students as well. So one of the benefits of sending our students to FQHCs, for example, is they have this opportunity to see what it's like to team treat a patient with physicians and nurses and pharmacists and social workers and so on. And I think that they would, most of them certainly would agree that that's a really terrific way of approaching patients and getting the job done.

Dr. Lisa Belisle:

I have to say one of the most tragic things that I see is young people who have no teeth. I mean, and this is sadly something that I see more often that I would like. You know, I have a patient who can't be 30 and she has no teeth at all. And it goes back so far, it seems as though we haven't had adequate dental coverage in the state of Maine. When I have patients who come in and they have dental issues, I don't often have anywhere to send them or they're on long waiting lists, or if they've got an infection or some painful issue with their teeth, I have to prescribe them antibiotics and pain medication because they have to wait for a month to see a dentist. And to me, this feels like almost like a public health crime, like there's something wrong with the situation. Because once you have no teeth, like, how do you eat? How do you eat good, healthy, nutritious food? How is that even possible? And then once you have no teeth, how do you afford to get new teeth? Because those aren't often covered in this population. They don't have any way to get dentures and they don't have any money.

Dr. Jon Ryder:

Right. And I think the literature would also show that the time taken off work or the time out of school due to pain and oral health issues is also enormous and often overlooked, I think, when it comes to public health initiatives. But access to care is a complicated problem. And you know, you can. First, we have to at least our philosophy with putting a dental school here is to build a dental school, recruit from areas that have need, recruit students from areas that have need, educate them and then try to help them go back to those areas. And we know that through research. Research that if you come from a small town, you're more likely to go back to a small town or at least practice in similar kinds of areas. So I think that's part of addressing the access to care issues. However, you can lead a horse to water and you can't always make them drink. So the other more complex issues are often cultural issues. And even in Maine, you can go from one county to another county and have a surprisingly completely different culture. And you know, 30 year olds that don't have teeth are sometimes coming from a background or a culture that believes that, you know, that's just what happens. You lose your teeth when you get to a certain age and it's time for your third set of teeth. You know, when I was a dental student, and I'll never forget a family, nice family came in and they brought their 18 year old son in and their complaint was that it was time for their son to have all of his teeth extracted and get a denture, because that's what you did when you were 18. You know, you just don't have to worry about your teeth then anymore and you're not going to be in pain or whatever. And then we have cultural issues with some different ethnic groups, especially working in different parts of the world. I've been exposed to people or parents bringing in their children and wanting the canines extracted, for example, because the canines are associated with erratic and crazy behavior, because they come in about the same time as adolescence starts. So there's a lot of different types of. And we can be appalled or laugh, but they're serious issues and they're real. So we have to do our best to work with cultural beliefs, whether they're here or overseas or wherever, and try to do the best we can to solve the problems, solve the issues. But it's going to take time. And I think that's again with our program. We have so much public health in our curriculum and we've purposely added more public health than average that our students are going to graduate with a DMD degree but also a certificate in dental Public health leadership. So we want them to graduate and go out into the community with to be able to speak intelligently about public health issues, about, you know, being able to comfortably being able to deal with legislatures, you know, address public health policies and so on, because they're going to be the leaders of the future. So we need to educate them in that way. And it'll take time, but it also takes well educated and engaged healthcare professionals.

Dr. Lisa Belisle:

You make me feel optimistic for the future. And as a primary care doctor for the past two decades, I really appreciate the work that you are doing in this area and I appreciate the fact that we finally have a dental school in Maine and that we are working on these issues.

Dr. Gregory Nevens:

Great.

Dr. Jon Ryder:

Thank you.

Dr. Lisa Belisle:

I've been speaking with Dr. John Ryder, who is Dean of the University of New England College of Dental Medicine. I appreciate all the work that you do and I appreciate the time that you took out of your busy schedule to come in today.

Dr. Jon Ryder:

Oh, thank you very much for having me in. It was my pleasure, love.

Dr. Lisa Belisle:

pleasure to work with a group of integrative practitioners who put on a symposium and one of these practitioners who was involved in the planning of the symposium and is affiliated with the Group still is Dr. Gregory Nevins. Dr. Nevins is a health psychologist with long term experience in integrated and integrative health care. He has spent most of his career embedded within and working conjointly with family practices and some specialty medical practices. Nice to have you in today.

Dr. Gregory Nevens:

Thank you. Nice to be here.

Dr. Lisa Belisle:

You have a very long and interesting background as a health psychologist, but you're kind of a. You're a health Psychologist with, like, lots of different interests and expertise.

Dr. Gregory Nevens:

Yeah, my journey has. I actually started 35 years ago in an integrative medicine practice with three docs and three acupuncturists, massage therapists, polarity therapists, et cetera, which was an idea way, way before its time. And it's really been the impetus for much of my career since in terms of advocacy for integrated and integrative medicine. Integrated meaning health psychology or emotional issues as part of chronic pain and chronic illness presentation. And that experience was great. Working together, taking the tough cases and analyzing what kinds of intervention systems would be helpful for them, from what kind of discipline. And so that's really been what I've been advocating for in larger systems, smaller systems of medical delivery systems since. And now I find myself back in another integrative medicine center with a small group doing what I was doing 35 years ago, which is kind of a nice full circle.

Dr. Lisa Belisle:

You're right in that 35 years ago, the idea of integration really hadn't taken off yet. I remember 20 years ago, when I graduated from medical school school, the idea of integration hadn't taken off yet. We were still calling it alternative and complementary medicine.

Dr. Gregory Nevens:

Right.

Dr. Lisa Belisle:

So what was it that caused you to become aware that this was an important thing to be involved in?

Dr. Gregory Nevens:

I would say that I'm the kind of person that's always thought outside the box. Of course, you know, education as a health psychologist involves certain kinds of sciences and certain kinds of approaches. But as I started to practice, especially in those early years, I became very interested, not just in kind of being supportive of the medical side in terms of just doing cognitive behavioral work for compliance and that kind of thing. But I started to see there were opportunities to actually affect medical symptoms through work with emotional problems and started to have some patients. For instance, a patient very early on who presented with chronic pain, she rated it a 9 or a 10, and she was out of work. She was in the workers comp system. She. She was struggling with her previous employer. It was really obvious that the strongest emotion involved in her presentation was really intense anger. And this was before I knew any of the kinds of more complex integrative techniques I know now. But just through helping her take that angry energy. And that's how I see emotions as energy. Take that angry energy and use it for her own rehabilitation and functioning, rather than just sit there on the couch feeling the tension in her muscles. And she was able to recover remarkably and get much more functional and even start talking about returning to work and that kind of thing. So that that was a seminal case that kind of drove me for further research in terms. And many of the lectures I gave around the country 20 years ago were about not separating mind from body, recognizing that depression, anxiety, anger are part of the presentation of a chronic pain patient. And they're inextricable, intertwined. And it's only more recently that the neuroscience actually proves that that's the case. And the pain matrix, the new models of etiology of chronic pain and other chronic illnesses now includes through brain imaging, we see that the anterior cingulate gyrus that holds much of our emotional experience, good and bad, and the insula and the somatosensory cortex, where the pain is actually experienced and the discriminatory aspects of pain interpretation occur. Those three areas are stuck in this pain matrix, in this feedback loop. And if you break that feedback loop in any stage, whether it's the insula or the anterior cingulate gyrus to the somatosensory cortex, you get relief. In my experience, when you break it at the core emotional issue that's stuck in the anterior cingulate gyrus, sometimes it's long term relief. It really gets better and stays better. So it's exciting stuff.

Dr. Lisa Belisle:

I believe that when many people think about health psychology, they do think about the types of things you've described. Cognitive behavioral therapy, for example, there's a lot of talking involved and it's all about the words and the thoughts and the sharing of things, which is all which has its own validity. But you're actually talking about using techniques that will get kind of get in there without necessarily just spending a lot of time talking about things.

Dr. Gregory Nevens:

That's true. As an integrative medicine person, somebody who is a CAM practitioner and you know, I've served on the board of executives, the American association of Integrative Medicine, have met lots of pioneers and innovators in all sorts of different intervention systems. But integrative intervention systems are based on energy. Western intervention systems tend to be based, medical intervention systems tend to be based on mass. How can we create a synthetic molecule to fit the MOO receptors to block the pain impulses? How do we take an MRI or CAT scan and find where the lesion is that we can fix? So it's mass based and. But I think what's really exciting about our time and a lot of the innovations that are going on and a lot of the integration that's going on is that we're now starting to see energy and mass at the same time as both valuable and this has been a conundrum since the early quantum physics explorations, where it was confounding to Einstein and Bohem and the others how we could take light, which is one of the energy intervention systems I use. We could take light and we could see that light was mass in terms of developing experiments which would show protons hitting a screen. And we could also see light is energy, but we couldn't see both at the same time, or they couldn't see both at the same time. And the other confounding variable has a lot to do with, I think one of the issues that we're struggling with now in terms of how to do research with integrative medicine, and that is in the act of looking at light as energy, you change what you see. And what that really enters into is this whole notion of intention when you're working with energy medicine, okay? Whether it's acupuncture, Ayurveda or whatever. So that I'm very optimistic that perhaps we're entering into an age of consciousness where we can see both at the same time, and that that's happening systemically, especially through the grassroots movements that's driving integrative medicine in this country. It's the fact that 70% of patients who are going to their medical doctors are already doing something in terms of all alternative medicine. So it behooves the medical side to understand integrative medicine, know what it's good for, what it's not good for, contraindications even. Okay? You don't want somebody who has a pulse that's damp in acupuncture doing hot yoga. That's a problem. And of course, medical side would also say, and somebody that has a cardiological issue doesn't want to do hot yoga at the same time too. But having a general knowledge of all these intervention systems that are out there that people are using and can be very, very valuable. Western medicine is fantastic for, Basically, for emergency kinds of situations. Western medicine saved my life at least twice. Okay. But for the more chronic issues, again, we get into a much more complex ideology that involves people's emotional backgrounds and is in need of integration and involves energy. Energy that gets stuck in certain patterns in neuronal networks in the brain. And different approaches can impact those kind of stuck neural networks. And the energy based ones make sense because when we take a functional MRI or an MEG or CAT scan, what we're seeing, or PET scan, what we're seeing is energy. And Energi can change those neural networks, I think, quicker than cognition in terms of the cognitive behavioral approaches can certainly help people learn how to manage their stress better, can deal with compliance issues, can affect depression and those kinds of things, but they don't get right at those kinds of core emotional issues in the anterior cingulate gyrus in the background. And they don't impact those in an energetic kind of way. They can sometimes identify them. But if you've been in psychotherapy a long time, you know, patients that have been in psychotherapy for 30, 40 years, they have also the insight in the world. But it's not changing the behavior or the feelings or the medical issue that may have developed out of those long term patterns of feelings and effects on the autonomic arousal system, especially like in fibromyalgia.

Dr. Lisa Belisle:

Well, let's talk about fibromyalgia and pain. We think of pain as a very physical thing. And also fibromyalgia, which is a syndrome, it's not really a diagnosis, but it's a pain related set of symptoms that a person experiences. But there is a very interesting emotional and psychological interaction in those situations.

Dr. Gregory Nevens:

Absolutely. And what again the pain matrix shows is that however the initial pain develops, you can get fibromyalgia patients during a car accident. They get myofascial pains in one area, but then it spreads throughout the body. And that's what fibromyalgia, myalgia is, as opposed to myofascial pain problem. So fibromyalgia and myofascial pain problems are caused by the way to identify fibromyalgia is do you have 11 out of 18 pressure points that are active? Okay, so those actual trigger points are spasmings of the inner muscle fiber bundles. Okay. They're not involved with the peripheral nervous system that tells the muscles how to move to pick up a cup of coffee and bring it to your mouth. They're involved with the autonomic nervous system, the sympathetic, the parasympathetic nervous system. So what we know about those spasmings of those interfusal muscle fiber bundles is that they have excess sympathetic energy in them and they have excess norepinephrine in them, which is the stress hormone. Okay. So one of the ways to the other issue is that I've never seen a fibromyalgia patient that didn't have a significant part of their life where they were walking on eggshells. Their autonomic nervous system was on hyper alert all the time. And very often that goes all the way back to childhood. They had very difficult childhoods where they weren't free to speak their truth. They weren't heard, they were abused, they were neglected, they were abandoned. And those kinds of issues create emotional trauma. Core neuronal networks in the anterior cingulate gyrus. Over their lifespan, more and more situations bring them back to and remind them of that initial core trauma. And those branches and neuronal networks in the interior singlet gyrus grow and grow and grow. In chronic pain, the somatosensory cortex, which involves sensation, sensation can also trigger memories. So there is a connection there. And that's where it gets stuck in these chronic pain syndromes. So most of the times when you see chronic pain patients, you'll notice that not only do they have a consistent pain pattern, but they also have a consistent emotional presentation that they come in with, whether that's anger, depression, helplessness, hopelessness, anxiety, and that's showing you where the core issue is or what that pain matrix is involved in. But with fibromyalgia, you can't. Most chronic pain patients, you can't separate the emotional piece from the pain experience piece. They're inextricably intertwined. And again, if you can impact any area of that pain matrix, you'll get relief. If you can take care of the original emotional trauma, that relief tends, in my experience, tends to be long term. It's not just two to six days. I can use auricular therapy with somebody and get relief a majority of the time, but it lasts two to six days. That's not a solution that can help with exacerbations so that they can remain more functional during that period of existence. Exacerbation, but it's not taking care of the core problem.

Dr. Lisa Belisle:

By auriculotherapy, you mean using acupuncture of the ear? On the ear, yeah. When I went to visit your office, you were showing me the work that you do with applying energy to acupuncture points, and that's one aspect of what you do. But you referred to light therapy. That's another thing that you do, which I found fascinating. I don't think I've ever been in a situation where somebody was exposing me to a bright light. And I knew that there was going to be a direct impact on my brain waves.

Dr. Gregory Nevens:

That's a really complicated system that. One of the people I admire most in terms of an innovator in this whole field of integrating modern technology with kind of ancient wisdom is a man named Steve Vasquez. And the system that he developed is very complex. It's called emotional transformation therapy. But what Seems to happen. If I can explain this very, very briefly, one of the ways to impact that anterior singlet gyrus I was talking about is to activate different parts of the anterior cingulate gyrus, okay? And one of the ways of doing that is light is energy, okay? So as we've evolved as human beings, okay, there were three things that started life. There was water, air, and light. It makes sense that the cells in our body can communicate in vibration systems consistent with the different electromagnetic wave band links associated with color. If you take white light and break it apart, you get all the colors. So light goes everywhere in our brains very quickly. And we seem to use the different electromagnetic wave band lengths of light to organize different kinds of information, to file it so that we can as a survival of the species kind of mechanism. So when I don't remember whether I showed you this or not when you came into my office, but one of the early things that I can do with people is just use some goggles to allow a very small piece of white light hit their eye at different angles, okay? And while they're looking straight forward and what happens is that there's another place in the brain called the frontal eye fields. The frontal eye fields are responsible for smooth pursuit eye movement, where every time you walk into a new environment, you scan it. We all do, okay? When I walked into this room, I scanned it, okay? And what we're doing when we're scanning is we're using those frontal eye fields to go through all of the files in that anterior cingulate gyrus and tell us how we should behave. Okay? If some. If we're going to walk into some environments and say, oh, this feels relaxing. I've been here before, I can let my hair down. I can be myself. There's no problem. Walk into other environments saying, something doesn't feel quite right. Here, I think I'll sit in the back of my head and test it out until I know exactly how I want to react to this environment. And we'll walk into other environment where we'll pick up cues that tell us, I want out of here. Okay? So it's kind of a survival of the species mechanism. But as you activate as most of our visions in dark, and you activate just one. One angle, one tiny piece of the optic nerve goes back to the occiput in all sorts of places in the brain, but activates only a tiny piece of the frontal eye fields, which are directly connected to that anterior cingulate gyrus, lights up a small piece of that anterior cingulate gyrus or neuronal network in that anterior cingulate gyrus. So as you switch the angle, people feel different emotions at different angles, different autonomic arousals, different through the insula at different angles. And pain patients can feel their pain levels go up or down dependent upon that insula and emotional activation. And I've seen patients who have had patients, I mean, had pain levels, they rated a 7 to 10 for 10 years. And they're in those goggles, you find a really good, comforting, relaxing one neuronal network with all sorts of good memories in it. And their pain level goes down to a zero or a two even after years and years and years. That's a quick little introduction to a very complex system. And then we get into the color aspects. And sometimes you can expose people to the whole spectrum of color. One nanometer is a time. And when you get to certain colors, their pain levels will spike up. And when you get to other colors, especially the cool colors that activate the parasympathetic nervous system, while the hot colors activate the sympathetic nervous system, which is what is the problem. In most chronic pain problems, their pain level can go down. But if you can identify the those specific nanometer wave band links where that pain level goes up, that's probably where you're going to find the emotional trauma that's at the core of the pain matrix. And you can explore it with a variety of techniques, but including this angle that now you use with that specific color as opposed to the white light that you use in the goggles. And there's another component which is neurofeedback, which is strobe, because you can entrain brain links through exposing people to different strobe rates. The delta wave strobe rates will get at really kind of deep memory. That's pretty unconscious. Theta wave activity will bring up a lot of memory. Alpha. Alpha is more relaxing. Betas where we are when we're kind of on our A game, we're at work and we're figuring out a problem and our brain is just going at it. So when I'm working with people with cognitive deficits, I'll often work on beta waves in terms of indigo, which is usually about cognition. And then gamma wave activity also accesses important memories in this network, but also is where you can get peak spiritual experiences, peak creative experiences. So I often use that kind of at the end of the program.

Dr. Lisa Belisle:

Well, I encourage people to learn more about the work that you're doing. And we will give people information on our Show Notes page as to how to be in touch with you.

Dr. Gregory Nevens:

Great.

Dr. Lisa Belisle:

I've been speaking with Dr. Gregory Nevins who is a health psychologist with long term experience in integrated and integrative health care. I really appreciate all of the work that you're doing and I hope that people who are impacted by some of these very significant problems will take the time to learn more about your practice.

Dr. Gregory Nevens:

Great.

Dr. Lisa Belisle:

You've been listening to Love Maine Radio Show 281 taking care of Teeth and treating trauma. Our guests have included Dr. John Ryder and Dr. Gregory Nevins. Follow me on Twitter as DrLisa and see my running travel, food and wellness photos as bountiful1 on Instagram. We love to hear from you, so please let us know what you think of Love Maine Radio. We welcome your suggestions for future shows. Also let our sponsors know that you have heard about them here. We are privileged that they enable us to bring Love Maine Radio to you each week. This is Dr. Lisa Belisle. I hope that you have enjoyed our Taking Care of Teeth and Treating Trauma show. Thank you for allowing me to be a part of your day. May you have a bountiful life.

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