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Cranial Dental Comanagement: When is the best time to add spinal and cranial care?








We often get asked by dentists, orthodontists, and patients, “when is the best time to coordinate cranial and structural care” in regards to dental or orthodontic treatment.

Although there is no right or wrong answer and often the answer varies depending on what appliance is being use or what procedure is being done, we have found the following to be a good starting point.

1. Getting aligned prior to any dental or orthodontic work is a good idea.

Prior to getting impressions made, prior to getting a new crown, etc. it’s a great idea to get as aligned as possible (in the pelvis, spine, and cranium). Often a few sessions spaced around 4-7 days apart will go a long way in regards to getting one ready for any dental/orthodontic impressions or treatment. Since so many areas of the body can affect the way your teeth come together and the way your jaw is aligned, getting these aligned prior to having the impressions made will not only help your dentist/orthodontist in getting a solid head start in aligning your teeth and jaw, but will also help you maintain all the positive changes in the rest of your body as the teeth and jaw are important in maintaining alignment in the structures below.


2. Once one is in a removable appliance, especially an appliance that requires adjusting (an occlusal splint, bite work, etc.) it’s a good idea to coordinate your appointment in our office with an immediate visit to your dentist/orthodontist. You would come to our office and get treated with your appliance OUT of your mouth. We will treat you with a wafer between your teeth so your teeth don’t come together. You would then go straight from our office to your dentist/orthodontist, lay back/sit in the chair, and he/she will take out your wafer, put back in your appliance, and then check it for any adjustments that might need to be made. This way the dental orthotic can be aligned to the structural changes we have made and the appliance will help you maintain this new position.


3. If one is in a fixed appliance, expander/remodeling device, orthodontia, etc. it’s a good idea to check in every 4-6 weeks to ensure the neck and cranial dura are moving well, as restriction can impede your progress.


Sometimes a dentist or orthodontist has found a different way that he/she feels works more efficiently, or sometimes things such as hypermobility, age, and symptoms would alter the schedules outlined above. Different appliances and procedures may warrant different intervals of intervention. Hopefully this is a helpful jumping off point for anyone considering major dental/orthodontic works, or changes to the bite or jaw, to get help get the most out of that treatment through integrated structural care.




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Jason Scoppa, DC, CSCP, CCSP®

Bellevue location:

Northwest Structural Medicine

12330 NE 8th St., Ste. 202, Bellevue 98005

Tel: 425-278-5678

Lynnwood location:

Balance Epigenetic Orthodontics

2322 196th St. SW, Suite 201. Lynwood, WA 98036

Tel: 425-361-7499

Fax: We prefer email, please. Office@StructuralMed.com

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