Beyond Your Teeth: Understanding the Trigeminal-TMJ Nexus

In our latest group visit, Dr. Ruan explained the role of the trigeminal nerve—the nerve system responsible for jaw formation and function. This revelation came from an unexpected source: veterinary medicine. Veterinarians have long understood that manipulating a dog's canines can trigger severe neurological responses, a phenomenon called canine dysautonomia. The same principles, it turns out, apply to humans.

The trigeminal nerve doesn't work in isolation. Dr. Ruan describes what's called the "trigeminal respiratory interface"—a system where the nerves in your face directly influence how you breathe. When these nerves are triggered by jaw dysfunction, your body responds with clenching and grinding (bruxism) as it attempts to optimize breathing.

Your jaw is responsible for your heart rate and blood pressure. This connection explains why jaw problems can cascade into conditions like obstructive sleep apnea, which then triggers a fight-or-flight response in the body.

The Jaw-Spine-Brain Connection

The neurological implications go even deeper. Dr. Ruan pointed out the the cervical spine nerves (C3, C4, and C5) that medical students memorize with the phrase "C3, C4, C5 keeps the diaphragm alive." These nerves are intimately connected to jaw function.

"Chronic jaw dysfunction signals C3, C4, C5 to completely disrupt," Dr. Ruan explained. When this occurs, you develop a hunch in the back of your neck. Your posture disintegrates and your diaphragm can't deploy downwards. The result? Brain fog, fatigue, attention issues, elevated blood pressure, and over time, even increased risk for Parkinson's, Alzheimer's, and other neurological conditions.

Perhaps most surprisingly, the jaw serves as what Dr. Ruan calls "the central pain hub" of the body. Your jaw determines how much pain you perceive in the body. This explains why jaw dysfunction is connected to conditions like fibromyalgia, complex regional pain syndrome, and chronic migraines.

The Unexpected Connection: Your Jaw and Your Bladder

One of the most startling discoveries involves the relationship between jaw clenching and bladder function. The pontine micturition center in the brainstem, which controls bladder contraction, is neurologically connected to the jaw.

Whenever your jaw clenches, the pelvic floor for men that holds your prostate and bladder, for women your bladder and vaginal vault—if you're clenching, it has to tense up. This creates a cascade effect leading to hip pain, knee pain, plantar fasciitis, and frequent nighttime urination.

Dr. Ruan shares a personal story about his mother, an acupuncturist who suffered from severe leg cramps for years. "Night one of wearing the CPAP, that's the last time she had cramps," he revealed. The problem wasn't her legs at all—it was her contracted pelvic floor caused by jaw dysfunction.

Dr. Alkhiro's Approach: DNA Epigenetic Dental Appliances

This is where Dr. Alkhiro's specialized work becomes crucial. Unlike traditional night guards that simply protect teeth, Dr. Alkhiro uses what are called epigenetic appliances—devices that "activate your own genes to grow your own bone."

"It is possible at all ages," Dr. Alkhiro emphasized, pushing back against conventional wisdom. Even when we stop growing and our bones fuse, we still have the potential to grow new bone in our mouth and jaw. We just have to activate the right genes in order to do so. 

The Process: From Construction Bite to Full Appliance

The journey begins with what Dr. Alkhiro calls a "dental contributions to body symptoms consult." During the first visit, patients fill out forms about their mental, medical, and dental wishes. Dr. Alkhiro takes detailed photos and assessments, then creates something called a construction bite—a clear silicone temporary appliance made chairside.

"We check where your jaw wants to be, if it was free from how your teeth are aligned," Dr. Alkhiro explains. This construction bite allows the jaw to sit in its optimal position, immediately relieving pressure on surrounding structures.

The results can be immediate and dramatic. Patients wear the construction bite for a week, journaling their symptoms. Common improvements include better range of motion, reduced tension, improved posture, and even changes in walking gait as the pelvis becomes less rotated.

The Science of Growing Your Jaw

If the construction bite shows positive results, the next step is creating a custom epigenetic appliance. "These appliances activate your own genes to grow your own bone," Dr. Alkhiro explained. "It's really just understanding how the body works and activating that. Even as an adult, if you break your bones, they're gonna heal. Those are the same genes we're trying to activate."

The key is applying the right amount of pressure—intermittent, cyclic, and low pressure. "Too much pressure, your bone doesn't grow. It's gotta be just the right amount," Dr. Alkhiro notes.

This approach focuses on guided growth, moving the jaw downward and forward to create more space for the airway, tongue, and surrounding structures. The process isn't about creating a "Frankenstein" face—it's about millimeters of dimensional improvement that can dramatically impact overall health.

Why This Isn't Your Traditional Night Guard

Many patients ask about the difference between these specialized appliances and traditional night guards. The distinction is significant.

"A lot of traditional night guards are horseshoe-shaped, which means your back teeth can touch," Dr. Alkhiro explains. "Now your back teeth are touching with that night guard, which means your muscles are still activated. It becomes like a human chew toy, and patients have more headaches with it than without it."

Traditional night guards also don't address the position of the jaw or create proper space for the tongue. In contrast, epigenetic appliances have a specific "parking spot" groove where the lower teeth sit, positioning both the upper and lower jaw optimally.

The Three-Pronged Benefit

Dr. Ruan believes the benefits come from three mechanisms:

1. Immediate cervical spine relief: When the appliance lifts pressure on C3, C4, C5, the phrenic nerve that goes to the lungs allows immediate diaphragm activity, opening the airway.
2. Fascial retraining: The appliance trains the brain and fascia to relax in certain areas and come into neutrality, similar to myofunctional therapy or tai chi.
3. Enhanced regeneration: With less pain and better sleep, the body naturally produces more growth hormone and activates stem cell regeneration.

"I actually don't think you have to even grow the jaw to actually relieve apnea," Dr. Ruan theorizes. "I think that for those three reasons, I don't even think you necessarily have to improve any of the metrics in terms of expansion to actually get benefit, which is a really good thing because that means there's instant gratification."

Working With CPAP and Sleep Apnea

For patients already diagnosed with sleep apnea and using CPAP, Dr. Alkhiro takes a careful, integrative approach. "I would never tell a patient to get off a CPAP because that is not safe for them," he emphasizes.

Instead, he recommends adding the jaw appliance while continuing CPAP use. "Sometimes just adding that to their CPAP, all of a sudden they start getting the outcomes they were hoping to get in the first place."

As the jaw grows and moves into better position, patients do another sleep study. Some no longer need CPAP at all. Others continue using it but at lower, more comfortable pressures with better results and less sleep fragmentation.

The Outside-In Approach

This work represents what Dr. Ruan calls the "outside-in approach" to medicine. "Instead of looking at just the labs and supplements and diet and medicines, the outside-in approach is: what am I seeing in front of me right now? What does the axis of symmetry actually look like?"

Facial asymmetry, forward head posture, tilted eyebrows, and uneven ears all provide clues. "If your head's forward like this, your cholesterol will be high, your blood sugars are going to be high, you can have a hard time losing weight," Dr. Ruan noted.

By addressing the foundational structure—the jaw—the body can naturally come into alignment, triggering a cascade of positive health effects.

Phase One and Beyond

The beauty of Dr. Alkhiro's approach is that it doesn't require pre-work or braces. "To get us to a place of orthopedic stability, this is phase one, which is where all the symptoms tend to improve," he explained.

Some patients choose to pursue phase two—clear aligners to close any remaining spaces—but it's entirely optional. "Some patients are like, 'I'm happy where I am. I feel so much better as a person that it doesn't matter,'" Dr. Alkhiro shares.

A Paradigm Shift in Dental Medicine

This integrative approach represents where neurology meets dentistry, airway medicine, and functional medicine. "I see one day where there's a neuro-dentistry division," Dr. Ruan predicts. "Mayo Clinic just started it."

The implications are profound: addressing jaw dysfunction may be key to resolving chronic pain, sleep issues, cognitive problems, posture concerns, pelvic floor dysfunction, and countless other seemingly unrelated conditions.

At Texas Center for Lifestyle Medicine, we're committed to exploring these connections and offering patients comprehensive solutions that address root causes rather than just symptoms. If you've been struggling with chronic pain, sleep issues, frequent nighttime urination, migraines, attention problems, or postural concerns, the answer may lie in a place you never expected: your jaw.

To learn more about DNA epigenetic dental appliances or to schedule a consultation with Dr. Alkhiro, contact Texas Center for Lifestyle Medicine and Innovative Smiles. Let us help you discover how optimizing your jaw function can transform your overall health and wellbeing.