Nutrition and Oral Medicine (Nutrition and Health)

158 Part III / Nutrition and Oral Healthinvolves long gliding strokes, kneading, and friction. Rolfing is a popular type of deeptissuemassage and involves working with the fascia to loosen the sheaths that cover themuscles, which is thought to allow the body to be held erect with less muscular effort.Acupressure is an example of pressure-point massage and involves pressing with thefingers on the acupressure points throughout the body (see Subheading 2.1.3. on TraditionalOriental Medicine). Shiatsu massage is a popular Japanese form of this pressurepointtechnique.2.3.3.1. Dental ImplicationsIndividuals may use massage therapy to ease chronic myofascial pain, fibromyalgia,or TMD. Research in the 1980s suggested that ice massage of the webbed area betweenthe thumb and index finger was helpful in relieving dental pain, but the practice is notwidely used (80). Massage with aromatherapy has been suggested as an effective alternativein relieving symptoms of teething (81). Massage is not known to cause harm andmay actually provide relief to those with chronic pain and allow for relaxation prior todental treatment.3. PRACTICAL APPLICATIONS3.1. Potential CAM–Medication InteractionsMany consumers believe it is safe to take herbs and supplements because they are“natural.” However, it is important to keep in mind that dietary supplements are subjectto the same mechanisms of interactions as pharmaceuticals. Pharmacokinetic or pharmacodynamicinteractions may occur with food, medications, or other supplements. Pharmacokineticinteractions are related to absorption, displacement, and metabolism, whilepharmacodynamic mechanisms refer to additive, opposing, or transport changes. Forexample, kava and valerian may have additive effects when combined with alcohol orprescribed sedatives; anticoagulants such as garlic can have additive effects with warfarin;and St John’s wort has been implicated in pharmacokinetic interactions with severaldrugs using similar metabolic pathways (49,82). Current information on druginteractions and advisories can be obtained from the NCCAM Website at http://nccam.nih.gov/health/.3.2. Working With Patients Who Are Using CAM ModalitiesThe health practitioner has a professional responsibility to the patient to protect,permit, promote, and partner, described as follows. The practitioner must “first do noharm” and protect the patient from toxic or ineffective therapies that would be used inplace of efficacious treatments. The practitioner should, however, also permit the patientto choose safe treatments and adjunctive treatments with no demonstrated side effects,as long as the therapy is accessible, not prohibitive in cost, and does not displace provenremedies (83–85). Health practitioners can promote dialogue for safe and effectivetreatments and help consumers discern good information and reputable therapies andtherapists. Finally, practitioners should partner with their patients to comanage illness,provide direction to resources and evidence, and provide professional input into thedecision process. Partnership is advisable also for monitoring progress and response totreatment if a patient makes an informed decision to engage in CAM.