Medical rehabilitation includes «application of a complex of medical measures in order to restore ability to work and health of individuals in the status of patients». In its turn, dental rehabilitation restores the health of the oral cavity organs, jaws and surrounding tissues of the face and neck. The WHO defines «Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity». Remembering that «dentistry is a branch from the clavicles to the eyebrows», dental rehabilitation should be carried out within this anatomical frame. In this respect the methods of physical rehabilitation used in a comprehensive treatment of dental pathology are of great value. One of such methods is therapeutic massage.
The procedure of therapeutic massage with diseases of the maxillofacial area consists of three parts: 1) preliminary massage with the purpose to eliminate cast-off epithelium from the skin, to intensify excretion of the sweat and sebaceous glands, to improve the flow of the venous blood, lymph and intercellular fluid in the massage zone. Massage consists of smooth) effleurage from the center of the face to the periphery along the veins and lymphatic vessels; 2) Detailed massage is performed for separate parts of the face; 3) Final massage is applied at the end of the procedure. Releasing methods are used promoting blood flow; the final methods are percussion and tapotement.
Therapeutic massage with dental diseases possesses several peculiarities associated with anatomical-physiological properties of the facial soft tissues (blood supply, lymph circulation, and innervation). Massage on the face (especially warming-up) should be performed carefully to avoid considerable skin extension and damage of the elastic fibers. The tenderer the soft facial tissues are and the more disturbance of the skin elastics is, the more sparing and tenderer the movement should be. The direction of the movements on the face should coincide with the direction of lymph flow along the lymphatic vessels. For evenly distributed effect on the symmetric parts of the face massage should be made with both hands in the direction of the force lines or at an acute angle to them. After massage passive and active movement of the head are made. The procedure lasts 5-15 minutes every day depending on the functional body state, age and stage of disease. 15 minute rest is necessary after the procedure. The whole course consists of 5-20 procedures.
Thus, therapeutic massage stimulates mechanical receptors of the skin, which in their turn normalize mobility of the nervous processes, blood and lymph circulation; intensify inflow of nutrients and medicinal agents to the maxillofacial area, provide resolution of swelling, hematomas or exudates; normalize tonus and supply of the muscles and ligaments; stimulate the processes of bone consolidation; prevent destructive-atrophic processes in the maxillofacial area.
Assistant L.М. Herasym
Assistant I.I. Dronyk
Department of Surgical Dentistry and Oral Surgery Higher State Educational Establishment of Ukraine
“Bukovinian State Medical University“, Chernivtsi, Ukraine
