As most readers know, Dr. Ricketts passed away recently. In memory of one of the giants in the orthodontic profession, we continue with more insights from Dr. Ricketts in his extended interview with Dr. Larry White. We are honored to present these articles and share with the Ricketts' family, the orthodontic community and the world, the sadness of his loss and the joy of his life.

Part 6 of the Interview with Dr. Robert Ricketts, Interviewed by Dr. Larry White

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LWW: Dr. Ricketts, you have stressed the advantages of extraoral tradition such as cervical and face mask. You have also made a special issue of overtreatment and finishing. All of these require compliance. How do you account for your successes with these modalities when others have difficulty?

RMR: Yes, Dr. White, you are correct on both these issues. All of these procedures take cooperation by the patient. The first requires extraoral devices and the other entails intraoral (elastics).

As I perceive the situation, the first requisite is a knowledge of possibility. The operator must truly believe in the merits of a procedure and the expected objectives to be met.

The second requisite is that the operator be a manager. In dealing with the public, anyone encounters all types of personalities. Motivation, therefore, may take different methods. In fact, my first day of two week advanced courses deals with the subject of selling. You must sell the patient on their need to help you in the successful result.

Oral Hygiene

To be more specific, there are many conditions where compliance is required. The very first is oral hygiene. Cleanliness is next to Godliness, as the old saying goes. My chair-side assistants were instructed to hand me the “Scope” when my breath was bad. I had a “tooth brush center” directly adjacent to the treatment theater in which a part of my service was to teach oral hygiene, which I supervised.

I found that oral hygiene training, monitoring and appreciation were very difficult to delegate. Patients would come in with mouths as dirty as I would tolerate. Both children and adults have different notions of cleanliness. Strangely, my greatest challenge seemed to be in the families of physicians. The importance of removing food impaction cannot be overemphasized with regard to periodontal health.

DNS

The second condition is the keeping of appointments. “Did not show” was a term I picked up from my old school days as a dance instructor. “DNS,” then, was the notation on the chart. If I looked at a record and saw a number of DNS notations, I would usually quickly conclude three other events: their mouths would be dirty; they would not be complying with the appliances employed and their time for finishing would be delayed.

We found that there was a difference in two offices. One was in Pacific Palisades, California and the other in the “valley” at Canoga Park. The first was a white collar professional bedroom type community.

The second office, in the San Fernando Valley, was more blue collar. From top to bottom, the compliance and respect was better in the valley practice. They took treatment more seriously, perhaps, because of appreciation of the service. The Palisades practice was much more challenging. Therefore, the type of clientele made a difference in practice management.

A review of hundreds of records confirmed that patients of all ages who miss appointments were also those that did not cooperate in the compliance requirements. Missed appointments, in the end, cost money, and, for sure, time.

I took the total number of visits per year, divided it by the number of chairs and then divided that into my total overhead. This told me how much on average it cost me to prepare that chair and that slot in my office for one appointment. It was a surprise. Most offices are too casual about appointments missed for fear of losing a patient. Explanations regarding ethics are required. Ethics means being fair to all concerned.

Removable Appliances

The third situation is the use of removable appliances. After trying to use removable posturing methods on five different occasions over the years, I gave up. In the end they were not as rewarding or successful or as economically feasible to the standard Bioprogressive modalities we developed.

I found that removable retainers on the upper were satisfactory and eventually tried to limit their need to six months. But problems arose in removable lower retainers. They take tongue space and, if left out, may not seat properly again. It’s easy to be lazy and the impression to the lab. I found that a lower fixed first premolar to premolar retainer was far, far superior. I learned to make them directly and have them cemented in three minutes. General dentists seem to object to cleaning around them, but, after all, they are not responsible for the stability and this should be explained to them.

The same idea is there with the fixed Herbst appliance. I won’t argue the idea of a forced compliance. I will argue that it doesn’t stimulate the growth of the mandible in the end and I have seen condyles damaged when the treatment was too aggressive.

Extraoral Traction

Now the greatest obstacle seems to be with extraoral traction. The most effective treatment the orthodontist can offer is facemask applied for Class III in the deciduous dentition. Placing a quadhelix and attaching it by crossing the elastics over the tongue and at the distal loops on the palatal appliance is efficient. The fitting of the facemask must be done with care, and it must be comfortable. It is successful if worn at night only, but every night is important and essential.

Cervical Traction

After a career of work, I found that, for Class II, cervical headgear was the most “orthopedic” of any appliance at my disposal. When applied as I instruct, it widens the nasal cavity, changes the palatal plane in three dimensions but fosters vertical growth of the ramus! I recently wrote a book, “Extraoral Traction—A Phoenix.” The important aspect is that this appliance takes understanding and management. Our research indicates that it can stimulate mandibular growth in a discreet manner as revealed by arcial growth analysis.

Cervical traction was abused in the past. It is simple but it takes more sophistication in management than it would appear. Decades ago I listed 22 mistakes that people made with it. It is truly for the specialist.

Again, the bottom line is education. It is truly amazing to witness the changes in a five-year-old Class II with severe open bite, in which was applied cervical traction on only the second deciduous molars. The whole maxillary complex was altered in three phases of space. It is even more surprising and pleasing to find some patients never requiring further treatment.

Intraoral Elastics

In some patients, compliance with intermaxillary elastics is challenging. This takes education. In some types of appliances, up to six week visits are acceptable. But in a person failing to wear elastics or not complying with instructions, I have scheduled them on weekly visits until they “shape up.” Taking playing time away from children is a quiet method of getting their attention.

Elastics are extremely important in the overtreatment process. Since 1954, we practiced breaking up the arch into segments. This was also explained in a book we wrote, “The Wisdom of Sectional Mechanics.” The “Facile Formula” for bracket and tube design assists in this “set-up.” Still again, the patient is made a part of the treatment and it needs to be explained with a mirror in hand. The success is achieved by a partnership.

One method of motivation I found useful was to show to the patient their head x-rays. I would first show the models and photos, but when teeth were protruding, the headplate could be used to really demonstrate the severity and the need for their personal commitment. I would emphasize the need for straightening of the face, not just straightening the teeth. The service for esthetics and beauty is a major source of motivation.

It is amazing that many patients associate orthodontics with mere alignment of the teeth. Patients need to be taught, so that they can appreciate arch and “bite” relation as a part of the process. The word “fit” of the teeth together usually is effective in the explanation. This also pertains to the “fit” of the jaws to each other.

In the end, the keyword is communication. After all, the word “doctor” means “teacher.”

LWW: You have maintained an interest in the general health and nutrition

of your patients throughout your career. What led you in this direction, and

what are the present results?

RMR: My interest goes back to my childhood. I was born and raised in the “goiter belt” in central Indiana in the United States. One of my older sisters had a thyroid removal operation in which they also took a part of her parathyroid, which regulates calcium metabolism. I saw the results of it. She was in a wheelchair in her 60s. I was impressed on learning that goiters can be prevented by simply supplementing iodine in our table salt. In other words, thyroid hyperplasia was a deficiency disease. I watched these problems affect the nervous system of members in my own family.

In dental school, the interest continued with caries and the findings of Phillip Jay with the sugar etiology in the 1930s. Also, as an undergraduate student, one of my senior papers was on periodontal disease in which I proposed that the crater-like reaction around a periodontically infected tooth was like a foreign body phenomena. In other words, periodontal disease was related to the immune system.

Then my interest was heightened by witnessing the crippling effect of rheumatoid arthritis when I was a Navy dentist. I also started research on an acute neurotic gingivitis epidemic aboard a battleship at Norfolk, Virginia. Why would only a certain group get “trench mouth.”

Still further, as a graduate student I was charged with the job of obtaining proper tomographic x-ray sections on children with juvenile rheumatoid arthritis (Still’s Disease). Brodie had written on its devastating effects on growth of the mandibular condyle and, hence, on the face. On studying a few of these children, at the school of medicine at the University of Illinois, I sought information among the professors as to the cause of this horrible disease. I came up empty. So I went on a search. It was discovered that in the nutritional literature someone had reported the arrest of rheumatoid arthritis in patients given dolomite. Dolomite is a rock-forming mineral containing calcium and magnesium (Ca Mg (CO₃)₂) It is used in fertilizer and also in the ceramic industry. It is found in mineral beds. Aha! I thought, another mineral deficiency.

In the study of osteoarthritis, a medical colleague referred me to the work of Dr. Hans Selye who was the originator of the stress phenomenon. I also obtained the books of Melvin E. Page who was prescribing sea kelp tablets and giving micro-dosages of endocrines (both thyroid and pituitary extracts) for arthritis victims. I went to Florida to visit Page. Later I met and befriended Selye in our dental-medical circles and in 1975 interviewed him in a talk show.

I read Weston Price and, on moving to Pacific Palisades, became a friend of Francis Pottinger in Monrovia, California who sent me many patients. He was a remarkable researcher in nutrition and a fine physician.

All the knowledge I had gained came in handy as I developed a practice in TMD together with orthodontics. Treatment of TMD came to be not only mechanical but also biologic.

I reached the conclusion that the normal joint could break down by physical overloading. This could be from loss of posterior teeth. It could also be produced by chronic clenching as teeth were intruded. Avoidance patterns and trauma were other factors. In some patients it was found that clenching and bruxism could be caused by interference problems in occlusion. But bruxism also was obviously triggered by psychological stress. It appeared that nutritive deficiency problems also could be a factor in bodily stress. Hence, another factor in bruxism. This was, of course, branded ridiculous by the mainstream of medicine at that time (in the 50s and 60s.)

But even a greater factor was the breaking down of joints with only normal loads of chewing and swallowing. It became clear that the resistance of the joint tissues per se could be the fault. The problem in treatment of these patients was restoring the regenerative mechanisms, mainly, in the beginning, the cartilage.

After about thirty years, the next step was an interest in interstitial fluid together with the biologic mechanism of delivery of oxygen and nutrients and the control of the local environment of the cells. The synovial fluid is the life fluid to cartilage, which is avascular, aneural and alymphatic. The synovial mechanism is its life source. The interstitial fluid should contain the “soup” for nutrients for the cells. It feeds the synovial cells, which produce the “soup” for the joint.

The synovia received its name from the ovum-like egg white matter, and “syn” means with. It is the grease for the joint together with its nutrient supply and macrophagic functions. One needs only to understand gout with elevated levels of uric acid in the blood and the precipitation of urate crystals within the synovia to perceive of the systemic connection of the body to the joints.

As I then studied mandibular and midfacial growth, I found the indissoluble connection between the nasal and oral cavities. Conditions of the nasal capsule for speech and breathing came under investigation. I was led to respiratory obstructions of all kinds, particularly adenoidal conditions and allergies. I found that clinical orthodontics also was associated with airway problems. At the latest report, one in fourteen children has asthma or breathing problems in the state of Arizona where pollution is not as severe as elsewhere.

Through meetings and circles of contacts, we found from Dr. Bluestone at the University of Pittsburgh that 25% of American children do not have the enzymes to digest milk. That’s quite substantial. Further, narrow upper arches and maxilla characterize all the major types of malocclusion. It didn’t make sense to me to attempt to handle biologic problems with mechanics alone. Thus, knowledge of the immune system became obligatory.

Two other diseases caught our attention. These were candidiasis and chronic or recurrent herpes. I had written a senior paper also on herpes. It is a neurotropic virus with spores at nerve endings in the extra-cellular matrix. Local injury to tissues such as the lip or mouth could trigger multiple and spreading lesions. But also, herpes type II is transmitted on the genitalia. Herpes zoster is an infection of the ganglia of the fifth cranial nerve, but it also may occur on the body along the course of cutaneous nerves, which is called shingles. This can be precipitated by uncontrolled emotional stress or other febrile (or fever) conditions.

Candida albicans is a yeast-like fungi. It is a symbiotic organism inhabiting the digestive tract. Under ordinary circumstances, it is ever present. It appears to be in competition with lactobacilli organisms, which keep it in check. When gaining ground, candida may produce thrush in the oral cavity. Vaginitis is common and well known to most adult women. But when not challenged, candida can spread into systemic infection where it will mimic other diseases. It seems to lower the immune system. It thrives on sugar.

The theory is proposed that antibiotics, chlorine and preservatives alter the equilibrium in the intestinal flora and that favorable bacteria are reduced. Restoration of normal flora is made by way of planting new colonies of bacteria, which can correct the imbalance. This is known as “probiotics.” The problem was to control the temperature of the new colonies until they could be taken. Research led to strains that could tolerate room temperature. This was a substantial improvement. It was further found that, in the soils as well as the gut, bacteria need minerals as their food.

It was recognized further that modern processing and food habits put extra loads on the pancreatic enzymes. When it was all put together, we formulated a combination into one product called “AZ 2-12:”

1. Fulvic base, as developed from fulvic acid, contains 73 minerals and trace minerals. It alone, in liquid form, was produced as “Sedona Spark.”

2. Probiotics in the form of four different species of lactobacillus.

3. Enzymes to promote the processing and assimilation of foods.

4. Several other agents to promote digestion.

The feedback from patients was terrific. Of course, no one can guarantee anything. But also, users began to report remarkable improvement in their allergies. I, together with other colleagues in the nutriceutical field, applied for a grant from the AAO Research Foundation, but it was far beyond the allowances for student research, which was disappointing. We could have had it finished by now. I still say that the orthodontist can give AZ 2-12 to his allergy children without harm and probable good. It can be ordered from the website: www.DrRickettsNutri.com or by phoning 480/367-0845 or 800/820-9235.

LWW: That’s interesting! What other work have you done in the nutriceutical field?

RMR: When I started my private practice in 1952, I gave patients a recommended diet sheet. I listed positive foods to use and negative foods to avoid. Mothers would have their own opinions, and they would take it to their family doctors who would ridicule it. I found it was not good public or professional relations, so I stopped because who wants to argue with patients and build a practice at the same time?

My interest in total patient health did not stop. I continued to recommend and prescribe vitamin, herbal, mineral and enzyme support for TMJ patients. I limited to two new patients each clinical day. I had about 6000 TMD patients referred. Some patients claimed that my nutritional program was the principal factor in their treatment. I didn’t say much because the American Medical Association was opposed to supplementation programs. But that was changed in June 2002 when they reversed their stand and now recommend daily supplementation.

LWW: If my memory serves me right, did you not study root resorption?

RMR: There is another big story that the reader should know. It deals with root resorption. With the heavy .0215” x .025” steel wires used in .022” brackets for torquing, for expansion and for the forces employed for canine retraction, we saw root resorption. This was sometimes to the level of one-half the root. As we developed the .018” slot (.441 mm) and went to the .016” blue Elgiloy square wire (.406 mm) for the same purpose, the resorption almost disappeared. Still, there was the lingering question regarding why some patients, with the same technique used, would experience root loss while others would have minimal root damage.

About 1959, in my laboratory, I laid out all the patients’ records I could remember who had major root resorption. They remained there for weeks. At breaks I would go over these records again and again. One day I was struck with the likenesses. The key was in the photographs observed around the eyes, which Marks called “allergic shiners.” With that I found that every one of those patients had allergies, asthma or some type of respiratory obstruction. By 1999 we were led to look at the whole nasal cavity. Nasal atresia is an imperfect opening of the nasal space. In reviewing problem patients it was observed that the inter-dacryon distance was very narrow. Why it took so long to look at that area critically I don’t know. Perhaps this is also present in Downs syndrome and other dysplasias.

Root resorption is necrosis, so I immediately suspected anoxia. On a visit to Dr. Selye later, I had tea with one of his students, a Dr. Rohan. He was investigating the stages of necrosis. When I asked about the relation of necrosis to anoxia, he was stopped. “How did you know?” he asked, “Have you been reading my papers?” “No,” I said, “I sensed it in root resorption, which had been considered idiopathic.” He exclaimed that anoxia was always, always the first stage of necrosis. We agreed that oxygen is diminished in the blood of asthmatics. The tissues look cyanotic. Heavy forces in a weak system did indeed appear to be the cause.

But later, as we studied interstitial fluid it was reasoned that the transfer mechanism from the capillary to the fluid and thence the fluid to the cells could probably also be a factor. So here I was back to nutrition again and to considerations of the immune system. We should also be reminded that cancers grow in an anaerobic environment.

LWW: Have root resorption and breathing problems been recognized and reconfirmed?

RMR: No, not to my knowledge. I would love to pursue it, but I ran out of my own private funds.

The need for oxygen comes to mind from several other observations. Breathing exercises are used for relaxation techniques. It is a practice in the yoga tradition and a part of some of the Far East religious rituals for health benefits.

It has further been speculated that at the time of the dinosaurs the oxygen in the air was double what it is today. Another bit of information is that the highest frequency of office visits to physicians is related to the respiratory system.

I think I have already referred to the increase in asthmatic children in our present population.

LWW: Now what else have you produced? Please go on with your story.

RMR: Thank you. With this “side interest” in clinical practice and with a view to the need, together with my wife, we developed a company in order to produce and distribute supplements in the 1970s and early 80s. It was entirely premature for the profession. I lost my shirt, but I still believed in the service to patients. In a divorce, she took the company and went into skin care and, through training, became one of the top three formulators in the U.S. Her very high end line is called “Shankara.”

I dropped out of the nutritional field until the 1990s when the interest in the environment emerged again with my son Craig. I found myself back in it. After developing AZ 2-12, the digestive formula, we were asked to design a formula for bone and joints. Osteoporosis is not a result of excessive bone resorption, but it is a deficiency of new bone replacement. The key then is collagen formation, the basis of all connective tissue. This includes the blood vessels. So we went to work on a combination of ingredients for connective tissue formation. It was named, “CJB” for “Collagen, Joints and Bone.” Of course, anyone needs to be constantly mindful of the placebo effect, but when taken regularly (in the appropriate amounts), arthritic pain and range of motion is improved in people following instructions in the programs.

CJB was produced in order to help control the extracellular matrix and its contents, the interstitial fluid. Clive Buirski helped develop this formula. It contains Vitamin C, which is absolutely necessary for collagen formation. It also consists of Vitamins D and B complex with generous amounts of Niacin (B3). Also, there are six major minerals for connective tissue building together with glucosamine sulfate and methyl sulfonyl methane (MSM). A proprietary blend of 10 other ingredients was added. Finally, as in the AZ 2-12, we included our Fulvic Base consisting of 73 trace minerals.

The exchange between the cell and the interstitial fluid is critical. Higher potassium levels are within the cell, but higher calcium levels are in the adjacent fluid. This is a part of the acid-base control and electrolyte equilibrium. Finally, toxic by-products from cells empty into the interstitial fluid before it is picked up by the lymphatics or venules. This was a part of the concern for the additional ingredients.

One factor to consider is that under biologic or mechanical-physical stress, one capsule or dose is not enough. It’s almost as if the individual needs to determine his own safe intake. I take one or two each day. If surgery is contemplated, the patient takes three morning and evening with meals.

Collagen starts with adequate vitamin C and, again, requires minerals. Also, calcium is needed together with glucosamineglycans and the necessary food for osteoblasts. This was our second most essential product and also was employed for the rebuilding processes in bone and soft tissue after surgery. This is available from the web at www. DrRickettsNutri.com or by ordering directly.

LWW: Why did you not stop with those programs. Why did you pursue general health still further?

RMR: Again, it must have been the large TMD practice together with the challenge of being a patient’s “last stop.” Many years ago it was concluded that, for the best health care, we would need to concentrate on the immune system.

As you know, the B lymphocyte and the T lymphocyte work in a different manner. The B elaborates materials (like gamma-globulin), which operate in the blood stream. But the benefits of the T lymphocyte was so called cell-mediative, meaning that it must come directly in contact with a bacteria or cancer cell in order to act. It was found that immune deficiency was often characterized by low production of killer T cells. It was discovered that a particular Aloe vera, produced in a precise process to insure its potency, would trigger new T cell development. When this was plied with several other ingredients, it was named “Immune Power.” I take it daily. But it is expensive and people sometimes do not want to invest in prevention. It, too, is available on our website. www.DrRickettsNutri.com.

In my writings, based on experiences in practice, I described three crisis periods. The first is age 35. The peak of the curve of patients presenting for TMD was age 36.5 years for both sexes. This fact suggests that the condition was chronic and that it had been brewing maybe two decades before.

The second crisis is age 55. Data shows that 80% of cancer becomes evident after age 55. Many people begin to have numerous complaints at this age. Women go through menopause. Men begin to recognize a loss of libido. Its hard for people to realize at 55 that only an average of 20 years is left. Many, if they can, will try to retire by 60.

The third crisis seems to be around 75 with degenerative diseases manifested. Today the average male dies at the age 74 and the female at 80.

Cardiovascular problems account for half of the deaths and cancer almost one third. But our potential is age 120 years. Dr. Roy Wolford, M.D. at UCLA, has explained how to live long and still be productive. I have written a book, “Why Fear Cancer.” It, too, can be obtained from the web. Here I am at age 83, still writing and trying to help people. One never knows, and I have noted that one crisis will lead to another. But I want to write several more books. One will be on the endocrine system so it can be understood in lay terms. Another will be on the cardiovascular system and diabetes.

LWW: You seem quite convinced of the merits of nutritional support. How

do you view this in a clinical practice? What are some of your views of the

future?

RMR: The True Physician

I often wondered how the word “physician” was derived for doctor of medicine. I assumed that it was associated with the physic or with physiology. I learned that the Greeks established it as “one who works with the ways of nature.” I would gather, therefore, that it was one who works with the “physical world.” I found later that they mitigated pain with electric eels from the sea.

I think we are seeing a change in the manner in which health care is conducted. I could get in trouble for these comments, but all I am doing is replying to the question on the basis of the publications I have read from numerous sources.

Ancient physicians gathered herbs and natural substances. They would give them in various forms. Long before the immune response was discovered in detail, the homeopath physician was giving minute doses for the building up of a patient’s resistance. Maybe they took a cue from the athletes training for increased endurance. They made their own concoctions and, as we know, some obviously were nothing more than a placebo.

Enter Pharmaceutical Manufacturers

As time went on, chemistry and physics entered into medical science. Other people were engaged to build and furnish a supply source. This was the basis for the pharmaceutical industry. At first producers were subservient to the physician. But as patients and huge profits became powerful, the situation was reversed.

Medicine itself changed and even the concepts of etiology of disease changed. Doctors had the obligation to keep the sick from dying rather than focus on keeping them optimally healthy. The pockets of the doctors’ lab coats were filled with prescription blanks. More and more drugs were produced for treating symptoms and producing comfort.

Current Conditions

Currently, prescription drugs mark the whole senior community. One elderly person, whose daughter I interviewed, was on nine different expensive drugs at the same time. Two were different labels for lowering blood pressure, two were for depression, one more was a blood thinner, one was taken every six hours for pain control, another was extended nitroglycerine and one, after all those, was an energy booster. Our whole society wants to be vigorous, happy and comfortable almost to the state of euphoria. It is no wonder that the “inside” information is that iatogenics is the third leading cause of death.

Many people are going to doctors for a diagnosis and throwing the prescription in the wastebasket and then going to chiropractors or alternative services to be cared for. But even diagnosis is slipping because symptoms and lab findings are typed into the computer and the outcome is rendered on a spreadsheet. This is the present status. But, doctors do provide tremendously good emergency care and surgical care under great pressure from a society that demands absolute perfection.

The New Era

There is a new era developing in which provisions for health care are found in supply niches within the physicians’ offices, alternative care offices, naturopathic physicians’ offices, chiropractors, physical therapists, message therapists, health resorts and even individual homes. In order to help people, and to supply them for convenience, I would often dispose these in my office and absorb it in my fees. The problem came when the patients were finished and insisted on me making health enhancers available.

Thus, the new trend is to make a small profit center and train one or more nurses to be accountable for it. Buying by the case wholesale and dispensing it for retail yields a profit margin, and everyone wins.

The issue now comes with which substance to prescribe and how much at a time. Over the years I found patients tending to fall into five categories. So, as a base, I formulated five programs. These served my family, my fellow workers, my patients and myself and colleagues. If the reader wants to know more details they can research on my website, www.DrRickettsNutri.com .

LWW: How are clinicians to learn about a nutritional kind of service to

their patients?

RMR: Education

Yes, it’s becoming an important subject. Up until the last decade medical students were not informed regarding free radical damage nor were they made aware that the human body cannot manufacture certain vitamins and, certainly, minerals. Much of this was self-education for me.

The whole process requires some education. Some time ago I gave courses in nutrition and life extension. It was derided and held in malicious contempt by those sticking with the established tradition. All that is changing. But there is dishonesty to contend with, and the doctor and patient must be aware of the source and quality of products. I would still give courses in this subject if there were enough interested scholars with an acceptable attitude.

Products and Programs

I think I mentioned that our AZ 2-12 formula helped the digestive tract and helped reduce allergies. In addition, for disease susceptible patients at any age (colds, etc.) we developed the Immune Power formula. This was in order to supply an aid for the formation of lymphocytes and boost the immune system in general. We hope it will help prevent or slow down the degenerative diseases.

In addition, the Collagen, Joint and Bone formula (CJB) was aimed at helping replacement mechanisms in the whole connective tissue system. This includes the fascia around muscle and the strata of the blood vessels. Said again, because new tissue is always being formed, the objective was to work at the interstitial fluid medium. Remember that oxygen and nutrients do not pass directly from the capillary to the osteoblast but must pass through the extra-cellular matrix.

Free Radical Theory and Antioxidants

It took me a while to what I hope is an understanding of the free radical theory and the use of antioxidants. First, of the five theories on aging, the majority of biologists have accepted free radical damage as the most plausible explanation for aging.

Second, the free radical process occurs in the tanning and hardening of leather from the skin of animals. Therefore, tissues undergo a loss of elasticity and pliability in the aging process. The smoking of meats puts a protective layer on the outside as well as imparting taste. Most everyone has observed the browning of an apple, which starts within minutes after a bite. The housewife also knows that fruit salad will brown quickly unless lemon juice is added. The lemon juice contains vitamin C, which is an “antioxidant.”

Antioxidants are present in a wide range of nutrients. The more traditional aids in the 1970s were vitamin C, vitamin E and selenium. A part of the lexicon was that tissues would undergo oxidative stress.

Third, the chemists tell us that, in biologic chemical reactions, an open valence or free radical may be available. Mitochondria within the cell convert glucose to energy and form some free radicals as a by-product. Because oxygen unites with virtually all the elements it will grab onto that free radical as an opportunity and at the same time grab an open slot on another to unite or to form cross-linked molecules. These kinds of linkages are undesirable and tie the tissue and bind up fibers. At the interstitial area it potentially may even shut off capillary action and limit local circulation.

Fourth, in order to combat this action, at least three proven enzymes are produced naturally within cells in the body. These are: superoxide dismutase, catalase and peroxidase. Cytoplasm, ordinarily produced within the cell, protects the nucleus and its DNA so that the repair processes can occur.

Fifth, when toxic chemicals or other environmental substances “hit” a cell, the normal internal equilibrium is disturbed or overcome. Hence, the oxygen molecules more than ever need to be engaged by other agents in order to prevent cross-linkage.

But in addition, in order to protect the cell from toxins, the interstitial fluid needs to be healthy. It needs help also because of the vital role it performs in acid, base and electrolyte balance. This is also where nutritive support is of significance.

However, other natural and biologic substances were found to be much more potent and perhaps more selective. On the basis of study, we “networked” our own formulas, Super 20 and Super 50+. These are flavinoids (principles in the skins of fruits) known as OPCs (oligomeric proanthocyanidins). We used Resesrvatol from grape seed and grape skin extracts for the catechins, which support the immune system. We added bilberry, which contains cyanidins, for most all tissue support. These are a very important component of our programs.

The Programs

Program I is for daily health maintenance (after the body systems are in synchrony)

Program II is for people under stress and for tissue distress

Program III is aimed at all connective tissue structures including arthritis, osteoporosis and cardio-vascular disease support.

Program IV is for orthodontic patients undergoing rapid change or for pre and post surgery of any kind.

Program V is for aid in balancing endocrine problems in both sexes and for pre, peri and post-menopausal women.

Please do consult our web site, www.DrRickettsNutri.com .

In conclusion, it would seem that each of us is a victim of our training and discipline. Many would have no interest in this kind of attention. But in the near future, there will be fourteen elderly people for every newborn child in the United States. Many people have artificial hips and knees and dental implants. These people need maximum support and as a specialty we need to accept our responsibilities in this area in the future.

Dr. Ricketts, I believe you have shed more light on more topics of interest to me and to readers of Orthodontic CYBERjournal than anyone of recent memory. I and our readers thank you for generously sharing your knowledge and hope that you persist at least to that 120 years of age you spoke of in this interview. Orthodontics has greatly prospered from the challenges you have presented.