It is impossible not to love him. He is deep, versatile, humane person. The work style of the Italian professor Stefanelli is unique. In his work, he applies not only orthodontic knowledge, but also knowledge from the field of posturology, chiropractic, osteopathy, acupuncture, homeopathy, functional medicine and other «holistic» disciplines, which allows him to focus not on pathology, but on the patient. Professor Stefanelli tells us about all this, as well as his life philosophy and hobbies, in this exclusive interview specifically for our readers.
— Doctor Stefanelli, a lot of years ago one of your colleagues diligently attended your courses, said that you should spread what you are doing, write books, study at universities, otherwise you will always remain the one who “dances with wolves”. As I understand, we are talking about the main character of the movie «Dances with Wolves». How does it feel in this role?
In my field I was a pioneer and thirty years ago it was not easy, I was accused of witchcraft and shamanism but in the end today many people talk about systemic orthodontics, i.e. the connection of the dental system related to the posture, so now I’m not dancing with wolves alone anymore but there are a lot of us and number of us are increasing.
— As a secret, I’ve found out that in one of the Italian ministries they could not understand what you were doing — is it surgery, orthodontics or something else, that you even told them with all your temperament: “cretino!” Do you often find such misunderstanding in some official departments?
Often. I am a surgeon and a gnathologist, and I work with occlusive-postural connections. And, unfortunately, I often have to oppose the old dogmas of academic orthodontics.
— You started your career with the study of surgery at Universita Statal di Milano, where you got degree in 1978. What was the reason for choosing this specialization at that time? Are you from a medical family?
My first dream was to become a thoracic surgeon, but at that time I was already married, my daughter was born, and therefore I had to choose between five years of specialization in surgery or immediately start working to earn for the life, and the profession of dentist was more profitable in that sense. There were no doctors in my family, they made good wine and did not support me on my way.
— In one of the interviews you said that your world outlook was turned by the meeting with the great Harold Gelb when he came to Italy with his courses. Could you tell us more about this meeting and what struck you the most then?
I met Harold Gelb in 1984. I was struck then, when he tested gnathological devices using principles of applied kinesiology, and I thought: «I will never be the same as this crazy one», but instead that already a short time later entered the Italian Academy of Applied Kinesiology (AIKA), and such a way my Adventure began.
— Having obtained a Magister degree in AIKA, you worked there as a teacher and then become vice-president for almost eight years until 1998, when the Academy was closed. What was the reason of this?
At that time there were reports of injuries of postural damage due to dental damage that the insurance did not cover, and therefore chiropractors could not exercise with these cases if not covered by a medical director. It bothered us, and we were summoned to the order of the doctors in Rome, where we held courses and conferences. And, when they realized that the damages could be there, this have imposed the closure of AIKA. Unfortunately, the Academy closed its doors because it was considered “inconvenient” for the powers of medicine and dentistry of that time.
— At that time you met Jean Pierre Meersman (a famous chiropractor who was one of the first studying the connection of occlusion with a posture) and have been friends since that time. What did this collaboration give to you?
He made a great contribution to my knowledge of chiropractic and osteopathy, we have been friends for thirty years, and I respect him very much. Our communication became fundamental for my personal growth, and we still send patients to each other precisely because we speak the same professional language.
— Tell us about your connections with the American Orthodontic Society.
I have no contacts with the American Orthodontic Society now, because American orthodontics is based purely on aesthetic concepts that are contrary to my principles of work. In 2007, I held a biological research conference in Milwaukee, and then at Tufts University in Boston in 2010, where I presented information material, and since then I have stopped my contacts with America.
— How did you get to know John Mew?
In Rome at the Congress of the Society of Myofunctional Therapy. I want to say this is a great person with whom I share several orthodontic concepts.
— Since you are working with the ALF, I can not help asking about Darick Nordstrom. Do you know each other? And how did you start working with the ALF?
We have never met each other, except on the professional courses of James Strocholm in Birmingham. It was there that I became acquainted with the ALF method, fell in love with it and since then I have been constantly practicing it. The ALF system is concerned with mobilizing the cranial bones before the teeth, and the cranial diagram or engram takes absolute authority. Acting wisely with the device, we can modify and mobilize, above all, the premaxilla and palatine sutures, which represent the cranial base modifying it.
— I read the reviews of your colleagues who visited your courses, and they write that they cannot then find a way out of the room, because your information “explodes the brain” — you talk about occlusion in the general context of the body, up to the immune system and neurons … Can you comment this?
It is really difficult and complicated, so many of the colleagues come back to attend courses again, because sometimes university preparation is not enough, so you have to study neurology, immunology, etc. For a classical dentist, this means that sometimes you have to take medical books again, to study a bit of skeletal and muscular anatomy, also neurology.
— Traditional dentists rarely look in the direction of the patient’s neck. You do a lot of additional rare studies, for example, the connection of occlusion with such problems as displacement of the first cervical vertebra, Kimmerle anomaly, Chiari malformation, compression of the vertebral artery, and you even the first in the world recorded after craniodontic treatment a case of its decompression. At the same time, getting such results as a “bonus” to the treatment you’re doing, you do not get extra money for it, so it would be much easier just to put braces for big money. Is it such a strong passion for your work? Did you ever want to just take it all and quit at least once? Is the burden not heavy?
My work gives me pleasure, each patient is individual and expresses his gratitude. True orthodontic treatment should take into account posture. Perhaps the classics should lower the price for their treatment. Several times I felt I wanted to surrender, but not for these reasons. In any case, I will never go back to becoming a dentist, it will mean ignoring knowledge.
— A lot of young specialists are disappointed in craniodontics and do not stand up, because the treatment is long, unpredictable, there is often a misunderstanding of the processes from patients’ side, and it takes a very long time to learn this art. What do you think is needed to become a really good craniodontist?
A lot of study, patience, desire to learn, to ask questions to yourself and to have the curiosity to find the reasons behind the things taught.
— A topic that most craniodontists are very reluctant to touch is the patient’s emotions during treatment on the ALF. In one of your articles, you wrote that occlusion should also be considered in the context of biochemistry and psyche. And it is not a secret that during the treatment of severe cases of TMD in many patients, there are temporary mental complaints. Please comment on this “awkward discussion” thing.
The psychological aspect is also important, but it is not related to the treatment. Sometimes a patient begins to have a real psychosis caused by poorly guided therapy, various attempts of treatment by different specialists, or inappropriate treatment, causing the patient to focus on his symptoms. These patients need more empathy, but treatment is the same for them as for others.
— Tell us about the most difficult case in your practice.
The most difficult case is not my clinical case. It’s a girl followed with photographs from six to twenty years. It presented a simple inverse bite at the level of first permanent molars, which, according to the common practice, almost never creates problems to the occlusal evolution, and in any case can be cured with the standard ALF. But this girl has undergone a rapid expansion of the palate, extraction of four premolars, and, finally, combined maxillary and mandibular surgery, as well as plastic of the septum. At the age of twenty, when she came to me with her previous medical notes, she had bilateral dysfunction of the temporomandibular joints, and she did not breathe with her nose. This is the first case that I present to my students so that they know what you should never do in orthodontics. For the rest, regarding my difficult cases, we helped many patients to avoid orthognathic surgery with the ALF technique and the MEAW Sadao Sato.
— There is quite pleasant “home” atmosphere in your clinic. Who was involved in creating it? And how did the “lady” of the office the red-haired “lion woman” administrator Elena appear there?
We have always tried to create a warm and familiar atmosphere that would not resemble a polyclinic supermarket of various profitable organizations. Here we are engaged in medicine and dentistry, where the patient’s welfare is in the first place. My secretary Elena has been with me for twenty-nine years and she is the “cornerstone” here because she maintains class, elegance and empathy in relations with all patients, and also helps to conduct research.
— On the forums there are reviews that you are very strict, but humane person. One lady even dedicated after treatment poetry to you, something like: “Doctor, I don’t want to see you again! I was not alone on this couch!” How important is humor during treatment for you and the emotional contact between the doctor and the patient?
It is very important because it is essential to establish peasuful relationships and empathy with every patient. In my studio, in addition to good background music, there are also images of animals and landscapes on screens that I love, and my patients feel good.
— I noticed another regular member of your team — “Hamlet’s Yorick”, who not only carefully watches the visitors of your clinic, but also accompanies you on your courses. What is his real name?
His name is Willy. He was always in my office with other bones, skulls and vertebral columns. He is a part of my studies from university and postgraduate studies. With the years we need Willy on holidays — for Christmas and Halloween. In some cases, we put a hand on his head, as if he was tired and desperate of too much work. This humor is a bit dark, but a lot of patients like to be photographed against his background and taking selfies, this reduces the seriousness that is present in the studio.
— Who else is on your team who the patients don’t see? I’m asking, because the device that combines orthodontics and gnatology that you invented is called STEVI, a name that comes from the surnames (Stefanelli-Viglioli) …
My dental technician Massimo Viglioli has been with me for twenty-five years. He develops all my functional devices, including STEVI, which is the variant of the ALF system and was invented by me and Massimo. We are very proud of the work that has been done over the years, and Massimo is almost always present with me on the courses and he also sometimes exposes the practical constructive part of the devices. I would call him a friend and an exceptional technician. Having a good technician is a fundamental part of our secret team.
— Until recently, you taught at the University of Genoa. What course did you teach there?
It was masters in posturology and clinical orthodontics, a complete master class with many colleagues from other disciplines, orthopedists, speech therapists, etc. — all in function and correlation with the posture. The course has been successful, but due to bad publicity it’s currently suspended, so let’s see what will happen to it in the coming years.
— You have already published five books, and the book “Craniodonzia: Il sistema ALF” currently has no analogues in the world (it describes the process of construction of the device for specific cases of cranial deformations and the effect of such treatment till the feet). How long have you been collecting materials for this book?
I wrote “The ALF System” for one year, but practical knowledge was collected there for the entire period of my work. I wrote these books to give guidelines to my colleagues, something to which they could refer in the field of orthocraniodontics. And, after two books on the theory «The ALF System» is applicable in your own practice.
— Each chapter in this book about craniodontics is preceded by a philosophical thought. Which one is your favorite?
I think this is not very philosophical, but my life position in general, applied above my profession, is “don’t do to others what you don’t want done to you”. It’s simple, but very valuable, as I teach and treat my patients with devices and techniques that I would apply to my children and myself. Sometimes it is easier for the doctor to separate himself from the human side because it makes his work easier. But, being a patient myself, I can feel a more human and sensitive touch to the patient in my chair.
— Your son Alberto works with you, helps during your conferences and courses, you share a passion for singing and guitar, and even performed together on stage. As I understand, he is not only your son, but also is a companion and a friend?
After graduation, my son plunged into the world that I built, and I believe that the passion for music, the motors and dedication to the family inside and outside our studio are teachings that I unintentionally transmitted to him. I am happy that he is moving forward what I started many years ago with the same dedication and curiosity that I had.
— The guitar, love to drive on a bike — what else interesting people reading this interview should learn about you?
I’ve had so many passions in my life, but the love of music, I think, was the most important. In the end, part of my studies was paid for poorly paid evenings in the seventies. I had a band where I played the guitar, and I never stopped playing it. At one of the last concerts I even wore a T-shirt with the words «I work as a guitarist and hobby dentist». I would say it gives an idea of how much I love playing and music.
— You made your professional choice thirty years ago. If you would have a chance to go back in time, would you like to change something?
No, I would not change anything. Regarding the profession, I think I made the right choice. My patients are happy and grateful, and I think this is the best feedback to see if you have done a good job. Patients come to me from all over Italy, and even some from Europe too, usually after long medical pilgrimages from various specialists, and when we can stop this endless pilgrimage, all my employees are happy and know that they have done a good job.
— Dr. Stefanelli, thank you for the very interesting interview. Finally, I would like to ask you to give some wishes to young craniodonts, dentists, osteopaths, posturologists, orthopedists and other specialists.
Thank you. The advice I give to my colleagues and specialists from other fields is to be curious, not to stop studying and always ask questions. Do not marry only one philosophy because it is imposed by universities or the market. There are exist the answers, just search and have the desire not to be afraid of difficulties or what is considered impossible.