Have you ever wondered why some people develop crooked teeth?
Do you think that it is dad’s sized teeth in mum’s sized mouth or that we are just born this way. Why is it that some people have almost no chin and others have pronounced chins?
The mouth and face is genetically programmed to develop in an optimal and balanced way to give us the best form and function. If the genetic program is allowed to develop to its full potential, the jaws and teeth will usually end up in a straight and uncrowded manner.
However sometimes factors like breathing through the mouth will interfere with this genetic blueprint and the result is the under growth of the jaws. Mouth breathing caused by habit, blocked nose, large tonsils and or adenoids forces the tongue to be displaced away from the roof of the mouth. The tongue is a powerful force in the mouth that will push the top jaw forward and to the sides to make space for it, due to the around 2000 times we swallow a day. However abnormal breathing and swallowing will not allow for this force to be expressed. Normal breathing is completely through the nose day and night and normal swallow is with the tip of the tongue just to the top and back of the upper front teeth in the roof of the mouth curling back and up from there.
An abnormal tongue position forces the lower jaw down and towards the back and could result in further problems like snoring, grinding of teeth and sleep disturbances (sleep apnoea, sleep hypoxia or sleep hypopnoea). Think of this like the need for the lower jaw to be lifted and pulled forward when mouth-to-mouth breathing is initiated in order to get the air past the neck and into the lungs.
There is however good news as these abnormal forces can to a large extend be reversed with exercises and appliance therapy and even better news is that there are appliances available that can remind nature how the jaws are supposed to develop. With children if intervention happens at the right time we may only need fixed braces for a short period after the appliance therapy and even in some cases not need them at all. In adults, the appliance therapy will however lead to the placement of fixed braces after the therapy. The treatment however is not primarily aimed at the very important aesthetics but at the balanced development of the jaws and we like to call it Dental Orthopaedics rather than Orthodontics.
Dental Orthopaedics look at improving the position of the jaws, that will have a beneficial effect on the bite, teeth position, jaw joints and airways as well as the smile. The last procedure we want to do in Dental Orthopaedics is the extraction of teeth as this will result in a still smaller space for the tongue to fit into and have further negative effects on all these areas we seek to improve.
A clinical assessment will allow for a treatment plan and the following is just a guide as to some of the treatment that may need to be applied and is general in nature.
This lovely patient, a medical professional, has had longstanding jaw clicking and jaw joint and facial pain. She also suffered with on average 4 migraines a month. The assessment revealed that this patients symptoms could be attributed to mid face deficiency that has resulted in her lower jaw being forced back compacting her jaw joints causing the pain and clicking.
The treatment option decided upon was upper jaw development and lower jaw de-compaction to allow for better movement and better breathing. We did 10 months of jaw development and this patients jaw has stop clicking and there is no jaw joint pain. Also her migraine frequency has decreased significantly to 1 migraine in 8 months. She also reports better sleeping as her breathing has improved and she feels less pain.