Concepts in Orthodontics
The concepts and appliances of Orthodontics
1- The first function of the jaws is to support our airways and breathing pathways.
Sleep researchers sleep neurologists, sleep respirologists and interested dentists are all now working
together to redesign how we repair damaged airways and grow them better in our children.
2- The second function of the jaws is to support breastfeeding.
The organization Physicians for breastfeeding really understand that the first and best health measure
is breastfeeding for the health of both the child and the mother. This is where orthodontics begins in
nature. All mammals must breastfeed and only the human mammal has willingly changed its feeding
practices and its food supply. We have made a big mistake! We and our children will all suffer from this
mistake until we change our feeding habits back to imitating nature.
3- The third function of the jaws is to support good erect vertical upright head and neck
posture and function.
4- The fourth function is to enable speech which is also an airway function and unique to
the human mammal.
It also means we can snore and choke because our swallowing of food and breathing of air must share
on tube for a short time and herein lies the dilemma. Evolution has given us the capacity for speech and
the new super brain for speculation and spirituality but snoring and choking came with it.
5- Jaws are also useful for chewing and all the other minor functions that we invent.
Like hanging from a rope, cutting thread or fishing line and so on.
For all orthodontic practitioners to be our best we must broaden our patient’s jaws and our personal outlooks to be the best possible imitators of Mother Nature. That is copy the best in facial growth, airway development and joint and muscle function that is found under ideal conditions in Mother Nature. We must encourage wider jaws, healthy jaw joints and ideal growth of the airways in our younger patients and try to restore ideal function in our older patients.
Our ideals must be a beautiful broad maxilla including a well developed or ideal roman arch form of a well rounded maxilla .The maxilla or upper jaw must have the correct osseous or cranial relationship to the temporal bones and the hyoid bone as well as the cranial base bones which are the nasal bones, the sphenoid bone and the occipital bones. Remember all cranial bones have micromotion and they are plastic they are not skeletal rocks. Human jawbones are like an airplane in their movements in that they can “pitch, roll or yaw “and this is powered by the muscles and limited by the sutures or ligaments that are attached to them . Don’t forget the maxillary-mandible complex is unique in that its master joints the left and right jaw joints are the first to be mature for breastfeeding, breathing, and expression in the growing fetus – baby and thus they are our most embryiologically, orthopaedically and neurologically profound joint systems in the human being. Micro trauma and macrotrauma also can also unfortunately move and break bones as we all know, but we are just talking normal day to day function.
The moving condyles of the mandible must be ideally located against the left and right temporal bones in dynamic function so that the articular discs are ideally interposed in all functional movements between the mandibular condyles and the glenoid fossae of the temporal bones. Thus in more detail the articular discs have their concave superior surfaces functioning smoothly and intimately against the posterior slopes of the articular eminences of the glenoid fossae, and their inferior concave surfaces of the articular discs are intimately in contact with the anterior –superior sloping surfaces of the moving mandibular condyles.If we don’t achieve these basic relationships then the condyles will be dislocated off the disc and relocated pathologically against the bilaminar zone of the retrodiscal ligament part of the time or all of the time.(Hey now my clicking jaw has stopped clicking which means it is either corrected which is good or permanently off the discal tissue which is bad)
These ideal jaw growth and ideal jaw function principles are the driving concepts behind what we call functional orthodontic appliances to grow better jaws and to correct malfunctioning ones. Remember these jaw bones are the most functionally mature in other words the most neurologically and embryologically advanced at birth ie they are derived from neural tube tissue and neural crest cell tissue. Thus these are the most advanced bone and muscle systems in our body yet they fall under tooth tissue influence after 6 months of age and this can prove to be a sabotaging influence from an embryologically inferior tissue. So the enemy can be ‘TOOTH ENAMEL’ “ which is merely of ectodermal origin. This inferior tissue (with no nerve tissue supporting it ) can completely disrupt the good function and growth of these critical facial bones or jaw bones and completely the ideal functional growth of these facial bones so that our airway, our chewing our appearance and our jaw joints suffer for a lifetime. No where else in human natural development has Mother Nature made such a huge blunder. Imagine the children (the teeth) telling the parents (the jaw joints) what to do! That should not happen in your family or mine. Thus the teeth should not dictate to the jaw joints!
To guide and correct these problems dentists world wide have worked for almost 200 years to design guiding and corrective appliances to keep Mother Nature on track so that the jaw bones grow to their fullest extent and the jaw joints are kept in proper play against the cranium. The upper jaw bone is often underdeveloped in modern humans. It is called the maxilla. We say our office theme is to maximize the maxilla so the lower jaw (the mandible )is also free to grow to its genetic blueprint potential.
This is called “Max the Max!” and “Max the Man.” And thus “Max the Airway”
This is the most important orthopaedic and neurologic care that your child can receive at a young age .This is why early swallow diagnosis and jaw growth development must be monitored from the earliest age possible. Let us now look at some of these appliances and study also the inventors and their ideas.
Examples of the Old School of Functional Appliances are:
The Schwartz Appliance to expand the upper jaw developed by Dr. Schwartz
The Bionator to create good mandibular-maxillary growth and function of the swallow and the jaw joints
The Frankel Appliance to encourage normal bone growth by controlling the neuromuscular envelope of facial muscles. developed by Dr. Frankel
The Saggital appliance to encourage anterior posterior arch development ie create more arch length
Examples of the most recently developed new functional appliances are:
The DNA appliance developed by Dr. David Singh.
The Homeblock appliance developed by Dr. Ted Belfor.
The Clark Twin Block and The Transforce appliances developed by Dr. William Clark of Scotland.
The MARA (Mandibular Anterior Repositioning Appliance) developed by American Orthodontist Dr. Jim Eckhart of California and orthodontist European Dr. Douglas Toll of Germany.
The Bioblock Facial growth system called Orthotropics by Dr. John Mew of the Purley school of orthodontics in England and now his son and orthodontist Dr. Michael Mew the next generation.
The Tandem appliance developed by Dr. Klempner to correct young Jay Lenos or class three patients
The Biofinisher by Dr. Jack Lynn to hasten vertical growth in the posterior arch area for bicuspids or promolars and molar movement in orthodontic or tmj patients.
The Spahl Split Vertical appliance by Dr. Terrence Spahl.
The Galella Tongue Training Appliance by Dr. Steve Galella of Tennessee to correct a tongue thrust or poor tongue swallowing function and open bites from tongue malfunction or thumb sucking.
The C.D. Distalizer or C.D. Anterior Remodeler These appliances were developed by Dr. Peter Ching.
The Ultrablock appliance is used to develop the maxilla and good maxilla to mandible relationships.
The key for new patients to understand what is happening to modern orthodontic practice is to embrace the concept of Integrative Medicine as taught by advanced forward thinking Medical Doctors.
Today orthodontic or rehabilitative dentistry can be and has to be multifactorial in its approach to pain or orthodontic patient.The easiest way to break it down is to divide it into 5 parts
1- is the airway compromised? Will our treatment impede the present or future airway in any way?
Mouthbreathing or Snoring isues? Rule out any autonomic nervous system issues using
2- Are the jaw joints functioning well and comfortably and correctly positioned against the the upper jaw
and the cranial bones (the temporal bones)
3- Is the maxilla and the mandible well developed and well positioned (the lower jaw which can be
compared to an airplane that is subject to 3 movements within the greater context of the skull .It can
pitch, roll or yaw or any combination of these 3 movements). It is key to human health to have the
maxilla, the upper jaw, properly developed laterally, anterior-posteriorly and on an even plane parallel
to the ground . If not then the cranial dentists and the world’s osteopaths of this world will tell us that then there are going to be cranial strains and imbalances that
should be addressed? (I love osteopathy and always tease my osteopath collegues by telling them that
they are the only profession that was Still born.)
4- Are the muscles and the whole neurovascular trigeminal nerve complex functioning well Are there any
neuromuscular habits like clenching or grinding which can be distinctly different than grinding. Are
there any muscular trigger points referring pain .Are there any neural deficits (the three minute
cranial nerve review)
5- Are the teeth and arches well aligned? Is there a deep bite? Are there any missing teeth Is the case class
1,2 or 3? In this case a class 2 division deep bite case, are there any periodontal (gum) problems? In this
case we need to maximize the use of the waterpik, sulcabrush and do some intense cleaning and 1064
nanometer laser gum therapy at the end to get the gums in top shape and eliminate the 4 mm gum
pockets thst we have that we have charted. This is very simple with the periolase and the
Iplus waterlase , root planning and the topical antibiotic irrigation system that we employ at the
Talk to our staff and our patients about the revolution in managing gum diseases. That is another whole story in itself.
The key steps when you move from a class 2 to a class 1 jaw posture is holding the class one position while we are doing the treatment and then retraining the neuromuscular system to think class one when you eat sleep and swallow. We observed that you always speak sing or yawn in a neurophonetically correct position which you can usually test for simply by using the sounds of “MISS MISS” or “boston” or counting 65 to 76. This is classified as The best breathing Bite or a super class one speech or chewing position. That bite is determined by optimizing the airway or using the speech function portion of our brain as a vital clinical clue to where to finish our orthodontic and prosthetic cases.
Note millions upon millions of dentures have been made in this posture and are still made successfully every year by dentists and prosthodontists around the world for patients who have few or no teeth and the same rules of jaw posture and a physiologic bite in centric relation apply to patients with no teeth or misaligned teeth or many missing teeth. This good jaw posture concept is where dentistry and sleep medicine is heading and a good airway. The key in orthodontics is starting with the end in mind to finish close to a good class one good airway posture. Thus all dentists should have the same eventual end point to our treatment. The key here is close communication and good cooperation with our medical colleagues to ensure the speech position and the good airway position is always respected by all clinicians. We call this the “ Best Breathing Bite”.)
For you the patient understand that dentistry is changing its concepts of how we determine a good bite to harmonize with what is a good airway. Keep your appointments and report any problems at once i.e. a headache or a slipped wire or sore spot on an appliance. My staff and I have extensive training and skill and we are highly motivated to have our patients end up with a winning smiles and comfortable jaws and muscles. If you ever have a problem or question just call us and talk to us about it.
In many class 2 cases (deep bite and posterior bites) because of bad chewing and swallowing habits and because of the extensive intense clenching and grinding habits you will need to be retrained to a physiologic good breathing bite. This comes only with time and practice and you will initially get the position temporarily but then lose it as we move teeth and then with time and practice you will finally have a 100% class one jaw and bite. A night time bionator or a tooth and jaw positioner called a Greenie 4 will help you learn to retrain bad swallowing movements and poor chewing positions during the day and also control the nighttime clenching and grinding associated with a class 2 jaw posture . The key at the end of treatment will be to retrain the muscles with a sleeping appliance at night. Be patient we will retrain your jaw muscles, improve your snoring, your airway and your swallow, but it requires a motivated responsible patient to learn everything we have to teach you.
Anthropologists and archeologists can see that our changes in breast feeding and diet and the use of artificial nipples has contributed to the shrinkage of the human face and our sedentary lifestyle has meant that we are not as well muscled as our forefathers. The key to the head and face shrinking is the smaller upper jaw and they are really narrow now and have steep palate thus a small nosebox and poor capacity to breath via the nose.
We are all in this thing called life to live, love, learn and leave a legacy. We want our children to live well and have healthy happy prosperous lives but what we have learned here is that they will be handicapped if they have a small upper jaw and a displaced lower jaw and a poor breathing system. We have to change how we do diagnosis in dentistry and how we do orthodontics to meet the problems of the “shrinking head and face”. I know my colleagues and all the 60 doctors with whom I have trained in orthodontics are ready to change the world of orthodontics.
The key now is to get the attention of all the families who want the optimum in growth for their children to study the issues and grow their jawbones and airways with us.
Are you up to the challenge?
When you are looking around for the right orthodontist, you need to be specific about who the dentist will treat. You might be looking for an orthodontist for your child because you don’t want him or her to grow up with ugly teeth. Or perhaps you are an adult with teeth that badly need orthodontic treatment. Whether the patient is a child or adult, you can find a good orthodontist to help you.
There are various ways that a patient will need orthodontic treatment. The most obvious one is that the patient has teeth that are growing crooked so the dentist needs to intervene. Or perhaps the teeth of the patient are no longer growing but the bite and smile need work. Some people think that orthodontic work is only a cosmetic procedure but actually crooked teeth, gaps between your teeth, and the wrong bite can also affect the health of the patient. For example, a patient with crooked teeth might have food particles stuck in between the teeth but cannot remove these particles through brushing alone. A patient with a bad overbite may not be able to eat properly especially when biting into food. These are just some of the ways that you will need help from an orthodontist.
A good orthodontist will be able to help you by identifying problems with your teeth that he thinks he needs to work on. Some orthodontists specialize in working on the teeth of children and teenagers because the teeth and jaws of these two age groups are usually still developing and require special treatment. Other orthodontists focus on serving adult patients. The advantage with working on children and teenagers only is that the dentist will be able to arrest the growth of crooked teeth so they can be straightened with retainers or braces. On the other hand, your orthodontist might focus on adults only because they are easier to work on due to fully developed jaws and don’t get frightened easily by machines that an orthodontist uses. There are also orthodontists who can serve both children and adults. So you will need to specify what type of patient you want the orthodontist to work on.
Your orthodontist may be able to provide you alternatives to the usual metal wire braces if you do not want other people to notice your braces easily. For instance, you could opt for invisible braces that are connected to the back of your teeth rather than the front. This way you still get orthodontic treatment but don’t have to be self conscious that others can see your braces. You could also ask if your orthodontist can attach partial braces or make retainers instead.
Take note that orthodontic treatment may cost quite a lot whether the patient is a child or an adult. You should ask your health insurance provider if they will cover orthodontic treatment aside from the usual dental treatments. If the insurance doesn’t cover orthodontic treatment, you may ask your orthodontist if he has staggered payment plans so that you need not pay a lump sum for the orthodontics. If you have a credit card, you can also ask the dentist if that is applicable for his payment. These will help you to shoulder the cost of having orthodontics made and attached to your teeth.
We offer sound orthodontic treatment at our clinic for all types of patients. You can count on our orthodontists to give sound diagnosis of your dental problems and recommend the right orthodontic treatment to correct them. You stand to benefit from our years of training and experience in dealing with problematic teeth. You no longer need to keep looking for a competent orthodontist – do visit us today so we can determine how we can best help correct your dental problems.
You’ll want to learn as much as you can about different orthodontist’s experiences, including their schooling and special training. You want an orthodontist who has the necessary experience and training to quickly and accurately assess your treatment needs.
Do they own their own practice or work for someone else?
If they own their own practice, you should find out how long it’s been in operation. It’s generally best to find an orthodontist who has a well-established practice in the community. It simply makes it easier to trust.
Is the orthodontist certified by the American Association of Orthodontists?
This is crucial. The AAO is the governing board responsible for ethical and practical standards for orthodontics in the United States. It’s a must that you find an orthodontist who is certified by the AAO. Most reputable orthodontist will be certified, so it shouldn’t be too difficult.
Try and think of any other questions that may help you narrow down your search.
Quite a few specializations exist in the field of orthodontics. One orthodontist may focus solely on kinds, others might be more interested in family orthodontics, and still others may narrow their focus down to something like hidden braces for teens and adults. The orthodontists you consult with will depend on the treatment you’re looking for. If the treatment is just for you, it might be worth it to look into orthodontists who specialize in adults. However, a family orthodontist may be a better options if everyone needs work.
If it is discreet options you’re looking for, you’re in luck. Modern orthodontics strives to cater to all needs, and that includes individuals who don’t want their treatment to be noticeable. Devices like clear braces and lingual braces have been around for years. Clear braces function just like traditional steel braces, but they are made of a clear plastic polymer instead of metal. They’re more difficult to notice. Lingual braces are usually made of metal, but they are hidden from sight, since the brackets are attached to the back of the teeth. They’re more difficult to install and work with, so it takes an especially skilled orthodontist to treat with lingual braces. Finally, Invisalign presents perhaps the best form of treatment when it comes to discretion. The system uses clear plastic aligners to gently push teeth into place, and while it won’t work for everyone, it’s a great solution for many adults trying to keep treatment under wraps.
Finding an orthodontist with experience, skill, and the knowledge to accurately and efficiently treat you and your family is essential. At the same time you want to make sure that you find an orthodontist that you actually like, since this professional relationship will likely last one to two years or more. For this reason it’s important that you consult with a couple of different options and find out who you mesh with best. Whether you need braces for kids or discreet braces for adults, you shouldn’t have much trouble finding the right orthodontist.
You know, we all want to look the best that we can. It’s the human condition, after all, and vanity is a big part of the human condition, it would appear. And that being the case, if you want to make sure that you will be able to look your very best, there are a few things that you are going to want to be looking into.
To begin with, you are going to want to make sure that you are taking care to look your best. This means working out from time to time, being mindful of what you eat, things like that. Then, of course, you are also going to want to make sure that you are working to ensure that you will be able to get the most out of your smile, and that is what I would like to talk to you about today; what you can do, with the help of your local professional orthodontist office, to make sure that you will be able to have the best smile that you possibly can. And the fact is that the list of things that you can do to make sure your smile will look its very best is a long list, one that is full of things that will be able to help you to improve your smile and its look. Here are just a few things that will be on that list:
1. Just taking general care of your teeth. I know, this may sound crazy, but if your teeth are basically falling apart, there is not much that anyone will be able to do for them, and that being the case, it behooves you to make sure that you are going to be brushing and flossing them as best you can be, and just generally making sure that you will be able to have a smile that is not falling apart. Seriously, if you end up needing your teeth realigned, there is not much that you can do if they’re basically falling apart.
2. I know that many of you think that the big thing I’m going to talk about is braces, adult braces, teen braces, whatever kind of braces. Right? Well, it will be, but I have something else to talk to you about first. Before you apply anything to the teeth, you are going to need to make sure that you will be working with your local professional dentist to ensure that you are going to be taking care of them, as I mentioned, but then you will find that you are going to need to be sure that you are doing things like, you know, getting your local orthodontist to take a look at your smile. Sounds crazy, but it will make your smile look its very best in the long run.
3. What are the most common methods that you think of for fixing up the alignment of the smile? Chances are that one of the things that comes to mind is the orthodontic headgear, right? And that will make sure that your smile will look its best, sure, but it will also involve a whole lot of hassle, and that being the case, you find that orthodontic headgear is something that, in a lot of cases, people really want to avoid. They do work, they’re just kind of terrible and old-fashioned.
4. Braces. Yes, I knew that we would get here, so don’t worry. Adult braces, teen braces, and even children’s braces, they are common ways to go out and make sure that your smile will be able to look its very best. They have been in use for quite some time, and the truth is that if you are going to go into your local orthodontist office, you are going to be very likely to find that there is someone who will be able to help you with those. In fact, the almost knee jerk reaction to the need to fix up the smile? Braces.
5. Invisalign. Of course, just because braces are common and whatnot, that does not mean that you are going to end up having to turn to them. Indeed, if you are looking to make sure that you will be able to not just fix your smile up, but to fix it up with a minimal amount of hassle, you are going to be looking to something more along the lines of Invisalign, which not just makes your smile look better, but will do so with the most discretion that you possibly can. Something to think about, folks.
And make sure that you keep your smile taken care of. You’ll be glad that you did.