Beautiful ten-year-old Maggie arrived at my office with her sweet mother for Maggie’s FIFTH orthodontic consultation! She had already been to see four orthodontists who all wanted to extract two of Maggie’s upper bicuspid teeth and pull her front teeth back to match her retruded (posteriorly positioned) lower jaw.
Before I even looked into Maggie’s mouth I knew she had some serious problems; the very least of which was the fact that her teeth were probably crooked. Just looking at her face I knew she had a lower jaw that was not growing forward as it should, she had a severely compromised airway which caused an extreme forward head posture and her TMJ’s were severely compromised.
Had Maggie continued down the road she was traveling she would have had a lifetime of problems including neck aches, backaches, headaches and severely compromised facial aesthetics. She almost assuredly would have developed temporamadibular joint dysfunction (TMJD) and sleep apnea. Had she allowed one of those four orthodontists to amputate two healthy teeth and pull her upper front teeth back to meet her retruded lower jaw she would have exacerbated her already diseased condition.
Looking into Maggie’s mouth only confirmed what her face already told me. Her upper and lower dental arches were severely underdeveloped causing severe crowding of her teeth and her lower jaw was misaligned with her upper jaw.
Why would four orthodontists all recommend extracting teeth? I will give the orthodontists the benefit of the doubt and assume that they also offered the option to surgically reposition Maggie’s lower jaw forward. I not only refused to amputate any of Maggie’s teeth but rather I offered to enlarge her dental arches (thus creating sufficient space to align Maggie’s teeth) and also permanently reposition her lower jaw forward; all NON-surgically.
When dental arches are underdeveloped (like Maggie’s were) there is not sufficient room in the mouth to properly align the teeth; but perhaps more importantly, the lower jaw is often trapped well behind the underdeveloped upper jaw and does not grow forward as it is supposed to. This causes a dramatic change in facial aesthetics (and we are not talking for the better) and it also pushes the tongue into the throat, which severely compromises the airway. The reason Maggie had such an extreme forward head posture is so she could continue to live. She was forced to posture her head forward in an effort to breathe! Imagine what it must have been like for poor Maggie to sleep. Many people believe that sleep-breathing problems (sleep apnea) only occur in old, fat men. Unfortunately, there are tons of people walking around with undiagnosed sleep breathing disorders. Maggie was one of those people.
We immediately began treatment for Maggie with a removable appliance that enlarged her upper dental arch, enlarged her lower dental arch and repositioned her lower jaw in a more forward position to match her upper jaw. The appliance immediately allowed Maggie to sleep better, which leads to innumerable health benefits. While Maggie diligently wore her appliance, we gave her several exercises to help improve her posture, tongue position, proper swallowing and proper breathing. We have not finished Maggie’s treatment yet but I thought the changes we have seen in her head position and posture are dramatic, instructive and might help deter someone else who might be contemplating the extraction of healthy teeth in conjunction with orthodontic treatment.
Wishing everyone smiles galore!
Dr. Brad
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