written by Jimmy Kilimitzoglou, DDS of e.s.i. Healthy Dentistry
In anthropology we move back into the past and study skulls of ancient man in order to learn more about ourselves as a species. When you look at cavemen, they ended up having 32 teeth, perfectly straight, never having braces, never having crowding, never having sleep apnea. You look at cats and dogs, you’ll find the same thing. As a matter of fact, crowding was never noted until about 500 to 600 years ago. The noble aristocrats that could afford softer, fancier foods ended up not stimulating their jaws, teeth, and muscles of the mouth. The result was crowding and crooked teeth. It ends up that hard foods started at an early age stimulate the lips, cheeks, tongue, and teeth in a way that allows for proper growth and development and perfect harmony leading to straight teeth. The foods that were available in the earlier days where of hard consistency and it promoted exercise of the oral musculature. Like any muscle in the body the principle of use it or lose it still applies. Therefore, if the lips and tongues are not stimulated they end up atrophying.
That means we lose muscle tone in certain muscles that are not properly stimulated. The healthy pressure of hard foods allows proper tension and resistance of muscles, increase blood flow to those muscles joints and bone and ligaments. Hyperactive lips and a hypoactive tongue results in retruded teeth as they incline in words. This crowding in the early dentition discourages growth and development of the jaws and does not allow for permanent teeth to come in to the mouth and then aligned fashion.
When we feed infants a completely liquid to soft diet we don’t help them with their oral musculature. Conversely, we encourage weaker muscles for chewing and swallowing. Hundreds of years ago babies would gnaw on ribs, beef jerky, berries, nuts and vegetables without ever choking or having abnormal jaw development. The tongue, pharyngeal constrictor muscles, cheeks and lips were accustomed to the tough consistency of the food that was available to them. If we introduce children to these types of foods we would benefit their future development.
For parents who are nervous to try that, there is an appliance that resembles a net where these tough foods can be placed so that the child can get used to the consistency and strengthen the swallowing muscles. Urge parents to allow their babies to eat these foods and reassure them that they will not choke. Even for adults, when we exercise, and workout in the gym, we end up clenching, grinding and stimulating our teeth, gums, ligaments, jaw muscles, and everything is in perfect harmony. These motions keep the mouth healthy, stimulated, they increase blood flow and maintain our teeth in the proper position. Who would have thought that exercising can maintain your straight smile!
When children are not evaluated for this orthopedic development and eventual orthodontic condition, problems can potentiate. There are a lot of children who have constricted Airways, a forward head posture, a retruded mandible, narrow nostrils, and narrow palates. A pacifier is one of the biggest culprits that contributes to abnormal jaw development. It encourages an open bite and significantly stunts the growth of the palate or maxilla. It promotes very narrow arches which in turn constrict the airway. There is limited room for the tongue and pushes it to the only direction it can go; back to the airway causing partial obstruction. The palate maybe the roof of the mouth but it is simultaneously the floor of the nose.
Therefore, if the palate doesn’t develop into a broad arch, it in turn creates a narrow nasal cavity. This makes it very difficult for the child to breathe through their nose with a narrow nasal pathway and a big tongue that squeezed into the back, the child is forced to extend their neck forward in an attempt to get more air flow into their lungs. This forward head posture can create neck and back problems. These children end up getting decreased oxygen intake which translates to kids that cannot focus, or irritable, emotional, and underperform in school. Many times, these children are diagnosed with ADHD and the physicians prescribe medication for it. The true issue however is lack of proper oxygen. The children end up not performing well in sports and develop social issues. It ends up being a vicious cycle where more drugs are prescribed and the children still cannot get proper sleep and oxygenation.
Another significant symptom in the recognition of this problem is Venous pooling under the eyes. When a child has purple, dark circles under their eyes it’s an indicator of low oxygenation. The treatment for this is expansion of the maxilla. The age group would be anywhere between 5 and 10 years of age. Early detection and early intervention is the key. One appliance that is commonly used is a rapid palatal expander which provides orthopedic treatment through the use of teeth. Often times within 2 months the palate is expanded in these growing individuals, the teeth are on raveled, the nasal passage is widened, there’s more room for the tongue which can move forward freely, the airway is enhanced, the head posture is in a more normal position and the patient can breathe significantly better.
One analogy that I use is to imagine 20 people in one small room. If you knock down a wall you effectively why then that room and the people can all fit. This is better than taking out two to four people from that room. In the past, a widely accepted orthodontic practice was to extract for premolars and retract all the teeth back instead of expanding. The result was a more prominent chin and nose. This is sometimes referred to a witch’s nose and chin. You can imagine that this type of treatment permanently locks a patient into a more back position which compromises the airway. The key is to identify the real problem and create a functional solution.
Sometimes it looks like the upper teeth are too forward but if the maxilla is wider and more forward the mandible will follow. A more contemporary, natural orthodontic philosophy is functional Orthodontics. Through the use of functional oral appliances, the cheeks and lips are kept away from pushing teeth in, and restricting the expansion of growth out words. Teeth are then naturally encouraged to be aligned by the function of the tongue and teeth. The result is a more rounded Arch form, a broad, aesthetic, functional smile that feels in the lips, buccal corridors and proper lip support.