Monday, May 16, 2011

Epigenetic Orthodontics: Building Better Bites, Faces and Health?

Wow, I didn't mean for so much time to elapse since the last post, but I've been putting a lot of time and effort into this one and I'm really enthused to bring you this information. This is a bit of a continuation of the theme presented in my last post. In it, I touched on how pre- and postnatal nutrition affects our dental and facial development.
I've recently done some research into the surprising and far-reaching effects of poor jaw development, as well as what can be done once you already have poorly formed facial bone and jaw/dental structure and it's been fascinating. I've included the interviews that I listened to so you can also listen to the pioneers in this innovative field.
I'm not going to get into the nutritional aspects of what creates poor development because so many others have already covered that subject. In this post, we will deal with the side effects of poor bone structure and how we can correct it.

For a really thorough look into the effects of nutrition on our teeth and facial structure, check out Stephan at Whole Health Source's excellent 9 part series.

You can also read Weston Price's classic "Nutrition and Physical Degeneration" online for free.

Far-reaching effects:

While it might seem like a chiefly cosmetic concern to have crowded teeth or an overbite, it goes so much deeper: a poorly formed maxilla (upper jaw) also affects the eye sockets that support and shape the eyeball (leading to things like astigmatism and near-sighteness), it supports the nasal airways, leading to deviated septums, asymmetrical noses, snoring and sleep apnea (a contributing factor in childhood ADHD, by the way). What if so many sleep issues are really due to our poorly formed airways? The implications are sort of staggering.

Here's a picture of the facial bone structure. Note how the maxilla (in green) supports the underside of the eye sockets, as well as the floor of the nasal passages. It also forms a good portion of the cheekbones. Do you know anyone with droopy lower eyelids and visible whites under their irises? They have an underdeveloped maxilla. Someone with a nose that leans to one side? One side of their maxilla is less developed than the other. Someone with flat, saggy cheeks? Again, an underdeveloped maxilla.

So, what about an underdeveloped lower jaw? Compromised airways and/or a tongue that rests too far back in the mouth from an underdeveloped lower jaw can lead to a forward head posture, which helps to open the airways. However, this can throw off the alignment of the spine (and whole body), leading to headaches, bruxism (teeth grinding), neck/shoulder tension, lower back pain and fatigue, to name just a few things. Also, when your bite doesn't line up properly, the teeth can be subject to uneven patterns of wear.

The forward head posture also causes a tendency of the Sympathetic Nervous System to be overactive. You've probably heard of "Fight or Flight"- the state in which you're on high alert and are secreting stress hormones like adrenaline and cortisol. The posture of your neck can keep you in this state (here's an article detailing Fight or Flight and how to deal with it).

In an interview I listened to with Dr. Richard Quinttus, who practices Oral Systemic Balance (OSB) therapy, Dr. Quinntus talked about how blocked airways and poor tongue posture can trigger excess adrenaline. He says that many people who feel the need to run to get the famed "runner's high" may actually have high adrenaline and airway issues (the running helps to open their airways and forces them to intake more oxygen), as well as poor sleep quality.

When the mandible (lower law) is underdeveloped, TMD can be an issue, as well as headaches. The development of the facial support structure also affects hearing. One of the most striking examples of how a malpositioned temporomandibular joint can affect someone is demonstrated in the work of Dr. Brendan Stack, D.D.S. who has found a remarkable way to treat Tourette's Syndrome by repositioning the jaw!

As you can see, it goes so far beyond just the aesthetic aspects. So, what can we do if we have facial structure that didn't exactly develop to its full genetic potential? This is where Epigenetic Orthodontics comes in.

Epigenetic and Functional Orthodontics

Epigenetics: In biology, epigenetics is the study of changes in phenotype (appearance) or gene expression caused by mechanisms other than changes in the underlying DNA sequence, hence the name epi- (Greek: επί- over, above) -genetics.

Epigenetic Orthodontics (also called Functional Orthodontics) is a specialized field in dentistry dealing with correcting the narrow palates, poorly aligned bites, facial asymmetries and small jaws that so many of us are afflicted with (it can also deal with crooked teeth). It takes a look at where our development went wrong and looks at the dental structure in the context of the whole face and how it all functions, rather than just looking at whether or not the teeth are straight.
The objective is to allow the craniofacial structure to develop in the way they would have, had our gene expression been optimized. Epigenetic Orthodontics stimulates a person’s genes to correct and straighten the teeth without the use of force brackets, affecting craniofacial, dental, and airway structures so that natural developmental processes are evoked by the use of orthodontic appliances. In simpler terms, the appliance makes room by causing new palate and jaw growth and the teeth naturally move into a healthy position.

Unlike traditional orthodontics, where the main objective is to simply straighten the teeth at all costs, (how many of you had teeth yanked before you got your braces?), it addresses the foundational issues. It's like the difference between "flipping" a house by doing cosmetic fixes and doing a real renovation, addressing the structural issues. Other issues with traditional orthodontics are that the teeth often shift and somewhat revert back to their original positions, unless a retainer is worn and the shape of the face and profile can be negatively affected due to extractions and pulling the upper row of teeth back, creating a pinched appearance or a receded chin.

Epigenetic Orthodontics uses removable palate expanding retainers, usually worn at night, that use light biological force, making it a much more comfortable process. It's not only more comfortable, it's also safer, as high forces from traditional orthodontic palate wideners can exert unhealthy pressure on the cranial bones (even affecting mental function in children.) There's no way you can put s much pressure on the cranial bones and NOT affect brain signaling.

The result of treatment is horizontal bone tissue growth resulting in better facial symmetry, nicer bone structure, healthy orthodontic alignment, better airways and better TMJ alignment.

Identical twins. The one on the right received palate expanding treatment and the other did not. Note the drastic difference in facial structure! The twin on the right has a much wider face- an example of proper horizontal growth, rather than the vertical facial growth that is so common these days.

Getting Treatment
[Edit: you can find lists of practitioners on each of the treatment option sites listed below.]

It used to be thought that you could only change the palate during childhood, but it's now been demonstrated that the palate can be expanded in adults even into their 70's, so there's hope for all of us. There are a number of different orthodontic appliances being used to accomplish adult palate expansion:

The pioneer in this still relatively obscure (at least in the U.S.) field is Dr. G. Dave Singh, DDS, creator of the DNA Appliance. You can listen to an interview with Dr. Singh. The DNA Appliance is worn while sleeping and works with the circadian rhythms (night is when most of the body's repair goes on).

Another appliance also worn only at night is the Homeoblock appliance, developed by Dr. Theodore Belfor, DDS. This was used in the treatment of the young man pictured at the top of this article (this change is after only 6 months of treatment). You can see that his facial structure became wider- that's what horizontal growth looks like. There are some fascinating videos on the website of people's faces morphing from "before" to "after" and some of the facial changes are absolutely amazing. Definitely check them out!

Here's a woman after 6 months of treatment. You can see the improvement in symmetry- the right side of her face is now less drooping and she almost looks like she's had a subtle lower face lift. Her cheekbones are slightly more prominent and less flat (and no, it's not just because she's wearing makeup in the second shot):

More effects on symmetry:
After 4 months of treatment:

There are many skeptics in the dental community claiming that Functional Orthodontics don't actually change the bone structure, but when you look at the cases presented in the Facial Development Newsletter, complete with computer imaging of areas of bone growth and expansion, it's pretty clear that they do indeed change bone structure and increase bone growth.

A slightly different type of orthodontic appliance that is less bulky, but worn continuously is Advanced Lightwire Functionals (ALF), developed by Dr. Darick Nordstrom.
Dr. Raymond Silkmanm, DDS, who uses ALF appliances, did a fantastic 2 part interview that I highly recommend listening to. Here's Part 1 and Part 2.

What about treating children?

Early Orthotropic growth guiding treatment during childhood, when development issues first surface, is ideal, but treatment can be done at any point during childhood, usually avoiding the need for braces. There are early signs that parents can look for to determine if their child's jaw and bite are developing improperly.

Here's an example of Orthotropic-guided growth:

So, I've given you an overview of the effects of poor jaw development and some of the treatment options. I hope to try this technology out for myself one day, as I could definitely benefit from bite correction and better airway development (and, let's be honest, more sculpted cheekbones sound pretty good, too!)
There's no one currently in my area (I'd have to go to Memphis or Knoxville) but in a few days, Dr. Belfor is speaking at the Sacro Occipital Technique Organization's annual conference, right here in Nashville. Fingers crossed that some local dentists attend his lecture:-)