Straight Talk About Crooked Teeth

STRAIGHT TALK ABOUT CROOKED TEETH

The Lauson System: Ten Keys to Facial Harmony Key #1: Unobstructed Nasal Breathing

Unobstructed nasal breathing is the number-one key because a person’s quality of life is so dependent on it. This is paramount in having normal facial development, and so many health considerations require it that it is almost impossible to overemphasize its importance. Obstructions, for whatever reason, must be evaluated and eliminated. Without elimination of the obstruction, mouth breathing can result and will lead to many unnecessary problems, including poor facial and dental development. The primary causes of nasopharyngeal obstruction are allergic rhinitis, deviated septum, underdeveloped maxilla, and obstructive tonsils or adenoids.

Key #2: Correct Adverse Oral Myofunctional Habits

As many as 3 out of 4 children have adverse oral myofunctional habits.

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An oral myofunctional habit is anything that places abnormal pressures within the oral cavity and therefore can influence facial growth in a negative way. The most common is mouth breathing, which causes the tongue to rest low in the mouth and takes away the normal simulative pressure in the roof of the mouth to create normal upper jaw growth. The underdeveloped upper jaw is almost always responsible for developing malocclusions, requiring orthodontics. Other oral habits that are destructive include thumb and finger

sucking habits, lip biting, and chewing on objects like pens, pencils, or even ice.

Key #3: Treat as Early as Possible

Eighty percent of children will need orthodontics at some point in their lives. AOTMJ's  philosophy is to treat as early as patient cooperation can be established. As explained earlier, malocclusions needing correction are mainly the result of poor nutrition and poor oral myofunctional habits. Since there is abundant available information regarding nutrition, the purpose of this book and AOTMJ's treatment is to inform the parent about the effects of poor oral myofunctional habits and how, with proper guidance, they can be corrected so more ideal facial development occurs. The earlier these habits are corrected, the more ideal the result. This concept is well explained earlier in this book.

Key #4: Fully Developed Upper Jaw (Maxilla)

The upper jaw holds the key in many ways to facial beauty and proper function of the lower face and teeth. It should be wide and full to accommodate all fourteen normal teeth (excluding third molars) in proper alignment and provide proper lip support. When the patient is giving a full smile, he or she should not show an excessively gummy smile or expose dark triangles between the teeth and the cheeks. This result can be accomplished with slow maxillary expansion (SPE), as the cranial sutures, including the mid-palatal suture, remain viable throughout life.

The following case is a good example of the use of FFO to expand the maxilla to an ideal shape to create a handsome, movie star smile. This patient was 16 years old when treatment began. He had substantial crowding of his front teeth. His upper jaw was narrower than what is considered ideal. Traditional orthodontics typically would have recommended the removal of four first bicuspid teeth and then straightening of the remaining teeth with braces. The recommendation might also have been made to use maxillofacial surgery to achieve the desired result.

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Pretreatment photos showing crowding and narrow arches

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Photos at completion of treatment

After treatment was completed, the patient’s smile was full and confident. This result would not have been possible without the expansion of the arch forms.

Key #5: Proper Positioning of Lower Jaw (Mandible)

The lower jaw should be in balance with the upper jaw. The most common imbalance is retrusion of the lower jaw, created when a narrow upper jaw forces the lower jaw back, trapping it in a recessed position, resulting in undesirable overbite and overjet. This malocclusion can lead to TMJ dysfunctions, forward head posture, or even obstructive sleep apnea. With lower facial balance, teeth can be positioned ideally and facial harmony can be established.

Key #6: Healthy TMJ Function

The TMJ, or temporomandibular joint, is the joint on each side of the face in front of the ears. It is used for speaking and eating and is the most complex joint in the human body.

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Normal anatomy of TMJ

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Dysfunctional TMJ anatomy

The TMJs become dysfunctional when they become strained because the positions of the teeth are forcing the lower jaw out of alignment and into a pathologic position. The TMJs are the cornerstone of a proper bite and must be corrected if dysfunctional. If not, a myriad of symptoms, such as headaches, facial pain, clicking jaw joints, and problems with the eyes and ears, will appear and worsen over time. To establish a healthy balance for the chewing system, function of the TMJ must be taken into consideration and corrected if dysfunctional.

Key #7: Ideal Head Posture

Proper head posture is very important concerning a person’s neck and back health. Teeth and jaw positions profoundly influence head posture. If proper balance is achieved with the first six keys above, then head posture can be positively influenced. As an additional benefit, further care from a neck and back doctor or therapist also can be more effective.

Key #8: Avoidance of Obstructive Sleep Apnea

Obstructive Sleep Apnea (OSA) is a serious medical problem affecting as much as 20 percent of the population. It can lead to heart disease and even premature death due to strokes, heart attacks, or choking in the night. Recent studies have even shown a link to cancer. OSA is a restriction of airflow while a person is sleeping. This causes a person to stop breathing during an apnea event. The most common reason for OSA is when the lower jaw is recessed too far back. Another common contributor to this problem is a narrow upper jaw. By properly following the keys listed, the possibility of OSA can be reduced in severity or avoided altogether.

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Normal

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Snoring

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Obstructive Sleep Apnea

Key #9: Ideal Lower Facial Symmetry

Facial asymmetries can develop because of a mismatch of the upper and lower jaws and dental malocclusions causing the lower jaw to shift to one side or the other. A narrow upper jaw is almost always the source of this type of asymmetry. A correction should be made early in life or complications such as a TMJ dysfunction may occur. The chapter on this important key shows how easy it is to misdiagnose this problem, which can result in unnecessary surgeries used to correct an asymmetry. Early correction of asymmetries is highly recommended.

Key #10: Optimal Teeth Positioning

Crowding or spacing of front teeth is the most obvious that an untrained eye can easily see. However, for the trained orthodontist or dentist, problems that are less obvious also must be addressed. These can be things like crossbites, overbites, and underbites. Decades ago, Dr. Larry Andrew’s “6 Keys to Normal Occlusion” established a guideline for dental specialists to use regarding this topic, assuming the full complement of twenty-eight teeth is maintained and that permanent teeth are not extracted during orthodontic treatment.

The Lauson System: Ten Keys to Facial Harmony was developed over the last thirty years in private practice. By following these goals, it is my belief that the healthiest, most beautiful, and stable results can be achieved while sparing the patient permanent teeth extractions and surgery.

Aurora Orthodontics & TMJ

  • Aurora Orthodontics & TMJ - 14991 E. Hampden Ave., Suite 300, Aurora, CO 80014 Phone: (303) 690-0100 Fax: 720-881-7406

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