For those who didn't want to wade through the entire nerd safari, I offer a simple summary.
Our ancestors had straight teeth, and their wisdom teeth came in without any problem. The same continues to be true of a few non-industrial cultures today, but it's becoming rare. Wild animals also rarely suffer from orthodontic problems.
Today, the majority of people in the US and other affluent nations have some type of malocclusion, whether it's crooked teeth, overbite, open bite or a number of other possibilities.
There are three main factors that I believe contribute to malocclusion in modern societies:
- Maternal nutrition during the first trimester of pregnancy. Vitamin K2, found in organs, pastured dairy and eggs, is particularly important. We may also make small amounts from the K1 found in green vegetables.
- Sucking habits from birth to age four. Breast feeding protects against malocclusion. Bottle feeding, pacifiers and finger sucking probably increase the risk of malocclusion. Cup feeding and orthodontic pacifiers are probably acceptable alternatives.
- Food toughness. The jaws probably require stress from tough food to develop correctly. This can contribute to the widening of the dental arch until roughly age 17. Beef jerky, raw vegetables, raw fruit, tough cuts of meat and nuts are all good ways to exercise the jaws.
In one, he made more space in her jaws by extracting teeth. In the other, he put in an apparatus that broadened her dental arch, which roughly mimics the natural process of arch growth during childhood and adolescence. This had profound effects on the girls' subsequent occlusion and facial structure:
The girl on the left had teeth extracted, while the girl on the right had her arch broadened. Under ideal circumstances, this is what should happen naturally during development. Notice any differences?Thanks to the Weston A Price foundation's recent newsletter for the study reference.
44 comments:
Great post Stephan
Great find, simple and powerful
and of particular interest as some one has had a tooth extracted to "make room"
Great work! Very solid analysis through the last couple of months. I enjoyed keeping up on it.
Thank you!
Wider face on the girl on the right. I would also say she looks prettier.
Great advice. Already implementing for my kids.
My son starts his orthotropic orthodontic treatment this afternoon for overbite and underdeveloped mandible. We have opted for the less conventional treatment of arch expansion and growth guidance for the jaw (similar to the "right twin" treatment), even though it means driving about 2-3 hours each way in So Cal traffic. While plenty of local orthodontists do upper palate expansion, I could find no no one who proposed guiding the lower jaw forward instead of pulling the top front teeth back, let alone one familiar with any of the causes of malocclusion discussed in this series of posts. The LA area seemed to have more "outside the box-thinking" orthodontists. Dr. Hang has also published a paper purporting that orthotropic treatment results in increased posterior airway after Biobloc treatment. Breathing and airway space seems to be an important health issue that could be overlooked too often in conventional orthodontic orthodontic practice.
Journal of Craniomandibular Practice:
http://www.ncbi.nlm.nih.gov/pubmed/17508628?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=1
Dr. Hang's treatment is mostly based on the research of (now retired) British orthodontist John Mew, who also did studies comparing conventional treatment with orthotropic treatment on identical twins.
Ha, the girl on the right is way hotter!
Thanks for guiding us on this "nerd safari" Stephen. When I go back to re-read it, I'll be sure to part my hair down the center, button my top button, wear my old glasses from 5th grade, and keep my belt above the navel at all times.
I know that thumbsucking was low on this list. Any readers have references to how to get a two yr old to stop enjoying their thumb!
Our diet is inline, just have to start practicing with cup drinking more, but I suspect the thumbsucking will have to stay for now!
Any thoughts of the influence of nutrtition after birth?
This was almost too painful to read.
My family moved twice during my braces years. My *second* orthodontist looked in my mouth and said, "I wouldn't have pulled out all those teeth. I would have widened that arch and given you more room to breathe up there."
Those words have haunted me since. I look more like the less-hot twin.
I also had a humongous adenoid, allergies, and chronic mouth-breathing. The humongous adenoid was discovered by my third orthodontist, via x-ray. (He was very concerned about the resulting mouth-breathing's continued effects on my teeth and jaw.) The surgeon who removed it, who was old, said it was the largest he'd ever seen.
I'd been going to doctors for years, trying to figure out why I had a constant cold. They just shrugged. I didn't have mono or strep.
This is one reason when the claim is made that Weston A. Price gained insights into health by looking at people's teeth, I believe it.
The narrow nasal passage contributed to the mouth-breathing (and maybe the adenoiditis?), which made the orofacial development situation worse, and so on.
Mouth-breathing is also physiologically linked to depression and anxiety. The front part of the brain needs to be cooled by air going through the nasal passages. If not cooled, as in when you mouth-breathe, you feel more depressed. Bummer.
Two bright spots: Because my diet's been pretty good (since adulthood) and I floss, my teeth and gums are fine. Also, despite my inferior orthodontic treatment, I managed to mate and have kids, one of whom looks a lot like me, minus the occlusion problems, so I kind of get a do-over - seeing what I would have looked like, "if only."
I believe you are implying the twin on the right, who has a more "natural" procedure (supposedly similar to what paleo ancestors would experience) looks more attractive.
1) Are these identical twins? Even though they look similar, they may not be identical. For example, mary kate and ashley olsen are actually fraternal twins, so it is entirely possible those twins are not identical. Fraternal twins often appear identical. That might be one reason why the twin on the right appears more attractive. They appear similar enough to seem identical but actually are not.
2) It is possible the girl who underwent the procedure had teeth extracted inappropriately or needlessly. I have 4x impacted wisdom teeth; there is NO reason to pull out erupted teeth to take care of wisdom teeth, usually. If you go to a dental surgeon he will simply removed the impacted ones. No one needs three sets of molars, ha.
If the problem were teeth other than wisdom, I would argue this condition is not common and is probably a sign of adverse conditions in development.
All teeth should erupt without problem, except for wisdom (see below).
3) I believed the prevailing hypothesis is that our jaw shape is shrinking/smaller faster than we can adapt by reducing #s of molars, and this leads to dental crowding and impacted wisdom teeth. Small/narrow jaws are considered elegant and refined, they are not found in earlier humans.
Speaking personally, I have fairly excellent teeth. Few/no cavities, straight, white & healthy looking. As a little kid I would look at other kids teeth (which were invariably busted up) and wonder why their teeth were so terrible. Every one of my brother and sisters have good teeth (except perhaps my brother who has had issues with crowding - but he is very english looking and so has quite a small jaw). But even he has relatively fine teeth.
The only issues with my teeth (other than the 4x impactions) are that my upper right second incisor is a bit small (possibly from the crowding of my wisdom teeth)
The main reason why I think I have impacted wisdom teeth? I have very big teeth and a small jaw. My first incisors are pretty huge, all my teeth are rather big. It's that simple. Genetically, earlier humans probably did not have large teeth and small jaws or else they would have ran into similar problems.
I do think the busted ass smiles of a lot of people who live on grain are probably related to nutrient deficiencies (I think back to some of the asian children I knew in school who had all kinds of teeth problems)... but the very common problem of impacted wisdom teeth/mild crowding of teeth relates better to the evolutionary trend to select for small jawed individuals with larger teeth.
There is a thought which states european pale skin was selected by men preferring to reproduce with pale women, as paleness indicates high estrogen and low testosterone (testosterone increases skin pigment, hgb synthesis; estrogen makes skin soft and pale). This was possible in europe because of an unlikely change in resources that made it possible for males to actually select females.
It is entirely possible that the tendency for people to have smaller jaws today relates to similar selection. A large broad jaw is another sign of high testosterone, and if pressure was to select people who have genetics that augment femininity (small jaws and fair skin) then the trend toward people having smaller jaws (in tandem with paler skin) would develop. Large teeth would also make the jaw look smaller.
And so, today people don't have enough space for all their teeth. Heh.
Other than the fact it appears more elegant, and enhances beauty, I cannot think of a reason why there was a trend toward reducing jaw size.
As well it seems a tendency toward pale skin occurs with a tendency toward small jaws so it is entirely possible this is a ethnic/racial trait.
@ It's the Woo -
You're right about the twin issue, but don't they look pretty similar in the "before" pictures?
I think (and I think this was the whole point of Stephan's series) that dental crowding and malocclusion are not genetic or ethnic, but due to diet and "lifestyle" factors (if breastfeeding, etc., are a lifestyle - I guess they are). But I'll let you know in 18 years, when the results from my daughters are in.
Larger jaws are indeed caused by higher testosterone (in the context of genes - some people just have wider jaws) in both males and females, but this looks different from a wide dental arch.
Don't you think Europeans' white skin has something to due with lack of sun up north? ...Are you saying that males in Europe had more resources than males in Africa, or less? The former strikes me as unlikely, unless you're talking about the most recent millennium.
"
If the problem were teeth other than wisdom, I would argue this condition is not common and is probably a sign of adverse conditions in development."
Actually I think it is becoming much more common. I had four teeth in addition to wisdom teeth extracted: the first bicuspids on both top and bottom, to make room for the cuspids. Neither of my parents had this problem.
I can accept that in recent times Europeans may have developed preferences for smaller facial structures but if a halthy mate was desired then well formed teeth and good oral health should have also been desirable. Dental problems were no small issue in earlier times. Even a horse trader (and dare I say slave trader?!) knew to look inside the mouth as a guage of health, right?
Anna,
Last year I attended a whole day lecture given by Dr. Hang. I was very impressed. Good choice.
Hi Anna,
That's interesting. I bet it relates to the fact that traditionally living people are generally nose breathers, even during exercise.
Hi Greg,
Growth of the sutures postnatally also involves vitamin K. I don't know if it's a limiting factor postnatally though.
Hi Helen,
Don't feel bad. Most people reading this blog have some kind of malocclusion, or at least a history of it, including myself.
Hi ItsTheWoo,
They're identical twins. I can't say I find the theory very convincing that our jaw size decreased because there was selection on the basis of attractiveness. What's more attractive, a narrow jaw full of crooked teeth, or a wide jaw full of straight teeth? Furthermore, malocclusion sometimes has life-threatening consequences and would have been heavily selected against. Malocclusion is very rare in nature, likely for that reason.
The twins look different in the before shots to me -esp. the side view...The bottom "before" twin is better looking (although, the unfortunate hairstyle of the top twin perhaps has an effect...). Stephan, do you know which "before" corresponds to which "after"? My husband agreed that the "after" twin on the right is more attractive, but thought the difference in attractiveness between the two was much smaller in the second set of (smiling) photos.
That said, this series has freaked me out as I worry about my kids. All 3 either sucked (or suck) thumbs/pacifiers. They all also hang their mouths open and my middle son in a chronic night-time mouth breather...so I am scared of what this might do to jaws and teeth. Has anyone had experience with correcting mouth breathing? I’m trying to stop my 4 year old from sucking his thumb- mostly he does it at night at this point.
Anna, is an orthotropic orthodontist covered by insurance? My own dentist had not heard of orthotropics, although she told me to forward the info to her. She also said that the tendency today is to avoid extractions, but I haven't consulted with the local orthodontist yet. I had neck gear as a kid for an overbite and I wonder if my current jaw stiffness and clicking is related. My daughter has the same big, slightly protruding front teeth I had...
I breast-fed all my kids, but probably not long enough as I had so many problems with it. I was wondering after reading this series if the issues I had with breast feeding could have been caused by poor nutrition before/during pregnancy- one lactation consultant I worked with said I was doing everything correctly, but the pain/bleeding was caused by the way my first baby was suckling. Could abnormal jaw/mouth development in the womb lead to incorrect suckling patterns? I wanted to nurse longer, but it was such a bad experience from the beginning I only made it 6 -7 months with my first 2. The 3rd was better and he self- weaned at 12 months at which point he went straight to a cup… but he still loves his thumb!
If you look at the before photos of both girls, their jaws are different just like the after photos. Also, in regards to teeth and overcrowding, we are a much more multicultural society, it can't just be blamed on diet. Perhaps the reason some non westernized cultures still have good teeth is because they are not breeding with other cultures?
Gabriella,
Thanks for the thumbs up on Dr. Hang. I keep hearing from more people who have had professional contact with Dr. Hang that this is the right way to proceed (though I had my doubts today about the distance during the lonnnngggg drive home today during LA commuter traffic (I love car pool lanes and seeing the live-time traffic status on my phone!).
Here's another identical twin study with more treatment comparisons and B & A photos:
http://www.ncbi.nlm.nih.gov/pubmed/17580512?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=14
Here's one of Dr. Hang's papers on soft tissue changes using Biobloc appliances:
http://www.ncbi.nlm.nih.gov/pubmed/19739499?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=2
Here's his opinion column piece (page 28) on Obstructive Sleep Apnea in relation to orthodontic treatment. http://www.orthodontics.com/Journals/JAOSspg07print.pdf
Browsing around in the sleep-breathing issues is what led me to look further into this out-of-box-approach and eventually to Dr. Hang ( who referred me to Dr. Corruccini's research, but I already knew about it thanks to Stephan).
Sandra,
The treatment we are pursuing definitely isn't conventional (but it isn't especially new), so I'm not surprised your dentist is unaware (neither had our dentist, nor had he heard of Weston A. Price).
Orthotropic treatment has the best results if done when active growth is still occurring and isn't near completion. If you want to consider it, look into it sooner rather than later. At 11 yo, our son is actually near the end of the optimal treatment time, but his secondary teeth are coming in a bit later than average so that extends the time frame a bit. I almost waited too long because the conventional orthodontists wanted to treat much later. Phew!
Also, be aware that *everyone* will think you are nuts if you end up traveling outside your local area to find this kind of orthodontic treatment - especially when there are dozens of run-of-the-mill orthodontic practices very near (So Cal has nearly as many orthodontists as 7-Elevens, it seems). Most people think orthodontist treatment is fairly generic and universal; they are simply seeking cosmetically straight attractive teeth and nearly any orthodontist can achieve that (even if it shrinks the space for the tongue or later contributes to TMJ or headaches). Instead they choose based on location/convenience, cool office decor (we've seen some *very* cool set-ups), video games/homework stations/computers in the waiting area, personality, flexible financing packages/price, etc. Consults/proposals were always complimentary for children, btw.
You probably won't have an issue with your dental insurance IF it covers orthodontic work. It isn't so "unconventional" that insurance doesn't cover it IF you have an orthodontics benefit (if you call the insurance co the Cust Serv Rep probably won't have any idea what you are talking about if you mention "orthotropic", btw). The office staff are very good about checking coverage with the insurance company right after you make the consult appt, however they are all careful to point out that you are responsible if for some reason the insurance doesn't pay. Orthodontists often offer a discount for multiple patients in a family, and all seemed to offer a few percent off "bookkeeper's discount) for payment in full up front (all also also flexible payment options). Those pre-tax payroll deduction plans some employers offer for tax-savings are useful for out of pocket orthodontic expenses not covered by insurance, but they require some advance planning during the open enrollment period to set up the deductions (usually about this time of year). Hopefully, you have a generous orthodontic benefit. ;-)
Also, Dr. Steven Y. Park's sleep/breathing blog has a great audio interview with Dr. Hang that you might find interesting - email Dr. Park to request a link to download the file.
Hi Sandra and Sherrie,
The paper states that they were identical twins with identical class I malocclusions, and that's the same thing I see when I look at them. You have to be careful not to be fooled by the hair in the top shot.
Sherrie, I strongly disagree with the "racial mixing" theory of malocclusion. The evidence for it is somewhere between slim and none. It was mostly promoted in the first half of the 20th century, when many people weren't too fond of racial mixing to begin with...
Yeah, Stephan, I did sound a little whiny there. It is the part of my appearance I've had the most angst about (show me a woman without angst about her looks), and when I found out - a long time ago, not from your article - that it wasn't just dumb luck but preventable, at several points in the story, it bummed me out.
If it were just that, though, I probably wouldn't have much to say about it. I look "normal." :) It's the whole package of complaints that led to and came out of my poor occlusion story that have really been a drag on my well-being over the years. And that, I think, is the point, right?
The chin, nose and mouth are different in the original photos, you can see it in the side on photos.
How is the evidence "slim to none" when different races share common facial features, surely its possible?
I should rephrase that to members of a particular race share common facial features.
So what can adults with Malocclusion do to fix the problem?
This got me wondering - what if one of the evolutionary advantages to nasal congestion in the winter was not simply due to keeping germs out due to diminished immune system, but also to discourage nose breathing to reduce the amount of brain cooling.
Any thoughts on this?
Wow! I was treated like the twin on the left...I have had 12 teeth pulled--4 "baby" teeth, 4 pre-molars ("adult" teeth) and my wisdom teeth. Also had a palate expander (before having any teeth pulled...we moved, and the new ortho changed things up a bit, I suppose). Very interesting post, thanks!
For those who have the opportunity to be treated by Dr Hang, just do it! I live in Australia and if my son weren't too advanced in age (14years old), I would be on the first plane to the US. Conventional orthodontics (train tracks) doesnt necessarily have to extract teeth to damage faces, retracting the teeth alone can cause problems. I have been visiting the local orthodontists since my son was 10 years of age (3separate orthodontists = vastly different opinions except for all of them telling me to wait) and I was told to wait until my son was older. In waiting, my son now has all of his permanent teeth and he's no longer a good candidate for orthotropics. Dont be fooled by pictures of straight teeth in close up photos, you want to see the persons profile and a front on photo with the mouth closed (facial structure) and then the teeth!
Melodia,
Had you come to Dr. Hang's practice, you would have taken the prize for coming the farthest distance, I'm quite sure, though many patients do come a very long way and fly in from Alaska, the East Coast, etc. Your comment makes our 2-3+ hour drive each way seem much shorter, in perspective. Thanks very much for sharing that.
I almost waited too long to start treatment; good thing his secondary teeth were taking their time coming in. My husband is thinking about scheduling a consult to see treatment would help him (Dr. Hang treats adults, too, but doesn't have the benefit of growth, of course). I suspect surgery would be required.
In many online blogs I read regularly, many people are now coming forth with positive words about Dr. Hang's treatment goals. I have yet to hear anything remotely negative or contradictory. He is trying to increase the number of practices who use this treatment by conducting weekend "mini-residencies" for interested orthodontists, but it's still such a small % of the profession.
Your comment will also help those who need more information about what to ask during the initial consult, and what to look for when they compare proposals, and on what criteria to make a decision (I've had some nice emails from readers of this blog who have questions about getting the best orthodontic treatment for their children).
Stephan, The pictures of the twins are fascinating. However, I don't understand something. My son's ortho tells me it is possible to widen the upper jaw, but not the lower jaw. Assuming their molars were in correct alignment top to bottom before hand, how could he widen the one twin's top arch without messing up the alignment with her lower molars?
Daniel,
Have you seen Dr Wm Hang's www.facefocused.com website? My 11 yo son is in treatment with him currently. Upper jaw has been expanded with a removable appliance during the first phase (early dec '09 - late mar '10). The next phase is about to start to guide growth of his lower jaw wider and forward with a removeable Biobloc appliance.
Hopefully I'm not too late on this post!
Anna, how did your son react to the treatment? I found an orthotropic orthodontist in my area and really want my 10 year old son to get this treatment. His father has the recessed chin, tongue thrust, etc., and I can see already that my son has the weak chin. Was it painful? I'm worried that my son will have trouble accepting and keeping up with the treatment. Any advice you can give me would be great. This practitioner that I found also uses Biobloc.
Wow now that we know this thank God we can work to rid the world of the scourge of ugly girls!
Hi Anna
I hope all goes well with your son. I'm at a similar stage with my boy, late treatment case with not as much room for improvement. I’m afraid my son was placed under the supervised neglect of the local Orthos in Cairns, Australia. Traditional Orthos like you to wait until you are 14 when all of your options have run out. Fortunately I have found an Orthotropics practitioner who I travel (a 400 k each way trip) to visit who was prepared to accept him as a late case. He’s gone through the expansion and teeth forward / cosmetic line increased and will get his bioblock very soon. I pray that even a small improvement is better than the alternatives!
Stephan, I love your articles! I feel that you would have a lot in common with Drs John and Mike Mew in the UK! They are trying to get the British 'General Dental Council' to discuss the causes of malocclusion, the idea of which the GDC seams to steadfastly refuse to entertain!
How many of us have visited Dentists or Orthodontists and ever been told 'why our teeth or our children's teeth became crooked'? Apparently causes of malocclusion are not taught or discussed with Dentists or Orthodontists (with the exception of the oh so convenient 'it's a case of genetics'). Perhaps you can find Mike Mew’s Facebook Site ‘Y Crooked Teeth’ and share some articles. I feel sure that he would be happy to add a link to Whole Heath Source.
Best regards
Melody
I love your blog and am very glad I found it!
I have seen this pictures of the identical twins before. Each time I have seen it, there has been a different description of the treatment.
The one I saw most recently said that the twin with the narrower face had her bicuspids removed and the one with the rounder face had her back molars removed.
Another description said that one received treatment from a holistic orthodontist; the other received it from a regular orthodontist.
Hey, thanks for writing this interesting post.
I see that a lot of people mention Orthotropics and Dr. Hang which in my opinion is a good sign that some enlightenment is going on.
There is otherwise a lot of talk about extraction vs non-extraction orthodontics and how palate expansion should be used instead of extracting teeth. But a lot of orthodontists will use palate expansion followed by retraction head gear and lip bumpers, all of which move teeth backwards into the face. This is what my boyfriend had done and his profile is similar to mine (I had extractions) - "dished in" with a protruding nose, chin too far back, diagonal upper lip, lower lip outside of upper lip when mouth is closed, oblong and sagging face. So the discussion shouldn't just be about extraction orthodontics, I think, but also about retraction.
Orthotropics/Dr. Hang/John Mew are some of the few orthos that promote forward growth of the face and not just the lower jaw, but the upper jaw as well. Read this article: http://facefocused.com/jamerorth1.html
that states that this is important especially to maximize tongue space and breathing.
A lot of treatments today involve bringing the lower jaw forward by holding the upper jaw back (some of these appliances are mentioned in the article).
Also, palate expansion is possible in adults without surgery (although I don't know exactly how drastic results can be produced but for most people it will be enough). This is usually done with the ALF appliance, the Schwarz plate, Crozat or Homeoblock. Most ALF orthodontists seem to promote forward expansion of the upper jaw.
They can also do "reverse extraction orthodontics" where they expand the jaws and place implants of the extracted teeth (in fact I'm looking at this treatment myself).
Interestingly enough, since my son has had his upper jaw expanded as part of his Orthotropics treatment, he's no longer getting ear infections from swimming every couple of weeks (he swims in a squad and we live in the tropics. This should highlight that Orthotropics has benefits other than improving 'facial appearance' it also improves 'function'. Retracting & extracting his teeth as per what the orthodontists were proscribing would have made his problems so much worse.
My son gets his Biobloc on in the next few weeks and I'm elated, as he's gone through the 'ugly duckling phase' (upper teeth brought forward in the face but lower jaw still set back prior to Biobloc being worn) for quite some time which you can imagine is not easy for a 15 year old boy at such an age.
Dr John Mew's amazing work / treatment modality has been long been ignored / vilified / suppressed for the main part by the British Orthodontic establishment for so long! Finally he and his treatment seems to be getting the recognition and acceptance that he deserves!
There is no "girl on the right". These are two different girls, both after treatment. One of the twins is smiling in all her photos, the other one is not. Obviously, they both changed their clothes (and hairstyle) in between the photos.
Hi, I am presenting at the AHS in a weeks time in Harvard on this very issue. My argument will be slightly different, the causes in order will be;
1) Decrease masticatory effort; from eating less of a higher quality much softer diet (it is estimated that we are using our jaws only 5% of what they were designed to do.
2) Lowering of the tongue due to nasal blockage at a young age, leading to open mouth posture and lowered tongue to breath that become habitual.
3) Early weaning to soft food, introducing food that can be "suckled" before a child is ready for an adult swallow. They are able to use a modified "suckle" with soft modern food and continue to do this throughout life, always sucking in on their food.
As I only have 20min an cannot support these fully with evidence could you give me some feedback as to which one you disagree with most and why. This would be of really great help to me, and it will be helping every child faced with orthodontic treatment, and extractions especially wisdom teeth.
Thanks,
Mike Mew
Our baby is breastfed, does not use a pacifier or suck his thumb, is getting all the nutrition he needs, and his baby teeth are coming in crooked just as mine and my siblings did, in the same pattern.
I don't find the twins very convincing, as the pictures have a great deal of difference--notice the one on the right has a much wider HEAD. I don't believe any orthodontist has equipment that will widen your skull between the temples. I measured the distance across each face just below the eyes. Left twin is 1.4 cm, right twin is 1.7 cm. Left twin has a little under 3 mm between the eyes, right twin has a little over 3 mm.
Is race mixing at all responsible for the rise in orthodontic problems? My son inherited his mother's big Asian teeth and my European jaw. Our dentist told us there's just not enough space for his teeth and advised us to visit the orthodontist. I would expect that in a small homogenous community, you'd have fewer orthodontic problems. When you marry your cousin who's not so different from you, I'd expect that the teeth would fit just fine.
As father of a 13-month-old we're always told not to give him anything tough or chewy because he might choke on it (even apple/grape skins). I guess you pick your poison :)
Gabriel Hanna - The device used to widen her maxilla was a Frankel appliance. The reason her cheekbones have widened is because the maxilla and zygomatic bones make up our cheekbones. If you google image the maxilla, you will see that it encompasses much more of our face than simply the palate, which is why proper development and avoiding mouth breathing is crucial. The Frankel appliance also widened the mandible, which is not usually done any longer.
I also had an orthodontist who pulled 6 (yes, 6!) of my permanent jaw teeth before putting on braces in order to align my teeth at the tender age of 10 years. The result was stunted growth of my upper jaw, resulting in severe TMJ and a grossly deformed face. I have to live with both of these conditions, since insurance will not pay for what they consider to be "cosmetic" surgery and the TMJ procedure I had was unsuccessful at fixing my issue.
I'm very sorry your doctor mutilated you. I would sue.
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