This patient is the younger sister of one of my existing patients. When she would sit in the waiting area of my office, I noticed that her jaw was deviated.
At the time she became my patient, she was a little under 7 years old.
In addition to, and as a result of her structural issues, her medical history showed that she was suffering from frequent colds and ear infections.
The image below is what I saw when I initially examined her mouth. You don’t have to be a dentist to notice that something was not right.
Her upper and lower teeth were not aligned. Her teeth were crooked and she was definitely suffering from a deformation process.
As is part of my typical treatement plan, before I worry about how the teeth are fitting, I examine how the dental arch form is configured in relation to the cranial and facial structure. My goal is to adjust any arch deformations prior to making any decisions about the need for surgery or braces.
I generally start my cases using my patented appliance and treatment methodology to reshape the dental arch.
You can see that after three months the arch is starting to configure to a more normal shape. You can also see that her teeth are starting to line up and her lower teeth are starting to level.
After about 5 more months, using only the device and 6 weeks of brackets on only the front four teeth, you can see that her teeth are much more aligned and level.
I also spoke to her mother at this time to find out that the patient had not been getting ear infections or colds.
After phase one I started to monitor her and you can see, after a about a year, that her teeth are leveling very nicely. It is important to note at this point her lower teeth have not had any treatment yet.
I continued to monitor the patient and after two years I noticed that her lower jaw started to grow a little bit and she started to develop an open bite.
This is when I decided to start the next phase of the treatment plan.
During the second phase of treatment, I would use a combination of my device and braces.
After 6 months wearing my device, you can see that her arch was starting to return to the normal shape.
Once the upper and lower teeth are reasonably leveled, I start the braces.
Her facial mid-line and smile line have been dramatically improved. Her teeth are straight, but more importantly, are configured according to a more normal dental arch form.
This was done without surgery or any shaping of the individual teeth and in a total time in braces that was less than one year.
Current Treatment Philosophy and the Dental Arch
In current dentistry, there are no methods of looking at the normalcy of the arch form itself. As the dental professional, we talk a lot about the occlusion but the arch form itself is assumed to be normal, if the occlusion is normal. The problem is, often times even when the occlusion is normal, the dental arch form is deformed.
The dental arch form is an anatomically configured biological form in the human skull. The landmark points on my analysis represent the anatomical location of the teeth not by the occlusion itself. The importance of these landmark locations according to the skull anatomy is that they are configured and conformed to the adjacent facial structures, such as the nasal and throat cavities.
The significance of my paradigm is that the dental arch is functionally correlated to the functions of nasal, ear, and throat.
If my patient went through the current method of treatment, she may have the straight teeth but the smile line would have remained deformed and the anatomical function of her mouth would have be negatively impacted.