The Tale of Cranky Kat and the Happy HyGenius

She was beautiful, blonde, and already angry- not a good way to start a dental hygiene appointment.  I'll call her Cranky Kat (not her real name, but you knew that).  She'd been dismissed as a patient from her last office so I was already on high alert. (It takes a lot to be dismissed as a patient.)   She told me in no uncertain terms, "do not touch" her front teeth, there was bonding holding them together.  The last hygienist managed to undo it and break that bond.  That's when I put everything down and just listened to her.  Then I heard about the real problem.  She'd had invisalign braces six years ago.  It was only suppose to take nine short months.  Six years later, her teeth are still moving, daily.  Kat wears her last invisalign tray every night and moves her teeth back in line, but, by the end of the day, her teeth have moved yet again.  Now I understood her anger and frustration with her previous professionals.  I also knew what they all did not, and I had not even looked in her mouth.  Am I psychic?  No, but stay tuned for the answer!

Today's talk is about orthodontics.
Why would Kat's orthodontics fail so profoundly?  Why do people need to get braces again and again?  We're going to talk about braces, a little bit of history, and why we get crooked teeth.  Then let's chat about "ortho fails".  I freely admit to not being an orthodontist.  However, I've seen so many folks have repeat orthodontics-- why?  Here's my opinion and with some research mixed in!

(Quick reminder- all my sources are cited in the clickable links! and if you have any further questions please email me, or comment below.  I am more than happy to provide specific information if you're interested!)

 Evolution of the Human Jaw 

Prehistoric man had beautiful straight teeth and big wide dental arches. There was room for all 32 teeth.  They had big, broad faces and widely developed jaws which created wide open sinuses and wide open airways.  No mouth breathing or  sleep apnea here!   There was little malocclusion or crooked teeth at that time.  Toothbrushes had not been invented, yet little gum disease or decay was noted in the remains that have been found.  Babies were all breastfed, training the tongue to be in its proper position on the roof of the mouth.  Their jaws developed around their tongue.  Also, their coarse diet was great for their teeth - both for wearing any early decay down, and for jaw development, causing prehistoric man to develop big, robust jaws from using his jaws to chew this coarse food.  No tooth decay, no gum disease and no crooked teeth for our prehistoric ancestors with nary a dentist or an orthodontist in sight!

Cha-, Cha-, Cha- Changes 

 What's changed?  Man went from hunter/gatherer to farmer and field.  Good changes in some
areas yet problem-creating in others.  Tooth decay was first detected approximately 13,000 years ago by something so simple as the switch to farming and change in diet.  The switch between low sugar/high fiber Paleolithic diet to high sugar/low fiber diet, increasingly processed foods triggered the change in oral flora leading to tooth decay.  Then along came the Industrial Revolution of the 18th and 19th centuries.  Wow, a lot more changes.  Since as a whole we are no longer chewing hard foods and not encouraging long-term breastfeeding, our facial development changed drastically.  We sped up evolution.  This is called epigenetics. (Changes to our DNA genes due to interaction with the environment. Chemicals, nutrition and habits that change our facial development. I've link to two fantastic blogs that are very well researched.)  The tongue, our mighty tongue, was no longer up on the roof of the mouth, creating those big, strong jaws and beautiful straight teeth.  Pacifiers, baby bottles, soft food, and lack of breastfeeding have instead resulted in our developing long narrow faces, narrow jaws,crooked teeth, and high narrow palates with small sinus passages- the sinus passages are directly above the roof of your mouth, so the development of the latter greatly impacts the former.  All these changes but we still have 32 teeth, plus we have a too-big tongue in a too-small jaw, blocking the airway and creating what is now called  "Sleep Disordered Breathing," which encompasses snoring, mouth breathing, obstructive sleep apnea, and upper airway resistance syndrome.  Twenty percent of the US population has various forms of sleep disordered breathing and 90% of those folks are undiagnosed!  Lack of proper oxygenation of our cells has been connected to many severe health issues from depression, anxiety, diabetes, cancers, cardiovascular diseases and dementia to name but a few.  I highly recommend the brand new book  GASP!: The Hidden Path to Wellness by Dr. Howie Hindin and  Dr. Michael Gelb which discusses this in more detail.

Braces Again and Again

Nope, didn't like them the first time and yet, as my teeth moved, I did them a second time.  Why did my teeth move back?  (Even after wearing my retainers all those years! I was diligent!)  It comes back, yet again, to the tongue.  The pressures of the cheeks and the tongue on the teeth are normally about even - counterbalancing each other and preventing teeth movement.  Braces move teeth ever so slowly and gently through the bone. The bone cells, when pushed upon, breakdown, allowing us to move teeth through this semisolid mass.  They remake new bone behind the teeth.  It is quite a miracle!  Then braces come off.  If the tongue's in its proper "tongue rest posture" on the roof of the mouth all is well and stable.  Hollywood smile complete!  If the forces are not even or there's no retainer, teeth move.  Often, the culprit is force from the tongue.  Incorrect swallowing, with the tongue gently but constantly pushing the teeth with every swallow causes the tongue to act just like your braces.  We swallow every 30 seconds while awake - which amounts to around 2000 swallows a day.  That's a lot of unthinking pressure on teeth and it does indeed move them.

Peek a boo! 

I had previously worked for a dentist who just expected to wear braces for yet a third time.  She assumed that was the natural way of teeth.  Unfortunately, she didn't know what she didn't know.  Now you, my favorite readers, know more than a dentist!

Cranky Kat and the Big Reveal  

Finally, back to my patient, Cranky Kat.  Poor Kat was beyond frustrated with her teeth, her smile and her dental personnel.  Were it me, I'd be too!  I'd be angry, frustrated and generally disgusted with having spent precious time, lots of money and for no results and no answers.  I put on my detective hat and like Columbo set out to learn.  Before even opening her mouth, she and I discussed her teeth movement and then I asked about her sleep habits.  She reported she did not sleep well.  Sleep aids were on her medical history.  Does that all relate to her mouth?  You bet it does - keep reading!  As I did my exam and lifted up her tongue, I saw what no one else had for six years or maybe even 36.  She was moderately tongue tied.  (It's called ankyloglossia and it's caused by the little piece of string that connects the tongue to the floor of the mouth.)   I asked her about it and she said: "no one had ever mentioned her tongue tie before.  Her sister was so tongue tied, it effected her speech and she had a frenectomy."  Nobody had ever discussed Kat's tongue, and the fact it was mostly anchored down to the floor of her mouth.  She "functioned well" so no one had even thought to check it.  Functioning well only means she had no lisp and could swallow food.  She had many other issues no one ever connected to her tongue tie.  As I've mentioned before, the tongue has a "proper rest posture" on the roof of the mouth.  When one swallows, it should move the food or liquid backward.  Kat's tethered tongue instead moved forward, pressing against her front teeth, 2000 times a day.  No wonder her teeth moved daily.

Poor Kat had every right to be cranky!  All the evidence was right there.  Even before looking in her mouth, her medical history told the story.  She has sleep issues, and is taking a sleep aid.  She probably has sleep apnea and that's directly connected to tongue ties.  Research shows there's a direct correlation between a tongue that is tethered and sleep apnea.  Since it's stuck in the down position, it falls back and closes off her airway when she sleeps.  She was tense, had head aches and shoulder/neck pain.  Tongue ties cause the lower jaw to not develop properly.  It anchors the muscles down and causes neck strain, and can contribute to head aches.  (I have entire posts on tongue ties, tongue position, jaw development and sleep apnea.)  Lack of oxygen from sleep apnea can contribute to body pain.  All of Kat's signs and symptoms fit together like a puzzle piece.  I have to admit to being thrilled, a little smug, and very happy I "discovered" her tongue tie and gave her hope to resolve her many and varied health issues.  Time to look more closely at her tethered tongue and release it!  This is "to be continued"...

So now you know the Tale of Cranky Kat and the Happy HyGenius (that's me!).  The moral of the story is look at ALL the pieces, read the medical history, listen- really listen to the entire story, and look for the causes of the problem.  Don't stop until you find what you are looking for.
                                                                     ~The End~

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Happy New Year to all my many readers.  I am excited to report this blog has had over 70,000 page views.  I'm amazed and astounded, and very honored you stopped by to read and learn.  Knowledge is power.  Have a wonderful and powerful 2017.

And keep smiling!

Sincerely,
Barbara