From extractions/braces to jaw expansion - the transition

I just listened to an 8 minute long radio recording with Dr. William Hang who has lately become my guru. He is one of the few orthodontists out there who try to solve the cause behind crooked teeth by fixing the jaws first. I have to say I am completely taken by this interview! This is the first time I hear Dr. Hang talk and it is almost as if he has read all the different thoughts I’ve had for 17 years (that is, ever since I had my braces removed).

Dr. Hang explains how he “converted” from extraction/retraction orthodontics to what he does today (mainly expansion of jaws and bringing them forward). Even Dr. Hang was once “on of those who recommended that you had teeth pulled”. But today he doesn’t even want to look at these people, it makes him shudder. He didn’t realize back then how bad it really was and how much damage that kind of treatment can do.

In the middle of the transition he still had a couple of patients who were undergoing traditional treatment and of course he had to finish what he started. He tells us how his pulse started to accelerate as he saw their names on the schedule. He almost had anxiety attacks and it was all very difficult for him. I am so impressed that he had the courage to break lose, that he was so far ahead of the others and that he later on had the strength to admit to himself and the public that this was wrong.

He also talks about women he met who had teeth pulled and braces and who look back at the result and say, “I don’t like this, not even a little bit!” One of them even said, “My life was over at 13. When I had my braces removed and saw myself, my life was over.”

This almost brought tears to my eyes. For 17 years I thought I was crazy! I have never liked how my mouth turned out or felt and I have hated what the orthodontic treatment did to my face. But I have never heard of anybody who feels the same way. My experience was very vague and I didn’t understand what was wrong, I couldn’t explain it. This is what it must feel like to suffer from a disease that doesn’t have a name yet and is suddenly recognized one day. An awakening, an aha moment. It is an incredible relief! 

Types of orthodontic appliances

I have read more about orthodontics than is healthy for the brain. Slowly an opinion began to take shape, an opinion that is based on something I've felt all along: "Why only consider the teeth, that they need to be straight, if they don't fit the face, if the face loses its shape, if the profile is damaged?" And: "Why defy the body, nature itself, when it's the most brilliant machine that exists? Why torture people for years with uncomfortable and sometimes horrible appliances?"

These thoughts make me very upset, especially at this age because I've started thinking, "What if I get kids, how do I deal with these things? I can't make it go through just anything." But now I know everything worth knowing about new findings and that it doesn't have to be this way. You don't need to wear the worst appliances available for it to work. The less bulky ones usually work better because they take advantage of the body. It really makes a lot of sense! The body wants to change, to correct itself, but only if it's done in the right way. Furthermore, you don't have to choose between straight teeth and face/function because the good techniques improve the facial appearance and the mouth!

ALF or RPE - which would you prefer? Do you believe me when I tell you that the thin, discreet thing to the left solves more problems?

First and foremost, to not take the entire head and the shape of the jaws into account is often pointless. That's not the way to solve a problem. For years I have been telling myself, "Wow, people who used to wear braces sure have flat faces! And narrow smiles!" and now I realize that I wasn't the only one having these thoughts even though for the longest time I thought I was.

Though bothering too much about the cosmetic part isn't necessary because it comes as a bonus along with all the other advantages with functional orthodontics (functional appliances and braces for adults) and orthotropics (facial growth guidance for kids). TMJ problems, headaches, neck pain and sleep apnea are all serious things, (in my opinion far more serious than wearing out a tooth or two which are often the argument for orthodontic treatment). They are all things you want to avoid. The aesthetic part is related to them though since we humans tend to be able to judge from the appearance of a person if they are healthy or not. Someone who has their chin very close to their neck probably has breathing difficulties. To make the mouth smaller and pushing everything backwards doesn't solve any problems, it makes everything worse.

To guide the growth of the face isn't synonymous with torturing people. In most cases there is no retraction involved. The facial profile should be convex. It improves the airway (trust me, I know all too well what it's like not to be able to breathe properly). The whole purpose is to help the body become as it would have been had it grown correctly.

If I had to make a choice on my child's behalf between crooked teeth or moving everything backwards I would pick crooked teeth any day. As far as I'm concerned, health and a beautiful face are more important than straight teeth. Luckily there are methods where you don't have to choose. Sadly, they're not very commonly used.

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