There comes a time in everyone’s life where we question the way we look. Is the image in the mirror the real version of ourselves? Or would we have looked different if certain physical changes to our face and body did not occur while we were growing up? Indeed we start wondering if there were things we could have changed – so we investigate why we look the way we do. For instance, understanding how our excessive sugar intake over all these years contributed to where our bodies are today. Did we spend too much time in the sun? Or have all the sports injuries ended up leaving us with an asymmetric face. We ask ourselves, “is this the best version of myself?” And if not, how can I fix this? Or even better, how can I find solutions to spare our children from this?
The demand for looking presentable, confident and attractive has become more relevant to the era we find ourselves in. Not only is it easier to find a job, but the feeling of looking beautiful also has a remarkable effect on our confidence levels, which may, in turn, leave us with a feeling of self-actualisation – especially if this could be achieved in a healthy and holistic fashion. This science also applies to our mouths and the structures surrounding it. This will include our mouths as a whole, the positioning of our teeth and our jaws, the bone surrounding our teeth, and our ability to have normal lip closure and oral functionality. We are destined to accommodate all of our teeth in our mouths to enable us to have an adequate hard tissue framework.
Hard Tissue Functionality
There is a reason why we are born with all our teeth. Our most optimal functional version of ourselves will also be the most beautiful version of ourselves. This should say something about the intricacy of the way we, as humans, are designed. The reason for this is simple – our soft tissue (tendons, ligaments, fascia, skin, fibrous tissues, fat, and synovial membranes (which are connective tissue), and muscles, nerves and blood vessels are optimally supported by our hard tissue (Bone and teeth). The explanation lies in the fact that for every one tooth that gets removed, we lose a huge amount of hard tissue to support the soft tissue. It is like the foundation of a building. For example, lips: if we want them to look effortlessly pouty, they would require support from the teeth being in the correct position with the correct jaw relationship
Hard Tissue Loss: Adverse effects
Many practitioners allow the removal of premolars to “fit the teeth into the mouth”. In the long run, this often leaves a face with inadequate hard tissue support, almost begging the lips to pout, thereby looking unnatural where ideally we should look ‘effortless’. From what we have learned over the years of research is that the reason behind not having sufficient space for our teeth to be accommodated in our mouths is because we have “too many teeth” or that “we need to make space for the other teeth”. A more accurate diagnosis would be that the bony arches that carry the teeth – the jaws – are too small or underdeveloped. Now the reason why the teeth do not fit the bony arches is most often due to the underdevelopment of the upper jaw – the maxilla. This could be attributed to many reasons, which include babies not being breastfed, vitamin D deficiency, early loss of primary teeth, chronic bone loss, and habits such as mouth breathing, etc.
The orthotropic method
While it is more difficult to fix this situation in adults, dentists introduced orthotropics – a treatment modality that “grows the jaws” by leading to the expansion of the bony arches. In adults, orthotropics also includes the use of mini-screws in the jaws in combination with orthopedic elastics to manipulate the positioning of the jaws. These forces are then applied to manipulate the maxilla. In cases where teenagers have their premolars removed (the teeth further to the back of the mouth, next to the molars), the elasticity and firmness of the skin camouflage the often devastating effects that result from removing hard tissue from the face. Sadly, the effects of hard tissue loss would only be revealed on a face many years later. The lips may be much thinner and the corners may become downturned, the nose may become hooked, the profile may even become dish-faced. Our DNA predetermines the amount of hard and soft tissue that a human will have. The hard tissue is needed to provide a framework of support to the soft tissue. The body, however, does not have a switch to reduce the amount of soft tissue after we remove hard tissue (such as teeth), or when we restrain maxillary growth.
Orthotropics in the early years
With the help of early intervention (around the age of seven to eight years old), we can apply orthotropic to stimulate the bony arches, helping them to accommodate the developing permanent teeth. Orthotropics is the use of orthopedic forces in dentistry to either manipulate the positioning of the bony arches or increase their size. In this manner, not only is the smile enhanced but there is also a noticeable improvement in the facial profile and functionality. From this, optimal maxillary expansion and forward development of the maxilla can enable a face to achieve the potential it was destined for, so that removal of teeth is prevented. This can be called natural orthodontics, and is based on facial beauty rather than straight teeth.
We utilise orthopedic devices that may or may not be removable, with the aim to make the face fit the teeth and not the teeth fit the face. That means that we would rather manipulate the potential of the facial bony structures to accommodate all our teeth, rather than reducing the number of teeth to fit the underdeveloped bone (jaws).
In adults, we use mini dental implants (called tabs) on which we apply these orthopedic forces to bring the upper jaw forward. This process may then take up to eight months, depending on the sutures that are between the facial bones and how susceptible they are to be manipulated. The success of the treatment therein relies on the ability of the sutures to be controlled, which is easier in younger patients. Compliance also plays an important role. Although orthotropics cannot guarantee whether a child will still need braces at a later stage, it will most likely prevent the removal of permanent teeth, which we need to achieve our full potential in facial beauty.
The maxilla role
The maxilla forms the major support to the facial profile. We refer to the “magical maxilla” in the sense that it is the most connected bone to the other bones in our mid-face. The positioning of the maxilla is very important to provide us with lip support. It forms the inferior supporting border to the nose and hosts the maxillary sinuses, which help us to breathe. The maxilla’s anterior-posterior dimension also determines how high our cheek bones appear.
The most successful results rely on early intervention. Once we have our hard tissue support in place, we will look better, age better and live better. We never have to be someone else, but we can be the best version of ourselves.