Family OSA

[sylvie]

Is There an Alternative to Extracting Teeth (Such As Wearing Braces) to Correct Teeth Crowding for a Smile Makeover?

http://www.realself.com/question/there- ... owding-for

Avoid extractions in almost all cases

Removing teeth for cosmetics can lead to disastrous and dangerous results. Crowding is due to insufficient arch development. Removal of teeth for cosmetics can lead to snoring, sleep apnea, chronic headaches and other serious medical problems. The tongue fits in the oral cavity and reducing the size can cause distal displacement that blocks the airway.

Ira Shapira, DDS
Lake Forest Cosmetic Dentist

Getting teeth straight !

Extraction is an option, but not always the best and not worst. It really depends on the case. Sometimes it is best to extract to lighten the bite forces, and at times extraction causes more bite forces on the remaining teeth. So I really do not think we should give any advice, unless some records or details are given. I am sorry if this does not help. But I will be more than happy to email and answer you if you like to contact us and email photos or details.

Soheyla Marzvaan, DDS
Orange County Cosmetic Dentist

Braces as an alternative to tooth extractions for smile makeover

Good comments by other Doctors. Sometimes extractions do sound fast and easy but future complications in the TMJ or breathing issues or wear or gum problems may result. Review all options before pulling teeth. It depends on where the teeth are and their positioning in the bone also. Get another opinion also from another dentist or two and you may get a new idea. Best of Luck!

Scott LeSueur, DDS
Mesa Cosmetic Dentist

Alternatives to extractions

There are many different ways of enhancing your smile without removing teeth. Sometimes removing teeth is the easiest way so it may be suggested, but there are a lot of troubles that can go along with removing teeth. We have had patients suffer from sleep apnea, headaches (including migraines), posture problems, tmj pain, etc., and these are all related to having teeth removed. Orthodontics without extractions is definitely an option for some people, but you have to make sure that the teeth are worth saving. Hope this helps

Blaine McLaughlin, DDS
Cedar Rapids Cosmetic Dentist

Alternatives to extractions

You can ALWAYS treat people without extractions....it just might not be the best alternative! You can get additional room from expansion, slenderizing teeth, pushing teeth "backward" but there are limits to these methods and the final result might be better with extractions. Just make sure you have all of the pros and cons given to you and get a second or third opinion just to make sure!

Robert Waxler, DMD, MS
Saint Louis Orthodontist

[sylvie]

Orthodontists Guilty Of Institutional Professional Misconduct, Says UK Lobby Group 'Orthodontic Outrage'

March 15, 2005

http://www.medicalnewstoday.com/releases/21288.php

According to a new lobby group called Orthodontic Outrage, the UK's professional orthodontic body is using its power to intimidate and suppress dissenting opinion - to the potential harm of patients.

"Their behaviour certainly amounts to institutional professional suppression and - given the harm that can be caused by unnecessary surgery and inappropriate extractions - could even be seen as institutional professional misconduct," claims John Mew from Orthodontic Outrage who is a leading advocate of the non-extraction and growth guidance approach. "In most other countries there is a healthy debate on the recent scientific evidence which has questioned the merits of extractions, but in the UK the professional body is closing ranks to suppress any form of debate."

"They are afraid of engaging dissenting intellectuals such as myself in open debate - either in the press or in court - because they know that they're on weak scientific ground," adds Mew. "Instead they use their professional power - resorting to intimidation and suppression."

For over a hundred years orthodontic opinion has been split in two. One group favours straightening teeth by mechanics and surgery and the other by natural growth guidance to avoid the need for extractions. At different times over the past century each group held ascendancy almost to the exclusion of the other.

In 1999 orthodontics became a recognised specialty within dentistry and by 2003 the mechanical group had established control in the UK and, claiming to have become the 'recognised authority', they ensured that their own views were used to define the guiding criteria* (on which any profession is based):

1 a common body of knowledge resting on a well-developed, widely accepted theoretical base;

2 a system for certifying that individuals possess such knowledge before being licensed or otherwise allowed to practice;

However the UK body's definition of the common body of knowledge promotes the mechanical and surgical group's views, and excludes the views of the rival growth guidance group. This ideological bias is not supported by any sound theoretical base - something recognised by a series of the world's top independent scientists:

-- Sackett, D. Professor of Evidenced Based Research at Oxford. 1985 "Orthodontics is behind such treatment modalities as acupuncture, hypnosis, homeopathy, and on a par with scientology".

-- Johnston L.E. Professor of orthodontics at Ann Arbour Michigan. 1990 "Clinical practice �is at bottom largely an empirical process that is little influenced by theory inferred from any of the life sciences".

-- Richards Derek. Director of Evidenced Based Dentistry, 2000 "The current focus of dental schools leans toward the teaching of technical skills rather than scientific thinking".

-- Shaw, W C, 2000. Dean Manchester Dental School. "Sadly it is hard to see this situation changing unless the inadequacy of current (orthodontic) knowledge is acknowledged by its practitioners".

[sylvie]

RadioNational
Life Matters

http://www2b.abc.net.au/tmb/View/AlertM ... 1%26p2%3D0

To the caller who said his 11 year old child is getting their permanent teeth extracted soon to create space for orthodontics... please reconsider!

I cannot believe that some members of the dental profession are still practicing this harmful, stone-age “treatment”. The paradigm really needs to change. I went through exactly this procedure unnecessarily at 10 yrs of age, after the corrupt family dentist convinced my parents it was “necessary”. I ended up with significant ongoing health problems (TMJ disorder, sleep apnoea, migraines) and my FACIAL STRUCTURE has been ruined. It was the absolute WORST thing my parents ever allowed a so called “healthcare professional” to do to me.

A good orthodontist will be willing to address the root cause of dental crowding and malocclusion, without subjecting growing children to unnecessary, invasive, and potentially detrimental excision of healthy body parts. Crowding and malocclusion are caused by both dietary factors (refined carbohydrates, soft foods) and oral habits while growing, such as mouth breathing, incorrect swallowing patterns or thumb sucking. Some narrow-minded, old-fashioned orthodontists will still tell you it’s all “genetics” or whatever because it’s easier to give you a one size fits all treatment of 4 teeth out and braces, and because they don’t want to lose business by admitting that there are other proper ways of fixing problems with teeth, but BE WARNED: the child’s health and facial structure will likely suffer. You are not just dealing merely with teeth here.

Please seek another opinion. Find a good orthodontist who will utilise your child’s bone growth by helping to DEVELOP THE JAWS FORWARD into their proper morphology/size/position. Have your child’s jaws gently and slowly EXPANDED with removable plates and oral posture retraining. Let her retain a full set of natural healthy teeth. Let her facial structure develop to its full potential. Improve her airway space. Don’t let her end up with a sunken, dished in facial profile, a narrow retracted smile, and jaw and airway issues as a result of having her good teeth ripped out and her young, still GROWING jaws retracted. Please research ORTHOTROPICS, growth guidance, non-extraction orthodontics, and palatal/jaw expansion. There is plenty of information out there.

[sylvie]

Should putting in braces require removing 4 teeth? (Excerpts)

http://wiki.answers.com/Q/Should_puttin ... ng_4_teeth

ANSWER

Find a oral surgeon and orthodontist that specializes in sleep dentistry and get a second and a third opinion. You won't be able to get them back. I had my bicuspids removed when I was 15 to make "room" and correct an over jet. I am now 32 and suffered from severe sleep apnea and the reduced oral cavity caused by this barbaric practice was a contributing factor to my condition. To improve the situation I had to undergo tongue and throat surgery and be out of work a week in severe pain, and it's still only 90% improved. Other people that have small mouths and develop severe sleep apnea have to undergo extreme lengthy, and painful two-year-long procedures and multiple surgeries to reverse the damage that was only made worse by tooth extraction to "look better".

The latest clinical data shows that extraction can aggravate sleep apnea later in life, but not all dentists review or work with the latest data. There are many other ways to get pretty looking teeth that do not involve reducing the oral cavity via extraction, yes some of it requires jaw surgery, and longer / more expensive treatment by more experienced and higher trained dentists and oral surgeons.

Sleep dentistry is a specialty, not all dentists and oral surgeons are the same. If your dentist/oral surgeon treats people for sleep apnea regularly I would listen to them, but if you ask them and they dispute the latest findings or don't know about the latest clinical data I would seriously recommend you reconsider if they are the right dentist for you.

Think about it before you do this... we used to drill holes into people's skulls and let them bleed because we thought it improved mental illness... and that was "clinically" the right thing to do at one time.

ANSWER

My advice is that, if at all possible, try to keep all of your teeth especially if you have a small jaw. You will need all of your teeth to keep your lips up. See if there is some way to widen your jaw instead if your jaws are small! It doesn't happen to all patients; however, when teeth are pulled there is definitely a risk of the remaining teeth "dishing in." I know, this happened to me. Don't let anyone tell you differently. Patients in which this happens have a flat look to their face, their lips drop, their profile looks awkward, and their nose sometimes appears larger. (Less mouth -- other features appear larger.) I had straight teeth, but I had a bad bite. Appearance wise, I looked fine. Actually, I once liked it. My orthodontist pulled four teeth to correct my bite, and to this day I still cannot get used to my appearance. Now that I am getting older, I especially realize how important my teeth are in holding everything up, and now I have less to do so with. I am looking for an orthodontist to open up the spot where the teeth were pulled and I am going to try to replace the missing teeth if possible.

ANSWER

Do not get your teeth removed. Trust me it happened to me and my mouth has never been the same. The Dr said it would take less time 2 years instead of 4 years and i went for it. I think it was just a money grab he makes more money by removing your teeth because it makes the job easier for him. It is less complicated for him because he has more room to make the adjustment. It will give you a narrow smile and will change the bone structure of your face. Your face will sag in the process, it also takes me forever to chew my food. If your dentist agrees, you known that he will make money for removing your teeth. It cost me 800.00 dollars to get my teeth removed.

[VikingGnome]

My Dad died of after his 5th myocardial infarction and snored like a freight train. He was also Type II diabetic.

My mother was finally diagnosed with sleep apnea at age 78 and has been on CPAP for 10 years

I've been on CPAP for OSA over 12 years

1 Sister died at age 50 from arrthymia caused by enlarged heart (undiagnosed OSA). Snored so bad she and hubby slept in separate rooms.

1 Sister died at age 55 from Massive myocardial infarction (never diagnosed with OSA but suspicious for having it)

1 Sister suffered Sudden Cardiac Arrest and survived only because her husband did CPR for 20 minutes until paramedics got there. They couldn't get even a pediatric airway tube down her so ended up doing a tracheotomy. Docs implanted defibrillator. Then found she had severe OSA and has been on CPAP two months now.

My brother (a dentist) has been on CPAP over 12 Years

So out of family of 2 parents and 6 children, only 1 child does not suffer OSA (both parents and 5/6 probably do/did).

The one common element to all of our apnea problems: the doctors always comment on the extremely small airways we have (hard to intubate for surgery). Also extremely short faces (brachyfacial).

So seems we all have inherited a facial structure that causes OSA in our family.

[sylvie]

Get Rid of Class – A New Look for Orthodontics
July 15, 2012
by Michael L. Gelb DDS

http://www.sleepscholar.com/get-rid-of- ... hodontics/

Dental Malocclusions can be severe or not even noticeable to the patient. The classification of dental malocclusion was first developed by Edward Angle around 1900. His three classes lower jaw. Over the years other subclasses have been added. It is interesting to note that insurance may not provide benefits if the malocclusion is not severe enough to effect eating or talking. Image at right: (A), Normal occlusion; (B), Class I malocclusion; (C), Class II malocclusion; (D),Class III malocclusion. Note the position of the mesial cusp of the maxillary molar relative to the mandibular molar in each type of occlusion.

The main problem with this method of classification is that it only describes the relationship of the teeth and has nothing to do with the position of the teeth with respect to the skull, tongue, hard palate, soft palate, temporomandibular joints and especially the airway.

The profession of dentistry is moving beyond a focus on teeth while giving little or no attention to the role that oral conditions impact on systemic health. The current hierarchy places the airway as the number one priority. What will treatment or lack of treatment do to the airway? Today more and more studies are showing that maxillary and mandibular retrusion, mouth-breathing and the lack of early intervention puts children at heightened risk for morbidity and mortality.

Early intervention to promote ideal nasal breathing by maxillary expansion, myo-functional training, treatment of allergy and sleep disorders is essential, even as early as 2-3 years of age. So much of our growth and development and brain maturation is completed by 6 years of age.

The stigma of ADHS and other learning disabilities is often made by kindergarten at age 6. We know from the recent article in the J of Pediatrics that many children with behavioral issues really have a sleep/breathing disorder. ADHD has been reversed by treatment of sleep disorders through adenotonsilectomy and palatal expansion therapy.

Airway obstruction in children is most often caused by enlarged tonsils and adenoids, well as constricted palates. Airway obstruction can be diagnosed as obstructive sleep apnea by overnight sleep studies (PSG) or home sleep studies. Due to poor nutrition, allergy and epigenetic factors children’s airways are frequently narrowed. Most children have bimaxillary retrusion even in class 1 normal occlusions. Most maxillas are retruded according to McNamara , and therefore the mandible is forced into a retruded posture with a retruded tongue base. Retruded maxillas are associated with retruded hard palates and retruded soft palates further obstructing the airway. The Angle classification exposes crucial flaw in orthodontic theory by basing occlusion on tooth-to-tooth relationship with no consideration of the airway. The result of orthodontic treatment can be perfectly aligned teeth and diminished airway.
Lack of early expansion, which may then be followed by the extraction of the four bicuspid teeth and the utilization of headgear, further constricts the airway and predisposes the child and adult to learning disability, ADHD, depression , fatigue and neurocognitive defects.
Orthodontic classification should be based on the airway and ideal skeletal potential. Dished in faces, narrow maxillas and closed airways with compressed TMJs can and should no longer be acceptable.

We need to be face focused, airway focused, TMJ focused, not tooth focused. The current Angle orthodontic classification puts undeserved importance on the teeth, often at the expense of the airway. Straight teeth are not necessary for survival but a sufficient airway day and night is. The hierarchy for survival and the ability to thrive is Airway , then proper nutrition , and oral structures that allows ideal sucking, swallowing and chewing and then lastly the occlusion.

[chunkyfrog]

All things considered, avoiding orthodontics altogether may actually be advisable unless there is access to a
COMPETENT practitioner. My orthodontist was shocked when he saw my oral surgeon had gone ahead
and removed my 12-year molars. I still wonder why they were not communicating.
Little has improved in 50 years.

[sylvie]

All things considered, avoiding orthodontics altogether may actually be advisable unless there is access to a
COMPETENT practitioner. My orthodontist was shocked when he saw my oral surgeon had gone ahead
and removed my 12-year molars. I still wonder why they were not communicating.
Little has improved in 50 years.

ChunkyFrog, that is tragic. But I also have a ton of teeth missing. Including my wisdom teeth and I"ll be posting stuff about that soon. Even impacted wisdom teeth do not necessarily have to be removed and really shouldn't be. A functional ortho can address this. I remember when they told me I had to have all 4 impacted wisdom teeth removed at age 20 and they told me that many patients would wake up from the anesthesia crying. At the time I thought that was stupid. But indeed I woke up crying. I wonder if that was the body's way of saying you took out perfectly healthy body parts. Sometimes I feel like I could cry a bucket of tears over this topic, and I see that a lot of people having had this happen to them feel the same way too. At least I know I'm not alone. Also, about 3 years ago my back molar was rubbing against the back of my mouth and causing irritation and I was tired of dealing with it. So I went to the dentist and he told me to have it removed. So I did, and the dentist had a terrible time removing it, pulling and drilling. Now I find that they can make a tooth thinner and that could have been avoided. Was I ever told that?!! No! They just sent me to the guy next door who yanked it out.

On a positive note, I read last night that the DNA appliance can really help people, maybe even eliminate the apnea, that have AHI's under 30, by growing the jaw to allow the tongue to fit into the mouth as it was originally supposed to, so that my tongue isn't halfway down my throat at night. I think it's expensive, but hopefully the dentist will allow me to pay monthly till I pay it off. I also read that in order to avoid thousands more dollars down the road due to your facial structure further collapsing into the airway, it is a good idea to try and "regrow" the jaw and palet as soon as possible. I' m not verifying that or promoting that route, I'm just saying what I recently read about.

When I start to feel sorry for myself, I remember a girl I was friends with about 10 years ago. Her mother had taken thalidimide in the '60s, a drug that was supposed to ward off nausea for morning sickness. That drug was shown to produce many birth defects in their children, and my friend was one of them. She was practically totally blind, had very poor muscle tone, severe scoliosis, and a host of other internal problems I can't remember. She loved to dance and be in theatre, even with all her problems. Even thinking about her now makes me cry. She did tell me that she allowed herself "pity parties" now and then and asked me if she should feel guilty about that. Of course I told her that was ridiculous, that I perfectly understood. That really convicted me, as at the time I would have pity parties over "love gone bad" experiences. I haven't seen her in many years, and wonder if she is even still alive.

[lazer]

............Avoid extractions in almost all cases

Removing teeth for cosmetics can lead to disastrous and dangerous results. Crowding is due to insufficient arch development. Removal of teeth for cosmetics can lead to snoring, sleep apnea, chronic headaches and other serious medical problems. The tongue fits in the oral cavity and reducing the size can cause distal displacement that blocks the airway. .............

Maybe this is why I'm battling with some form of apnea? I've had quite a few teeth removed over the years due to decay/cavities and also where an "Upper/partial" although I take it out at night. Hrmmmm..... Wonder if I should get my dentist involved in my sleep apnea symptoms and discussion.

[Shellie_p]

My orthodontist is recommending to pull four of my teeth (Premolar teeth) can this solve the problem?
http://www.stopsnoring.com/jawstart.htm

Unfortunately no and it can create a major problem later in your life. If your orthodontist has recommended extracting few of your teeth to create room because your teeth are crowded you may want to have a second opinion. In a study of 6,200 patients with sleep apnea we have found that many of the individuals who had taken their teeth out for orthodontic reasons when they were younger have developed obstructive sleep apnea when got older. When a dentist pulls your teeth and pushes your front teeth backward it can make the internal size of your mouth where your tongue is located too small. If you already also have a receded chin and jaw when you sleep the tongue falls in the back of your throat and blocks the airway.

Had 2 of my wisdom teeth pulled in my early 20's because one wasn't in fully for a month and it literally exploded one day. one of the others was also coming in at the time and he pulled it cause it was 35% sideways, Then i had another tooth pulled next to one of the previously pulled molars and after that one, I ended up with TMJ.. I can't open my mouth fully anymore due to the pain, Dentist says my jaw shifted.. yea major problems.

[GracieAutry]

Dr. Silva Arejian, DDS combine comprehensive care and the latest techniques to offer you the full scope of general dentistry and cosmetic dentistry services.

Address : 1127 Wilshire Blvd. Suite 509, Los Angeles, CA 90017
Phone :(213) 481-2080

[ChicagoGranny]

Sylvie, I think you will find this fascinating (and sad) - https://www.facebook.com/YCrookedTeeth

and https://www.youtube.com/watch?v=iO56y_czoCU

[sylvie]

Sylvie, I think you will find this fascinating (and sad) - https://www.facebook.com/YCrookedTeeth

and https://www.youtube.com/watch?v=iO56y_czoCU

This information is also included in the article I posted previously, "10 Things Every Mother Should Know About Teeth and Sleep." It's an important article, and one I think should be revisited, due to PMs.

http://www.sleepscholar.com/10-things-e ... and-sleep/

[jencat824]

Is it because there are so many different causes? Perhaps it is considered hereditary and I just don't know. Lol

Beware: Extraction orthodontics has caused, and continues to cause, sleep apnea:

If your orthodontist has recommended extracting few of your teeth to create room because your teeth are crowded you may want to have a second opinion. In a study of 6,200 patients with sleep apnea we have found that many of the individuals who had taken their teeth out for orthodontic reasons when they were younger have developed obstructive sleep apnea when got older. When a dentist pulls your teeth and pushes your front teeth backward it can make the internal size of your mouth where your tongue is located too small. If you already also have a receded chin and jaw when you sleep the tongue falls in the back of your throat and blocks the airway. We also noted that patient’s nose gets longer too because when the teeth are pushed back the upper jaw does not move as much hence causing a longer nasal tip and a protruded upper jaw. Unfortunately most orthodontists are not trained in sleep apnea and this point is completely ignored. Hundreds of patients are being told every year to have their orthodontics repeated to move the teeth in the opposite direction (Upper teeth forward) and consider jaw surgery to correct the position of the jaws as well.

http://www.stopsnoring.com/jawstart.htm

I agree with you, I had 8 teeth extracted at age 12 for braces. Age 20, had terrible TMJ, chose not to have surgery due to expense. Age 40 diagnosed with severe OSA, treated and just now figured out I have a leak problem, hopefully treatable with chin strap and/or another mask. I am a believer that there is a direct correlation to teeth extraction and these disorders. Something that supports that theory is that after my OSA was treated, wearing the mask pushed my front teeth back to the overbite position they were in before my braces. Kind of a coincidence?
Jen