Discussion of Small Jaws as Cause of Obstructive Sleep Apnea

[momof2inmn]

I was just thinking about this same topic over the past week! In my case, I had to have baby teeth removed and permanent ones cut out so that there was room in my jaw. I had a headgear that was supposed to correct my overbite but I never wore it because it hurt! I can fit my pinky finger tip in between my upper and lower teeth and they had considered breaking my jaw when I was a teen to correct that.

Now, as an adult, I deal with OSA and an issue that I originally thought was asthma. I have periods where I cannot seem to get enough air in my lungs. I was referred by my allergist to a speech pathologist who said that my vocal cords were extremely tight and that my voice breaks constantly (which I now notice all the time) and can't exhale long enough due to the way I hold my tongue in my mouth.

It makes total sense to me that I hold my tongue differently because my jaw is so far back. It has to be pushing my throat muscles and tongue back so far that it's a huge factor in my OSA.

I have recently been looking at taping and chin straps and FFMs and thought the only solution for me might be to break my jaw so that I don't have an overbite any more.

You've given me much more to consider!

[elena88]

I just looked in the mirror, and my tongue is scalloped too..

I had no idea until a few months ago a small jaw could cause so much havoc!


My brother does not have osa.

He is four years older than I am, and when he was a kid, he had his tonsils out.. My folks stayed right by his side, good thing, because
he almost bled to death.. He also had braces, and wore head gear for years..

so when I came along, and my teeth started to crowd, they thought it would be kinder to have four of my permanent teeth pulled when I
was just a little kid. They also did not have my tonsils removed because of what happened to my brother.
I just ran into two more people who had permanant teeth removed when they were kids, and guess what.. they have OSA too!

My tongue feels like its three sizes too big for my mouth, like Im trying to fit a double "D' into an A cup bra!

When I see gene simmons (KISS) stick out his seven inch tongue, I cant believe he doesnt have OSA!

[roster]

Gene's jaw is fairly wide and deep, at least from the few photos I have seen. His tongue may fit in there well.

[elena88]

now that I think of it, his jaw is very wide, isnt it?

I hope his kids got his nice wide jaw.... if they got that long tongue GENE!

[socknitster]

I have an appointment two weeks from today to see an orthodontist that is at the top of my list. He is British, and does continuing education both here in the US and in Europe, according to his website. He also uses the Damon system as well as functional orthodontic retainers. I like the fact that he is experienced and is using cutting edge tech, as well as a variety of tech. That approach appeals to me more than "one-size-fits-all."

Over the weekend, I emailed Dr. Sue in Honolulu (see links on first page) and he sent me a list of doctors in my state that practice functional or non-extraction orthodontics. I thought that was very kind of him. I explained that the website for the American Association of Functional Orthodontics was not working and he quickly fired back a list of about 12 orthodontists that practice this kind of orthodontics, though he said I would have to interview them as he doesn't know any of them personally. The Doc I made the appointment with is on his list.

I also made an appointment for the end of August with another one, but his office staff did not seem as knowledgeable about what exactly he does and that put me off a bit. I may choose another one to go see as well.

If the first one I see suggests a non-surgical route, I may go with him. I intend on looking for reviews on orthodontists today online via the ADA website the IDA, Yelp and google business. Hopefully I will find some good reviews--at least more to go by than glossy websites.

Thank you for your encouragement Rooster. My OSA is so mild now due to the tonsilectomy I had 3 years ago, this might do the trick. It will likely take years to get the result, but that is fine with me. I will happily strap on my bipap knowing I am doing everything I can to improve my health and well being.

[SleepingUgly]

Socknitser, I just saw my ENT today for a post-op check. She told me that I cannot gain weight, and that even 15 lbs would be a step backwards (she tells this to all her apnea surgery patients). I don't know if you have gained weight or not lost weight since your tonsillectomy, but your apnea sounds so mild now that I wonder if something like that would be enough for you to be "cured".

[stacia123]

Interesting stuff, Rooster, and thanks. I had sleep problems even as a kid, and I now know in hindsight it was sleep apnea. I inherited my grandmother's mouth; that is, small jaw with a tongue that's too big (and I get sores on it constantly from where it rubs against the teeth even during rest), crowded lower teeth, and a normal upper jaw that in comparison looks like an overbite. As an adult, my doctor told me when I started the CPAP that I would need a full face mask because of the "deformity", as he called it, and there's only one face mask that fits because my chin is "weak." I wish everyone who is going with surgery or braces lots of luck! I hope it works out for you!

[socknitster]

Socknitser, I just saw my ENT today for a post-op check. She told me that I cannot gain weight, and that even 15 lbs would be a step backwards (she tells this to all her apnea surgery patients). I don't know if you have gained weight or not lost weight since your tonsillectomy, but your apnea sounds so mild now that I wonder if something like that would be enough for you to be "cured".

Yes, I have no doubt that losing weight would help. I would need to lose about 70 lbs to get to a healthy weight. Unfortunately I have chronic fatigue syndrome. That means that daily activity feels like a workout. I try to add exercise when I can, but its a battle. I have been improving over the last couple of months so I'm hopeful that the future holds the possibility of more exercise without excessive post-exertional fatigue. It doesn't pay to exercise if you are nearly bedridden for a day because it makes you so exhausted. My diet remains excellent as ever. But since the chronic fatigue set in, I have gained weight. Experts in chronic fatigue syndrome say that a patient with this gains an average of 33 lbs. I've probably only gained 10-15, but its enough to make me outraged, since my diet is very sensible. Chronic fatigue affects the metabolism on a cellular level--all the way down to the mitochondria, or so I've read. So, anyway, I hope that in time I will be able to lose weight again. I have weight in the past when I was feeling well and able to exercise.

So, yes, your advice is very sound. With one caveat. I had sleep problems even when I was stick thin. I have always slept longer than everyone else, had difficulty falling asleep, waking unrefreshed. I used to fall asleep in high school and college classes, despite the 10+ hours I regularly got. I wasn't a typical teen--out at all hours. I slept a lot. I often came home from high school and just couldn't keep my eyes open, would crash for a couple of hours and then get up, do my chores and homework and go back to bed. That was at 6' tall and about 150 lbs. In college it was the same. If I had an hour between classes I would go back to my room and nap. Crazy.

I would really like for my mouth to be larger. Like Stacia123, I feel like I have a ginormous tongue in a tiny mouth and that in itself is irritating. I hope this is a good solution. I know it is an experiment. So, time will tell.

It is annoyingly difficult to find reviews of orthodontists online. I did tons of searches but only came up with one review of my 1st choice ortho, which luckily was extremely positive. Did you know Angie's List is charging now? Outrageous! I coudn't ever find any reviews for anything when it was free on there. I can't imagine paying for NOTHING. Stupid. Maybe it is useful in big metropolitin areas, but not here.

[elena88]

Unfortunately I have chronic fatigue syndrome

Oh that is a bummer, I had that about twenty five years ago.. It all started with eptein barr virus and went downhill from there..
It got so bad, I didnt have the energy to open my mouth to TALK!

Then I found out I was allergic to some foods, changed my diet, was better in two weeks.. also had my amalgam (mercury) fillings removed,
and after that have not caught an infection since! Used to be sick ALL the time till I got those fillings out..

That is just what worked for me, and I know how tough it is.. sorry you get so tired, I do know what that feels like..

[socknitster]

Thanks, Elena,

It is getting better. It started with getting the flu last October. I wish it were something as simple as having fillings removed (I don't have any mercury fillings)! Thanks for offering the suggestions though. Over time I slowly am gaining more stamina.

Jen

[elena88]

I think something happens to our immune systems sometimes when are are fight an infection, system wide crash..

Its no fun, Im glad you are getting better each day.. and very glad you dont have any silver fillings!

what was the key for me was just changing my diet, no preservatives or chemicals nothing my body had to fight on top
of what was going on.. no dairy, wheat, or corn.. and I began to thrive again..



I hope you do too!

[nadlemgarcia]

I have a certain question to be raised. It has something to do with the jaw. Lately, it has been sensationalized in the TV how Charice Pempengco was given a botox by Dra, Vicky Belo, a famous doctor in her field. We know all that Charice Pempengco, is a big star and she was even offered to be part of American most loved television series, GLEE. On news, it says that Charice Pempengco's jaw has become bigger because of chewing gum. So, in this scenario, how would you justify that her reason is correct or is there any scientific basis about it? Thank you for your future response.

[roster]

I have a certain question to be raised. It has something to do with the jaw. Lately, it has been sensationalized in the TV how Charice Pempengco was given a botox by Dra, Vicky Belo, a famous doctor in her field. We know all that Charice Pempengco, is a big star and she was even offered to be part of American most loved television series, GLEE. On news, it says that Charice Pempengco's jaw has become bigger because of chewing gum. So, in this scenario, how would you justify that her reason is correct or is there any scientific basis about it? Thank you for your future response.

A person's jaws can appear wider due to idiopathic hypertrophy of the masseter muscle. Idiopathic hypertrophy of the masseter muscle is a rare disorder of unknown cause. It does not increase the size of the jaw and therefore the breathing airway is not larger.

Here is an image of a patient who has masseter muscle hypertropy on the left side only.



The prominence of the left mandible is due to the unusual size of the masseter muscle. The skeleton of the jaw is of normal size on both sides.

Some doctors associate it with the habit of chewing gum, but there is no solid science behind this and most doctors do not believe it is caused by chewing gum.

The Thermage skin-tightening procedure and Botox injections were intended to make Charice Pempengco's "naturally round face" more narrow. I bet if you could find photos of her before she had teeth to chew gum, you would see a nicely rounded jaw.

In any case, none of the photos I have seen would indicate she has masseter muscle hypertropy.

[chunkyfrog]

Hey, Rooster; here's a plan:
Has anyone attempted to put together a database of 3D facial images or dimensioned wire frame renderings to enhance the inadequate data now being used by mask manufacturers? It would seem to me that a standard template and directions would suffice to enable individuals to take the images at uniform distance and angles with ordinary digital cameras--or even camera phones. If we could collect enough data, along with what (if any) masks were known to fit each subject; the result might be made available to the mask designers. They would no longer be limited to using themselves or their perfect-featured girl-friends as models. Imagine all the machines that might be pulled from dark closets and brought back onto nightstands--to save lives, instead of gathering dust.
Sound like an idea? --any thoughts of software, 3D resources, etc?
You sound like the guy who might know who, how, where, whatever.
I'm thinking public domain--we want everyone to have access --competition = low prices.
Whad'ya think?
Breathlessly yours,
Frog

[Janknitz]

Frog,

The genetic disorder I have, Noonan's syndrome, has some facial dysmorphisms, and my daughter and I participated in a study being run by Harvard Human Genetics which includes 3-D face mapping. In our case, there are several genes located along what is known as the RAS MAP-Kinase pathway, and they are trying to correlate facial features to particular genetic mutations to see if they can predict which of several genes is implicated in various expressions of disorders along this pathway.

The technology is definitely there already. If you PM me, I can give you the name of the doctor in charge of the study and you can find out what face-mapping software she is using.

It also seems that animators in Hollywood are using some sort of face mapping for the CGI-type animation as in Avatar and Lord of the Rings (Gollum).

My guess is that it's pretty expensive equipment at this point in time!