Orthodontic Treatment – What to Consider

There are many issues to think about and discuss with your doctor when deciding to pursue orthodontic treatment. Orthodontic treatment has lasting effects on your quality of life not only from an esthetic perspective but also from an airway, postural and neuromuscular perspective. We use the term functional orthodontics when describing how we provide orthodontic treatment. The reason it is called functional orthodontics is because we also look at the posture, airway, and musculature to ensure that when your jaws close and teeth come together, the airway is optimum, the muscles are functioning with in their most efficient state and the condyles of the jaw are seated properly in the joint space.

The Esthetic Perspective

Orthodontic treatment is often necessary to eliminate crowding and misaligned teeth. The use of braces accomplishes many things in enhancing a person’s smile. It enables more efficient cleaning, broadens a smile and reduces the effects of wear on teeth which can cause tooth shortening. It also reduces the chances of cavities by eliminating food entrapment areas and increases the ability to clean in between teeth. This is the most common concern from patients seeking orthodontic care. There is, however, far more to this story.

The Postural Perspective

The alignment of the jaws and how teeth contact their neighbors and the opposing teeth play critical roles in how you hold your head and how comfortable your neck muscles are. There are many situations when patients come to me for migraine and headache pain. Since the nerves and muscles of the mouth are intimately connected to the cervical vertebrae and then the spine, many myofascial pain symptoms can go unrecognized by physicians as being related to the mouth. Misaligned jaws are a very common. When the jaws are misaligned through trauma or genetic factors, the muscles that control the jaws can become fatigued. These muscles then enlist the help of cervical muscles to chew and maintain posture. If the fatigue and misalignment are great enough, this fatigue can extend down through the rest of the body, even to the feet. The nerves that connect to the teeth communicate with other areas of the brain that control the visual and balance systems. When the jaws and teeth do not align or work harmoniously together, the patient can have neck and shoulder pain, head tilts or a forward head posture. When these situations remain untreated, this individual can get headaches, and migraines. Many of these patients end up being treated with drugs which only cover up the origin of the problem.

The Functional Perspective.

In order to ensure that your stomatognathic system has occlusal (tooth) forces balanced and that the muscles of the chewing system are working harmoniously, it is imperative that electromyographic studies be performed prior to placing braces and also following the removal of braces. The muscles of the mouth and airway form the shape of the mouth. When there are undiagnosed airway issues in the child, the child will present with signs such as a being a heavy snorer, grumpy, irritable, difficult to wake up in the morning, have behavioral issues, and may also perform poorly in school. These situations can be eliminated by improving the airway so the child can sleep properly. This will often lead to dramatic improvement in all aspects of a child’s development not only in the classroom and socially, but also from an anatomic development standpoint. Often times orthodontic relapses occur because these issues were not addressed at the beginning and since form follows function, the teeth move, the posture of the head changes, and masticatory (chewing) and cervical muscles become fatigued and airway issues develop. As you discuss these issues with other friends or family or perhaps even noticed about yourself if you have had braces previously, relapses are common. We will do everything possible to ensure that this is minimized.