You Have Everything To Lose

What happens in the mouth is usually just the tip of the iceberg and a reflection of what is happening in other parts of the body. Okay, you have everything to lose. It’s the story of your health, prosperity, and longevity. But no matter what your story is today, it’s not finished. If your mouth could talk, it would tell you to pay attention, keep reading, and write your own happy ending. But despite our collective genius, we’ve really managed to fall behind when it comes to health. We have some of the worst quality sleep in the world, with 1.2 million workdays lost annually to sleep deprivation. We suffer from a myriad of chronic diseases, from Alzheimer’s to diabetes. We rank sixth in the world for greatest number of preterm births. As we have discussed, we are doing no better in the dental realm. Dental crowding, gum disease, and airway disorders are on the rise too.

All Things Must Pass

It all comes back to your mouth. Nearly everything has to go through your mouth to get to the rest of you, from food and air, to bacteria and viruses, to environmental toxins. From the moment you are conceived, oral health impacts every aspect of your life and that of your children. Poor oral health can be a result of systemic disease, or the cause of it. The microorganisms in an unhealthy mouth can cause not only cavities and gum disease, but also chronic inflammation. And they can enter the bloodstream and travel anywhere in the body, posing serious health risks. Similarly, an underdeveloped mouth can not only result in dental crowding and bite problems, it can also obstruct the airway and interfere with breathing and oxygen intake, potentially affecting every cell in the body. There are many factors responsible for the epidemic proportions of many chronic illnesses in America, but you’re about to see the critical role that the mouth plays in your health. How did you get that way? Let’s take a closer look at the gateway to your body. As you probably know, jaws are the two bony structures that frame the mouth and hold the 20 baby teeth and, later, the 32 adult teeth. The upper jaw, called the maxilla, is formed from the fusion of two bones. The timing of upper jaw fusion, which starts at about age eight, is critical for the timing of orthodontic treatment, as you will learn later.

Breaking Down Barriers

The maxilla has been described as the architectural key to the face because every bone in the face, except the mandible, is in direct contact with it. It’s important to know that the maxilla doesn’t just form the palate and hold the upper teeth. It also contains the maxillary sinuses. The upper surface forms the walls and floor of the nasal cavity and the floor of the orbit for each eye, and it shapes the cheekbones. Since the maxilla is so intimately connected to so many other facial structures, its proper growth is critical. It is the largest bone in the face and the only one that is movable. Its ability to pivot in almost every direction is important for chewing, speaking, and making facial expressions. Proper growth of the mandible is crucial in the development of the dentition, the bite, and the support structures that control the tongue and the airway. There could be an evolutionary purpose behind why we find healthy mouths and balanced facial proportions attractive. In this case, and in many cases, attractiveness and health go hand in hand. We may not realize it in the moment, but when we seek out one, we’re also seeking out the other. It makes good sense that we would find health attractive.

Between A Laugh And A Tear

We’re hardwired to want to have healthy babies, and healthy babies start with healthy parents. They assume that, as their child grows, more space will materialize in that child’s mouth. As you grow, things get bigger, right? Not exactly, at least not when it comes to jaws. You might have guessed by now, but when it comes to orthodontics, waiting is rarely the best approach. It is true that the jaw will continue to grow as a child grows. But, strangely enough, that growth will not create more space for the teeth. In fact, the space for teeth will get smaller as the jaw grows. If you’re now totally confused, let me explain. The growth and development of dental occlusion is a very long process. It starts during week six of intrauterine life and ends during the late teen years or shortly after 20 years of age. The growth of the jaws and teeth is influenced by both genetics and environment. Before birth, it is primarily influenced by genetics. I’m going to use the lower jaw to discuss growth and space. However, the lower jaw’s midline suture fuses by age one. So, when it comes to space, we are always more concerned about the lower jaw since what we can do there is more limited. As the teeth are transitioning between baby teeth and permanent teeth, the jaw grows backward to make room for first, second, and sometimes third permanent molars. In contrast to the front area of the mouth where permanent teeth are bigger and wider than the baby teeth, the back baby teeth are actually wider than the permanent teeth that will replace them. So, as the back baby teeth fall out and get replaced by smaller permanent teeth, the permanent molars behind them drift forward to occupy this extra space, called the leeway space, decreasing the total arch perimeter. We can do true skeletal expansion only in the maxilla because of the suture I mentioned earlier. Aside from a few exceptions, avoiding extractions of permanent teeth can generally help maintain the fullness of the lips, reduce the speed of aging and the development of wrinkles, create a nicer profile, and leave more room for the tongue and airway. Plus, excessive removal of enamel from the sides of teeth can potentially jeopardize tooth health too.