The changing American profile

Sep 22, 2017

How in the world did we get into the state we’re in? 

Every day, the dentists at World Class Dentistry see adults in their 40s with sleep apnea and temporormadibular joint syndrome (TMJ) pain. At the beginning of the career for Dr. Burr Bakke, a dental implantologist and co-owner of World Class Dentistry in Sarasota, these problems didn’t occur until the later years when adults were in their 60s. Today, he sees young children who are experiencing sleep apnea, underdeveloped faces and receding chins. Their jaws are too small for their teeth even though genetically they were programmed to have ample room for their teeth. 

“When reading Hal Huggins’ book called Why have Ugly Kids? it became apparent to me why this progression of chronic dental problems in the American culture has occurred,” says Bakke. “Even the standards of beauty are changing because our society is used to seeing long faces, receded chins, narrow smiles and flat midfaces. As a result, the sales of facial fillers are also at a record-breaking high, as men and women try to create the beautiful cheekbones they were supposed to have instead of their flat midfaces.”

Why can’t people breathe out of their noses? Why do so many kids need to have teeth pulled prior to braces? Why do so many people miss work every year due to headaches? Why are sleep clinics popping up all over America with the sales of CPAP breathing machines at an all-time high? The answers to these questions aren’t that hard to find. 

It starts with the American diet, which is filled with highly processed foods, foods that are high in carbohydrates and low fat foods. This diet causes open-mouth breathing, allergies and mucous. This open-mouth breathing results in wrong tongue position. As a result, the dental arches grow narrow and the face becomes long with receding jaw lines, altering the overall shape of the face and preventing the teeth from fitting properly into the narrow dental arches, Dr. Bakke says.

More often than not when this occurs, parents are told to have the teeth pulled and then use braces and headgear to reposition the teeth. Although braces and headgear actually make the jaws even narrower with the lower chin receded. These practices create adults that show up in my practice with TMJ pain, clenching and grinding of the teeth and a tongue that blocks the airway during sleep. 

A sleeping infant should never have the mouth open, informs Dr. Bakke. Watch your children and see if they mouth breathe. Mouth breathing inflames the tonsils and adenoids, causing them to become enlarged and infected, because the air is not filtered through the nose first. This causes allergies and breathing difficulties.

In years past, traditional orthodontic methods centered around removing the four bicuspid teeth and then pulling everything back and aligning the teeth to allow the remaining teeth to fit together properly. However, these narrow dental arches create space limitation for the tongue. Through gravity, the tongue blocks the airway because of the recessed lower jaw, resulting in suffocation or sleep apnea, early deaths in adults and poor concentration in children.

What do we do differently today? At World Class Dentistry, they treat children and adults using a combination of orthopedics and orthodontics known as full-face orthodontics. Orthopedics involves jaw growth and expansion while orthodontics is the actual movement of the teeth. 

Today, Dr. Bakke’s primary goal is to expand and grow the upper arch of teeth via orthopedic movement, allowing room for the teeth to fall correctly into place. The teeth know where they need to go and will align correctly given the opportunity.

By controlling the direction of orofacial growth with full-face orthodontics, improvements in airway function and aesthetic appearance can be achieved. With the correct amount of room and spatial development we can then use orthodontics to correctly and beautifully align the teeth. 

This can be done on adults to correct sleep apnea, prevent the use of CPAP machines and stop snoring. In most instances, TMJ pain can be cured. In the past, we thought that surgery was the only way to allow the palate to grow or correct TMJ. 

“We know that through orthopedic appliance therapy, we can stimulate growth in the upper jawbone to expand and widen the arches,” Dr. Bakke says. “This will recapture the lost space from tooth removal or gain space that was not there. The lower jaw will follow the upper jaw as it moves out and wider in shape. Once the jaws are repositioned properly, it allows the roof of the mouth to reshape and the airway to reopen, allowing more nasal airflow, nasal breathing and more room for the tongue to prevent sleep apnea.”

Some orthodontics may be needed, but not nearly as much to make a beautiful smile. In children, the dentists at World Class Dentistry recommend early interventions at age 5 with Myofunctional therapy to teach proper tongue positioning, which stimulates jaw growth automatically. The jaws and face will develop automatically and again the teeth know where to go. Sometimes they can even eliminate or minimize the need for braces.