How Do Teeth Move through Braces and How Can This Impact the Way We Breathe?

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How Do Teeth Move through Braces and How Can This Impact the Way We Breathe?

The body is dynamic and constantly changing. It responds to environmental stimuli in thousands of ways. The pupils constrict in bright sunlight. The skin releases melanin in response to ultraviolet light. Muscles grow and multiply when challenged with heavy, repetitive movements. Bone changes its shape and density in response to pressure. All of this is the remarkable response of a human organism that is designed not only to react to an external stimulus, but also to adapt to it. 

Teeth are no different.

When a constant, light pressure is applied to a tooth, it moves. Note that I said light pressure. Light pressure is the most efficient way to reshape bone. Keep in mind that when we move teeth, we’re really reshaping the bone around the teeth. 

The teeth are merely acting as a tool to move the bone, or in some instances, to create new bone.

But can we actually grow bone?

It’s important to note the roots of the word osteogenesis. “Osteo” means bone, and “genesis” means formation or creation. We create new bone, liver cells, skin cells, and hair cells all the time. The great thing is that we can direct that growth and remodeling; in fact, that’s the entire basis of the specialty of orthodontics. 

Not only can we direct this growth and remodeling, but we’re learning how to speed it up!  We didn’t always understand how teeth move, even in our very specialized area of orthodontics. The classical theory of tooth movement was that applying lots of pressure to teeth would eventually cause them to move. This is true, but at what cost? 

We couldn’t move them very far, because the body doesn’t adapt well to heavy forces. That’s why we had to extract teeth so frequently: we just couldn’t create the space necessary to accommodate all of the teeth because the body wasn’t adapting very efficiently, and it was our fault, because we had the true concept of tooth movement all wrong and many orthodontists and general dentists still do.

Understanding the correct biology of tooth movement has been quite a revelation for orthodontists. This understanding has allowed us to significantly decrease the number of extractions that we request. In fact, I went back and reviewed the last five hundred consecutive patients I’ve treated, and my extraction rate was 0.01 percent, a figure that frankly surprised me. 

Don’t misunderstand: there are cases in which permanent tooth extractions are required; however, those should be the exception, certainly not the rule. Avoiding extractions allows us to create broad, beautiful smiles. 

Constant, low forces move teeth. We know this and we’ve proven this, yet so many orthodontists and general dentists insist on using high forces.

Remember going to the orthodontist and having your braces tightened? Your mouth would hurt for at least a week or more. Then, just as you started to become pain free, you’d go back and the entire nightmare would play itself over, and over, and over. Those were heavy forces that were altogether unnecessary and even harmful in many instances.

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At that stage we’re just getting in and doing the heavy lifting early, so that when all of the permanent teeth erupt into the mouth, we can keep treatment relatively short. We refer to this second part of treatment as phase II. There are plenty of children who don’t need phase I; however, only experienced orthodontists taking full advantage of all of the patient’s diagnostic records should make the decision as to the need for an early phase of orthodontics. 

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