The alternative to orthodontics without extractions or facial surgery.
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How can parents balance the evidence?
This was the concern that brought a group of Dentists, Orthodontists, Chiropractors and other health workers together, from all over the world, to open a site that discussed various methods of treatment so that patients could consider some of the more Natural options. Unfortunately some clinicians make claims that are difficult to justify and the rest of this site contains information for patients, dentists and orthodontists and we hope this will help them to decide which option is best.
The Cause and Cure of Malocclusion
What is the problem?
From a very young age the faces of some children grow downwards (vertically) and they develop receding chins, flat faces, crowded teeth and big noses (see right). On the other hand some children grow forward (horizontally) looking much better (see far right). Most orthodontists think that these problems are inherited and that little can be done to correct them other than to mechanically straighten the teeth. However Orthotropists® believe that vertical growth is caused by open mouth postures or tongue habits so they convert the vertical growth to horizontal by training the children to change these habits. Obviously Orthotropics must be started young but it can have a big effect on facial appearance (see other faces on this site). Most orthodontic treatment (see below) actually increases vertical growth so look for treatments that encourage horizontal growth.
Vertical
Growth Damages Faces |
Horizontal
Growth Improves Faces |
 |
 |
| This child’s face was damaged by vertical growth following orthodontic treatment. Vertical growth is associated with thick lips, receding chins, protruding noses, sloping foreheads and tired eyes. | This boy received Orthotropics®. Although his front teeth stuck out both jaws were encouraged to grow forward. Few other techniques achieve this because they pull the teeth back. Horizontal growers retain naturally straight teeth for a life time. |
Orthodontic Treatment with Extractions.
Research shows that dentists much prefer Orthotropic results but may not recommend them because growth guidance takes longer and is more expensive. However orthodontic treatment usually requires wearing a brace for ever to hold the teeth straight.
Parents have a simple choice:
- Preventive Orthotropics while their child is young (5 to 8) or
- Conventional orthodontics when they are older.
For the last hundred years most orthodontists have taken the second option because it is easier and quicker than guiding the growth of the jaws. This is despite knowing that this option usually increases unattractive vertical growth and many good looking children finish with obvious damage (see Mary right). Teeth can be straightened at any age but if the jaws have grown the wrong way they are likely to require surgery.
Hundreds of children are committed to surgery each year although it can be completely avoided with Orthotropics.
Showing the facial damage after three years orthodontic treatment
Mary
All orthodontists are legally obliged to tell patients about alternative methods of treatment, especially if they are recommending irreversible procedures such as extractions or surgery. Unfortunately not all do so. If you were not told about alternatives, you have a legal right to complain. Mary above was told she would have to have four extractions and her teeth pulled back but she was not informed there was any alternative. You can see how the ‘train tracks’ changed her horizontally growing face to vertical, with flat cheeks, and a receding chin (illustration above). Because her parents complained about the damage to her face, the orthodontist suggested surgery to cut and reposition her jaws, so her parents sought a second opinion but by then it was too late to restore her growth.
Unfortunately citizens of the UK are unlikely to receive much help from the General Dental Council because this type of facial damage is considered normal. So we recommend that before treatment patients explore the various web sites for themselves and balance the needs of their children against the effort and expense involved. Do they want a ‘cure’ or are they content to settle for straight teeth with the risk of facial damage and the need to wear a permanent ‘retainer’.
What goes wrong?
Few parents realize how malleable the facial bones of a six year old child are and how quickly things like ‘leaving the mouth open’ or ‘sucking the thumb’ can spoil a child’s appearance for ever (see right).
It is difficult for a lay person to know if the face of a young child is growing correctly because most young children look cute (see above) but Orthotropists® are trained to recognise the early signs of poor facial growth so that treatment can be started in time. It may be too late at 8 (see above).
Many web sites promote orthodontic practices by showing beautiful women with straight teeth, often models that have never been treated. So ask to see your orthodontist’s own results before and after treatment, with photos taken from the side to see the true facial changes and compare them with the Orthotropic® faces on this page. Faces taken from the front can be misleading especially if they are smiling. If your dentist or orthodontist offers you Orthotropics® we suggest that you check that they are fully registered on www.orthotropics.com ‘Find a clinician’. Be suspicious if they say they might extract teeth or use invisible braces or ‘train tracks’ all of which can harm faces.
We also suggest that you ask for a photo of the side of the face before they start treatment, to check that the face is not damaged. Recent research has shown that dentists much prefer Orthotropic results but often do not recommend it because ‘it is complex and takes a long time’. Many orthodontists mislead patients by telling them they will not extract teeth when in fact orthodontic treatment nearly always results in four or eight extractions, while Orthotropics® should provide every young child with plenty of room for 32 teeth (see below).
Showing how the face improves if the oral posture is corrected.
Orthodontics can not achieve results like this.
Showing how the face improves if the oral posture
is corrected.
Train Tracks can not achieve results like this.
Orthotropics® uses removable appliances which hardly show. Encouraging horizontal growth works best with children under eight years old, provided they wear their appliances as instructed. However, it is a highly skilled treatment that requires patients to learn to keep their mouths closed which some children find difficult. Be cautious if your dentist or orthodontist tells you that they may use Orthopaedics, Functional appliances or fixed ‘Train Tracks’ as these methods all increase vertical growth.
Therefore you need to ask four specific questions:
- Will there be room for all 32 teeth?
- Will treatment increase vertical growth?
- Is there any risk of surgery?
- Will Fixed Appliances (Train Tracks) be needed?
If you don’t receive a firm assurance, you might be wise to seek a second opinion.
Surgery
Research shows that “Train Tracks”, “Dental Orthopaedics” and “Functional Appliances” can only move the jaw bones 2 or 3 millimetres and if more movement is required orthodontists usually suggest cutting the jaws and repositioning them (a major operation). Surgery is most often recommended for children with undershot jaws (when the top teeth are behind the bottom teeth). If treatment is delayed they are likely to need surgery (see below).
What should be done if the top teeth are behind the bottom?
Fortunately Orthotropics® can move bones ten or more millimetres (see several examples on this site) but for this the child must be young and dentists and orthodontists often do not tell patients until it is too late. As a result hundreds of children have surgery each year which could easily have been avoided. Make sure that you ask at the beginning of treatment if there is any risk of surgery. Prominent lower jaws are best treated before the age of six (see below) while the bones are soft, but some correction can be achieved in older children.
No treatment
A girl with a protrusive lower jaw which became worse.
With acknowledgement to Bjork, A. Acta Odont Scand. 24:109-127. 1966.
The patients below had Orthotropics to encourage their upper jaws to grow forward.
The two older children below were told they would need surgery but had Orthotropics instead.
What is the best thing to do if the front teeth stick out?
You can either take the top teeth back (near right) or bring the lower jaw forward (far right).
If the front teeth ‘stick out’ more than eight millimetres many orthodontists consider surgery inevitable. However Orthotropics® can correct most of these if they are under the age of eight and many much older (see Gordon below).
| Orthodontics – to pull the top teeth back. | Orthotropics – to move both jaws forward. |
This boy’s front teeth ‘stuck out’ so two side
teeth were extracted and “Train Tracks” used to pull the front ones
back. 90% of orthodontists thought this was the best treatment. Note
how his face has flattened and grown vertically.
|
This boy’s front teeth also stuck out but he had orthotropics® to move both jaws forward. No extractions, no train tracks and no relapse. |
Gordon
Gordon had Orthotropics; Orthodontics can not achieve results like this.
Is it right to change the shape of the face?
Orthotropics can achieve much greater changes to the shape of the face than other methods, but this also raises a moral issue. Is it fair for some children to be able to cheat nature in this way (see right).
Changing the shape of the face can have a big influence on a child’s self confidence. This reticent boy with a retruded jaw was treated with Orthotropics and subsequently became captain of his rowing team. Orthodontic treatment can not achieve results like this.
Evidence
Sadly orthodontic research has been widely criticised for its poor quality. As a result there is little agreement between orthodontists about which methods are best. This is why we recommend that patients educate themselves by looking at the illustrations on this and other web sites to find the best options, remembering that not only do you want a good looking face but a wide smile that stays straight for the rest of their life without wearing braces. If you are interested in research look at several pairs of Identical Twins treated by different methods. ‘Mew JRC 2007. Facial Changes in Identical Twins Treated by Different Orthodontic Techniques. The World Journal of Orthodontics. 8: 174-188’.
We show one pair, see right or look at the comparison of Best Results using a range of techniques. There is plenty of evidence to show that unless a child wears an appliance for the rest of their life, orthodontic results go crooked again, but parents are not always told this. Following forward growth the teeth stay straight naturally.
Orthodontic treatment can not achieve results like this.
Timing and Costs
Orthotropics® requires many years extra training; also guiding growth is more complex and takes longer than extractions or mechanics. The success of treatment is largely dependent on the cooperation of the child and the support of their parents during the twelve to eighteen months full time treatment with appointments every two to four weeks. Subsequently they will require two or three years night-time training with appointments every six to twelve weeks. This is why it is not really suitable for those from, poorly organised households, broken families or those who rely on nannies to bring their children. Currently it costs nearly twice as much as orthodontics placing it at the top of the scale except for surgery.
The Final Balance
Orthotropic® results may be considered best by patients and dentists but it is not popular with orthodontists because of the prolonged treatment and greater commitment required. The technique is also very technique sensitive and an inexperienced Orthotropic Clinician is unlikely to be able to correct a difficult case. Look carefully at their previous results and judge if the faces they show, have grown forward attractively. Orthotropics would seem to be the only way to avoid surgery, but for minor malocclusions traditional orthodontics may still be appropriate, unless you are especially concerned about your child’s long-term facial appearance. The pictures on this site should help you to understand orthodontics and Orthotropics and their effects on Vertical and Horizontal growth and enable you to decide if perfecting facial appearance and long-term dental alignment is worth the increased effort and expense of Orthotropics.
Click on the clips below to view videos explaining Natural Growth Guidance.
Video of John Mew’s twins study
Video of John Mew talking on changing faces for the better
