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Crossbites: The Reason for Their Necessary Treatment

There are many types of cross bites, numerous etiologies, several philosophies of treatment, as well as, the most appropriate time to treat this debilitating functional, dento-skeletal, and sometimes cosmetically disfiguring malocclusion. Cross bites can cause, or contribute to the following maladies, if not corrected i.e. nasal airway obstruction, compulsive mouth breathing, chronic sleep apnea, opened-mouth posture, severe maxillary crowding, impacted canines, asymmetrical growth and development of teeth and jaws, chronic cheek and tongue biting leading to leukoplakia and precarcinogenic mucosa later in life, speech impediments, severe bruxing and clenching, masticatory inefficiency, premature attrition, dental recession, idiopathic and spontaneous tooth movement, excessive secretions of hydrochloride acid, gastric juice and bile, in conjunction with reverse peristalsis, ulcerations, and halitosis (irritable bowel syndrome), malnutrition, temporomandibular joint dysfunction, associated with headaches, ear aches, neck and shoulder pain, loss of hearing, vertigo, tinnitus, meniscus subluxation (lockjaw), TMJ crepitus distorted/asymmrtical smiles and physiognomy, and last but not least, condylar osteoarthritic degeneration. During the growing phase i.e. mixed dentition, to, and including puberty (approximately 7 to 14 years of age) on both males and females, we use only 016” expanded maxillary arch wire, in conjunction with ¼ inch, 6 ounce cross elastics on one, or both sides, depending upon whether we are dealing with a unilateral bilateral cross bite. If it’s a unilateral cross bite we use a straight vertical 1/8 inch, 4 ounce elastic on the non cross bite side in conjunction with the 1/4”, 6 ounce elastic on the cross bite side. We have not had to use any other kind of expansion appliance in over 25 years. After puberty (approximately  14 years of age) when I believe the mid-palatial suture has closed, I will create a 2mm space between the mx 2’s and 3’s, and have the oral and maxillofacial surgeon perform the expansion in the OR, under conscious sedation, which takes approximately 45 minutes. Usually the 8’s are surgically removed at the same time, which takes approximately 20 more minutes. Post-surgically we maintain the stability of the cross bite correction with the technique, as above with elastics for 10 weeks. If the cross bite was the only problem, we remove the fixed appliances (braces) and insert an Essix (Biostar) retainer, on the same day, to be worn full-time for 2 weeks, and then at night time, on a decreasing scale, over 3 years, decreasing at the rate of one night every 6 months, until down to 0. I have never had a problem, to date, using this approach. I hope these suggestions will be of some assistance to those of you who are still struggling with the diagnosis, timing, and treatment of that most challenging of malocclusions, the “cross bite”.

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The Health Implications of Mouth Breathing

Oral respiration can signal problems that may be effectively treated when diagnosed promptly 

( Article from SUNSTAR )

The oral cavity plays several key roles in human anatomy. As part of the upper respiratory tracts, it can be used for oral respiration- unfortunately, “mouth breathing”[1] can have adverse effects. This Sunstar E-Brief examines the risks of mouth breathing poses to oral and systemic health, as well as its association with the misdiagnosis of attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD).

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New Study Links Dental Problems in Children to Bullying

St. Louis, MO- Dec. 17, 2013- Unattractive teeth in 11-12 year olds may be linked to bullying, according to a new study published in December in the American Journal of Orthodontics and Dentofacial Orthopedics. The study, which was conducted among sixth grade students in Amman, Jordan, reveals a significant percentage of children experiencing bullying as a result of dental and/or facial appearance. Teeth were the number one targeted physical feature to increase a child’s chance of being bullied, followed by the child’s strength and weight.

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The power of a smile

Believe it or not, your mouth and jaws have a great influence in your life. Many opportunities are lost because of an unattractive smile, crooked teeth or a bad bite. An employer will subconsciously hire a person who has a great smile over another applicant who has crooked or overlapping teeth. A negative attitude from TMJ (temporomandibular jaw-joint) dysfunction can be a life-long burden. Millions suffer in silence because they don’t understand that their symptoms are caused by malaligned teeth or an abnormal bite. Proper and timely orthodontic treatment can improve your quality of life, providing more confidence at work and enhancing, your self esteem.

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TMJ

Jaw joint dysfunction is often misdiagnosed. The result can be a host of painful symptoms and their treatments that only mask the real condition underneath.

BY DR. GENE JENSEN

Does your jaw hurt? If it’s based on TMJ dysfunction, it may be only the tip of the iceberg. For one thing, temporomandibular joint (TMJ) dysfunction is often misdiagnosed. The TMJ refers to the two symmetrical jaw joints located at the upper end of the lower jaw. The joints originally evolved as a prehensile organ, much like monkey’s tail, used in the acquisition of food as well as speech.

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Wisdom Teeth

Advising Orthodontic Patients About Their Wisdom Teeth: Dr Gene Jensen’s Rebuttal of Dr Randy Lang’s September 1, 2013 editorial entitled “advising Orthodontic Patients about Their Wisdom Teeth”

The subject of wisdom teeth and the debate about whether they should be extracted or not, dates back to about the year 1900, when Dr Edward Angle, the patriarch of modern orthodontics, and Dr Case, one of his disciples, had a running feud which lasted for years, regarding the necessity to extract teeth, or not, in order to facilitate orthodontic correction. As history would later prove, Dr Case was the winner of that argument, at least temporarily, since extraction of bicuspid teeth became a routine procedure in the orthodontic protocol of most orthodontic practices, from about 1920 to approximately 1980. Notwithstanding, Dr Angle continued to incorporate all of the permanent teeth, including the bicuspid teeth, as well as, the wisdom teeth into his orthodontic treatment, and his teaching, during his tenure. He believed that 32 permanent teeth could be accommodated in the jaws of most modern-day humans. Needless to say, repercussions of this philosophy were numerous, not the least of which were over-expansion, bimaxillary dental protrusion, labio gingival recession, dental relapse, periocoronitis, dental impactions, periodontal bone loss, root resorption, dental infection and pain, and all of the aforementioned, a full forty years before the discovery of antibiotics and effective analgesics.
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