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ORTHOPEDICS/ ORTHODONTIC: Beyond Functional Orthodontics

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“The ultimate responsibility of the orthodontic therapist is to treat all three components of the stomatognathic system to create an environment for synergistic function of the teeth, temporomandibular joints and the neuromuscular system.

Successful orthodontic treatment is predicated on eliminate adverse muscles forces on teeth that have been positioned in a zone of neutralizing muscle forces.”

– Robert Jankelson, DDS


Conventional Orthodontics
Conventional or retractive orthodontics, looks mainly at straightening teeth for esthetics and appearance and assumes that the facial muscles and jaw joints will accommodate to their new position. Teeth are considered for extraction if there is insufficient space to align the teeth. Making the teeth look straight is often the primary concern. Narrow and constricted arches will often result. This approach often does not consider the impact it has on the airway (breathing), proper tongue space, as well as the health of the masticatory muscles which must properly function for a stable bite. A “physiologic” relationship of the head and jaw posture are commonly over-looked when straightening and aligning the teeth.

Gneuromuscular (GNM) Orthopedic/Orthodontics
GNM orthopedic/orthodontics emphasizes how the muscles, jaw joints and teeth affect one another to find a homeostatic relationship before aligning the teeth to one another. A proper gearing of the teeth to function in harmony with the jaw joints, muscles and the complete postural system allows the teeth to wear and function evenly reducing abnormal forces and excessive strain to the supporting structures of the head, neck/cervial and pelvis.

Narrow dental arch forms are properly developed to a full contour, enhancing breathing and appearance. The closing of the bite vertically in the back regions of the mouth orthopedically is accomplished non surgically in most cases with great skill and understanding. The trained dentist will use objective measurements and TENS instrumentation to identify a more pleasing facial appearance, jaw position and postural alignment before and after treatment. This approach has been found to be more comprehensive going beyond just the straightening of teeth or “functional” correction.  Improved function, bite stability, facial appearance and cervical neck and head alignment is critical to avoid dental relapse is important to establish “Happy muscles” and overall occlusal stable jaw joints.

The stomatognathic system is comprised of the following entities:

Indications for Orthodontic/Orthopedic Treatment

In order to correct crooked (crowded) teeth, one must create space. That is a fundamental orthopedic GNM concept that few overlook.  Space or adequate room in the mouth comes in 6 dimensions.

  1. There is transverse/horizontal space
  2. There is anterior vertical space
  3. There is posterior vertical space
  4. There is antero-posterior space
  5. There is roll space
  6. There is yaw space

Traditional paradigms of orthodontics consider removing certain teeth if there appears to be in adequate space or room for the teeth to line up nicely in the arch form.  But today dentistry has advanced beyond mechanical thinking and is not looking at orthodontics from an Orthopedic GNM perspective which also includes airway and sufficient space for the tongue to function normally.

Aberrant tongue swallowing patterns will contribute to abnormal tooth alignment and pathologic jaw relationship problems contributing to numerous musculoskeletal TMD signs and symptoms as time goes on.


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