JOE ROGAN JAMES NESTOR THE HORRORS OF EXTRACTION ORTHODONTICS

[Lazlo]

This very well respected investigative journalist has written a book on breath and it he's featured here on the Joe Rogan podcast.

Start at about 1:07:30 if you want to hear specifically about how changes in diet and then ortho affects jaw shape.

Basically, he argues that MANY orthodontists are now saying that we will look back on these past decades of ortho (since extraction-orthodontics were developed in the 1940s) with HORROR at what we were doing to peoples mouths by making them smaller, less space for the tongue, and this creates smaller airways.

He says all the new approaches are about making the jaws wider (through sarpe, homeoblock, or other forms of expansion) to make space for the teeth, not the other way around.

It breaks my heart everytime I have to hear this s**t cause I know how my ortho butchered me.

Apparently this guy used the homeoblock for a year and catscans showed he had gained significant bone mass in his face, better airway tone with an expansion of 20 percent in his airway.

Don't get extractions folks. You hear a ortho who wants to give you extractions RUN RUN RUN. I might try the homeoblock, but I'm afraid it may cause my teeth to tip. Maybe it doesn't The claim that you can't widen the palate without surgery is bulls**t. I've seen people do it through other devices, so I know that's for sure.

https://www.youtube.com/watch?v=U5o9b2RVC2E

[Post bimax]

I had a palate expander as a kid, so it's definitely possible to widen the palate at least during the growth phase.

I still remember that thing.  Cranking the damn device with a key once per week.  It was a real pain.

[Lazlo]

I had a palate expander as a kid, so it's definitely possible to widen the palate at least during the growth phase.

I still remember that thing.  Cranking the damn device with a key once per week.  It was a real pain.

you're lucky

[kavan]

This sort of borders on what I was differentiating about in the other post where I said that extractions are bad when the ONLY goal of them is to get the 'bite right' and where that goal ALSO includes PUSHING the face BACKWARDS.

I differentiate that from having extractions in prep for a maxfax surgery where the goal is to push the face forwards. For example in a lower jaw only advancement where the person is not good candidate for CCW-r.

Anyway, the MEW father and son team have been talking about extractions pushing the face backwards for a number of years.

Keep in mind that on JSF, extractions that are suggested to patients are in reference to preparing for a surgery. Usually in situations where the person wanting single jaw surgery (to the mandible) and is NOT a candidate for CCW-r (due tolow MPA)

What you are referring to is extractions solely aimed at getting 'bite right' and NOT in reference to a jaw surgery.

[Yoroshiku]

I had a palate expander as a kid, so it's definitely possible to widen the palate at least during the growth phase.

I still remember that thing.  Cranking the damn device with a key once per week.  It was a real pain.

I wish I had had one of these, my palate is really narrow and teeth are too crowded, it makes my buccal corridors look huge.  Once you are grown it is too late to fix it without major surgery from what I've read.  I was that kid who would always wear my rubber bands and retainers and everything and my teeth didn't turn out that well (had to have braces twice, teeth moved back).  For some reason my orthodontist wouldn't do the palate expander with me.  Meanwhile my sister never followed instructions, never wore rubber bands or retainers when told, had a palate expander, and hers are perfect.  I've always had trouble breathing through my nose, not sure if that is related, but I've read expansion of the upper jaw can facilitate breathing through the nose.

[Post bimax]

I wish I had had one of these, my palate is really narrow and teeth are too crowded, it makes my buccal corridors look huge.  Once you are grown it is too late to fix it without major surgery from what I've read.  I was that kid who would always wear my rubber bands and retainers and everything and my teeth didn't turn out that well (had to have braces twice, teeth moved back).  For some reason my orthodontist wouldn't do the palate expander with me.  Meanwhile my sister never followed instructions, never wore rubber bands or retainers when told, had a palate expander, and hers are perfect.  I've always had trouble breathing through my nose, not sure if that is related, but I've read expansion of the upper jaw can facilitate breathing through the nose.

Issues breathing through your nose is more likely due to a deviated septum which is not solved by a palate expander.  I had a palate expander as a kid and still required a septoplasty as a teenager and jaw surgery as an adult.

[Nothing]

It breaks my heart everytime I have to hear this s**t cause I know how my ortho butchered me.

Have you ever managed to correct the damage caused by extractions? I'm in the same situation because I wasn't even told about the surgery option, I found out from a plastic surgeon later on. I still don't know how this will affect everything, I've seen 3 surgeons so far and the first thing they all said was something like "it looks like your treatment plan didn't take surgery into account".

[Gadwins]

[...] I've always had trouble breathing through my nose, not sure if that is related, but I've read expansion of the upper jaw can facilitate breathing through the nose.

I also just want to mention that a palate expansion, even surgerical assisted, only temporarily improves nose breathing. That was my experience and also can be read in different papers.

[Lazlo]

This sort of borders on what I was differentiating about in the other post where I said that extractions are bad when the ONLY goal of them is to get the 'bite right' and where that goal ALSO includes PUSHING the face BACKWARDS.

I differentiate that from having extractions in prep for a maxfax surgery where the goal is to push the face forwards. For example in a lower jaw only advancement where the person is not good candidate for CCW-r.

Anyway, the MEW father and son team have been talking about extractions pushing the face backwards for a number of years.

Keep in mind that on JSF, extractions that are suggested to patients are in reference to preparing for a surgery. Usually in situations where the person wanting single jaw surgery (to the mandible) and is NOT a candidate for CCW-r (due tolow MPA)

What you are referring to is extractions solely aimed at getting 'bite right' and NOT in reference to a jaw surgery.

My ortho knew I was going to have surgery. He said first you get the teeth straight in the gums then you have surgery. So my extractions were in fact done with a view toward surgery.

But even if you have extractions on the lower jaw in prep for surgery, to close spaces the teeth will be brought back and the tongue will have lest space. So I am still skeptical that extractions should ever be done when there are many ways to circumvent this. Don't get extractions.

[kavan]

My ortho knew I was going to have surgery. He said first you get the teeth straight in the gums then you have surgery. So my extractions were in fact done with a view toward surgery.

But even if you have extractions on the lower jaw in prep for surgery, to close spaces the teeth will be brought back and the tongue will have lest space. So I am still skeptical that extractions should ever be done when there are many ways to circumvent this. Don't get extractions.

Your ortho sounds WRONG. Like he just wanted to get your bite right. Because what he did doesn't sound to me like he was working along with the maxfax in prep for surgery. Are you saying that Sinn (who I believe did your jaw surgery) directed your ortho to prepare you for surgery the way he did?

It's hard to circumvent if someone has a sufficiently forward maxilla already a low MPA, a bite that would 'fit' with lower jaw advancement only and could be 'balanced' with around 5mm advancement. Someone who wants single jaw only and is actually good candidate for it.

[GJ]

Yeah lower jaw only is probably the only instance for them. That guy "notrain" had this treatment and liked his result...think he had a short face and linear advancement, from memory.

But even in those cases you're dealing with the problem of a crowded arch becoming the problem of excess space to close. By extracting and then closing that excess space the tongue will have less room. Whether the patient feels that might depend on how sensitive they are, but it's going to happen. There is also the issue of which premolar is extracted, and usually they go for the first premolar since it's slightly larger (.5mm) and thus gives them more space to advance the jaw. This is a problem because it has two roots (2nd premolar has just one) and hence causes more bone loss at the extraction site.

All in all it's not a great option, but in very limited cases might be one.

[kavan]

Yeah lower jaw only is probably the only instance for them. That guy "notrain" had this treatment and liked his result...think he had a short face and linear advancement, from memory.

But even in those cases you're dealing with the problem of a crowded arch becoming the problem of excess space to close. By extracting and then closing that excess space the tongue will have less room. Whether the patient feels that might depend on how sensitive they are, but it's going to happen. There is also the issue of which premolar is extracted, and usually they go for the first premolar since it's slightly larger (.5mm) and thus gives them more space to advance the jaw. This is a problem because it has two roots (2nd premolar has just one) and hence causes more bone loss at the extraction site. All in all it's not a great option, but in very limited cases might be one.

Do they actually try to close the whole space with the 1rst premolar plucking or just use the space to give room to retrocline the lower front teeth?

[Lazlo]

Your ortho sounds WRONG. Like he just wanted to get your bite right. Because what he did doesn't sound to me like he was working along with the maxfax in prep for surgery. Are you saying that Sinn (who I believe did your jaw surgery) directed your ortho to prepare you for surgery the way he did?

It's hard to circumvent if someone has a sufficiently forward maxilla already a low MPA, a bite that would 'fit' with lower jaw advancement only and could be 'balanced' with around 5mm advancement. Someone who wants single jaw only and is actually good candidate for it.

You're absolutely, absolutely correct Kavan. I'm going to PM you on this issue. No Sinn came in at the end when the max fac here had revealed he had no idea what he was doing. Thanks for your response.

[Dutcherhatcher]

GJ and Lazlo.
Just to piggyback of Kavan.
Take my case for example. I have a severe lower jaw recession of around 1.3 cm extremely narrow airway, TMJ pains and teeth grinding.
The need for jaw surgery is clear.

However my upper jaw needs a maximum of 3 mm movement at most
My teeth bite is perfectly compensated. I have a perfect occlusion plane and an excellent MPA.

Anything beside a very minor CCW is out of the question. So what other choice do i have? Would I rather have a slightly crowded lower teeth or live with the rest of the problems. I am pushing my ortho to put implants as soon as the decompensation ends. But that’s the most I can do.

[GJ]

GJ and Lazlo.
Just to piggyback of Kavan.
Take my case for example. I have a severe lower jaw recession of around 1.3 cm extremely narrow airway, TMJ pains and teeth grinding.
The need for jaw surgery is clear.

However my upper jaw needs a maximum of 3 mm movement at most
My teeth bite is perfectly compensated. I have a perfect occlusion plane and an excellent MPA.

Anything beside a very minor CCW is out of the question. So what other choice do i have? Would I rather have a slightly crowded lower teeth or live with the rest of the problems. I am pushing my ortho to put implants as soon as the decompensation ends. But that’s the most I can do.

It might be best for your case for the reasons we discuss above. I can't remember your specific case/records, if you posted them.
Why would you put implants in, though? That would defeat the point of creating space (for jaw advancement) via the extractions.