When I started taking courses to learn about TMD treatment almost 30 years ago, I also began my studies in early childhood growth and development. This is when I first became exposed to the multiple factors that can influence and retard the normal growth patterns in occlusal development and overall TMJ function. When these compromising factors are present, the permanent teeth are often never able to reach their full eruption potential. A deep bite, a reverse curve of spee, and/or a class II position for the mandible in addition to crowding are generally the result.
These developmental pathologies most commonly trace back to long-standing childhood breathing issues. For multiple reasons both anatomical and environmental, many children are unable to breathe through their noses regularly and easily. These children become chronic mouth-breathers – habitually breathing through the mouth to get the oxygen the body needs to survive, but also subjecting these same children to a host of developmental anomalies that accompany a mouth-breathing habit.
If this habit is not identified and addressed by parents and pediatricians, children may not learn to swallow correctly. They may develop narrow arches with crowded teeth and a high palatal vault. And frequently, they do not sleep well. All of these conditions can perpetuate and exacerbate the original breathing issue.
Certainly as orthodontic providers, we can help these children even as teenagers and into adulthood by moving the teeth, straightening the incisors, and giving them a beautiful smile. But if the original factors that caused the problem are not addressed, like mouth-breathing related to allergies or nasal blockages, orthodontic relapse (sometimes severe) is an all too common result.
In the 30 years since I began my exploration of the relationships between TMJ disorders and early childhood occlusal development, I have become more and more convinced that most people can be saved from years of pain and dysfunction with the appropriate multi-faceted approach to early bite development. Early growth analysis combined with guided eruption through interceptive orthodontic appliances when necessary is a great start for many children. But adjunctive treatment for airway issues may also be required to help that child maintain the corrective gains achieved through orthodontic treatment.
This November, I presented a lecture to the Columbia Orthodontic-Orthopedic Research Society on Interceptive Orthodontic Treatment and the preventive effects a successful multi-faceted approach to early occlusal development can have on the potential development of TMJ disorders and airway issues. This lecture was presented as an introduction to the seminar I will be teaching in 2014 on Interceptive Orthodontic Treatment and Functional Appliance Therapy. If you are interested in bringing this lecture to your local study club, and/or if you would like to be notified when my 2014 Interceptive Orthodontic Seminar is available for pre-registration, please contact me through the contact page on this site