Interceptive Orthodontics 101 - Part 4: Diet/Lifestyle & Prevention
For the final part of this interceptive orthodontics series, I would like to discuss several lifestyle practices that can encourage ideal orofacial growth. These topics include breastfeeding, diet, space maintenance and positioners.
Proper growth and development starts at birth! Breastfeeding provides proper upper and lower jaw development and positioning. This action advances the mandible (lower jaw), while bottles position the mandible back. Breastfeeding for this reason supports the development of a class I occlusion. Sucking pressure allows for a 50% decrease in malocclusion based on developing and defining the facial muscles. Additionally, breastfeeding prevents a tongue thrust habit from evolving. Breastfeeding promotes nasal breathing and proper palatal growth (broad and wide versus narrow and high vaulted, as in mouth-breathers). Furthermore, we see taste bud stimulation. Lots of good, besides the amazing nutrients provided by the milk.
There are many other benefits of breastfeeding, but for our purposes I will stay focused on our topic. If you are taking medications, please speak with your physician to make sure it is okay to breastfeed. Certain medications may enter breast-milk, and we wouldn’t want that.
Next, we will discuss diet and occlusion. Chewing matters! According to Dr. Mew in London, the modern diet only requires 3-5% of masticatory muscles. Chewing on tough foods help activate bony cells to support jaw growth. This may allow for room for
third molars in addition to the rest of your teeth. Less crowding = smooth sailing at the orthodontist. Processed foods comprise the “western” or modern diet. These foods have shown to increase crowding, as some call crowding a product of industrialization. In addition, narrow and inadequate dental arch form, malocclusions, increased dental decay and impacted (blocked out) third molars has been seen.
There are studies looking at Egyptian mummies that see this finding long, long ago! Only wealthy Egyptians had the affordability for mummification. Investigating the skulls of these mummies show that they exhibited significant dental decay and crowding compared to field workers. Coincidence? The wealthy Egyptians ate many processed grains while the more modest Egyptians had unprocessed and tougher foods. Consequently, their skulls showed very worn down teeth without a sign of crowding. Often times, there was spacing!
Did you know that in the US, approximately 50% of all wisdom teeth are removed? And, 95% of people’s wisdom teeth have deviations in dental alignment. What troublemakers! However, maybe it’s really our faults, and if we modify our diets we can reverse this trend.
Looking at diet and the modern face is also revealing. In the text Story of the Human Body by Lieberman, when controlling for body size, the human face size has become 5-10% smaller. This is seen especially in the anteroposterior (AP) dimension. Growth is seen more vertically. These are all those telltale warning signs of growth patterns I’ve mentioned in earlier parts of the series attributed with class II malocclusions, open bites, mouth-breathing and adenoid face syndrome.
Cooking and food processing are the results of industrialization. They add diversity to our food, which has become more calorie-rich. That does not necessarily predicate that these foods are nutrient-rich, and unfortunately, this is usually not the case.
So how do we encourage jaw growth? Tough foods! In fact, even gum chewing helps strengthen the jaw. That means introducing fruits, veggies, nuts at an early age.
Next I would like to discuss space maintenance, how we manage premature loss of primary teeth. Or sometimes we may be missing the permanent tooth, and that space should be managed, as well. Causes of early tooth loss may include caries (dental decay), trauma, or may be congenital. If not maintained, neighboring teeth may drift into the space, and that space is lost. This may cause impaction (blockage) or ectopic eruption of the permanent teeth.
Your pediatric dentist or orthodontist may provide several different kinds of space maintainers, depending on which tooth/teeth are missing. A few examples include the Nance arch for the maxilla, a lower lingual hold arch for the mandible, which are both held bilaterally. A band and loop or distal shoe are unilateral options.
Lower Lingual Holding Arch:
Band and Loop:
Lastly, I would like to quickly discuss tooth positioners. These devices help guide teeth eruption and arch development as a child grows in the mixed dentition stages. This is before all of the adult teeth are erupted. The come in various sizes, based on tooth size.
To conclude, it is important that orthodontic consultations begin ideally by six years of age. There are several different modalities of phase I interventional orthodontics to help optimize dental and facial growth. It’s key to identify development abnormalities such as severe crowding, blocked out teeth, or asymmetries. Facial growth modification via orthopedics is helpful to direct skeletal growth in the vertical, transverse and anteroposterior dimensions. Habit intervention is helpful in control thumb-sucking, tongue thrusts along with other habits. Finally, holistic methodologies via diet and lifestyle modifications that we discussed in this segment offer a comprehensive approach to early interventional orthodontics. If you have any questions, feel free as always to reach out!