What is Orthotropics

Orthotropics is a branch of dentistry that specialises in treating malocclusion by guiding the growth of the facial bones and correcting the oral environment. This treatment creates more space for the teeth and tongue. The main focus of this approach is to correct a patients oral and head posture.

Malocclusions

A Malocclusion is a misalignment between the upper and lower teeth so that they do not fit together correctly when chewing or biting. This condition can be described crowded, crooked or protruding teeth and is also referred to as an ‘irregular bite’, ‘crossbite’, ‘overjet’, ‘overbite’ or ‘underbite’

It is generally assumed that the way that we grow is predetermined by our genes and that crooked teeth are genetic. But why is it then that, from fossils and skeletal remains, it is apparent that before modern civilisation the human race had near perfect teeth.

The occurrence of Malocclusion appears to have begun when the human race became more civilised, and their behaviours and the environment they lived in changed. None of the other 5,400 species of mammals on earth requires orthodontic treatment and the few remaining indigenous populations also have little or no need for orthodontics.

Orthotropic treatment aims to provide space in the mouth for all teeth, including the wisdom teeth. This is achieved by improving muscle tone, correcting facial posture and teaching correct swallowing patterns.

These three factors determine the direction of facial development. We use a variety of different removable appliances that help with expansion and correct posture. We also use Myofunctional training (exercises that teach correct swallowing and muscle function)

Diagnosis

Any child with a malocclusion will benefit from Orthotropic Treatment.

Indicators of malocclusion include:

• No space between the baby teeth at 4 years old.
• Uneven upper or lower front teeth
• Set back upper or lower jaw
• Facial lengthening
• Teeth meeting the wrong way around (underbite)
• Slack open mouth resting posture.

At Orthodontic Health we like to treat patients with malocclusion early. For the Orthotropic approach to be effective the earlier a patient is diagnosed as having a malocclusion the better. Ideally treatment would start between the ages of 7 and 10.

Our next development is to take the principles into older and older people. We are regularly accepting people up to 20 years old if they are extremely motivated and occasionally up to 30 years of age.

There are several reasons we advocate intervention much earlier than traditional orthodontics.

With our treatment we aim to gently guide the growth of the face and correct poor facial posture. Facial growth guidance is easiest and most effective before the age of 10 when facial bones rapidly begin to stiffen. After this treatment, although still effective, may achieve less dramatic improvements.

Patient compliance is also a key part of our treatment programme. Without improvements in poor facial posture and correct appliance wear Orthotropic treatment will not be effective. We find that younger children are compliant, willing to wear appliances and learn and carryout facial strengthening exercises. As children approach puberty and early adolescence they become less eager to please, less willing to wear appliances or to work to change poor facial posture. The Orthotropic approach requires total compliance and commitment from the patient (and parent) without this treatment results will be compromised. As a result less compliant older children are more difficult to treat.

  • Charlotte's Before Treatment: Age 7 years 6 months
    Charlotte's Before Treatment: Age 7 years 6 months
    Charlotte After Treatment: Age 11 years 2 months
    Charlotte After Treatment: Age 11 years 2 months

Treatment

Orthotropic treatment is natural and permanent but hard work. This approach requires considerable commitment from the patient and practitioner alike. We avoid extractions and forcing teeth into position. We create space within the mouth for the teeth and then, using correct posture and strong facial muscles, let the tongue and lips naturally align the teeth, as our ancestor did from the dawn of time up until modern civilisation.

The treatment process is broken into three distinct phases:

This first phase of treatment aims to expand the jaws and create space for the tongue in the roof of the mouth. This phase uses upper and lower removable appliances. These may also be supplemented with head or neck gear.
This initial treatment creates a temporary malocclusion where the front teeth stick out and the upper jaw appears to be too wide. This will alarm uninformed dentists and orthodontists. It is however a normal part of this treatment and will be corrected during the second phase.

The second phase of treatment aims to teach a patient correct jaw posture and improve facial muscle tone. Over time, with good compliance, this correct posture will become the patient’s default resting position. This correct positioning will in turn allow natural alignment of the teeth and affect the craniofacial structure.

This training is carried out using removable appliances that constantly remind a patient to hold their jaw correctly and ensure good oral posture is assumed at all times. These appliances must be worn for 18-22 hours per day for approximately 18 months.

During this final period the training brace is worn at night only. Myofunctional exercises are given to improve the function and posture of the lips and tongue. During this phase we also occasionally use discrete reminder appliances in the lower jaw.

To ensure that every child maximizes the opportunity orthotropic treatment offers them we monitor treatment carefully, children all respond differently. We may recommend additional therapies to aid the orthotropic treatment. These may include Cranial Osteopathy, Orofacial Myology, Various posture therapies as well as Buteyko breathing techniques.

The success of a course of orthotropic treatment is dependent upon the compliance of the patient. We provide the tools, guidance and opportunity to create this change but ultimately the results are down to the individual.

20 hours of wear of the training appliance is expected and required to achieve optimal results. These appliances are fitted with timers and wear will be monitored. If a patient does not wear an appliance as much as instructed the treatment will take longer and may not achieve the desired results.

Orthotropic treatment requires a significant level of commitment from both patients and their parents/carers. It is vital for a parent to attend every appointment with their child.

During Phase 1 of treatment patients will need to attend the clinic once every two weeks. During the latter phases of the treatment this reduces gradually down to approximately once every eight weeks, and finally quarterly visits.

Orthotropics is a branch of dentistry that specialises in treating malocclusion by guiding the growth of the facial bones and correcting the oral environment. This treatment creates more space for the teeth and tongue. The main focus of this approach is to correct a patients oral and head posture.