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    Functional Orthodontics

    January 17, 2012 by Brandy Vencel

    Most of you have heard me whine and complain about the teeth issues we’ve experienced over the years. The other night, I looked over at my son, and was wowed to see how far he’s come. His smile is really looking nice these days, and that reminded me that I’ve been meaning to write a post to share what we have learned about the orthodontic issue so far.

    It all started a little over a year ago. We took Daughter A. to the dentist and she had just under seven million cavities.

    Or something like that.

    Basically, there were so many that we are still working on them, though some of that comes from trying to find a dentist that we liked that was willing to do lots of work on a child so young.

    But I digress.

    One pediatric dentist that we visited basically blamed the cavities on how tight her teeth were, and that really got my mind going.

    She had already begun losing teeth, and I was terrified of what I was seeing. This child did not have that normal crowded-we’ll-probably-do-braces-someday mouth. She didn’t have room for her first two adult teeth to come in.

    So they came in at 45-degree angles.

    In the meantime, her older brother, who wasn’t quite as bad, was still having problems of his own. He had teeth that simply were not coming in at all because there was no space.

    I did the math and knew that we simply could not afford braces, especially considering that it looked like all of our children would need them.

    And I do mean need.

    Though I think that aesthetics are important, this was becoming a health issue, and we also did not like hearing from various dentists and orthodontists was consulted that they would require multiple extractions of adult teeth.

    Some children really do have mouths that will continue to grow, but considering that these teeth issues appear to go back for at least two generations, I wasn’t holding out a lot of hope.

    So I began to do research.

    And yes, yes, I read all about how this is usually caused by a poor prenatal diet. That really would explain why Daughter A. has the worst of it: my pregnancy with her made me so sick that I was lucky if I could keep down 400 calories in an average day. There is no way she got optimum nutrition in utero. I was sick for eight months of all of my pregnancies, and always had a difficult time eating, but it was worse with girls than boys for me.

    But that is not the point. So what if I would eat lots of yellow butter and organ meats if I were pregnant today? My children are already born.

    So after kicking myself once or twice, I moved on to trying to figure out a solution that we might be able to afford {and I don’t mean financing}.

    I asked one dentist if there was a way to force the bones to grow, and he said no, and he answered so quickly and thoughtlessly that my first thought was that he didn’t really know what he was talking about. So I went home and asked Google and that was when I discovered the concept of functional orthodontics.

    If you search the Internet for functional orthodontics, you will see a lot of different options. Some are pricier than others. Some are for tougher cases–like cleft palate patients. Some work for adults, while others are better for children. A lot of websites will make it sound like the primary purpose is aesthetics, and though that is a great way to market it, I think that philosophically it misses the point.

    I had a long talk with our orthodontist last week. He does functional orthodontics as well as traditional braces. He was telling me that braces are the typical way that orthodontists in the United States are trained to deal with the problems of crooked teeth. They extract teeth to make room, and then they use train-track-style braces to align whatever teeth remain. In some worst-case scenarios, head gear is actually used to restrain upper jaw growth in order to maintain bite alignment.

    Functional orthodontics, however, are actually more orthopedic in nature. They seek to make room by encouraging palate expansion and jaw development. He told me, for instance, about reverse-headgear, which, instead of restraining the upper jaw’s natural growth, encourages growth of the bottom jaw by pulling it out.

    He equated this to a child born with one leg too short. In his mind, braces are {usually–not always} equivalent to waiting until that child is almost fully grown, and then hacking on the good leg to make the sides equal. Functional appliances do the opposite, trying to straighten and force growth that should naturally occur, but doesn’t {for various reasons}.

    All of that is a fancy way of saying that it helps the mouth make room for the teeth.

    What I found appealing {besides the fact that it is costing us less that a quarter of what braces would cost} is that it works with nature rather than against nature. Most people are not born with grotesquely large teeth, or teeth that come in backwards. Rather, they are born with underdeveloped jaws. Nature says that the twisted, short leg ideally would be longer and straight. Working with nature is fixing that through orthopedics, and working against nature is hacking at the good limb. Likewise, working with nature in orthodontics is encouraging natural growth rather than removing teeth to “make room.”

    In my experience, there are a lot of options out there, but unless you live in a big city with lots of fancy orthodontists, what you will really need to do is find out what is even available to you. In our case, we heard that a certain doctor offered this service, and we went to see him. He was very discouraging at first: Kids these days, they won’t wear their appliances, he said. They don’t think it’s cool, so they take them off when they get to school. Then all the research says it doesn’t work. It doesn’t work because they won’t follow the protocol! Unless your children are homeschooled, I cannot suggest this to you.

    That was when I told him they were homeschooled. He he.

    He immediately changed his tune. He was more than happy to use his expertise–in fact, he prefers it. But he tells me that 30 years ago children followed his instructions better than they do today, and he hates to see parents throw good money after bad.

    I know what it is like to realize that your children may need something you think you cannot afford. In my experience, this is not only a more “natural” route, but it is much, much cheaper. The price can vary drastically depending on your geographic location, but I have notice that it is consistently priced between one-quarter and one-half the cost of braces. If you think you are facing orthodontics in the future, you may want to do some research and see what you think. In our case, treatment will start with our younger two once their first adult molars erupt.

    Just something to think about* **.

    *I was going to use photos and then I realized that I hate looking at teeth photos…and you might, too!

    **Obviously, sometimes braces are necessary–like when teeth come in twisted or backwards. I just thought you all would like to know that there are options out there.

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  • Reply Tara August 3, 2022 at 12:43 pm

    Hi Brandy, this is a very old post, but I’m wondering if you might be able to name which type of orthodontic appliance(s) you have found so helpful for your children. I know there are multiple types of palate expanders (is that what you guys use?) – plastic ones, metal ones, etc. Or is yours called something else?

  • Reply Roxy August 27, 2016 at 10:00 am

    Hi there! I know this post was written a while ago but I thought I would take the chance that you might still respond.
    I was wondering how the functional orthodontics went for your children?
    I have TMJ, and have just met with a very nice general dentist who practices functional orthodontics and orthotic/splint therapy. I have a minor cross bite and she mentioned a palate expander as part of my treatment plan. I am 26 though. She seems to have great success in using this technique with people my age and even older than me because she goes carefully and slowly, but traditionally palate expanders are used in children/teenagers. So I’m a bit scared. I guess it comes down to if I trust this doctor or not, and so far I do. But I just wondered about your experience and if you would still recommend this process years later?
    Thank you!

    • Reply Brandy Vencel August 27, 2016 at 4:36 pm

      Hi Roxy! My children are still using them, and we are still thrilled. I love to see how their faces are slowly expanding over time.

      With that said, my orthodontist does *not* like using traditional palate expanders with adults — he says much can go right, but much can also go wrong. OrthoTain has a device for adults, and he recently offered to give it a go with a friend of mine and she is loving it!

  • Reply Rose Harrington June 10, 2013 at 11:54 pm

    Brandy, Thank you for the info on functional ortho. This is new to me, and I wish I had known about it a decade ago when my daughter had braces to correct her overbite. Fortunately, she didn’t have any extractions. Unfortunately, she complains of TMJ, her jaw not feeling right, asthma, and difficulty finding a comfortable sleep position. The orthodontist pushed her top teeth backward to meet her Class 1 recessed jaw. I have been searching the internet for a functional orthodontist in our area. Any recommendation on how to locate one? Thanks, Rose

    • Reply Brandy Vencel June 11, 2013 at 3:13 am

      In the end, my husband thought it was most expedient to call every dentist office in town. In his defense, the one he found is the one we are at now, and they do not have a website and their name says “dentistry” not “orthodontics: so I would *never* have known. If you live in a small town, try the biggest city close to you because the best guys are usually in big cities. In our case, the doctor is from San Francisco and “retired” to our area, meaning he only works about 25 hours per week. If you are trying the internet, you can try using key words in addition to {or as an alternative to} “functional orthodontics”–for example, some of these guys call themselves “orthopedics” and some of the appliances used are “reverse headgear” and “palate expander.” maybe that will help?

    • Reply Brandy Vencel June 11, 2013 at 3:19 am

      Ahem. Hi. πŸ™‚ Me again. I just googled a little and found an article that may help you. πŸ™‚

  • Reply Hayley January 9, 2013 at 7:12 am

    Brandy, would you be kind to email me the orthodontist you see? I’d like to hear more of your experience, if you’re willing to share.

  • Reply Rebecca Dolores July 6, 2012 at 3:34 am

    Hi! I had functional orthodontics as a child. I have much straighter teeth than my parents thought I would ever have and a great smile :)… However, my mother swears it changed the general shape of my face and my jaw pops a lot when I open it past a certain point. So, it’s not perfect, but I’d much rather have straight teeth. Jut thought I’d add a oittle perspective from a former patient. πŸ™‚

    • Reply Brandy @ Afterthoughts July 6, 2012 at 4:35 am

      Thanks for your perspective! I will have to mention to our orthodontist how important a good bite is to our family. πŸ™‚

  • Reply Brandy @ Afterthoughts January 18, 2012 at 3:17 pm

    Meredith, It could very well be the same thing? Is there a little “key” that you put into a hole and turn every so often, which expands the device?

    I know that our orthodontist said that braces/tooth extraction as a primary approach were very “American” two or three times.

  • Reply Meredith in Aus January 18, 2012 at 12:52 pm

    Great news! Well done on the research.

    I had my crew at the dentist last month, and it appears that my eldest will need a plate soon in order to correct her bite by pushing it out. We just have to wait for her to lose a couple more baby teeth – she’s only 15!

    Is this the same kind of thing? Different terminology for different countries, perhaps. It is also quite common here, I’m led to believe.

    In Him


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