Sunday, April 21, 2013

APOLOGIES, relevant info about "tori", slow progress, and approaching final stages

It has been a very long time since the last posts and I apologize to those who were hoping for more. I also apologize that I haven't set aside time for individual answers to all the questions people have sent in (amid the literally thousands of spam emails that arrived in the same email box this blog forwards to), but please realize I have 1) Reported all that I know 2) Am not a dental professional or an expert on this subject and am not qualified to answer dental/medical questions, or advise people what they should do, or what prices of various things might be. I also don't have that much spare time.

This was always meant to be more of a journal, for whatever use that might be to others. I am trying to remain neutral and merely report, not be an expert.

As to the reason it has been such a long time since the last post, it is because nothing has really happened worth reporting from then until now. It has simply been a period in which I expanded the lower appliance at the recommended interval and experienced very slow progress, and continued to wear the upper appliance as a retainer overnight, as previously reported.

Those who have followed since the beginning might realize that progress on the lowers has been much slower than it was for the uppers. At first I was under the impression that this was simply due to the bone density of the mandible (lower jaw) being greater than the maxilla that supports the upper teeth, and thus it takes longer to lay down the new bone. However I have recently been informed that normally the lowers should not take longer. That my problem specifically is the "mandibular tori" in my mouth slowing progress.

While my teeth have "uncrowded" and straightened significantly,  my lower arch has not yet expanded adequately for perfect "occlusion" (mating of the upper and lower tooth surfaces for chewing purposes)

There have been suggestions I get the tori removed surgically but I am very reluctant to go that route for multiple reasons. The issue is currently unresolved and the docs will be consulting about it. I am hoping a satisfactory, if not perfect end can be achieved without going that route.

The lesson for readers is, if you have tori, it may add a complicating and expense-generating factor to your DNA treatment.

Other than that, significant progress has been made as you can see in the photo below. You may also notice spaces or gaps between the lower teeth. The essential problem there is the number of upper vs lower teeth the orthodontic docs ordered removed from me when I was a kid getting braces. With the DNA appliance, we got the uppers in a nice straight, tight row, but to get the matching arch on the bottom, some spaces have been created as expansion has occurred.

I am OK with some spaces but if I were a perfectionist from the cosmetic standpoint, I would have to get veneers. I am not a perfectionist. A decent set of useful natural teeth and a comfortable mouth with everything accessible for good hygiene going into my later years is what I wanted.

My current status is that I have been told to stop expanding the lower appliance but wear it as a retainer at night along with the upper appliance. Meanwhile, the docs here are planning to review my status with Dr. Singh in the coming weeks, at which time they will decide how to proceed. One possibility mentioned was to "touch things up" to finality using Invisalign but since we have the tori issue and some malocclusion at hand, we'll just have to see what they come up with.


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  3. Thanks a lot for this update! I've been following your blog for a while now and patiently been waiting for new updates.
    Basically I'm in the same situation as you, only, I'm using an upper and lower Schwarz appliance 24/7. I have this tori as well. At first it hurt a lot to expand the lower because of this, but then we made some adjustments and filed the appliance down a little bit. It fits better now.
    Exactly in what way is this tori slowing down your progress? Is it because of the pain when the appliance pushes against it? Or is it more complicated than that?
    I appreciate your

  4. My question: is anyone involved in this blog also working with a myofunctional therapist to assure proper orofacial posture? Gentle, light forces remodel bone and help move teeth. You know that or you wouldn't be undergoing orthodontics, right? If the tongue rests on the floor of the mouth, if one spends time mouth breathing, day or night, and/or if one has an "active" swallow (lips must close and other facial muscles activate while the tongue pushes forward against the front teeth, plus the jaw has a completely different action that includes pressing back against the jaw joint, remodeling it) cases move more slowly and tend to relapse. When one has a narrow upper arch, usually because the tongue doesn't reside there always, generally teeth on the lower arch tilt/collapse inwards. Because there is less room for the tongue when the face has suffered a 3D contraction due to improper oral posture over a lifetime, a person must clench at night to keep the jaw from falling back on the airway and bringing the tongue with it. Clenching also stiffens the muscles near the airway, thus opening it a little. (Airways are usually develop smaller when people fall into this scenario.) The more a person clenches, the larger the lower inside tori become to help bolster the teeth's support system. You weren't born with them!
    Part of the orthodontic process is uprighting the lower teeth. It gives some tongue room back and changes the forces on teeth.
    Just wanted to help with some insight. There are so many pieces to the puzzle. Keep in mind, orofacial myofunctional therapy also helps strengthen muscles that have gone flaccid. 39% of those who have mild to moderate sleep apnea no longer do after they do therapy, and apnea is a killer. You can check out my site and I particularly recommend listening to the following podcast for more information:

  5. what country are you in?? I'm 30 and have an overbite and a cross bite. I also think my jaws are a little narrow combined with retroclined teeth. I really feel that i'd benefit from something like this dna appliance or a homeoblock or something like that. Can't seem to find many practitioners here in the UK, though.