The Treatment Process

We practice Facial Orthotropics in order to improve the lifelong function, health and appearance of our patient’s faces and body posture.
The Orthotropic method strives to guide facial growth naturally through muscle strengthening exercises, posture improvement and non-intrusive, discrete orthotropic appliances.

Preparation Phase

The first step in Biobloc Orthotropics is to move the upper front teeth to their ideal position in the face (typically 8-10 mm). This is accomplished with a removable appliance, worn 24 hours a day, which also widens the upper jaw and increases the space for the tongue to be positioned properly to the roof of the mouth. The appliance, called a Biobloc Stage 1 appliance, is typically worn for 4-6 months, and creates a mild to pronounced discrepancy between the upper and lower front teeth. During this first phase of treatment, the upper dental arch is widened to open the airway, create tongue space and improve midface appearance. The upper and lower permanent teeth are then tipped forward. and ends with what is referred to as the “Ugly Duckling” phase due to a vertical gap between the upper and lower front teeth and a protruding teeth.
The aim of this treatment is to encourage horizontal growth. This means to allow the face to grow to it's full potential. Parents tend to get concerned and may hear disparaging remarks by dentists or dental personal who are unaware of the orthotropic approach.   As appears in this photograph;

Please keep in mind, as long as the child wears their appliances correctly, this stage is only temporary and will correct itself with time. The end gain will result in correct horizontal growth of the face - a beautiful and healthy face. This stage is our deliberate intention so please remain patient and do not be alarmed.  You have been forewarned.

Training Phase

As soon as the upper front teeth are in their idealized positions, a second removable appliance, the Biobloc stage 3 or 4, is used to posture the lower jaw forward into a more ideal position in the face. It fits on the upper jaw and has small plastic guides extending downward to cause the lower jaw to posture forward at rest. The child learns to wear the Biobloc 24 hours a day except for eating, vigorous sports, singing or playing a wind instrument, and brushing the teeth. Over time, the device teaches the patient to maintain a closed mouth posture and builds up resting muscle tone (treating the causes). This part of the process is more about teaching than treating and finishes when the facial posture has been improved and the jaw growth effected. This is the most difficult phase of treatment, lasting anywhere from 9 to 24 months. Success depends greatly on the child’s commitment and the level of parental support.
The stage 3 or 4 appliance is the most difficult and boring stage of treatment. However without a doubt it is the most powerful stage in gaining horizontal growth and correcting your child's malocclusion. This stage relies on complete co-operation where the child, for a period of time, is required to learn to talk with their mouth closed. The jaw will only grow to where it is postured and by increasing it's muscle tone. The main cause of your child's malocclusion is due to having a "slack jaw". They hang their mouth open due to chronic mouth breathing and also have weak muscles of the jaws. Thereby the stage 3/4 appliance aims to increase their muscle tone, akin to bicep curls in the gym, by constantly applying a stimulus to keep it closed. Once again please do not be alarmed.  All things worthwhile require hard work.

Adjustments are made every few weeks to the appliance as treatment progresses. The full correction can often be achieved in a 6-8 month timeframe, depending on the severity of the problem and the child's cooperation. As the improved rest oral posture becomes a habit, the patient can taper back from full time wear to non-school wear, nighttime wear and, ultimately, no wear.
The changes occur through movements and remodeling of the bones of the head.

Active Retention Phase

The last phase of treatment involves wearing a training brace at night and completing swallowing and chewing exercises during the day (i.e. Oral Myology). By this phase, the teeth sit in balance between the lips and tongue and there is adequate space between the molars. Effective Oral Myology will gently move the teeth into alignment. Children who align their teeth them selves have naturally straight teeth forever.
Nightwear usually continues until age 14 for girls and age 16 for boys.

Remember this treatment is entirely about giving the child the opportunity to change. We are not doing the work for the child but simply offering an opportunity to change. Retainers are not needed after successful completion of treatment because something taught lasts a lifetime.

A Philosophy Dr John Mew on Dispatches - Part 1

Dr John Mew on Dispatches - Part 2

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