Daddy's Teeth and Mommy's Jaw

I think there are 2 different issues and this post confuses them as Dr. Wertheimer noted. Extractions may be used to alleviate crowding that expansion cannot resolve (your choice if expansion can cause bone growth or not, and it should be noted that the maxilla is very different than the mandible). Secondly, A-P masking of poor jaw position can also be facilitated by using extractions rather than surgery, though some patients prefer the esthetics and function of orthognathic surgery, some will prefer to avoid surgeries and this option is an ethical one to offer, if the patient declines to consider the orthopedic surgery. An ethical doctor must offer and explain all possible choices, and allow the patient to make their own choice based on their own needs and desires.

We have grown with the theory of "Daddy's teeth and mommy's jaw" and also thinking thay if a patient has respiratory diseases , mouth breathing, sedentary lifestyle with bad posture, tooth decay and so, it will result in bad growth patterns. I think the main factor are the genetic load and miscegenation over the years. In the other hand external factors do have an influence over it in a partial way, a minimum percentage, because I can not imagine a small chihuahua dog eating stones and leading the jaw to grow the size of a bulldog, even when it has an influence it would not transform the genetic load. As simple as thinking that feeding a human or an animal with hard ailment will change cells information and contraindicate genetic load to grow different than they are already programmed. In orthodontics we are taught to achieve class I as a the main goal, in despite of the means, e.g. teeth removal, withhold jaw bones, growth constriction.. however during my practice I have experienced that achieving this goal does not necessarily benefits the patients health needs, that is why we should aim for more health benefits in our patients rather than a mere class I,II or III occlusion, we must look at the big picture considering breathing, sleep, development and general health according to each patients' features. In 1910 first and original Angles' paper "Bone growing" he describes that the main goal of an orthodontist is to grow the jaw bones in order to make enough space for them to fit in the mouth of the patient.José Paul

The question is in my opinion : What determines the shape of the bones during development ? Genetics and function. In an ideal body, the jawbones grow to their maximum genetic potential, helped by normal functions. If there is balance between the forces of facial and oral muscles and the tongue, the teeth will grow in their intended locations. Our "civilized " bodies more often get little exercise , lack of breastfeeding , upper respiratory diseases , mouth breathing, sedentary lifestyle with bad posture , tooth decay, et cetera will result in bad growth patterns. The result is less than harmonious relationships of our teeth to each other and to their surroundings : tongue and oral muscles. Most of the time the tongue looses.... Dr. Wertheimer is correct , saying that extraction does not cause retraction. Poor function does. When we remove the "seemingly " superfluous teeth ( premolars and wisdom teeth ), we accept this retraction by "nature". Dr Hang's approach (and mine) is to promote healthy habits from nasal breathing to exercise. I agree with Dr Hang on regaining those extraction spaces and give back the proper space to the tongues. I practise the same way.

Hi Dr Hang: I have treated more than 14,000 patients from ages 7 to 70 during my 40 year career in the specialty of orthodontics. Based upon my experience , my philosophy and my technique, the only teeth that I have removed are the third permanent molars ( wisdom teeth ) preferably, between the ages of 12 and 16, and preferably, by an oral and maxillofacial surgeon, which takes no more than 20 minutes, under conscious sedation. Based upon my evidence-based research, as a consultant in three local Halifax hospitals, one of which is the international training centre for the specialty of oral and maxillofacial surgery, established in 1972, by my long-time friend and associate, the late, and internationally respected, Dr David Precious. Our combined philosophy evolved over several years, and by successfully and atraumatically treating several thousands of patients. The philosophy is, that most human beings are blessed, or cursed, with 32 permanent teeth, however, most of us only have sufficient space in our maxillary and mandibular alveolar arches for 28 well-aligned teeth. Please refer to an article that I had published in the SPECTRUM dental TEAMWORK journal volume 7, issue number 5, May 2014, a well-respected publication. DrJensen

Extraction doesn't = retraction. That is nonsense