There are differing opinions about the effect of extraction on the face as illustrated in this video from 60 Minutes in 2003, featuring Dr Derek Mahony, a world-renowned orthodontist from Sydney and incidentally one of Dr Gonsalvez’s orthodontic teacher. It illustrates the differences in opinion and the potential impact of orthodontic extractions on the face. Dr Mahony completes 95% of his treatment with braces without extractions.  When extractions are required, it is for the face, not for the space

Part 1:. //www.youtube.com/watch?v=VvqndYJRniI&list=PLyZGBZwsDv-EDIPEm8kcSRUEOfMDKqx0b&index=1

Part 2: //www.youtube.com/watch?v=OAITgloDeAU&index=2&list=PLyZGBZwsDv-EDIPEm8kcSRUEOfMDKqx0b

Part 3: //www.youtube.com/watch?v=oKMu38k8SBk&index=3&list=PLyZGBZwsDv-EDIPEm8kcSRUEOfMDKqx0b

At the dental gallery we aim to:

1. Address the airway issues
2. Address the functional issues
3. Address the crowding issues.

Each orthodontist or dentist will give advice based on their training, experience and what they believe is best for you.  Knowing there are varying perspectives, it makes sense to get a couple of opinions to ensure you can make a well informed decision.

Can extraction orthodontics impact the airway?

There is growing awareness that this type of retractive orthodontics reduces tongue and airway space and can contribute to sleep breathing problems.  With a qualification in dental sleep medicine, this factor is something that has influenced Dr Gonsalvez’s approach.

Websites like Right To Grow are helping patients around the world to understand the implications and make a fully informed decision before proceeding with extractions.

The orthodontists featured on this site include Dr Derek Mahony, Dr Bill Hang, Dr Barry Raphael, and Drs John and Mike Mew.  They are big advocates of early interceptive orthodontics – to develop the face and airway and non-extraction orthodontics.  They have been the most influential on our approach on avoiding orthodontic extractions.

The Passive Self Ligation Philosophy – Point Cook Braces for the face

The difference with the Passive Self-ligation System and traditional braces is that it is a philosophy of treatment that extends beyond the braces and achieving straight teeth. It is centered around achieving the best facial balance and using light forces that work in harmony with the muscles of face, tongue, bone and soft tissues.  The bio-compatibility of this system makes it easier to stimulate the formation of new bone that the teeth can move into, and therefore often eliminates the need for extractions.  Click here to read “Will I Need Teeth Pulled?”

What are the limitations of the system?

• It does not work if the root causes like airway, breathing, tongue and lip function, habits and correct swallowing patterns are not dealt with. Hence good compliance is required to follow through with the Myofunctional therapy.
• It works in teenagers and adults but good general dental health and gum health is vital for the therapy to succeed. Adults may require an assessment with a Periodontist (gum specialist) prior to commencing treatment.
• It needs to be combined with expansion appliances in cases with very narrow jaws.
• It is not suitable to be used alone in non-growing patients with severe discrepancies of their jaws as these patients will require surgical treatment and need to be managed by specialist orthodontists.

There are many passive self-ligation systems available in the market and to find out more about the theory behind the system please visit the Damon Brace website

Contact us to organize an assessment to find out if Damon Braces is a suitable option for you.

Early Functional Orthodontics – Braces Point Cook

This is the treatment employing fixed or removable appliances to correct the size and position of the facial structures and jaws so that teeth can be aligned.  This early treatment often eliminates the need for extractions, creates space for teeth to straighten and minimizes the need for jaw surgery. This then helps to improve the health, function and appearance of an individual.

The best time to commence treatment to correct the upper jaw position and prevent tooth crowding is usually between the ages of 7-9 years. Normal growth of the lower jaw is dependent on the proper position and size of the upper jaw, and so the lower jaw is usually addressed later.  When the child’s jaws have stopped growing, then this type of treatment is not as effective.

For this reason we support the American Association of Orthodontists’ recommendation that an evaluation of facial and dental development as soon as problems are recognized and no later than age 7.

The are several main goals of treatment

• To develop the upper jaw three dimensionally
• To accommodate the adult teeth without causing overcrowding or crookedness which can compromise oral hygiene
• To allow the lower jaw the space to grow forward ideally without being trapped by a narrow or pushed back upper jaw
• To increase breathing capacity as the upper jaw forms the floor of the nasal passageway
• To increase the space available for the tongue to function ideally
• To broaden the smile and balance facial contours

The video below highlights how a narrow upper jaw is linked with snoring and how expanding the jaw can improve breathing and have wider benefits.

Lower jaw retrusion is not ideal and has the following implications:

• Social implications
• Greater risk of trauma to the upper teeth
• Poor head posture
• Poor airway space
• Increased risk of obstructive sleep apnoea.

Dr Gonsalvez is regularly involved in the management of adult patients with Obstructive Sleep Apnoea by referral from sleep physicians. She provides Oral Appliances that help stop snoring and manage sleep apnoea by holding the lower jaw forward to open up the airway during sleep. If in a child one can influence growth and development favorably it could potentially prevent the need for sleep appliances at night to treat obstructive Sleep apnoea in adulthood.

Furthermore studies have shown that bimaxillary jaw surgery (that moves both the upper and lower jaw and face forward) is a proven method to manage the increasingly prevalent condition of Obstructive Sleep Apnoea. This is invasive jaw surgery to correct what could potentially be prevented and corrected in childhood through Early Functional Orthodontics.

The Steps in the Early Functional Orthodontics Assessment is as follows:

Pre-Treatment – Assessment and Diagnosis

Visit 1 – Assessment – To see how we will be able to help your child

• 10 – 20 minute appointment to visually and functionally assess developmental markers
• Assessment of the completed questionnaire regarding your child

Visit 2 – Records Appointment – Gathering of information- 20mins

• Photographs
• Impressions to make study models of your child teeth
• Referral for x-rays – OPG, lateral x-ray and frontal x-ray (bulk billed by radiology)

Visit 3 – Case Presentation – Explaining what we have found, treatment options, time estimate for treatment and cost.

• 30 minute –We prefer to have child at this presentation
• Once we have the complete picture of your child’s dental and general health, we can tailor the best treatment to facilitate optimal growth, development and aesthetics.

To request an appointment, please fill in the “Make an appointment form” or visit our contact us page.