Berkshire Business | The modern way to straighten teeth - Technique allows pediatric dentists to solve, not treat, symptoms
Editor's note:This article was updated on Dec. 5, 2017, to replace "saltier diet" to "softer diet."
PITTSFIELD — The initial diagnosis occurred during a routine dental checkup about a year ago.
That was when Tosia and David Hodges of Adams learned that their 5-year daughter, Izzabell, had both a recessed jaw and a 90 percent overbite, meaning her front teeth jutted far out over her bottom teeth.
"It was causing some breathing problems with her, too, because she was breathing through her mouth not breathing through her nose as she should be," Tosia said.
One year later, Izzabell's overbite has been greatly reduced, and she's sleeping better at night.
It's due to an Australian technique known as the myobrace system, a preventive pre-orthodontic treatment best suited for youngsters between the ages of 3 and 15 that addresses the underlying causes of crooked teeth without using either braces or extractions. In the Berkshires, the myobrace system is provided by Yarmosky Pediatric Dentistry, which has offices in Great Barrington and Pittsfield.
Brothers Louis and Steven Yarmosky and fellow pediatric dentist Lauren Ballinger use a series of removable intra-oral appliances similar to a mouth guard or retainer to train children's facial muscles so they can learn to breathe properly through the nose and not the mouth. Izzabell Hodges is one of their patients.
Children who breathe through the mouth often contract a condition known as sleep-disordered breathing due to a compromised airway, which can put them at greater risk for a host of behavioral, emotional and cognitive problems such as attention deficit disorder, according to the Yarmoskys. It can be treated and permanently cured by establishing proper nasal breathing and swallowing habits.
"This is some of the most exciting stuff I've done in 43 years, to understand the link between growth development and whether or not you have good function of breathing and swallowing," Louis Yarmosky said.
Yarmosky Pediatric Dentistry has become a staunch advocate of the technique and is planning to have an office area for use solely by myobrace patients in March.
"Myobrace was the missing piece for us," Louis Yarmosky said. "It allowed us to start working with muscle function and other things that cause crooked teeth to begin with. Now we can take a 3-year-old, a 4-year-old, or someone sometimes younger, and just by teaching them to breathe properly and swallow properly we can make their teeth straight.
"It's a wellness thing, too, because by helping kids establish good breathing habits and sleeping habits, they're healthier," he said. "They're smarter, they pay better attention, they don't grind their teeth, they sleep better."
Crooked teeth, first noticeable when children are 5 years old, can be caused by a variety of factors, some of them hereditary, like a narrow palate or small jaw, and some avoidable, like poor dental hygiene. Modern research has found other factors that lead to crooked teeth including mouth breathing, tongue thrusting, reverse swallowing and even thumb sucking.
Two Stanford University scientists, Christian Guilleminault and Shannon Sullivan, found that pediatric sleep disordered breathing can be found in children of all shapes and sizes, and can lead to problems with focus and concentration, hyperactivity, learning problems, headaches and mood disturbances.
According to Ballinger, crooked teeth in children is a relatively new phenomenon that began when humans began eating a softer diet following the beginning of the Industrial Age. In the 1930s, Weston Price, a Cleveland dentist known as the "Isaac Newton of Nutrition" according to his foundation, began studying aboriginal cultures and found that despite their diets most of those people had straight teeth.
"Go to the Berkshire Museum and look at the skulls of ancient people 5,000 years old," Louis Yarmosky said. "They don't have crooked teeth. They have straight teeth. Their teeth are worn down."
Pediatric dentists have been straightening children's teeth for many years, but by more traditional methods.
"We've always known there were problems early," Louis said. "The traditional way is to say, 'we'll fix it when you're 12 or 13 years old when your permanent teeth come in.' That's when most people in the past would think you would go to the dentist to get your teeth straightened. But the reality is by the time you're 12 or 13 you've finished growing in your face. We would make room and get results, but there was a missing thing. We saw problems with younger kids where we couldn't use mechanical means because they didn't have enough teeth."
Instead of working to treat the symptoms of the problems that lead to crooked teeth and poor breathing, the myobrace system allows pediatric dentists to solve the issue entirely.
"We're talking about trying to prevent it in the first place," Ballinger said. "If your jaw is narrow and you don't have room for your tongue to fit in your jaw and you cannot establish nasal breathing, you won't get better. Dentists are kind of the physicians of the mouth and understand that."
"It's always been a health issue," Steven said. "It's a matter of determining what causes it. ADD (attention deficit disorder) has been around a long time. Now we're putting together why."
Maxwell Adam, 12, of Lenox, began having issues because there wasn't enough room in his mouth for all his adult teeth to come in, according to his mother, Karen Alpert.
"Since having the myobrace the spacing has opened up and the teeth have come in straight," she said. "There's no need for orthodontics."
Adams, who began the treatment in April, runs cross country and plays basketball.
"He swears his new way of breathing has dramatically improved his athleticism," Alpert said.
Under the Myobrace system, children being treated by Yarmosky are given an intra-oral device to wear at night, and for one hour during the day. Three different devices are used: to teach youngsters to breathe properly, to expand the jaw and to align the teeth, respectively. The treatment generally takes 12 months, although it can last up to two years for older children who are given braces, Louis said.
Children are also required to perform a series of exercises for breathing, using the tongue, for swallowing and the lips and cheeks that vary month-to-month. Themyobrace technique doesn't work if all the steps aren't followed.
"I like to tell parents when you go to the gym you don't just stare at the dumb bells," Louis said. "You have to pick them up. This is a system that positions your teeth, your lips and your tongue in a certain way which allows you to go through these exercises that strengthen the lips, tongue and mouth and the muscles around it. When a child isn't breathing right or doesn't swallow properly we can teach them how to do that."
David Hodges, Izzabell Hodge's father, was originally skeptical about the myobrace system based on the experiences he went through with his teeth as a child. He didn't think wearing a plastic retainer every night and for an hour each day would correct his daughter's issues.
"It didn't really do much for me 35 years ago," he said.
But now Hodges said, the treatment has made a "huge, huge difference" in his daughter's face.
"When she smiles I don't see half of her teeth," he said, "I see all of her teeth."
Business Editor Tony Dobrowolski can be reached at firstname.lastname@example.org or at 413 496-6224.
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