"Bimaxillary Retrusion" and why some orthodontists don't know about it
The originator of Orthotropics, Dr. John Mew, noticed that there was a very common pattern among people who had crooked teeth: their upper jaw bone was not forming properly.
He explains this as a side effect of our modern diet and environment (sugary, soft diets that don't exercise our jaw muscles, and chronic open mouth posture). His theories have been corroborated by modern anthropology (Boyd, 2012)
In fact, the upper jaw is often set back (and narrow, and hanging down) even when it looks like the front teeth are sticking out! It's just that the lower teeth and jaw are even FURTHER back in the face! Unfortunately, some conventional orthodontic techniques push the front teeth back even more, leading to that "braces look" people have described to me over the years, and possibly aggravating breathing and jaw functions. If you don't know that BOTH jaws are too far back (Bimaxillary Retrusion), then pushing the uppers back makes sense. But if you DO know, you'll never want your front teeth pushed back at all.
What does Biobloc do that other techniques don't?
Biobloc is the ONLY orthodontic technique that can correct the upper jaw in all three planes of space (wider, more forward, and back up where it belongs) AND bring the lower jaw forward without anchoring on the upper jaw to do it. Only jaw surgery (orthognathics) can come close to this kind of correction. (Picture courtesy of Dr. John Mew)
Even better, the Biobloc technique has been shown to improve the airway. Since both jaws come forward, so do the tongue and tissues, thus opening up the throat. The nasal passages enlarge, too. This is especially important for children who snore or have other sleep breathing problems.
What is BioBloc?
"Biobloc" is actually a series of removable orthodontic appliances (and some brackets on the front teeth) that are worn full time, even during eating, sports and sleep. They are made of plastic and wire, and can feel quite bulky at first. Most kids take several days to adjust to the feel of each new appliance. One appliance asks you to posture your jaw forward and hold it that way for quite some time.
All in all, it is not an easy technique to do - not for the orthodontist, the parent, or the patient. But the rewards are so gratifying, it's called "surgery without the scalpel".
What are the steps in Biobloc treatment?
- It's easy to say that Biobloc treatment changes facial structure, but you will probably want to know HOW it's done. There are certain steps that each patient must go through in this process. Though it varies somewhat for each case the basic steps are:
- Widen the Upper Jaw. This uses a palate expander and some braces.
- Move the upper front teeth closer to the front of the face (using the nose as a guideline). This is the awkward looking stage and you have to put up with it for a few months.
- Spread out the lower teeth, especially if they are crowded or tipped inward.
- Moving the upper molars to the correct height. This is also done with the expander.
- Allowing the lower jaw to close to the correct height (This may require premature removal of some upper baby teeth).
- Bring the lower jaw forward. This is the part that takes the most effort and gives the most reward.
- Establish proper tongue resting posture and swallowing habits. This is done with training and with oral myology
- Establish proper nasal breathing and good breathing dynamics (with diaphragm at correct rate). This is also a training process and must be done to assure good long term results.
Dr. Raphael will be happy to tell you which stage you are in as the treatment progresses.
Do you ever take out teeth with Biobloc?
- One of the great features of Biobloc is that it virtually always eliminates the need to remove permanent teeth as part of the treatment. Because the jaws are helped to grow back to their proper (genetically normal) size, there will be plenty of room for all the teeth, even sometimes the third molars (wisdom teeth).
- However, if your child's face is long in height with a setback chin, there is an option in treatment which prematurely removes BABY teeth to help guide jaw growth in the right direction. Not all children need this, but if you do, click here or on the picture to find out why.
Is Biobloc right for everyone?
There are limitations:
- You must still have some of the back baby teeth still firmly in place. Once the permanent teeth are in and the face is grown, there is a limit to what the biobloc can do. You may need surgery or conventional orthodontics after all.
- It requires massive amounts of patience and commitment from all family members to make it through the year of treatment. While the treatment is not painful, it IS a pain to keep wearing the appliances FULL TIME. And limited cooperation will limit your results. Sometimes, families take a break from other activities to get this done, knowing that the benefits will last a lifetime.
Making the treatment stick
Biobloc treatment also depends on getting the tongue posture and nasal breathing correct. The next section will talk more about Oral Myology and training of Tucker the Tongue. more
Where can I learn more?
Click HERE for a detailed explantion of what is entailed in treatment.
Also, Bill Hang is an orthodontist and the foremost Biobloc practitioner in the US. I learned this technique from Dr Hang. Click on the picutre to see what he has to say about this technique in this very informative website.
Dr. John Mew, the originator of the technique, and his son, Mike, practice and teach the technique in London. Click on the next picture to see their site.