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Dental Health Resources.

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  • Guided Growth - Why is it Important?

    Jaw and Facial Development

    Helping Grow Healthy Faces

    Proper jaw development is vital for both children and adults, influencing various aspects of overall health.

    Airway Health:

    The upper jaw's development is critical for creating a well-formed airway, reducing the risk of sleep disordered breathing issues in both children and adults. This includes conditions like snoring, obstructive sleep apnea, and associated health concerns. In children underdeveloped jaws can also contribute to sleep-related Adhd-like behaviour, poor concentration and aggression type issues. 

    Facial Aesthetics:

    Balanced facial development, influenced by the maxilla and mandible, contributes to an aesthetically pleasing facial profile. This impact persists into adulthood, influencing facial harmony and self-esteem.

    Sleep Health:

    Jaw development significantly influences sleep quality. Proper jaw growth promotes optimal airway formation, reducing the likelihood of issues like snoring and obstructive sleep apnea. A well-developed jaw ensures unobstructed airflow during sleep, contributing to uninterrupted, restful sleep patterns.

    TMJ Health:

    The development of the jaw is closely tied to the health of the temporomandibular joint (TMJ). Proper jaw growth reduces the likelihood of TMJ disorders, ensuring comfortable jaw function and minimizing associated discomfort.

    In essence, the importance of jaw growth extends beyond cosmetic concerns. It is a fundamental aspect of overall health, impacting airway function, facial aesthetics, quality of sleep, TMJ health, teeth alignment, and various facets of well-being throughout life. Guided Growth Orthodontics and awareness of proper jaw development contribute to a lifetime of improved health and vitality.

    Facial Development: “The Big 4” Oral Postures

    1. Resting Tongue Posture

    2. Mouth Closed - Nasal Breathing

    3. Correct Swallow Pattern 

    3. Chewing Chewy/Hard/Crunchy Nutrient Dense Foods

    The Oral Postures and Functions "BIG 4" for facial development encompass critical aspects of muscle balance and proper breathing:

    1. Resting Tongue Posture: The tongue, a powerful muscle exerting up to 500g of force, plays a pivotal role in shaping the palate and jaws. When resting on the palate, it encourages healthy upper jaw growth, fostering facial harmony.

       

    2. Mouth Closed - Nasal Breathing: Maintaining a closed mouth, with teeth slightly apart, is essential. This position promotes forward and outward growth of a child's jaws, defining facial structures and ensuring a prominent airway. It is also essential for prevention of sleep disordered breathing conditions like sleep apnoea, a condition which contributes to a reduction in mental and physical development and well being. 

    3. Correct Swallow Pattern: A proper swallow pattern, with the tongue resting on the roof of the mouth, supports balanced facial development, dental alignment, and airway health. Conversely, an incorrect pattern, marked by low tongue posture and inward jaw pressure, can lead to imbalances, malocclusions, and potential airway issues. Emphasizing correct tongue positioning during swallowing is crucial for overall facial symmetry and well-being.

    4. Chewing Nutrient Dense Foods:  We have become the "Big Mac Society." Much like the iconic fast-food staple, our modern diets continue to become softer, less chewy and have reduced nutritional density.There has been a shift from natural diets to contemporary dietary habits, our society has transitioned towards processed and now ultra-processed choices. Moving away from wholesome nutrition, we have adopted a more convenience-driven, fast-paced lifestyle, often characterized by processed and easily accessible meals. This shift raises concerns about its impact on oral health, facial development, and overall well-being, emphasizing the importance of mindful dietary choices for Jaw growth and optimal health.

    These "Big Four" factors, when prioritized at any age, but particulalrly during growth and development, help prevent disharmony and imbalances in craniofacial structures, fostering proper facial growth, sleep and airway development.

     

     
     
     

     

  • Guided Growth - What's Involved?

    Guided Growth – What’s involved?

     

    What drives the development of our jaws and faces?

    Living bone is extremely susceptible to pressure and stimuli.

    The upper jaw and nose/sinus complex requires nasal air pressure to stimulate normal/ideal growth. This development is then modelled and retained by ideal tongue posture and swallow patterns (which is only possible during nasal breathing)

    0-5 years of age is the period during which the nasal/maxillary complex (upper jaw and middle part of your face) goes through its most significant growth.

    Upper jaw/mid-face growth is generally complete by 12 years of age, whilst the lower jaw may continue to develop into your 20s.

    What can be done?

    Prevention and Promotion of Natural Growth – 0-3 years

    Close to 60% of jaw and facial growth is complete by the age of 3. Therefore promoting good oral habits will optimise natural jaw and facial growth. 

    Can your child breathe? Any restriction in nasal airway compromises craniofacial development as well as overall neurological and physical growth.

    Prevention and Promotion of Growth

    • Breast feeding – sitting up, baby at ~45°
    • No tippy cups or straight teat bottles
    • Check fraenum at birth (tongue and lip ties)
    • Chew unprocessed foods
    • Retrain breathing/chewing/swallowing habits early
    • Encouraging good lip seal
    • Sleep Screening 

    Re-education of Poor Oral Habits

    Myofunctional retraining

    • Myobrace/Myomunchee removable trainer/retainer
    • Assessment with orofacial myologist if required
    • Mewing techniques

    Breathing retraining

    • Assessment of breathing behaviour/efficacy
    • Retraining of daytime breathing if required

    Ear nose and throat assessment

    • Tonsils, adenoids, nasal polyps, allergies
    • Nasal decongestants

    The Research:

    • Camacho M, et al. Myofunctional Therapy to Treat Obstructive Sleep Apnea: A Systematic Review and Meta-analysis. Sleep. 2015
    • Bruton A, et al. Physiotherapy breathing retraining for asthma: a randomised controlled trial. Lancet Respir Med. 2018 Jan;6(1):19-28.
    • Zhao Z, et al. Effects of mouth breathing on facial skeletal development in children: a systematic review and meta-analysis. BMC Oral Health. 2021 Mar 10;21(1):108.
    • Shirke SR, et al. Association of Sleep-Disordered Breathing and Developing Malocclusions in Children: A Cross-Sectional Study. Cureus. 2023 Jun 1;15(6):e39813. 

     

    Early Intervention Expansion– 4-9 years

    Guided growth arch development plate therapyHyrax Appliance ☑️ CD Ortho Studio Orthodontic Devices

    Early intervention expansion is a proactive orthopaedic orthodontic approach focused on guiding and optimizing the natural growth of the jaws in children. It typically involves the use of appliances like expanders to create space in the dental arch, promoting proper alignment of teeth and supporting optimal jaw development. This is referred to as Orthopaedic Orthodontics, Fowardontics and Orthotropics.

    Orthodontically, our aim with this step is to create beautiful healthy faces and smiles while also reducing the risk of premolar tooth extractions, surgical interventions and long-term braces orthodontics. In addition to the teeth, jaws and facial growth considerations, we also want to highlight the interconnectedness of underdeveloped jaws with sleep, airway, and disordered breathing. Underdeveloped jaws can have a significant influence on these aspects of sleep and breathing, impacting not only your smile but also the overall development, behaviour, cognition and quality of life of a child.

    Continued Myofunctional and Breathing Retraining as well as airway and sleep assessments are all esstential to ensure appropriate interventions are introduced to optimise the success of treatment the health of a child. 

    The Research:

    • Yoon A, et al. Impact of rapid palatal expansion on the size of adenoids and tonsils in children. Sleep Med. 2022 Apr;92:96-102. doi: 10.1016/j.sleep.2022.02.011. Epub 2022 Feb 19.
    • Andersson H, et al. Sleepiness, occlusion, dental arch and palatal dimensions in children attention deficit hyperactivity disorder (ADHD). Eur Arch Paediatr Dent. 2018
    • Izuka EN, et al. Immediate impact of rapid maxillary expansion on upper airway dimensions and on the quality of life of mouth breathers. Dental Press J Orthod. 2015 

     

    Teenage Orthodontics – 12 years and older

     

    Teeth Straightening. Aligners vs Braces - Commercial Road Dental

     

    At Symmetry Dental, Dr. Patrick Ryan undertakes orthodontic alignment to create beautiful straight smiles. While Dr Ryan can create amazing smile transformations and often mitigate the risk of surgery and tooth removal, there are limitations associated with teenage orthodontics. Recognizing that the jaw bones become more rigid in their positioning during adolescence compared to that of the 4-9 year age group, Dr. Ryan utilizes cutting-edge methods to address poor oral habits and implement orthodonitc expansion treatments in the teen years. By leveraging advanced orthodontic approaches, he aims to optimize the natural growth potential of the jaws, providing effective solutions for facial development and airway health. Through tailored and innovative strategies, Symmetry Dental aims to achieve the best possible outcomes for teenagers seeking orthodontic care. 

    Requirements for straight teeth

    • Bony space to fit all teeth - Broad Mouths
    • Bite pressure - Correct tooth on tooth relationship
    • Lip and tongue pressure – swallowing/breathing
    • No aberrant habits
      • Thumb sucking
      • Mouth breathing
      • Tongue thrust
      • Reverse swallow

    The Research:

    • Perez-Chada D, et al. Sleep disordered breathing and daytime sleepiness are associated with poor academic performance in teenagers. A study using the Pediatric Daytime Sleepiness Scale (PDSS). Sleep. 2007
    • Han S, et al. Long-term pharyngeal airway changes after bionator treatment in adolescents with skeletal Class II malocclusions. Korean J Orthod. 2014
    • TedX talk: Matthew Walker - SLEEP IS YOUR SUPERPOWER

     

     

     

  • TMJ Dysfunction (head, neck and jaw pain)

    HEADACH, NECK, OROFACIAL, BURNING MOUTH AND JAW PAIN (TMJ)

     

    The Dreadful Migraine and Why It Is More Common Among Women - NDTV Food

    Temporomandibular joint (TMJ) pain

    The temporomandibular joint (TMJ) is a complex joint that acts like a sliding hinge, connecting your jawbone to your skull. You have on joint on each side of your jaw. 

    TMJ disorders, a type of temporomandibular disorder or TMD/TMJ, Jaw pain can cause pain in your jaw joint and in the muscles that control jaw movement. 

     

    What causes TMJ dysfunction and pain?

    Occasionally, TMJ pain may occur because of dysfunction within the TMJ or it's supporting structures. Dr Joseph Ryan specialises in helping diagnose and manage your specific TMJ dysfunction. 

     

    Common Signs and Symptoms 

    TMJ dysfunction can cause a number of symptoms:

    • Discomfort or pain in the jaw especially when eating
    • ear pain
    • locking of the jaw, making it difficult to open or close your mouth
    • Headaches
    • Jaw clicking, crunching, clunking noises
    • Ear fullness or muffled ear sounds
    • Neck of shoulder pain
    • An uncomfortable or uneven bite

     

    Treatment 

    The treatment of TMJ dysfunction should be prescribed based on your specific diagnosis. The goal of TMJ dysfunction  treatment is to reduce pain, improve function and quality of life. 

    There are various treatments available and Dr Joseph Ryan offers treatment in both Wollongong and Canberra and would tailor the treatment to an individuals need. Treatment options include:

    Conservative care of a soft diet, use of heat or cold packs, jaw stretching/strengthening exercises

    Prescription of certain medication

    The fabrication of an occlusal night splint 

    Low level laser or photobiomodulation therapy 

    Injectable therapy such as botox of trigger point injections

    Headahce

     

    Headaches

    A headache is the broad descriptive name given to pain in the head. There are many different types of headaches. Dr Joseph Ryan may be able to help diagnose and treat your specific headache disorder.

    Signs and Symptoms

    Dull aching pain or pressure in the head that can change throughout the day

    Nausea

    Visual disturbances 

    Trouble concentrating

    Tender scalp and or face

    Patients with TMJ dysfunction can often wake with a headache 

    Treatment

    There are various treatments available and Dr Joseph Ryan would tailor the treatment to an individuals need. Treatment options include:

    Conservative care of exercises, sleep hygiene and massage

    Occlusal appliance therapy

    Injectable therapy such as trigger point injection and Botox

    Low level laser therapy and photobiomodulation therapy 

     

     

    Splint

    Prarafunction. Clenching and Bruxism

    Bruxism is the habit of forcible clenching and grinding of the teeth.

    It is very common and occurs in up to 30% of the population

    IT can occur during the day (awake bruxism) or while sleeping (sleep bruxism).

    Forces generated by functional tooth contact have no harmful effect on masticatory system but forces generated by bruxism which are directed laterally and are significantly greater, may affect one or more elements of masticatory system. Individual adaptability, duration, frequency and intensity contribute to the resulting effect.

    Signs and Symptoms

    Jaw stiffness in the morning

    Headaches

    Tooth wear

    Tongue indentation

    Cheek ridging 

    Cracked teeth

    Maester muscle enlargement

    Grinding noises  

    Alveolar bone loss

    TMJ dysfunction

    Treatment

    Management of awake bruxism is generally focussed on habit reversal training, relaxation, aiming to reduce emotional stress.  It is difficult to cease the muscle activity during sleep. As such, management of sleep bruxism is based on treating the consequences of sleep bruxism. Management may vary from lifestyle changes, such as avoiding smoking, alcohol, caffeine, and illicit drugs, to behavioural medicine including relaxation and good sleep hygiene. Some individuals may benefit from an occlusal splint  or injectable therapies  to reduce grinding sounds and prevent further damage to the teeth, while others may need additional medications to help with any associated 

     

     

    Jaw pain

    Trigeminal Neuralgia

    Trigeminal  neuralgia is a chronic pain condition that  affects the trigeminal nerve. The trigeminal nerve is the largest nerve arising from the brain. 

    People who have trigeminal neuralgia feel pain that is:

    • severe, sharp, stabbing, shooting or
    • like an electric shock

    Having this condition generally affects one side of your head. The main symptom is a short-lasting pain that happens from a few seconds to minutes 

    The exact cause of trigeminal neuralgia is unknown, it may be a healthy blood vessel, putting pressure on the nerve.

    Treatment 

    Treatment for idiopathic trigeminal neuralgia is often medication (anti-convulsant medication), other treatment modalities include Botox injections and neurosurgery. 

    Burning mouth

     

    Burning Mouth Syndrome

    Burning mouth syndrome is a condition in which you have a burning sensation in the mouth. The discomfort can affect anywhere in the mouth including tongue, lips and palate. Burning mouth syndrome may appear without any known triggers and be upsetting and interfere in daily activities.  

    Signs and Symptoms

    Burning mouth does not cause physical changes.

    • a feeling of burning, or scalding mouth
    • dry or rough

     

  • Respiratory and myofunctional centre (breathing and tongue)

     

  • Sleep Apnoea Brochure

     

     

     

     

     

     

     

     

     

  • Video Resources

    Airway & TMJ

    Page to be updated shortly.

    Airway Collapse Watermark 1

    Nasal vs mouth Watermark 1

    6 Ways Evolution Screwed Us Over

    Matthew & Patrick Ryan - Symmetry Dental

    https://www.facebook.com/LowCarbCanberra/videos/672880516668205/

    Matt Ryan - You are how you eat: building a healthy body from the mouth down

     Dr Patrick Ryan: Guided growth orthodontics

     

     

  • Early Intervention Orthodontic Brochure

     

     

  • Aesthetic Restorative Dentistry Brochure

     

     

  • Paediatric Sleep Disordererd Breathing Brochure

     

  • Grinding and Clenching Brochure

     

     

     

  • Chronic Head and Neck Pain Brochure

     

     

     

  • Symmetry Dental Growth Tips Brochure

     

     

  • Helpful Links

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