Do · Feel · Think

Think Carefully before Considering Orthodontics

In one of the world’s most famous assassination cases, John F Kennedy, the US President was shot in his head on 22 November 1963 while he was riding in a presidential motorcade in Dallas, Texas. Next to him, was his wife, Jacqueline, who had to witness the horror. Many of you would have heard about this famous piece of history. But not many of you would have known that President Kennedy’s death may have been avoidable, had he not been wearing a back brace, which he needed because of his poor back condition. Multiple shots came at the car, and those who were around ducked instinctively during the first few shots, except President Kennedy, who could not bend his back because of the brace, allowing him to sustain the fatal shot to the back of his head.

This story left such a big impact on me. Because the back brace, what was supposed to give him support and mobility, restricted his natural movement and at a time of his greatest need, failed to support him, and instead left him a sitting duck in the face of danger. I could not shake this story away from my mind. And it reminded me of something I went through myself.

In my journey towards seeking health, I started going for something called Rolfing, which is a type of bodywork, also known as Structural Integration, which helps your body find balance and work better with gravity. Through the palpation of my therapist, he could feel where the tightness in my body lay. Each person has a unique muscular or fascial pattern, owing the the strains and habits developed in the course of life. For example, someone who has a broken rib, may start walking in a lopsided way and overtime, the scar tissue and the muscular habit of walking in that lopsided way may remain, even if the ribs have fully healed, thus the person’s posture forever hints of the trauma that was once sustained. This can also be seen emotionally. Someone who is in perpetual distress from work or life, and always in a hunched and tense position with shoulder lifted up and head stretched forward, will over time, have this pattern reinforced and it becomes part of the person’s way of being and it shows in the person’s body and structure. As each of us experiences life differently, obtain different physical traumas, reinforce different emotional patterns, and allow ourselves to heal to different extents, every body is different and unique. These, a bodyworker, can easily feel, see and know, from just observing and sensing a person. The bodyworker, hence, has a way of knowing you from your body, even though you may not say very much.

So for me, my Rolfer, Hee Tan, noticed that muscles in my jaw and mouth and one side of my head were very tight. And he asked, if I ever wore braces. I was shocked that he even asked. And I told him that I did for a year when I was 12. And he said that many of his clients who wore braces, have similar tensions in the skull. Though this was a passing remark, I could not help but keep thinking about it. Because around the same time, I started becoming interested in craniofacial disorders and learned of issues that arise from poor function of the jaw muscles and tongue. And in my community, many have pointed out that orthodontics or the wearing of braces or clear aligners, while having straightened their teeth, had also at the same time caused their their faces to age prematurely and become elongated, led to a forward head posture and scoliosis (when some bones cannot move freely, other bones will shift to compensate for the loss of movement). The less lucky ones also develop the Temporal Mandibular Joint Dysfunction (TMD), which is also known as the suicide disease, because of how painful it is.

So what is the possible link between braces, the face, and jaw joint issues? It lies in the movement and breathing of the skull. Your skull looks like just one big thick bone, but it in fact consists of 22 bones that are connected by special joints called sutures (Figure 1). The flexibility of the skull is what allowed a baby’s head to go through the mother’s birth canal at birth. Some of these sutures fuse as you age, but not all and fully, because your skull performs a function of circulating the cerebrospinal fluid that bathes the brain and the spinal cord. To circulate the fluid, the skull bones perform a pumping motion, allowable by the sutures, which are spaces that are “chock-full of arteries, veins, nerves, nerve receptors, elastic and collagen fibres” and are “designed to move”. This breathing takes place all the time, rhythmically, just like the pulsing of your heart or the breathing movement of your chest, but it is less perceptible because you need to be quite still and meditative to be able to observe it in yourself (Figure 2).

Figure 1. The skull is made up of 22 bones, including the maxilla and mandible which holds our teeth.
Figure 2. This video clip shows the pumping of the cerebrospinal fluid to circulate it around our brain and and spinal cord.

The two palatine bones of the maxilla where all the upper teeth are located on are part of this skull breathing system. So what happens when you wear a brace, whatever type it is, is that it restricts the normal movement of the skull, leading to restrictions, scar tissues and poor patterns developing from the unnatural binding of the bones. Perhaps a poor example would be the traditional foot binding ritual of the Chinese. So the bones want to grow and develop in a certain way, but having a bind or a brace, restricts that natural development, resulting in distorted development. Because it cannot move in the way it wants to move, strain patterns develop, and tensions accumulate.

Quite like the case of the brace on the President’s spine that restricted his natural instinct and created a forced posture, so orthodontics does the same. The goal of orthodontics is to straighten teeth but at the expense of natural function and development. Did you know that after braces are removed, for life, the person has to wear something called the retainers to keep the teeth in the new position, or else, the teeth will once again, move back into their crooked positions? This means that the bones naturally want to move and find a position of equilibrium, and wearing braces only restricts and hinders this, they do not genuinely help your jaws and teeth find the most comfortable and healthy position to be in. As you can imagine, over time, strain patterns can develop from restricting this natural movement.

Is there a better way to correct problems with teeth and bite, other than orthodontics? This is an area I have been spending my time studying and hopefully, in time, I can share more with you. Meanwhile, I want to caution people who are thinking of wearing braces merely for an aesthetic effect, that there may be consequences that you may not even link to the wearing of braces in the first place. So think twice. Putting a brace on what is meant to move freely is generally not a good idea.

But if you really do need braces, choose a dentist who takes the craniosacral system into account into his or her methods. Find a dentist who integrates an understanding of whole-body mechanics and craniosacral therapy into his practice, one who first makes sure you do not have any imbalances in your jaw or who can first address it with a splint, before beginning treatment, such that the teeth and jaws are shaped towards your body’s ideal (Langly-Smith, 2020). “Is your bite quite right?” is a book I highly recommend to understand this area of study better. You need to remember that you are not just treating an isolated part of your body when you are correcting your teeth, but your whole body is connected, and pulling your jaws inwards and shifting the head off balance, will have systemic effects.

The only dentists I know who take a systemic approach to correcting teeth alignment issues now is Dr. Granville Langly-Smith, who has already unfortunately passed on, and Dr Jinhaeng Lee, who combine the palpatory skills of a cranio-osteopath and craniosacral therapist with the craftmanship of making splints and braces to return your bite and body into a more ideal position and function, hence enhancing your health and potentially correcting other issues that originated with issues related to the temporal-mandibular joints and bite.

Bibliography

Langly-Smith, G. (2020). Is your bite quite right? Inspiring stories of people regaining their smile and their health. UK: Langly-Smith Lecturing and Learning Ltd.

Pait, T. G., & Dowdy, J. T. (2017). John F. Kennedy’s back: chronic pain, failed surgeries, and the story of its effects on his life and death, Journal of Neurosurgery: Spine SPI, 27(3), 247-255. Retrieved Oct 16, 2021, from https://thejns.org/spine/view/journals/j-neurosurg-spine/27/3/article-p247.xml

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