Professional Documents
Culture Documents
by John Utama
size and shape of the upper jaw. There are numerous theories to this
phenomenon (2) (3). The wider the mouth is open at rest, the narrower the
upper jaw becomes, ie, the more people breathe through the mouth, the
smaller the jaw gets. It makes sense, in the ideal nose breathing, the tongue
rests against the roof of the mouth. The tongue exerts pressure against the
roof of the mouth and therefore shapes the upper jaw. In mouth breathers,
the tongue drops down, thus, the external forces of the lips and the cheeks
become dominant, disturbing the equilibrium, consequently constricting
the upper arch.
The nose is designed for breathing, the mouth is not designed for
breathing, it is mainly designed for eating and talking. The mouth is
designed as a secondary breathing apparatus, if there is an obstruction in
the nose such as allergic rhinitis (4) or enlarged tonsils (5) the mouth is
available as a reserve to breathe in Oxygen. Mouth breathing is only
designed as a temporary measure until the optimal conditions of nasal
breathing are reinstated.
From here there is a potential domino effect, the upper teeth become
crowded, the lower teeth also become crowded to fit against the narrow
upper jaw. Consequently, the upper and lower teeth dont fit together,
causing stresses in the muscles and the TMJ joints. When the TMJ joints
are stressed, the surrounding structures such as nerves, blood vessels and
ligaments are also stretched and compressed. There are a number chronic
illnesses such as vertigo, migraines and headaches, Menieres (6) that are
associated with TMJ dysfunction.
A more serious consequence of an orthodontic problem is the receded
mandible. Here the lower jaw is pushed back in order for it to meet up
against the upper jaw during the normal functional activities such as eating
and swallowing. When the lower jaw is forced back in the toxic bite
position, the tongue is carried with it backwards reducing further the
already constricted oral cavity and ultimately airway, directly behind the
tongue at the back of the throat. This can occur at any age leading to the
serious condition of OSA (Obstructive Sleep Apnoea). This topic will be
covered later on another blog.
The left pictureaboveshows a narrow airway, the right picture shows a
normal airway. The main difference is the size of the upper jaw length
(antero-posteriorly) (7), as shown on the picturebelow.Needless to saythe
patient on the left has been diagnosed with OSA confirmed with a sleep
study.