Why not go with an appliance supported by a professional?

Posted by: @wellwellwell

Why not go with an appliance supported by a professional?

 

Please continue......

So, few things from the first week:

Baring last night, according to my fiancee I haven't snored at all.

Have turned it width ways 4 times (1mm total) and forwards twice (0.5mm - not going to turn forward too much but want to turn a couple times to simulate forward pressure from mewing).

I am wearing it on average about 20 hours a day, working from home helps with that, I remove when eating, drinking, brushing teeth and leaving the house.

Was tough to talk properly when first started using it but getting better now. Was also a lot of saliva to begin with but not as much now.

When it's been turned the pressure feels a little like having wires on braces changed/tightened.

Too early to tell any changes, particularly looks wise but can feel sort of a tingling in my cheekbones and around my nose so am hoping that's a positive sign.  

Will likely check in with an update in the next week or so.

Take care, if any questions please ask.

Did you send braceshop your dental impression?

• @wellwellwell yeah, bit tricky doing own moulds, what appliance would you have recommended re your earlier post?

So just over 2 weeks in, am turning every 2 to 3 days.

My smile looks slightly 'wider', but don't know if I am convincing myself of that or not. Sometimes I also feel I am showing marginally more tooth vertically but again, is that my mind playing tricks or not? Who knows.

One thing I am 'convinced' has improved though are my cheekbones, I say 'convinced' as I am eating at a slight caloric deficit and weight training while working from home. I am losing about a pound a week (just shy of half a kg) and I want to lose another 10 pounds or so before end of August when hopefully holidays happen for me. Thats why I wonder ever so slightly that the cheekbones showing are down to weight loss or not. I also feel a very slight improvement in lower jaw/chin, my double chin seems slightly less visible than before (always have had a double chin even at my lightest weight of 150lb as an adult, am 175 atm). If I catch myself in the mirror at a slight angle it does seem my lower jaw is slightly more prominent but once again, too early to tell for definite.

If changes are happening, I am hoping that my arch drops a bit so more upper tooth shows. I have the u shaped upper arch, I have read it should be more flat on roof of mouth. As for health benefits I am sleeping better and according to the better half snoring less (she is happy with that), so hopefully that will continue.

Aren't your teeth going to misalign using that appliance?

Posted by: @tituss

Aren't your teeth going to misalign using that appliance?

Apparently the lower teeth/jaw expand with the upper.

So far I haven't noticed any issues.

So it's been 4 weeks now and I am still pretty happy with things. It does seem like there are small changes in the cheekbones, jaw line and slightly more vertical tooth showing when smiling.

I mentioned that I was turning the expander forward, I have since decided to undo that so it's now just width ways, total width (lateral?) expansion is 3mm.

I seem to have a little more width to my face as well, the masseter muscles seem to be working better maybe. So hopefully over the next few weeks I will continue to see some more subtle changes. Sleep wise snoring a lot less now, not 100% gone but much better. 

One other thing I have noticed is even with undoing the forward pressure, I can feel pressure at the top of my nose and my forehead; hopefully that's a good sign.

Will continue to update every few weeks or so and if it even proves helpful for one person that that's a bonus.

Interesting thread to follow, I have ordered my palatal expander and I will expand as well,so this is of great interest for me. I have a few questions though, you say that your mew line is 32mm, and your goal is for it to increase? 32mm is way shorter then what John Mew described as optimal, and the lower the number the better facial development, so I dont really understand what you mean by that. I also wonder what your intermolar width is, and how much do you plan to expand it? And what will you do after expansion? regarding potential misalignment of bottom and upper teeth, gaps between front teeth etc. These things seem like they should mostly work themselves out, but in case they don't, what would be your plan?

Keep the updates coming!

should i get one

@cheekbones1983

Hey, I just posted an update about regarding my experience with a palate expander. I thought that I'd let you know in case you'd like to compare our progress.

Posted by: @kilroy

Interesting thread to follow, I have ordered my palatal expander and I will expand as well,so this is of great interest for me. I have a few questions though, you say that your mew line is 32mm, and your goal is for it to increase? 32mm is way shorter then what John Mew described as optimal, and the lower the number the better facial development, so I dont really understand what you mean by that. I also wonder what your intermolar width is, and how much do you plan to expand it? And what will you do after expansion? regarding potential misalignment of bottom and upper teeth, gaps between front teeth etc. These things seem like they should mostly work themselves out, but in case they don't, what would be your plan?

Keep the updates coming!

Hello,

I want to increase my mew line so more upper tooth shows, maybe thats wrong of me though?

My intermolar width was 35mm to start.

In time I am hoping to get a new appointment with the maxifacial clinic and go from there.

Posted by: @rockyp33

should i get one

That's entirely down to you, what are your goals?

Posted by: @elwynn

@cheekbones1983

Hey, I just posted an update about regarding my experience with a palate expander. I thought that I'd let you know in case you'd like to compare our progress.

Hello, good to hear from you again, well read that and keep updating this as well, thanks and good luck :-)

You are saying that your teeth will not be misaligned because the down arch expands as well.Is the palatal expansion you are having rapid or slow? Propably the rapid expansion needs braces for bite correction afterwards..

@notfunnydidntlaugh

In my experience, the lower dental arch did not follow the expansion of the upper dental arch when using the expander. The two arches expanded together only when I achieved the expansion using my tongue.

Little further into my journey, not much else to report.

Cheekbones seem more prominent, not too sure though if gaining any forward growth/dropping of my upper arch which I would like to achieve.

Maybe need to be more patient, hasn't even been 2 months yet. Have widened the expander 4mm so far.

Any tips/suggestion for forward growth/dropping upper arch would be well received, thanks.

@cheekbones1983

I'm unable to find a practitioner ask for advice regarding the palate expander you're using, or other palate expanders like the DNA or Homeoblock. I currently don't see myself doing it alone as I am afraid I will cause more harm than good to myself. May I know how you decided to do this by yourself and what you had to learn before you did this?

Posted by: @mysterecessed

@cheekbones1983

I'm unable to find a practitioner ask for advice regarding the palate expander you're using, or other palate expanders like the DNA or Homeoblock. I currently don't see myself doing it alone as I am afraid I will cause more harm than good to myself. May I know how you decided to do this by yourself and what you had to learn before you did this?

Hello.

I decided to do this as my appointment to see a Maxi-facial surgeon was cancelled.

To answer the part of your question about 'learning', I haven't learnt anything as such, just to be patient and not to expect too much I guess.

Posted by: @cheekbones1983

Hello.

I decided to do this as my appointment to see a Maxi-facial surgeon was cancelled.

To answer the part of your question about 'learning', I haven't learnt anything as such, just to be patient and not to expect too much I guess.

Thanks for the reply. What were you doing see the Maxi-Facial surgeon for? Were you planning on doing invasive surgery?

Posted by: @mysterecessed

Posted by: @cheekbones1983

Hello.

I decided to do this as my appointment to see a Maxi-facial surgeon was cancelled.

To answer the part of your question about 'learning', I haven't learnt anything as such, just to be patient and not to expect too much I guess.

Thanks for the reply. What were you doing see the Maxi-Facial surgeon for? Were you planning on doing invasive surgery?

It was the next step after my sleep apnea test, don't know what they would have recommended. Hopefully in time I will get another appointment.

Another update - I am now working in the office on a semi full time basis and as such I am not wearing the expander as much. I have gone from wearing it 20+ hours a day/night to about 12 hours. Yet it doesn't seem to be doing any harm, in fact the opposite. In terms of my smile there seems to be a small improvement in vertical tooth showing, and my cheekbones seem more developed. I read a thread a while back that said it is actually better to wear just at night rather than all day, can anyone confirm if this is correct.

Also for those wondering if the bottom jaw/arch will widen with the top; well before I started using the expander I had a removable retainer I wore at night. Two months in, the top one obviously doesn't fit but the bottom one also now doesn't fit and feels tight on the outside of the arch (if that makes sense) so something is happening.

How many mm have you turned your expander so far now? Could you also provide pictures of your arch? that would be interesting.

What you're doing sounds like it's working. I have some questions

1) Does the expander expand evenly to each side?

2) Did you have to modify the expander in any way for it to work for you?

3) Why did you choose to undo the forward expansion? Were you turning the forward expansion 1 round every time you turned the lateral expansion 1 round too?

4) Did you do a mold of your teeth and palate before starting?

Posted by: @kilroy

How many mm have you turned your expander so far now? Could you also provide pictures of your arch? that would be interesting.

I have turned about 5mm so far; at this time I won't be posting pictures and it's highly unlikely I will at all, this thread is most likely me writing up my experience and it's up to the individual what they take from it.

Posted by: @mysterecessed

What you're doing sounds like it's working. I have some questions

1) Does the expander expand evenly to each side?

2) Did you have to modify the expander in any way for it to work for you?

3) Why did you choose to undo the forward expansion? Were you turning the forward expansion 1 round every time you turned the lateral expansion 1 round too?

1) Seems to expand evenly.

2) I have sanded down where the first canine sits; in an ideal world the expander wouldn't expand 100% laterally, it would be at a slight angle (hard to explain). The Front part of the Y plate sits on the 4 front teeth so they dont separate (which I why I went with that over the 2 way expander) so when you turn, the first canine kind of separates from the incisors, hence the sanding down.

3) Because it was simply tipping the front teeth forward; I had hoped turning it a couple of times would mimic mewing but I don't think that's the case.

@cheekbones1983 

Thanks for the reply. Did you make a mold of your palate and teeth before starting?

Posted by: @mysterecessed

@cheekbones1983 

Thanks for the reply. Did you make a mold of your palate and teeth before starting?

Nw. Yeah they send you a mould kit, enough for two moulds which was handy as I messed the first one up.

Sorry I haven't posted for a while - went on holiday about 2 months ago and got 2 separate bouts of food poisoning, only just getting over it now.

I have stopped turning the expander for now as I have had an appointment at the maxi-facial clinic and am waiting for them to get in touch.

As for my sleep apnea, I have got mild sleep apnea and they want me to have a mandibular advancement device to wear at night, but I would much rather also address the maxilla for a permanent solution.

Will keep you posted.

Any further visual changes?

Posted by: @cheekbones1983

I read a thread a while back that said it is actually better to wear just at night rather than all day, can anyone confirm if this is correct.

So, that's one of the theories that the inventor of the DNA Appliance has proposed - that evening + overnight wear, but then out during the daytime, yields the best results.  Some quick thoughts on that...

If you search for "tooth movement at night" there seems to be a lot of evidence that any re-arranging of your teeth that your body may have wanted to do anyway, would typically happen at night ... I guess maybe when there's growth hormone being released in your body, and it's just going about its normal daily repair cycle anyway.  So what you're doing is putting an appliance in to mimic the shape of what you want your arch to be during the time the body would have been doing minute adjustments to teeth anyway ... and I guess hoping that influences the small movements that may have happened anyway.

Worth noting, however, that the DNA protocol requires that the acrylic not be making contact with the palate - in order to give it room to drop down.

There's also belief that it is this "cyclical" approach to expansion with less than 24h wear is actually better for bone growth.  @greyham here has done some blog entries that get way more into the specifics of bone mechanics, but it seems like the cyclical approach could make bone act more like a "fluid", as opposed to "brittle" with constant 24h force applied. Even asphalt behaves as a fluid - over a long enough time horizon.

Interesting to note, what happens with DNA patients is they turn the screw on the appliance, and it feels snug / a little bit tight.  Maybe the teeth are mildly sore for a bit at the time, and the next morning.  But after 5-7 days when they put the appliance back in again at night, it doesn't feel snug any more ... it just feels ... normal.  It fits.  This is - in theory - evidence that the expansion changes have "consolidated" and you're ready to initiate another turn of the screw. 

It's also interesting to note that some DNA patients notice a small diastema opens up between their front two incisors, and then quickly closes up again.  This is a possible hint that the suture is - in fact - getting stretched, and it is compensating for that by creating new bone and closing up the tiny gap again.  All those tiny half millimeter (?) gaps that appear and then quickly disappear ... over 12-18 months ... would be one reason to believe you might be getting expansion at the suture.  

Or, it could just be expansion / stretching out of the alveolar bone material across the entire arch (centered where the split on the appliance is at) and no actual creation of new bone at the suture.  I think of it kind of like a ball of pizza dough - you can roll it out to make a 12" pizza.  But then if you decide you want a 14" pizza you can roll it out a bit more - but given that it's the same amount of dough as before, it's now thinner. 

Personally, I can buy into the idea of you push your body for a bit, then you give it a rest, then you push a bit more, then you give it a rest.  At a minimum, it probably reduces overall risks - even if it lengthens treatment time.  Providers like Dr. Miraglia in NYC that are doing adult expansion with "modified Schwartz" appliances are saying the same things - that it's the alternating of "pressure on the buccal, and tension on the lingual" when the appliance is in ... and then reversing when the appliance is out you're getting normal relapse dynamics which then puts pressure on the lingual and tension on the buccal.  He thinks this is what does the best in terms of triggering actual bone growth, cycling back and forth between these two states - to the point where he recommends 8 hours overnight, but then 8 hours of alternating in-and-out time during the day.  He says he's talked to orthopedists about cyclical forces and bone growth and says there is science that backs him up on this.

Is this all true?  I don't know.  Obviously, the orthodontic and oral surgeon community would say none of this is possible ... that you're just moving teeth out to the edge of the alveolar ridge, or even past that and running the risk of dehiscence/fenestration or pushing teeth entirely out of the bone.  All very frightening stuff.

Would love to hear a recent progress update.  I'm about to start with my provider with a "modified Schwartz" for a few months (basically "modified" in that they manage it just like a DNA but it doesn't have the front springs) for some forward/saggital growth - hopefully a millimeter or two - and then DNA for likely a year to get me from my IMW of 31mm up to something a bit larger.

Posted by: @polholmes

Any further visual changes?

A little, cheekbones are more prominent, jaw seems slightly squarer. Would like a little more vertical visibility with my upper teeth though when I smile.

I also chew with a jawliner 2/3 days a week for about 15 minutes and as detailed at /community/community/main-forum/modifying-y-plate-expander-for-forward-growth/, I have slightly modified my expander, please have a read of that and give your thoughts.

I am also doing weigh training at home and trying to improve my posture and build my neck muscles by doing heavy (for me) squats, deadlifts, presses, farmers walks and neck curls and extensions, maybe improving my posture will also help? Have also purchased a contour memory pillow which I am hoping will help long term.

Any more questions, please ask.

Posted by: @toomer

Posted by: @cheekbones1983

I read a thread a while back that said it is actually better to wear just at night rather than all day, can anyone confirm if this is correct.

So, that's one of the theories that the inventor of the DNA Appliance has proposed - that evening + overnight wear, but then out during the daytime, yields the best results.  Some quick thoughts on that...

If you search for "tooth movement at night" there seems to be a lot of evidence that any re-arranging of your teeth that your body may have wanted to do anyway, would typically happen at night ... I guess maybe when there's growth hormone being released in your body, and it's just going about its normal daily repair cycle anyway.  So what you're doing is putting an appliance in to mimic the shape of what you want your arch to be during the time the body would have been doing minute adjustments to teeth anyway ... and I guess hoping that influences the small movements that may have happened anyway.

Worth noting, however, that the DNA protocol requires that the acrylic not be making contact with the palate - in order to give it room to drop down.

There's also belief that it is this "cyclical" approach to expansion with less than 24h wear is actually better for bone growth.  @greyham here has done some blog entries that get way more into the specifics of bone mechanics, but it seems like the cyclical approach could make bone act more like a "fluid", as opposed to "brittle" with constant 24h force applied. Even asphalt behaves as a fluid - over a long enough time horizon.

Interesting to note, what happens with DNA patients is they turn the screw on the appliance, and it feels snug / a little bit tight.  Maybe the teeth are mildly sore for a bit at the time, and the next morning.  But after 5-7 days when they put the appliance back in again at night, it doesn't feel snug any more ... it just feels ... normal.  It fits.  This is - in theory - evidence that the expansion changes have "consolidated" and you're ready to initiate another turn of the screw. 

It's also interesting to note that some DNA patients notice a small diastema opens up between their front two incisors, and then quickly closes up again.  This is a possible hint that the suture is - in fact - getting stretched, and it is compensating for that by creating new bone and closing up the tiny gap again.  All those tiny half millimeter (?) gaps that appear and then quickly disappear ... over 12-18 months ... would be one reason to believe you might be getting expansion at the suture.  

Or, it could just be expansion / stretching out of the alveolar bone material across the entire arch (centered where the split on the appliance is at) and no actual creation of new bone at the suture.  I think of it kind of like a ball of pizza dough - you can roll it out to make a 12" pizza.  But then if you decide you want a 14" pizza you can roll it out a bit more - but given that it's the same amount of dough as before, it's now thinner. 

Personally, I can buy into the idea of you push your body for a bit, then you give it a rest, then you push a bit more, then you give it a rest.  At a minimum, it probably reduces overall risks - even if it lengthens treatment time.  Providers like Dr. Miraglia in NYC that are doing adult expansion with "modified Schwartz" appliances are saying the same things - that it's the alternating of "pressure on the buccal, and tension on the lingual" when the appliance is in ... and then reversing when the appliance is out you're getting normal relapse dynamics which then puts pressure on the lingual and tension on the buccal.  He thinks this is what does the best in terms of triggering actual bone growth, cycling back and forth between these two states - to the point where he recommends 8 hours overnight, but then 8 hours of alternating in-and-out time during the day.  He says he's talked to orthopedists about cyclical forces and bone growth and says there is science that backs him up on this.

Is this all true?  I don't know.  Obviously, the orthodontic and oral surgeon community would say none of this is possible ... that you're just moving teeth out to the edge of the alveolar ridge, or even past that and running the risk of dehiscence/fenestration or pushing teeth entirely out of the bone.  All very frightening stuff.

Would love to hear a recent progress update.  I'm about to start with my provider with a "modified Schwartz" for a few months (basically "modified" in that they manage it just like a DNA but it doesn't have the front springs) for some forward/saggital growth - hopefully a millimeter or two - and then DNA for likely a year to get me from my IMW of 31mm up to something a bit larger.

 

Hopefully my post above helps with this :-)