I appreciate your perspective; I appreciate your sharing.
There's plenty of this that is similar to my own situation. Plentyyy.
Even some of the things you mention...? The way I'm relating to you? The, the... canted smile you mention, for instance. I relate to that, and more.

Over the years, I would see a canted smile in the mirror and thought, "hm thats odd. I dont like that.  I dont like that at all! But I guess that's just a genetic flaw of mine! Guess I gotta just...accept it! Oh Well!"

And there's something about your sharing which makes me do a sort of exhale and say' wow...' you know, 'not alone' not alone.

No, I absolutely resonate with your experience, your perspective, and your newfound dedication to REALLY working on your routine.
I appreciat that; I appreciate your sharing.  (To repeat myself)

FHP and Anterior Pelvic Tilt. Kyphosis and Lordosis being under that umbrella. Main thing to do there is your stretches man.  Take it seriously.  Foam rolling.  Myofascial release. Get a massage therapist if you have to.  Get the tonic muscles to relax.  And get the phasic muscles to tighten up.  I'm still figuring this out myself, yet that is a framework to operate out of. 

Wish you the best with this all in the meantime. 

While I would like to achieve more prominent cheekbones, and cheek hollows, improving my facial symmetry is most important to me. My occlusal cant, deviated dental midline, and crooked nose were the main features that inspired my search for nonsurgical techniques to improve the structure of my face. I just took more precise baseline measurements of the deviation in my nose and my teeth to be able to track changes. My interpupillary midline aligns almost exactly with the crease between my eyebrows when I furrow my forehead. I took a piece of dental floss and tried to extrapolate that line vertically down the middle of my face. The middle of the bridge of my nose looks to be about 4mm left of that line, while my dental midline looks to be about 2mm right of that line. The overall discrepancy of 6mm between the center of my nose and the center of my teeth is most obvious. My occlusal plain is also canted about 3 degrees higher on my left side. I mentioned in my last post, that I think these figures show improvement from what I remember before I changed my oral posture. I believe my dental midline used to be about 4mm off center (an improvement of 2mm), and my cant used to be about 4 degrees (an improvement of 1 degree). I didn't measure the deviation of my nose previously, but I think it looks to be about the same.

Thanks for commiserating with me Gregory! It is reassuring to know there are others out there with similar problems who are also trying to find solutions!

The design for my extra-oral anchorage system is a hybrid of Plato's basic face pulling helmet ( http://jawpain-tmjtreatment.com/  ) and the MewVector ( https://www.youtube.com/watch?v=7dj1BGVsAhA ). Dr. Mew's more recent versions are stabilized by a neck brace rather than a head piece. I bought a neck brace and tried to make it work, but found there to be too much play between the fixation points and head motions, so I went back to a head-mounted strategy. My rig does incorporate 5 points of attachment like the Mew design (up in the front center, up in the back left, up in the back right, forward in the front left, and forward in the front right). Together, the resultant vector should distribute a protractive force across the maxilla better than Plato's standard face pulling setup with only two anterior vectors pulling up and forward. I just finished reinforcing the structure for the posterior anchorage points. I'm pleased with how it looks so far.

Planning my device around these two models brings up a few questions. To my understanding, Dr. Mew's philosophy suggests that I should maintain traction as consistently as possible, potentially throughout every night, and a few hours every day. Plato says I need only 30 minutes per day. Dr. Mew calibrates each of his elastics to about 200g of force. Plato is vague about how much force to use, but recommends starting with light tension and only increasing when you no longer see results. Dr. Mew uses orthodontic elastics connected to a facebow. Plato uses standard office supply rubber bands connected to paper clips.

So how do I reconcile these inconsistencies? I already have a facebow that I will interface with a palate expander. I plan to use orthodontic elastics stretched about 3x their small diameter rather than big rubber bands stretched to an anchorage on the top of my head, but I wasn't sure what size and strength elastics to order. I couldn't find any of the strength traditionally used for extra-oral applications, so I bought the strongest intra-oral elastics I could find. I also need to use these to hold the facebow and expander together. I'm unsure about what intensity and duration to use. I think I will start at a lower tension and less time than Dr. Mew recommends and then work my way up. Maybe about 100g on all 5 elastics for a couple hours every day/night to begin with, see how it feels, and increase from there. I intend to keep the palate expander in place for as many hours as possible (even when not connected to the extra-oral anchorage, potentially 12+ hours per day) and expand at a rate of 1mm per week as Dr. Mew recommends. Please let me know if you have any suggestions!

Re-reading your two posts. 

Yup there’s similarities in our cases and mindset. To the point that, I’m - - - mmm, awed — no, motivated — by your progressing plan in building your own device. 

Shortly after I thought, “(facebow?)” and looked at prices and acquiring. I was curious! Couldn’t help it  

I don’t have answers on the numbers, nor design side of things. 

However, did wish to offer that my last dentist visit had the man telling me that orthodontics needed to be engaging the mouth >=22 hours a day for results. I hope I heard him wrong. Related: I liked that dentist — he was the first traditional dentist that was an advocate for tongue being on the roof of the mouth, yet didn’t seem familiar with orthotropics.

your device/expander likely will be more effective but I had that to offer. 

From an uneducated perspective, I agree on your decision to take it slowly with the force that these elastics will exude. 

Thanks Gregory! When I say "facebow," I mean the the kind of wire attachment that interfaces with the headgear tubes on an expander, like the one Dr. Mew uses in the video I linked to. Google results for "facebow" might show a more substantial device used by prosthodontists to line up their prosthetics. It does seem hard to believe that facepulling for only 30 minutes per day could induce change as Plato claims. Maybe proper tongue posture between sessions helps prevent relapse?

I have installed a kind of metal tie plate with a grid of holes to provide options for where to anchor the posterior elastics. Now I am debating using a dremel tool to cut a channel connecting three of the holes so that a screw with a lock nut and a regular nut could be slid up and down that channel and tightened in place to precisely calibrate the desired tension.

I felt like trying a self-ncr/nasal release session last night. It has been several months since the last round when I treated myself every day for about a week. During my previous round, I struggled during the first couple sessions to inflate past the turbinates, but I didn't have that issue this time. I was able to successfully advance into the nasopharynx through all six meatuses. I try to use the thumb squeezing strategy to suppress my gag reflex, but it wasn't as effective as I remember, and I didn't really get any sensations of shifting or release that I have sometimes achieved in the past. I did feel some pressure in my right eustachian tube while inflating through the left middle meatus, but that was about the extent of what I could feel. I might try again today or sometime soon to see if I can get better expansion.

I cut the channels into the two metal tie plates on my protractive headgear so that the bolts I plan to use as my posterior anchorage points can be slid up and down freely to a desired position and then tightened down with nuts. I connected three holes in the tie plates creating a channel about 3cm long. I plan to tighten down the bolt at a position above and slightly forward from the hooks on the ends of my facebow, then measure the tension generated from an elastic stretched between those two points. If I want more or less tension, I will loosen the bolt, slide it up or down, tighten it, and then measure again. I wish that I had thought to do this before securing the tie plates in place because it was a little challenging to get the dremel tool into position to cut the plates, but I made it work, and smoothed off the edges with a file. I'll stop at the hardware store this evening to purchase the nuts and bolts I need.

While I wait for the final pieces of my DIY device to arrive, I want to ask a question about palate expansion. Is there any way to avoid or minimize opening a gap between the central incisors? I am worried that this would be the most obvious telltale to family and friends that I am doing something with my mouth, which I would rather keep private. The accounts of using a palate expander I have read here and in the breakthematrix forum differ on this point. Some say that their front teeth separated about the same amount as they expanded the appliance while others say that they had minimal separation between their front teeth but much less than the total expansion of the appliance. How might we control this outcome or correct it after the fact? My upper central incisors are just slightly overlapped, so it would be good to space them out about a mm, but I'd like to avoid much more than that if possible.

Speed of expansion is what is going to determine that gap. In every literature I have read, with a healthy amount of expansion this gap always closes within a few months. The gums end up pushing the teeth together, and if you have your wisdom teeth they will move forward and advance all of your teeth thus closing the gap.

So if you go very slowly the gap may never develop, the teeth re-aligning throughout the process. You can stop expansion when you notice a gap and wait for it to close. The gap is noted most in rapid and semi rapid expansion (upwards of 1mm per week). 

I've read through the rest of your topic, I want to discuss it in length but forgive that I can only post from my phone right now and it's a pain typing out long replies. 

Posted by: TGW

Speed of expansion is what is going to determine that gap. In every literature I have read, with a healthy amount of expansion this gap always closes within a few months. The gums end up pushing the teeth together, and if you have your wisdom teeth they will move forward and advance all of your teeth thus closing the gap.

So if you go very slowly the gap may never develop, the teeth re-aligning throughout the process. You can stop expansion when you notice a gap and wait for it to close. The gap is noted most in rapid and semi rapid expansion (upwards of 1mm per week). 

I've read through the rest of your topic, I want to discuss it in length but forgive that I can only post from my phone right now and it's a pain typing out long replies. 

Thanks TGW! So I want to go slow enough to minimize the gap between my central incisors but not so slow as to cause tipping of my molars rather than separation of the midpalatal stuture. I guess I will plan to follow the 1mm per week that Dr. Mew recommends, and then take a break as you suggest if the gap between my front teeth becomes noticeable. When you have time, I would definitely appreciate any thoughts about reconciling the differences between the approaches Dr. Mew and Plato take for their protractive headgear systems that I discussed in an earlier post in terms of short vs. long duration per day and fixed tension vs gradually increasing tension over the course of treatment.

 

Posted by: Gregory

FHP and Anterior Pelvic Tilt. Kyphosis and Lordosis being under that umbrella. Main thing to do there is your stretches man.  Take it seriously.  Foam rolling.  Myofascial release. Get a massage therapist if you have to.  Get the tonic muscles to relax.  And get the phasic muscles to tighten up.  I'm still figuring this out myself, yet that is a framework to operate out of. 

With this in mind, I think lunges, butterflys, malasana, child's pose, and pigeon stretches will help release my tight hip flexors and lower back. Planks will help strengthen my abs, and squats will help strengthen my glutes. Pullups will help strengthen my upper back and some chest stretches with my arms behind my back or against a doorway will help release my tight pecs. I will also try some myofascial release with a lacrosse ball. Further research might change my plans. Please let me know if you think I should add or remove any stretches or exercises from this list and why!

Your story has some similarities to mine.

It sounds like you are trying some very interesting things in order to bring about changes. I'll be rooting for you and looking forward to some good updates in the future. I don't have much to add since I am still figuring things out myself but my plan is to expand first and let things go from there. I think that having a wide enough palate to mew properly will be a huge game changer and a huge catalyst for other changes over time. My situation may be different from yours though.

As far as midline deviation goes, I can relate even down to the act of using a piece of floss to see which parts are out of line. Mine has gotten slightly better from mewing as well but not completely fixed. Only recently have I realized that when I push my tongue up, it's actually going off to the wrong side a bit and that I have to consciously mew off to my left to actually be mewing straight up. Maybe that idea can help you as well.

One thing I have noticed that does make changes is face pulling with just my hands. It can create temporary shifts in the midline from what I have seen, but I never did it consistently enough to see if the changes could become permanent. I want to expand first before I try anything like that. But all that I did was insert both thumbs into my mouth palms up and grab and pull my teeth towards the direction I wanted them to go while using my fingers to push my nose bridge in the opposite direction. Sort of like unwinding the face. You can also use one of your thumbs to push right behind your front teeth for more traction.

I've experimented with facepulling using bands and devices in the past as well and while it does feel good I never got the idea from doing it that the changes would be permanent. Even plato's changes seem to mainly be a result of his orthodontic treatment/better occlusion and not his facepulling. But definitely give it a shot because I never did things systematically and rigorously, I just kind of winged it.

I have gotten to the point where it is relatively comfortable for me to sleep on my back without a pillow, but I like to use a pillow when I turn on my side. Unfortunately, I often wake up to find that I have turned from my side to my back with the pillow still in place and the muscles along the back of my neck feel like they have been stretched too far. I was using a pillow about 7" thick in the past. I have now switched to a pillow I had in the closet that is about 5" thick. I am debating ordering a pillow that is just 2.5" thick. 

Posted by: Apollo

 I have now switched to a pillow I had in the closet that is about 5" thick. I am debating ordering a pillow that is just 2.5" thick. 

Why not just fold a towel? Easy to wash, easy to shape to your needs. Convenience: the product.

In my case working out and stretching by itself were not necessary, or even beneficial to fixing my posture. I think focusing on specific repeated exercises/movements will at best awaken only some parts of what Gregory calls the phasic musculature. Movements like lunges or pull-ups are rarely performed with the absolute full range of motion & tension throughout the WHOLE fascia chain, but instead usually only to the point where the first muscle of the chain begins to resist. This is a huge problem, because no other than a full ROM full tension movement can affect the whole postural chain in a truly healing way. The functional imbalance itself may even be worsened, because the heavier the weight, the more prone you are to reverting back to the habitual asymmetrical movement during the lift, and you will not probably even realize it. 

What I have had the best results with is self-engineered/improvised combination of yoga posing & do-it-yourself chiropracticism where the spine is stretched, rotated and twisted to any maximum direction, and where the movement-related musculature is simultaneously tensed so systematically and thoroughly that the phasic muscles are forced to wake up, spasming as they return to your conscious control and awareness. An awakened muscle will automatically gain back some of its basic muscle tone, lessening the phasic / tonic ratio of the musculature.

For example, in one movement today I was was standing, pushing my feet outwards, pelvis forward, sucked stomach in, then tried to round my whole back while trying to lift my torso and shoulders as high as posssible. Meanwhile I made sure that any muscle I could become aware of was activating equally on its opposite side too. As the shoulders neared ears a lot of little cracks happened along the upper end of the spine. Sometimes even lower verbetrae have popped loudly during similar movements.

Combining whatever muscles you can think of that can be rotated and stretched out to any direction is a good way of inventing these movements.

I second the recommendation to use a towel instead of a pillow. Pillows are mostly all too thick and too bouncy/springy. Using a towel or a folded sheet (what I use) gives the right amount of cushion with the right amount of firmness once you are settled in as well. Pillows always push back against you which never feels right. I use a sheet instead of a towel because my towels were all too firm for me.

Thanks Progress and Allixa! I tried a towel before I switched to the lower-profile pillow, but it just felt too dense. On my back, it seemed to keep my head up too much and stretch my neck muscles even though it was shorter than the pillow because it didn't let my occiput sink in. On my side it felt like it was crushing my ear. Maybe I just needed a fluffier towel, but I am more comfortable using nothing. I wish I had the same level of awareness of my body as Progress describes. I just don't have the intuition to feel the activation of individual muscles or to determine what positions would help me correct imbalances between opposing muscle groups. I will try to be more mindful of this, but for now I have more trust in the logic of stretching the muscles I know I need to relax and exercising the muscles I know I need to strengthen.

That is fine, not many modern human have a lot of innate awareness of the body. I certainly didn't. It's just easy to take it as granted now that I am so deep into the process. Perhaps it is unproductive on my behalf to make the self- sound easier than it is by not bothering to emphasize how great long-term dedication it has taken to reach this level of understanding of my anatomy. My aim has been to do so little in a week that it is sustainable, but just enough to make great leaps forward within the span of a year. That way, improving becomes more like a minor hobby than a major obsession. If you just commit to being aware of your body whenever you remember, that already will be of huge help in the long term. Eventually, you will inevitably start to notice "hey.. this does not feel right" during common daily movements, or that the weight of your clothes feels unevenly distributed along certain parts of your body.

However, you also say that you "have more trust in the logic of stretching the muscles I know I need to relax and exercising the muscles I know I need to strengthen."

How will you succeed in this with insufficient bodily awareness? Whether you do it my way, or your way, there is no way around having to develop a better sense of the physical body

Posted by: Progress

However, you also say that you "have more trust in the logic of stretching the muscles I know I need to relax and exercising the muscles I know I need to strengthen."

 

How will you succeed in this with insufficient bodily awareness? Whether you do it my way, or your way, there is no way around having to develop a better sense of the physical body

 Right, I was agreeing with you. I said "I will try to be more mindful of this, but for now I have more trust in the logic of stretching the muscles I know I need to relax and exercising the muscles I know I need to strengthen." In other words, I will have to lean on logical inferences in the interim while I am developing better body intuition. It seems to me I will only improve awareness of my body by using it in movements that I reason will help and reflecting on how they feel and if my posture improves.

Something that has helped with both my body awareness and my posture is the Feldenkrais method (a kind of yoga). I'd recommend it alongside any other postural exercises

There's some stuff on youtube, I like feldenkraiswithalfons

Hope this is helpful :)

Posted by: Melanie

Something that has helped with both my body awareness and my posture is the Feldenkrais method (a kind of yoga). I'd recommend it alongside any other postural exercises

There's some stuff on youtube, I like feldenkraiswithalfons

Hope this is helpful :)

Thanks @Melanie, I wasn't familiar with the Feldenkrais method but I'm intrigued after watching a couple of Alfons's youtube videos. @Progress, are you familiar with this "method of somatic education?" It seems like something you would appreciate!

It will probably be at least another month before I have all of the components of my device assembled, but I'm making progress! I was able to take a more accurate measurement of my intermolar width and confirmed that it is currently about 34mm. For the past few days I have been doing the exercises/stretches I mentioned very informally whenever I find a few moments of downtime. On the recommendation of @Melanie, I have also completed the first three videos in the "Getting Better Day by Day" introductory series on the "Feldenkrais with Alfons" youtube channel. This methodology has nothing to do with stretching or strengthening muscles but only improving the fluidity of their motions and awareness about how they function. I don't know if it has done anything for me, but Alfons is charming, and the lessons do compel you to slow down and think about how your body organizes basic movements.

Hill sprints are really good for glute ACTIVATION, I wasn't allowed to lift weights back then so that was my go to exercise (did it every other day), so even though I sat around the computer a lot I never developed anterior pelvic tilt. 

Almost all of the components for my DIY extra-oral protraction headgear have arrived or are on the way, but the inexpensive orthodontic elastics I ordered from a Chinese vendor a long time ago never came. I think I will place a new order from a local vendor even though they are significantly marked up. I don't want to be waiting on rubber bands with everything else ready. I should be able to start within a couple weeks. Unfortunately, the timing of this is not ideal. My work responsibilities will be intense for the next several months. I am a little worried that any pain or distraction from the process might disrupt my sleep and productivity. In addition to overnight use, I am also considering if it will be feasible to use the expander and/or headgear while working at home alone in the evenings. It looks like my schedule won't allow me to be as holistic in my approach as I would like without time for much in the way of stretching, exercises, diet, self-ncr, etc. Maybe I can begin to add on those strategies in a few months when my workload becomes more manageable. I am still trying to settle on an exact plan. TGW's (@admin) recent progress report says that he only wore his expander about every other night and only turned the screw when the expander felt loose. I think I want to be a little more aggressive, at least initially. I plan to wear my expander every night and maybe a few hours during the day. I guess I will start with the 1mm per week of expansion recommended by Dr. Mew. I am less sure about the extra-oral protraction. Plato and @fpquestion report results from facepulling for very short sessions (in the neighborhood of 20-30 minutes). I guess I will start with a couple short sessions and see how they feel, but I am disposed to try and maintain the traction for many hours as Dr. Mew prescribes with his MewVector headgear. Maybe the difference is what tension they use. For now I plan to apply about 200grams of tension on each of my 5 elastics.

Any chance of getting instructions or DIY version of this for more to try? 

Posted by: Yay

Any chance of getting instructions or DIY version of this for more to try? 

I've tried to describe my design in this thread as I've put the rig together. It is basically just Plato's facepulling helmet (instructions on how to make can be found here http://jawpain-tmjtreatment.com/ ) modified to be compatible with the five MewVector-style attachment points (  https://www.youtube.com/watch?v=7dj1BGVsAhA ) with a facebow connected to the headgear tubes on a palate expander. I am still waiting on a couple pieces to finish building and test it. I'll report back and write up a summary if I can get it to work.

Posted by: Apollo
 

The design for my extra-oral anchorage system is a hybrid of Plato's basic face pulling helmet ( http://jawpain-tmjtreatment.com/  ) and the MewVector ( https://www.youtube.com/watch?v=7dj1BGVsAhA ). Dr. Mew's more recent versions are stabilized by a neck brace rather than a head piece. I bought a neck brace and tried to make it work, but found there to be too much play between the fixation points and head motions, so I went back to a head-mounted strategy. My rig does incorporate 5 points of attachment like the Mew design (up in the front center, up in the back left, up in the back right, forward in the front left, and forward in the front right). Together, the resultant vector should distribute a protractive force across the maxilla better than Plato's standard face pulling setup with only two anterior vectors pulling up and forward. I just finished reinforcing the structure for the posterior anchorage points. I'm pleased with how it looks so far.

Posted by: Apollo
I cut the channels into the two metal tie plates on my protractive headgear so that the bolts I plan to use as my posterior anchorage points can be slid up and down freely to a desired position and then tightened down with nuts. I connected three holes in the tie plates creating a channel about 3cm long. I plan to tighten down the bolt at a position above and slightly forward from the hooks on the ends of my facebow, then measure the tension generated from an elastic stretched between those two points. If I want more or less tension, I will loosen the bolt, slide it up or down, tighten it, and then measure again. I wish that I had thought to do this before securing the tie plates in place because it was a little challenging to get the dremel tool into position to cut the plates, but I made it work, and smoothed off the edges with a file. I'll stop at the hardware store this evening to purchase the nuts and bolts I need.

Thank you, I think I’d you get it tweaked and post a picture of the device I can make one too, my husband is super crafty and good with things (I’m super visual and struggle with stuff unless there’s an object to link the description with something). 

I’d be very cool if both of us and others try this together (expanders and headgear) - I’m willing to also record and document with video and with any results post them too :) think my breaking point was seeing this when putting my head back after one year of oral posture and wanting to change much sooner:  https://imgur.com/a/Vk5ZI

Theres been improvements... but headgear or something is needed and I’d it can help me imagine what I can do for others with less severe cases! 

Posted by: Yay

Thank you, I think I’d you get it tweaked and post a picture of the device I can make one too, my husband is super crafty and good with things (I’m super visual and struggle with stuff unless there’s an object to link the description with something). 

I don't think I've invented anything groundbreaking. It's really just a helmet that I have added five attachments points to in the positions of the MewVector systems so that I can use a facebow with small orthodontic elastics rather than the long rubber bands attached to the top of the helmet that Plato uses. You might be able to come up with a better design than I did. Mew has several detailed videos about making his MewVector systems on youtube. Maybe you could figure out how to use a neck brace like his newer designs. I like the idea that the reciprocal force isn't pressing on any of your other cranial bones when it is pulling on the maxilla, but I couldn't achieve enough stability between my head and the attachment points. So I went back to basics and decided to use a helmet like Plato. I'm not saying I won't post pictures, but I have a couple reservations. The first is that I am much more inhibited than you are about posting anything identifiable, but I suppose pictures of just the device without me wearing it are anonymous enough. My second reservation is that this is a potentially dangerous apparatus. I don't want to be responsible for people hurting themselves or causing their condition to deteriorate. I'm comfortable directing others to the instructions I combined to make my design which are already out there, but I'm a little uneasy about putting mine forward as a prototype, especially when I see it as a compromise of my original vision, and I haven't tested how it impacts me. So I'll have to think about it. Maybe once I have tried it out and start to get a sense if it is working I'll feel better about sharing images.

I need to decide how fast I want to expand. TGW's (@admin) recent progress report says that he only turned the screw when his expander felt loose, and other users have commented that this might be the best way to determine the rate of expansion. Unlike TGW, my expander was already pretty snug in my mouth when it arrived. In fact, I'm a little worried that it feels like the wires are keeping the acrylic from sitting totally flush with my palate (fractions of a millimeter). In other words, when I push up on the expander with my tongue or my fingers or my bottom teeth, I feel it in the wires against the upper teeth rather than the acrylic against the palate. I haven't started wearing it consistently yet. When I take it out, it feels like the pressure pushing up on the wires will cause some shifting in my upper teeth to allow the wires to fit better between the teeth. At first, I wondered if I should bend the wires down just slightly, but I think what I'm going to do is wear the expander every night for at least a week without turning the screw and I think it should become more secure. But this brings me back to the question of how fast to expand. I think once the expander feels flush against my palate, I will try to adhere to Dr. Mew's 1mm per week schedule. If each turn of the palate expander screw equals about 1/4mm, then I should be turning the screw about 4 turns per week. I've read conflicting advice about if it is better to do these turns gradually or all at once. I think I'm inclined to go the gradual route and turn about once every-other day.

I wore my expander through the night for the first time last night. I haven't turned the screw yet because it felt like the wires between the teeth were keeping the acrylic from sitting totally flush against my palate when I initially tried it on for a couple minutes at a time. By this morning, I could feel much more contact of the acrylic on my palate including the split down the middle, which I couldn't feel at first. When I took out the expander, my teeth felt like they had shifted a little. So I'm happy that it seems to be fitting better. I am going to continue wearing it for at least a couple more nights without turning the screw. I'm still waiting on one last piece for my headgear. I have to decide if I want to start both processes simultaneously, or maybe expand for about a week before adding on the extra-oral traction. I am also considering a couple modifications to my expander. We discussed in this thread (  /community/community/main-forum/you-can-easily-shave-down-a-palate-expander-to-refit-it-to-your-mouth/ ) about how to adjust the labial bow so that it doesn't pull back on your front teeth as you separate the sides. My expander's labial bow is already almost touching my central incisors, so I want to be able to bend it out once I start expanding. I am going to order some inexpensive bird-beak orthodontic pliers which should do the job. I have a basic expander, not the y-plate design. TGW removed everything from the canines forward on his expander and said "I removed the front acrylic because I think it was preventing my front arc from expanding like it wanted to." I'm curious to hear more about this decision. I have some minor crowding in my upper central incisors, so I want to separate those front teeth by about a mm. After that I might smooth off the ridges at the front of my expander to better allow the teeth to shift back to together and minimize development of a midline diastema, but I think I want to keep the acrylic in the front to spread out the force of the extra oral traction across my palate. I have also debated if there is a way to add a wire to the labial bow that would encourage the four front teeth to stay together once I expand enough to resolve the crowding. I'm glad to finally get things rolling, and I'll update here with any progress.

May I know where did u get ur exapnder from? I live in thailand and i dont think there are any

Posted by: Kendo

May I know where did u get ur exapnder from? I live in thailand and i dont think there are any

/community/community/main-forum/buying-a-dental-appliance-straight-from-a-lab/#post-432

I wore my expander for a few hours during the day yesterday and throughout the night again. When I first put it in my mouth it still doesn't sit as flush against my palate as it does after wearing it for a while. I suppose that's what it might feel like when I start turning the screw. I made a case to hold my expander, facebow, and elastics. The facebow won't fit inside a typical retainer case, so I bought a small plastic case for photographs and drilled a few holes in the bottom to allow air circulation for moisture to evaporate. The facebow interfaces nicely with the headgear tubes on my expander. When I put the expander in my mouth with the facebow attached, it sits at the same angle as my occlusal cant. If I set the posterior attachement points at the same level on both sides of the helmet the one on the left will be several millimeters closer to the facebow than the one on the right, meaning I would get more tension on the right side. 

I just tried on my DIY headgear connected to my expander for the first time and it feels great! The traction is strong enough to know its doing something but light enough to not cause pain or be distracting. However, I still have one design flaw I'm trying to work out. I knew the orthodontic elastics are small enough that I can't stretch them directly from the expander/facebow to the metal facemask on my helmet for the three anterior attachment points. So I need something flexible to bring the attachment point from the facemask closer to my mouth but moves aside when I am taking the helmet on and off. I also want to be able to adjust the attachment point to increase or decrease the tension. Originally, I ordered some extra wide zipties that I was going to secure to the facemask, cut down to a couple inches in length, and then cut a slit down the middle where a nut and bolts could be tightened down on the plastic, to secure, or loosened to adjust. This was the final item I was waiting to arrive. Unfortunately, the zipties are too rigid and won't tighten all the way down onto the narrow metal of the facemask. So instead, I had some velcro cable ties lying around. I could get these to tighten onto the facemask, and I could attach the nuts and bolts to them, but the hardware just comes loose from the channel if you try to adjust its position. So I'll have to revise my plan. There are plenty of ways I could make this functional, but I also want to make it tidy and simple to use.

I'm still planning to wait another couple days before beginning to turn the screw, but I wore my expander again last night. I ordered some bird beak pliers to be able to adjust the labial bow. Since the labial bow is already touching my central incisors, I want to be able to bend it out once I start expanding. When I floss, I can feel that the teeth that the expander's wires go between have separated a little and I think this is what is allowing the acrylic to sit flush with my palate. Once my pliers arrive, I will start expanding. Last week I took some "before" pictures, but Mew's new video about taking interoral images, and his tip about using the flash was helpful, so I took a few more pictures yesterday.

Glad to hear that your expander came in. I don't have anything to contribute yet but I am keeping up with your progress and wish you luck.

Mine should come in soon and if I notice anything that I think might help you or might be good to know I will chime in.

Taking my baseline interoral photos with lip retractors in place helped me better understand aspects of my asymmetry that I had just started to suspect from looking in the mirror. When I took measurements more than a month ago, my dental midline was about 2mm right of my interpupillary midline, but the middle of the bridge of my nose was about 4mm left of my interpupillary midline. Looking in the photos, it's clear that a significant part of the dental deviation is because of my occlusal cant. In other words, if I was able to straighten out my occlusal plane so that the line between my central incisors was parallel to my interpupillary midline, the deviation would probably be 1mm or less. It's just that the right side of my mouth being lower than the left tilts the top of my central incisors farther to the right. Another revelation that I had suspected but looks more obvious in the images is that my maxilla appears to be slightly more recessed on the right side. I think these tilts might be the reason that my right side seems to be more of a V shape straight back as compared to the curving U of my left side. My expander looks pretty symmetrical. So my right side seems to be both lower and farther back than the left, and if there's any way to correct these tilts, it should correct my dental midline deviation.

This makes me debate again if I should pull harder up and forward with my DIY headgear elastics on the right than on the left. I'm not really sure how the observation that the left side of my maxilla seems to be "better developed" relates to the bridge of my nose deviating to the left. The right frontal process of my maxilla is significantly closer to my interpupillary midline than the left frontal process. This seems counterintuitive to me because it is as though the top of my maxilla is angled in the opposite direction from the bottom of the maxilla (see image). My nasal bone also seems to be shifted to the left of center.

The bird beak pliers I ordered arrived today and I used them to loosen the labial bow on my expander.

It was pretty easy to bend it out and re-level it, but I might have adjusted the wire out a little too far. Originally it was touching my right central incisor that slightly overlaps the left. Now there is about a 2-3mm separation between the labial bow and my teeth. I don't own the three-prong pliers in the image above recommended for closing the adjustment loop, but I could probably bend the wire back in by flipping the bird beak pliers with the round side on the inside of the loop. Since the labial bow will become tighter as I open the expansion screw, I think I will leave it where it is.

My expander seems to be fitting flush against my palate after using it for 6 days, so I plan to turn the screw for the first time tonight (Thursday). For now I am going to try to stick to Mew's recommended 1mm per week by turning the screw on Tuesday, Thursday, Saturday, and Sunday evenings (about 1/4mm per turn). I want to turn the screw in the evenings rather than before the few hours I wear the expander during the day, so that the expander has the entire overnight period to take effect. I still need to work out the anterior attachment points on my headgear before I can add the extra-oral traction to my routine.

Posted by: Allixa

Nice find.

Here's the powerpoint presentation to go along with it, lots of cool images and info in here:

https://www.aaoinfo.org/system/files/media/documents/Handleman%20--%20Point%3B%20The%20Case%20for%20Nonsurgical%20Expansion.pdf

The presentation posted by Allixa of the article posted by MewingWorks has a recommended expansion protocol. They are using a fixed Haas expander rather than the removable appliance I am using, so I'm not sure how much of this is applicable, but they recommend turning the screw no faster than every other day, and every 3rd to 5th day for patients over 30 to avoid pain and tissue swelling.

I am in my mid 30s, so this protocol would suggest that I should expand slower than Mew's 1mm/week recommendation. I was planning to turn every Tuesday, Thursday, Saturday, and Sunday, with consecutive days on the weekends to keep to 1mm/week. Based on this information, I think I will switch to every other day rather than consistent calendar days, and slow down further if I experience pain or tissue swelling as the presentation describes. Dr. Mew suggests that the disadvantage of going slower is causing more dental tipping rather than skeletal separation, but given my age, maybe I should consider turning the screw once every 3 days rather than every 2. Going slower than every other day would also increase the chance of forgetting how many days ago I turned the screw.

I turned the screw on my expander for the first time last night. I think the first turn was probably a little less than 1/4mm because the key hole started in the middle and I turned it to the edge. For future turns, the hole starts at one side and will turn to the other. Still, I can definitely feel some expansion. I'm currently planning to turn the screw every other day. I think I'll post here every time I turn just to help me keep track of the days and to make notes about what I am feeling, so forgive me if the thread becomes even more cluttered.

I have decided to use the velcro cable ties for the three anterior attachment points on my headgear, but I will sew maybe 3-5 hooks from hook-and-eye closures onto each of the straps to allow me to adjust the tension by stretching to a farther or closer hook. I tried the headgear on again last night and slept for a few hours with it on. The stretch feels good, but the pressure of the padding against whatever side of my head is toward the bed becomes uncomfortable, so I kept waking up and turning over, and ultimately took it off. It's a challenge to unhook all of the little orthodontic elastics when I'm half asleep.

I've written in the past about the differences in tension and duration of sessions between Dr. Mew's MewVector headgear and Plato's facepulling helmet. While Dr. Mew seems to suggest that patients should maximize the number of hours under traction, Plato says one 30 min session per day is enough to see changes. I think the difference must be the tension applied. Dr. Mew calibrates his 5 elastics to about 200 grams of tension each. Three of his elastics pull approximately upward and two of his elastics pull approximately forward so if we simplify and say this is a total force of 600 grams up and 400 grams forward, the pythagorean theorem tells us that the resultant vector is approximately 720 grams of force. For reference, this is about 1.6 pounds. While this might seem insignificant, I can definitely feel the strain after using similar traction for a couple 1 to 3 hour sessions so far. My setup might be applying slightly more tension but roughly the same as the MewVector. Let's round up and say I'm totalling around 2 pounds of force. I think people who are facepulling with a belt or towel, and using leverage or body weight, must be applying significantly more force. Plato is vague about the amount of tension he generates with his rubber bands, but he insists that he started with light "biologically compatible" force and only increased the tension when results plateaued.

After using my headgear again last night, it is becoming clear that I won't be able to sleep through the night with it on as I had originally considered. It is the discomfort of the helmet padding's pressure against my head, and the irritation of the upward anterior elastic's pressure into my lip that are limiting the duration of my sessions rather than the dull strain of the expander pulled up against my palate. So realistically, I think I'll probably only be able to wear the headgear for a few hours each day. This makes me wonder if I should try to compensate by increasing the tension, but for now I'm going to continue with light forces and try to fit in as many hours as I can.

I turned my expander screw for the second time last night. I'm going to keep a running tally of my expansion at the bottom of these posts. This turn felt more intense than the first turn. I felt it most in the area of my molars and maybe the alveolar ridge above them, but not in the middle of my palate. I guess that is normal. I also did a session of about 2 hours in my headgear. One of the questions I submitted for the next Mew Q/A asked if shifting the maxilla up would cause more of my upper incisors to be covered by my upper lip when I smile, since I don't have any gingival exposure in the front already. I have been thinking about my post on the Curve of Spee (  /community/community/main-forum/elements-of-smile-aesthetics-and-craniofacial-dystrophy/#post-784 ) and FPQuestion's post about a downward component to extra-oral traction ( /community/community/main-forum/facepulling-downwards-direction-seems-like-what-all-the-professionals-use/#post-707 ). At the time I dismissed even a slight downward angle out of hand, but TGW commented that this might be a part of forward advancement in some people. Since I have gingival exposure in the back but not the front, and a cant that gives me more gingival exposure on the right side, I am thinking about removing the central anterior upward elastic from my headgear. This is also the elastic that presses into my upper lip and causes pain that can limit the duration of my sessions. This would leave me with an elastic pulling up in the posterior on both sides and an elastic pulling forward in the anterior on both sides. I might also consider angling my right side anterior elastic up slightly to help correct the cant. 

Expansion total: 1/2mm

I've been wearing my expander for about 8 hours while sleeping every night and maybe about another 4 hours while awake. It still feels pretty tight on the second day after my second turn of the screw. I think I am going to delay turning the screw again until at least tomorrow evening. It might be that I should change from my plan to turn roughly every 2 days (close to Dr. Mew's recommended 1mm/week), to a 3-5 day schedule as recommended by the protocol for patients over age 30 that I mentioned in an earlier post. I'll also try to get in a few more hours of daytime use.

Last night I wore my headgear for a couple hours without the central anterior elastic pulling up. I mentioned in my last post my theory that I mostly need to bring my maxilla forward, and I might not need to lift the maxilla up in the front where I have no gingival exposure, but do need to lift my maxilla up in the back where I have some gingival exposure. This central elastic was also uncomfortably pressing into my upper lip. So I only used the two posterior elastics pulling up and the two anterior elastics pulling forward last night. It seemed to work better. It occurred to me after I was already strapped in that I could change the angle of the central elastic to pull forward instead of upward. This would give me three elastics pulling forward in the front and two elastics pulling up in the back. I'll try that tonight.

In my thread about using vibration to try and enhance shifting along the cranial sutures ( /community/community/main-forum/extracorporeal-shock-wave-therapy/ ), I mentioned that low intensity pulsed ultrasound devices like acceledent vibrate at a lower frequency (around 30Hz) as compared to electric toothbrushes (250-300Hz) and handheld massagers (100+Hz). I get the impression that lower frequencies might be more effective, but I've been using a handheld massager against my face while wearing my expander. I feel like it might be helping. I might be imagining, but it feels like the expander is not as tight in my mouth after holding the massager at different locations on my maxilla and along my maxillary suture lines for 10-20 minute session. I could also hear some cracking/popping in my right ear toward the end of my last vibration treatment.

Sometimes I catch myself snoring or wake up with a bad taste in my mouth, so I suspected that I occasionally mouth breath in my sleep. I tried mouth taping for the first time last night. I used 3M micropore tape place horizontally across all of my mouth. I think it made a significant difference. I woke up about an hour before my alarm and felt better rested. I definitely want to continue experimenting with this. It hurt my lips a little pulling it off, so I might put some chapstick on my lips before applying the tape tonight.

I have still only turned my expander screw twice for a total of about 1/2mm, but already my upper central incisors look less crowded. I had only a very minor overlap and this has almost completely resolved. My lower incisors are more crowded and will probably require at least 2mm of expansion before they start to straighten out. I am glad that my upper incisors have aligned, but I hope they don't continue to separate and develop a gap. I'm planning to try to turn my screw again this evening before putting on my expander and taping my mouth for the night.

Hey @apollo,

How long did it take for your expander to arrive after getting the email from them that it was shipped?

@allixa, it took a couple weeks to reach me here in the States (about the same amount of time for the impression kit to arrive after I got the notice it shipped). 

Alright, guess I need to be patient then. Thanks for letting me know the potential timeframe.

I turned my expander screw again last night, for a total of 3 turns and 3/4mm of expansion. I waited 3 days between turns. Such a small distance feels surprisingly significant inside my mouth. This turn gave me more of a stretching sensation in the center of my palate than I had after the previous turns, so I guess that is a good sign. Over the past few days, I developed some minor irritation on the roof of my mouth were a small section of my oral mucosa was being pressed into the groove where the key goes to turn the screw. I decided to use a nail file to round off the edges of the acrylic where the sides of the expander separate. This feels a little less annoying to my palate and tongue. The slight overlap of my upper central incisors is gone. After my next turn of the screw I think I will smooth off the indentations in the acrylic between my front six teeth to allow more freedom to realign and hopefully minimize the development of a midline diastema. Soon I will probably also need to file off some acrylic around my torus palatinus. I used my handheld massager around my maxilla after turning the screw and again heard some cracks/pops in my right ear but not my left ear (even though I pressed the massager in the same locations on both sides of my face). I think this is really encouraging since my right side seems to be farther down and back. I taped my mouth again last night. I woke up about an hour earlier than my alarm again this morning and felt well-rested. I was more careful removing the tape this morning, and I think putting chapstick on the night before helped protect my lips. It's still a little early to cast a verdict on the efficacy of mouth taping, but so far I am really happy with the results.

Total Expansion: 3/4mm

For anyone following along, I wanted to note that I haven't been logging everything I do each day. In addition to 12+ hours wearing my expander, including 1-3 hours connected to my DIY extra-oral traction, I also try to chew gum 1-2 hours each day. Other elements of the routine include using the handheld massager, and mouth taping during sleep. I wish I had more time to work on my body posture and add in some self-ncr. Today is the second day since turning the screw, and the expander still feels pretty tight. My current plan is to turn again tomorrow, but I will see how it feels. Sorting through some childhood items, I came across the before-and-after intraoral photos from my adolescent orthodontics. The teeth certainly look straighter in the after, but my canted occlusal plane is unchanged from the before shot.

I found my old retainer from my adolescent orthodontics among some of my childhood items in storage. I measured the intermolar width on the retainer and it is approximately 37mm. So my intermolar width decreased by about 3mm after I stopped using my retainer, maybe sometime around age 18. So far, I have expanded by 3/4mm and I'm planning to turn the screw again this evening to bring my current intermolar width up to about 35mm, still about 2mm below where I was after my braces. I mentioned in yesterday's post that I found the before and after pictures from my orthodontics and that I had a consistent occlusal cant in both the before and after pictures. This suggests to me that expanding back to 37mm alone won't improve my cant, but hopefully once I get enough tongue space, my mewing and extra-oral traction might make a difference.

Had you noted your face getting worse during the time you suspect the regression happened?

Posted by: Progress

Had you noted your face getting worse during the time you suspect the regression happened?

That's a change of 3mm over the course of almost 15 years, so any facial changes weren't dramatic. I think you could say that my cheekbones became slightly flatter, my undereye circles became darker, and the bridge of my nose became more asymmetric. Mostly I noticed the difference in my occlusion, biting my cheeks when chewing, increasing dental crowding, dental midline deviation etc.

Do you mind linking to the type of device you are using to vibrate your sutures? It sounds like it is working well and actually helping.

Also @progress, there was a period in my life where my palate became more narrow and my teeth fell down a bit due to an open mouth posture, and I definitely did notice some worsening in my face at that time. However since I started mewing I gained everything back and then some in terms of aesthetics, but the palate itself did not change back to where it was or get any wider than when I started.

Posted by: Allixa

Do you mind linking to the type of device you are using to vibrate your sutures? It sounds like it is working well and actually helping.

Like I said, the research I read suggests that a lower frequency vibration might be better, but this is the kind of handheld massager I am using because I already owned it:

I could be imagining, but it seems to make the expander feel slightly less tight if I hold it against my maxilla and along the sutures while wearing my expander for 10-20 minutes. Occasionally I have heard a cracking/popping sound in my right ear, especially during sessions soon after I have turned the screw. That being said, my expansion has progressed slower than the 1mm per week rate Dr. Mew recommends, so it's not like this is working wonders.

Yeah, I don't expect it to work magic or anything, but the fact that it creates popping noises points to it helping at least somewhat, which is amazing considering that most people don't even believe that adults can get expansion. And for how fast you are expanding, I am pretty sure Mew got his guidelines from the same study we found earlier, so for a patient of your age he would probably recommend the more gradual rate. As long as you are making progress and aren't tipping too much then the rate shouldn't be too important.

I turned my expander screw for the fourth time yesterday to complete my first 1mm of expansion in 12 days. I mentioned previously how a small section on the roof of my mouth was getting pressed into the key channel. Now that the sides of the expander have separated, a line of mucosa all along that gap is similarly irritated. I think it is from suction created by my tongue pressing up on the expander causing swelling in the tissue not covered by the expander. It's not that much of a nuisance, but it is a little difficult to distinguish if the discomfort I am feeling on my palate is from the inflamed epithelium or from separation of the midpalatal suture. I think the suction causing the irritation won't be as intense once there is a wider gap between the two sides of the expander.

Total Expansion: 1mm

Hi, 

I've been mewing for 3 months now. My mewing consists of maintaining the proper tongue posture and about two weeks ago I started doing some chin tuck series that dr. Mew showed in the video. I can't say that I see big changes like some people say in comments on youtube. What can I add to this routine? I started chewing gums regularly, but I saw that while I chew gums I 'forget' my tongue posture and I'm not expanding my palate, too. 

The second question is about the posterior third.  All people and Mike himself say that I should feel uncomfortable if I really get the posterior up.  I myself don't feel any discomfort. I can only feel discomfort when I do a big swallow when my tongue blocks my airway, but I can't stay in that position because I cannot breathe. 

Third question: How do you measure your intermolar with at home because Mike showed a method that includes a dentists appliance. I tried by putting some toothpaste on the ends of my molars and bitting a paper so it leaves on the paper. Is that good method?

And the last one. How much will it take to see some improvement? By 'some' I mean an improvement that other people can see and not only I because those changes are really subjective. 

I think I have a potential for improvement because I'm immature and have still some time to grow.

Please let me know how I can improve my routine because I feel I'm just losing time if I'm doing this wrong.

Thanks.

Hi Johan, I'll try to answer your questions, but I think your last question is most important: it generally takes many months to achieve even subtle changes that you might not notice without standardized before-and-after photographs. If you are still growing, your results might be faster. I could discern only subtle improvements from over a year of concerted effort to maintain correct oral posture. With my intermolar width around 34mm, I decided that I needed an expander to gain the necessary tongue space to make better progress. So what can you add to your routine? You didn't mention swallowing technique. Have you been practicing the push swallow? I think that the position of the posterior tongue against your soft palate that obstructs your airway during a swallow is the ideal position for mewing, but is impossible because it obstructs breathing, so sometimes I swallow to put my tongue in that position and then gradually back off the tongue and feel its resistance against gas exchange between my lungs and nose. Then I back off just a little more until I'm able to breathe freely, but can still feel the soft palate against the back of my tongue. It's still hard to maintain that posture for long, but that's what I try to do. In addition to the chin tuck, you can also work on improving the rest of your body posture. In addition to gum chewing, I like to mix in some repetitions mashing the gum against my hard palate with my tongue (your goal is to increase the resting muscle tone of both the tongue and masseters in balance). Dr. Mew's video uses a caliper to measure the intermolar width. You could probably purchase an inexpensive caliper from a hardware store. I have used dental floss that I inserted between my first and second molars and then marked with a pen. I've also used a tailor's tape. Both of these methods are imperfect but give you a close approximation. When I made impressions of my teeth I was able to confirm the measurement using a ruler. Dr. Mew wrote in the comments of one of his videos: "modern adults (or anyone over the age of 9) tend to have a molar width of 29 to 34mm. Anyone with 35 to 38mm will find it much easier but still very hard to make progressive improvements without any formal therapy." If your intermolar width is below 35mm, you might consider using a palate expander to gain more tongue space. There are other optional treatment modalities that you could explore including facepulling/extra-oral traction, NCR/nasal release, craniosacral therapy, nutritional changes, buteyko breathing, mouth taping etc. It's probably more important to get the oral posture basics figured out before moving on to more advanced techniques. Good luck!

Thank You for Your reply, Apollo. I've measured my width with floss and it's  ~4.1 cm. I'll buy a caliper because  I'm suspicious about my result. I do the push swallow, but not as an exercise,  I do it to retrieve proper tongue posture. Maybe I should do it more often and with more effort. 

How much time does it take to get hollow cheeks?

 Does mewing line up lips? Because my lips are similar to those in this picture:

Also, does mewing decrease this cavity between chin and lower lip?

Posted by: Johan

Thank You for Your reply, Apollo. I've measured my width with floss and it's  ~4.1 cm. I'll buy a caliper because  I'm suspicious about my result. I do the push swallow, but not as an exercise,  I do it to retrieve proper tongue posture. Maybe I should do it more often and with more effort. 

How much time does it take to get hollow cheeks?

 Does mewing line up lips? Because my lips are similar to those in this picture:

Also, does mewing decrease this cavity between chin and lower lip?

I have similar lips. What should ideally happen is that the mandible/lower lip expands/moves/projects forward in relation to the maxilla/upper lip. This rotates and pulls the lower lip inward into the mouth, reducing the "E" cavity you are talking about.

Posted by: Progress

Posted by: Johan

Thank You for Your reply, Apollo. I've measured my width with floss and it's  ~4.1 cm. I'll buy a caliper because  I'm suspicious about my result. I do the push swallow, but not as an exercise,  I do it to retrieve proper tongue posture. Maybe I should do it more often and with more effort. 

How much time does it take to get hollow cheeks?

 Does mewing line up lips? Because my lips are similar to those in this picture:

Also, does mewing decrease this cavity between chin and lower lip?

I have similar lips. What should ideally happen is that the mandible/lower lip expands/moves/projects forward in relation to the maxilla/upper lip. This rotates and pulls the lower lip inward into the mouth, reducing the "E" cavity you are talking about.

Since we already swallow many times per day, once you have the technique right I don't think you need to go out of your way to exercise swallowing. I'm just saying whenever you are eating or drinking or swallowing saliva that you should try to make sure you are only using your tongue and throat muscles and not activating any of the muscles of your face. This might help with the alignment of your lips, but I would trust Progress's expertise on that topic more than my own, and what he says makes sense. I haven't had dramatic success with increasing my cheek hollows, but mastering the push swallow should help reduce the size of your buccinator muscles. More pronounced zygomatic arches and developed masseter muscles form the outward projection that allows the cheeks to appear recessed, and I've read some people suggest that the zygomaticus major muscle might also play a role. I think keeping your body fat percentage low makes cheek hollows more visible.

Over the past few days I've been making some adjustments to the acrylic around my torus palatinus on my expander. I think this issue is specific to my structure, and is kind of difficult to explain. Because my torus palatinus is asymmetrical, with the right half extending lower and slightly wider than the left half, the indentation for the torus isn't evenly divided on the expander. The problem is on the right side of the expander, which is concave to accomodate the buldge of the torus, but this gives the acrylic closer to the midline separation a higher profile than the acrylic farther to the right. Does that make sense? So as I have started to turn the screw, this thicker part of the acrylic near the midline is starting to press against the lowest point of my torus on the right side. This is beginning to cause discomfort. Hopefully my torus will become less pronounced during the course of expansion, but I think this should be a result of the palate becoming wider and less vaulted. So I've tried to file off the acrylic by the midline down to the level of the indentation next to it. I've been using a nail file, but this makes it challenging to get down into that concavity. I will keep working on it. This pressure against the torus seems to be more of a rate limiting factor than the pressure out against the alveolar ridge, so hopefully these adjustments will help me advance. I'm planning to turn the screw again tomorrow evening. I got busy last night and didn't have time to use my extra-oral traction. I'll try to fit in a longer session today.

Posted by: Apollo

I would trust Progress's expertise on that topic more than my own, and what he says makes sense.

Sense is all I have, and it is something I have a lot :D. Even though probably true, I don't want anyone to mistake easily relatable common sense for expertise. There are no experts here, only people with potentially helpful information. No need to devalue your own ideas just because someone else has ideas too. You are already perhaps the most consistent contributor in this forum.

Apologies for the irrelevance.

Posted by: Progress

Posted by: Apollo

I would trust Progress's expertise on that topic more than my own, and what he says makes sense.

Sense is all I have, and it is something I have a lot :D. Even though probably true, I don't want anyone to mistake easily relatable common sense for expertise. There are no experts here, only people with potentially helpful information. No need to devalue your own ideas just because someone else has ideas too. You are already perhaps the most consistent contributor in this forum.

Apologies for the irrelevance.

Thanks Progress, I just don't have a good sense for how the position of the lips relates to the underlying bone structure and muscles.

I turned my expander screw last night after only 2 days rather than waiting for the third day. I had a long session yesterday evening with extra-oral traction for a few hours and using the handheld massager for about 10 minutes. The expander felt like it was really fitting well, so I decided to go ahead and turn the screw again. This brings my total up to 1-1/4mm of expansion in 14 days. I think the factor that was slowing down my progression before was the issue (I mentioned yesterday) of the thicker acryclic near the middle of the expander pressing against the more prominent right side of my torus palatinus. I want the force to be out against my alveolar ridge rather than against the torus. Filing down that acrylic helped alleviate the discomfort, but it's still not perfect. I'll try to refine that today.

Total Expansion: 1-1/4mm (14 days)

This morning I found an ulcer on the right side of my torus palatinus. I've mentioned how the expander acrylic was thicker toward the split in the middle on the right side and was putting pressure against the torus as I expanded. I had been trying to alleviate that pressure by filing down the acrylic between the midline and the impression where the torus is most prominent, but I had been taking all of the acrylic off of the top surface that makes contact with my palate. It seemed to help, but after finding this sore and not wanting to be sidelined by an injury, I decided to file off some acrylic from the back to make the U shape deeper. I tried to use the nail file that I have been using on the top surface, but I couldn't achieve that rounded contour, so I got up the nerve to use my dremel tool and it seemed to work very well. I was relatively conservative in how much of the acrylic I took off because I want to maintain as much of the structural integrity of the acrylic framework as possible to ensure that the force is transferred to the molars. So some of my torus is still covered in the acrylic, but I removed enough that the spot that had developed the sore is no longer covered. If this continues to be an issue I can make the U at the back of the expander even deeper. I left about 8mm of acrylic behind the screw mechanism. About 5mm of that distance remains in contact with my torus. Tonight would be two days since turning the screw. I will see how tight the expander is feeling and decide if I want to advance or wait until tomorrow.

I turned my expander screw again last night after 2 days for a total of 1-1/2mm in 16 days. This morning I decided to shave off the rest of the acrylic from the back of the expander that was still making contact with my torus palatinus. Once I had removed the acrylic from the part of the torus that was most prominent with the ulcer, the acrylic was putting more pressure on the rest of the torus that remained covered. I think it should be more comfortable now and better at pushing against the sides of my alveolar ridge rather than against the torus. Hopefully the sore will heal over in a few days. I haven't filed off the indentations in the acrylic behind my front teeth yet, but I plan to do that soon to allow the teeth to space out evenly. I will probably also have to continue removing some of the acrylic from the top of the expander as my palate becomes less vaulted. When flossing my teeth, I can feel that they are less crowded, but I still haven't developed any visible gap between my central incisors.

Total Expansion: 1-1/2mm (16 days)

In the past I've got sores heal overnight by wetting one end of a q-tip, using the dry end to absorb moisture from the ulcer, then dipping the wet end to a bunch of salt and pressing it against the ulcer for a minute or two. Uncomfortable at first, but pleasantly numbing after a while. Often when I do that the last thing in the evening, in the morning it's almost completely gone.

Tonight would be two days since turning my expander screw, but I think I will probably delay for a day to give my palate some time to adapt. I am having a little trouble distinguishing if the discomfort along the middle of my palate is from the pressure the expander was putting on my torus palatinus, or if it is from separation of my midpalatal suture. It feels a little achy but not overtly painful. When the expander is out and I press up with my tongue, it aches more on my right side than my left along both the torus and the alveolar ridge. I suppose this is a good sign since my right side is farther down and back. I've pasted a cross section of a maxilla with a torus palatinus below. I'm curious as I separate the expander, if I am opening that midpalatal suture along the entire thickness  including the torus such that the torus would become wider, or if the suture begins to peel open at the top and the bone of the torus would kind of fill in the opening gap, reducing the prominence of the torus. My torus is less prominent than the one in the picture.

That picture is a great find. It shows that the mid palatal suture runs down the entire thickness of the torus which is something I never knew before. It provides a hint that true expansion is possible even with a torus present, but I could see how getting the expansion started would be harder because of how much thicker the bone is.

Do you have any guesses as to why you developed a torus palatinus? I'm pretty sure mine came from grinding my teeth at night which I used to do before I found mewing. And looking at the photo that makes sense, if you push up hard on the teeth, the two halves of the palate probably get pushed against each other such that the torus represents a way for the bone to better absorb all the force being placed on them from a person who is grinding their teeth.

By the way, did Bracesshop give you a tracking number when they shipped out your expander?

Posted by: Allixa

That picture is a great find. It shows that the mid palatal suture runs down the entire thickness of the torus which is something I never knew before. It provides a hint that true expansion is possible even with a torus present, but I could see how getting the expansion started would be harder because of how much thicker the bone is.

Do you have any guesses as to why you developed a torus palatinus? I'm pretty sure mine came from grinding my teeth at night which I used to do before I found mewing. And looking at the photo that makes sense, if you push up hard on the teeth, the two halves of the palate probably get pushed against each other such that the torus represents a way for the bone to better absorb all the force being placed on them from a person who is grinding their teeth.

By the way, did Bracesshop give you a tracking number when they shipped out your expander?

I remember wondering about my torus palatinus before I had braces as a teen, but I suppose clenching and/or bruxism could have contributed even at that early age. I think it might have become slightly larger as I got older. I've had waxing and waning phases of clenching and bruxism issues that probably relate to stress. I also wonder if a narrow palate itself might contribute to the formation of tori and exostoses as the alveolar process constricts down from its physiologic proportions.

I emailed to ask for a tracking number for my expander and never heard back from them, but mine seemed to arrive within a reasonable time after the shipping notice.

I've had a couple different sensations today that I haven't noticed earlier in my expansion process. I have more of a feeling of tension under the orbit of my eyes around the junction of the maxilla and zygomatic bones. I also noticed a persistent feeling that I couldn't equalize the pressure in my ears for a few minutes after dinner. These sensations are subtle enough that I might not have noticed if I wasn't paying attention, and maybe I'm just imagining, but I thought I would document them for the record. As I mentioned earlier, I have decided to wait at least another day before turning my expansion screw again to relieve any inflammation on my torus palatinus.  

I remember wondering about my torus palatinus before I had braces as a teen, but I suppose clenching and/or bruxism could have contributed even at that early age. I think it might have become slightly larger as I got older. I've had waxing and waning phases of clenching and bruxism issues that probably relate to stress. I also wonder if a narrow palate itself might contribute to the formation of tori and exostoses as the alveolar process constricts down from its physiologic proportions.

I emailed to ask for a tracking number for my expander and never heard back from them, but mine seemed to arrive within a reasonable time after the shipping notice.

Interesting that yours developed at such a young age. That might rule out my theory as to why it develops. Maybe you are right in saying that a narrow palate itself is enough of a reason for one to show up in some people. I'll look into it more later.

And as for bracesshop, yeah they don't seem to respond to emails. I bet they probably have hundreds of unread mails of people just asking the most basic questions or even asking medical related questions, so they just stopped checking. I'm going to try and get a hold of them via phone or something because it's coming up on a month since my expander was shipped and there's still no sign of it. Pretty unprofessional of them to ship things across the globe without providing tracking info. I'll let you guys know if I can get any information from them, might help some people in the future.

Posted by: Allixa

 

And as for bracesshop, yeah they don't seem to respond to emails. I bet they probably have hundreds of unread mails of people just asking the most basic questions or even asking medical related questions, so they just stopped checking. I'm going to try and get a hold of them via phone or something because it's coming up on a month since my expander was shipped and there's still no sign of it. Pretty unprofessional of them to ship things across the globe without providing tracking info. I'll let you guys know if I can get any information from them, might help some people in the future.

I hear there has been a lot of delay for shipments coming through the East Coast of the United States recently because of the severe weather from several nor'easters.

Posted by: Allixa

Interesting that yours developed at such a young age. That might rule out my theory as to why it develops. Maybe you are right in saying that a narrow palate itself is enough of a reason for one to show up in some people. I'll look into it more later.

As I mentioned in my smile aesthetics thread, there doesn't seem to be any consensus about the etiology of tori or exostoses. They can occur on the maxilla or mandible, and I guess the mandibular variety seem to be more closely correlated with clenching and bruxism. Buccal exostoses and mandibular tori make more sense to me as an adaptation to stabilize teeth roots in response to excessive jaw forces, but I can imagine how they could also put pressure at the midpalatal suture. There are also different shapes including very nodular varieties. Mine is pretty smooth, but the right half is more pronounced than the left. Some research suggests a genetic inheritance, but this could also be due to similar environmental factors between parents and their offspring. I don't think the shape of my torus palatinus has changed much from the first 1-1/2mm of expansion, but I'm curious to see what happens as I advance.

I hear there has been a lot of delay for shipments coming through the East Coast of the United States recently because of the severe weather from several nor'easters.

As I mentioned in my smile aesthetics thread, there doesn't seem to be any consensus about the etiology of tori or exostoses. They can occur on the maxilla or mandible, and I guess the mandibular variety seem to be more closely correlated with clenching and bruxism. Buccal exostoses and mandibular tori make more sense to me as an adaptation to stabilize teeth roots in response to excessive jaw forces, but I can imagine how they could also put pressure at the midpalatal suture. There are also different shapes including very nodular varieties. Mine is pretty smooth, but the right half is more pronounced than the left. Some research suggests a genetic inheritance, but this could also be due to similar environmental factors between parents and their offspring. I don't think the shape of my torus palatinus has changed much from the first 1-1/2mm of expansion, but I'm curious to see what happens as I advance.

Mine is quite smooth as well. Yeah it will be very interesting to see what happens to it as you continue expanding. I wonder if a gap will develop in the center of it, or if it will flatten and smooth out somehow. I can't find any mention of this type of knowledge online, so it seems like you are breaking some ground here.

After 3 days, I turned my expander screw again last night. In the past 19 days, I have turned the screw 7 times for a total of 1-3/4mm. My upper central incisors started out slightly overlapped. The one on the left is still a hair farther back than the one on the right, but they no longer superimpose. I think this alone has improved the midline deviation to some extent, and there's now an attractive slight separation between the teeth toward the incisal edges, but they are still touching for most of the height of the teeth. I hope to avoid creating a bigger gap. I wonder if there is anything else I should do besides smoothing off the indentations in the acrylic between the front six teeth. I guess I will also slow down the rate of expansion if the gap gets bigger. I've been thinking about how the canine teeth sit at the corners of the arch with the molars and bicuspids on the sides and the incisors in the front. Do I want the canines to move as far laterally as the molars and bicuspids, or do I want more of a rounded shape? I haven't been able to reach any conclusions looking at broad smiles like Julia Roberts' to assess if the canines are more turned to the front or if they still mostly face the sides. TGW removed everything from the canines forward on his expander, and maybe this would allow the midpalatal suture to stay closer together in the front of the palate while the back separates more, and any bone remodeling of the alveolar process to take on a more natural curved shape in the front? Another option besides removing all of the acrylic in the front would be to shave down just some of the acrylic behind the canines. I'll wait to hear about TGW's rationale for the adjustments he made to his expander before doing anything drastic. The sore on my torus palatinus is healing nicely.

Total Expansion: 1-3/4mm (7 turns in 19 days)

I went back and read some of the progress reports from early adopters of the palate expanders. Both Collette ( /community/community/main-forum/palate-expander-update/#post-185 ) and irmathurma ( /community/community/main-forum/review-of-active-expander/#post-15 ) reported fit issues with their expanders after they reached about the same number of turns. Collette got to about 11 turns or 2.75mm and irmathurma got to about 10 turns or 2.5mm before the steep edges of the expander were displaced by the less-vaulted palate so that the expander pushed out against the teeth rather than the alveolar ridge. We've discussed in another thread (  /community/community/main-forum/you-can-easily-shave-down-a-palate-expander-to-refit-it-to-your-mouth/#post-619 ) about the strategies to file down the acrylic of the expanders to increase their longevity. I'm currently sitting at 7 turns or 1.75mm of expansion. My palate still feels pretty vaulted, but if precedent holds, I could expect to encounter some fit issues in 3 or 4 more turns. With the other adjustments I've made to the acrylic framework of my expander, I am confident I can make it work for a while. By filing down the acrylic, TGW reached 4mm (about 16 turns) of expansion at his last progress report (  /community/community/main-forum/palate-expansion-update-1/#post-797 ). I'm beginning to wonder about the maximum possible expansion from one expander. If there is enough excess acrylic to continue making adjustments to the changing contour of the palate, how far can the screw turn? I haven't read anything definitive about this, but the screw inside looks to be more than 10mm long. If we get to the end of the screw, does it stop turning, or do the sides fall apart? I want to use the expander as a retainer to cement my progress after I finish expanding, so I am wondering if I need to worry about stopping short of the end of the screw.

I completed my first 2mm of expansion last night. This should bring my intermolar width to about 36mm. I decided to turn the screw again after only 2 days. I didn't have time to use my extra-oral traction. I practiced chewing with my couterintuative clockwise rotation ( /community/community/main-forum/rotation-of-chewing-and-possible-correlation-to-canted-smile/ ). It feels like there might really be a connection between the default direction of rotary chewing and occlusal cant. For me, this might be more important than just what side of the mouth I chew on, because I think I use both sides, but it feels very strange trying to remember to grind my food in a left to right direction. I want to experiment with this more. 

Total Expansion: 2mm (8 turns in 21 days)

Posted by: irmathurma

A question for everyone who had the expander already: Do you feel a little ridge along your gums when you take it out? The expander doesn't touch the suture of my mouth, it pushes approximately 2-3 cm above my teeth. Along this point it leaves a ridge in the gums which slowly fades away. Seems normal, but I just want to check

Posted by: FPQuestion

Does anybody else get ridges into the gums where the palate expander is pushing against it? Secondly, I'm getting deep ridges on my left side and not as much on my right, which seems to imply that the left side is getting more pressure. 

Posted by: irmathurma

I had the same issue but that's because I was expanding more on one side than the other initially (my right side is less developed). Are you doing it evenly? 

Irmathurma, FPQuestion and maybe others have reported how the palate expander leaves indentations in the oral mucosa. I've also noticed that the indentations are more prominent on my right side, especially around my torus palatinus. This is my "less developed" side that seems to be farther down and back. I suspect the impressions might be more pronounced on my right side because that half of the palate is already lower so as it becomes less vaulted it is pushing into the expander more on that side. This might be a sign that I will need to file off some of the acrylic from the top of the expander soon.

After 2 days, I turned the expander screw last night. I'm now at 9 turns or 2-1/4mm in 23 days. I had a social event that prevented me from making time for extra-oral traction. The indentations in my mucosal tissue were more prominent this morning. I am trying to decide when to file down some of the acrylic from the top of the expander and which areas to reduce. I have a little bit of irritation on the right side of my anterior palate around the rugae. It feels kind of like when you burn the roof of your mouth or abrade the roof of your mouth with rough food. I'm not sure if the expander is causing it or if I traumatized it while eating. I've noticed that my lower arch doesn't seem to be expanding with my upper arch. Maybe I need more expansion on the top before the occlusion induces the bottom to expand. The crowding of my lower incisors is essentially unchanged so far.

Total Expansion: 2-1/4mm (9 turns in 23 days)

Yesterday I tried rounding off the back edges of my expander acrylic along the area that I removed from around my torus palatinus. I thought rounded edges might reduce the indentations on my oral mucosa from the pressure of the expander. It didn't really seem to make much of a difference when I took out my expander this morning. I still have that area of irritation around the rugae on the right side. I've decided that I am going to remove acrylic from the top of the expander before turning the screw again. I am at about the same number of turns as Collette and irmathurma when their expanders became displaced by the palate and began pushing out against the teeth. I want to avoid that. However, it's not as simple as removing the tallest parts on the expander. Because my mouth is canted lower on the right side, my expander is tallest on the left side, but it feels like I am getting the most pressure down on the expander from the palate on my right side. I guess the side that was already lower becomes less vaulted faster? So I think I need to file down the highest parts along the back of the right side, and maybe some from the front right where it is irritating my rugae. I think I will also file off a little from the back of the left side. I'll start with that and see how it feels in my mouth before removing more. Tonight would be two days since I turned the screw, but I think I will postpone the next turn at least one day.

Are you feeling any of the physical benefits of expansion yet like better breathing or increased energy?

Posted by: Allixa

Are you feeling any of the physical benefits of expansion yet like better breathing or increased energy?

To be honest, not really, at least nothing dramatic, but maybe I'm just not in tune with my body. I'm also really busy with work lately, so maybe that is just making me more tired than I would have been otherwise.

Yeah I can definitely understand how being busy/tired would keep you from feeling changes fully, but to be fair most of the stories so far where people said that they could breathe more easily came at around 5mm of expansion, so perhaps it will just take time and more expansion. I just felt like asking at this early stage to see if anything happened yet. But definitely make note of it if you do feel something like that, because I'm interested to see what level of expansion has to happen for those kinds of changes to occur.

Posted by: Allixa

Yeah I can definitely understand how being busy/tired would keep you from feeling changes fully, but to be fair most of the stories so far where people said that they could breathe more easily came at around 5mm of expansion, so perhaps it will just take time and more expansion. I just felt like asking at this early stage to see if anything happened yet. But definitely make note of it if you do feel something like that, because I'm interested to see what level of expansion has to happen for those kinds of changes to occur.

I wish I could go back and read the thread that a contributor called asdfasdf123 wrote on the BTM forum, but he deleted his posts for privacy concerns. I remember he reported some pretty remarkable systemic and mental effects from his expansion, and that he was expanding at a very fast rate initially before slowing down, but I can't recall how many millimeters he achieved. I know @admin mentioned several of these benefits in his article. Do you remember any of the other cases that reported changes in breathing, energy, mental health, etc. from expansion?

CP from back in the day did state that expansion with the biobloc allowed him to breathe more easily. I remember that clearly.

Then there are two cases from this forum:

/community/community/main-forum/review-of-active-expander/

/community/community/main-forum/palate-expander-update/

In both of those threads, if you read the posts there are mentions of better breathing and other benefits. Looks like I was wrong about the 5mm mark. Amber12 posted a while ago that at 5mm she saw better cheekbones, not better breathing. I know that Colette still posts so it would be interesting to see if her better breathing reverted or not.

I wish I were around for the asdfasdf123 posts. I didn't read BreakTheMatrix at that time. It looks like only a couple or a few of his posts survived, but there is still some useful info in them:

Thanks Allixa! So asdfasdf123 expanded 7+mm in approximately 45 days. That's more than a millimeter a week. This BTM post from Ian Hedley (one of the examples in the success stories thread who collaborated with Dr. Mew to provide NCR therapy) describing his own effects of palate expansion + facepulling + ncr is pretty remarkable:  http://breakthematrix.createaforum.com/therapies/could-you-please-give-advice-to-a-doctor-trying-to-perfect-maxillary-protraction/?message=641

Posted by: NCRintheUK

In the picture on the left was I chronically fatigued, in severe pain, had brain fog, a dished in profile, weak chin, jammed skull, facial pallor and a general stressed look on my face. In the photo on the right I was in way less pain, had more energy, was happier, felt better, had more support for my eyes, better facial symmetry, more attractive eye orbits, a wider face, stronger profile and generally look healthier. I have by no means finished my odyssey, I am continuing with NCR once a month, face pulling and expansion ortho

I decided to experiment with a self-NCR/nasal release treatment while wearing my expander this evening. I was able to inflate into the nasopharynx through all 6 meatuses. I didn't feel anything noteworthy. Maybe my expander felt a little less tight afterward, kind of similar to the difference I feel after using the handheld massager. I'm not sure if it is better to do the treatment with or without the expander in place. I'll try to mix in some more frequent sessions if I can find the time.

As planned, I filed down some of the arcylic from the top of my expander. It definitely feels better-seated in my palate, but it still left a pretty prominent impression in my mucosa this morning after I took it out. I reduced the right side, mostly along the back section beside my torus, and a little in the front corner. I didn't do much on the left side because it still seemed to be sitting up high on the teeth and I wasn't feeling the pressure on the roof of my mouth there even though the left side is taller. I did remove a bump beside the midline split on both the left and the right side in front of the screw. This is similar to the issue I was having with my torus where the expander was taller at the midline so it was encountering resistance as I expanded. For me it is easier to make these alterations using my dremel tool rather than the nail file, because it is sometimes impossible to get the flat file into the curved contours of the expander. I think I will plan to turn the screw again tonight.

Ian Hedley's results are/were really inspiring. What's more, there used to be another 'after' photo of him online as well that was taken a few years after the one posted above and in it he looked almost like a model, like a completely different person. It was clear proof to me that all of this stuff works and is important.

But it looks like NCR as a therapy never really took off and so whatever website that photo was on is now gone.

I turned the expander screw again last night, 3 days from the prior turn, reaching 2-1/2mm. It now looks like I need to file down some of the material from the left side of my expander after reducing mostly the right side a couple days ago. The labial bow is angled lower on the left side suggesting that the right side where I filed down the acrylic is now sitting up higher. I will work on that today. I mentioned in a previous post that I found the old retainer from my adolescent orthodontics, and measured an intermolar width of about 37mm on the retainer. I'm now back up to about 36-1/2mm. I held up my expander to the old retainer and confirmed that my first molars are still about 1/2mm closer together on the expander. However, the bicuspids are now about the same width apart, and the canines are about 1/2mm farther apart than they were on the old retainer. I've also noticed that the left side of my expander is more straight back in a V shape whereas the right side has a more curved U shape. This is apparent in my mouth when I smile because the buccal corridor is wider on my left side. For now, I think it is best to just focus on expanding, but at some point, I might need to figure out a way to make my arch more curved and symmetrical. Perhaps removing acrylic from behind the canines (as I have been planning) would improve the curve by separating the back teeth more than the front, but later on in my expansion, I might also try to remove a little acrylic from behind the bicuspids to fine tune their positions. 

Total Expansion: 2-1/2mm (10 turns in 26 days)

When I take out my expander in the morning, the mucosa on my alveolar ridge is now a darker red color than the rest of my palate. I guess this is a good sign that the pressure of the expander is correctly targeting the bone rather than the teeth. The ulcer on my torus palatinus has almost totally healed. This morning I noticed a little irritation just anterior to the torus. This is around where the screw is located. It will be problematic if I need to file down the acrylic in that area because there is not much excess material over the screw mechanism. I will probably wait until tomorrow to turn the screw since the expander still feels pretty tight.

I have done more research into the Buteyko breathing method. I discussed the theory in more depth on this thread about breathing (  /community/community/main-forum/deep-breathing-effects-on-the-spine-and-muscles/#post-1039 ). The guiding principle is that most people are chronically hyperventilating, blowing off too much of their CO2 which is needed for blood vessel dilation and the bohr effect's desaturation of oxygen from hemoglobin in the peripheral tissue. Paradoxically, breathing too fast and too deeply deprives the brain and other parts of the body of the oxygen it needs for electron transport and ATP production, at least that's what Buteyko practitioners claim. I've tried to be mindful of practicing slow, shallow, diaphragmatic breathing, but like mewing, it is hard to avoid falling back into old habits. One of the Buteyko strategies I have implemented already is mouth taping during sleep. The first night it seemed to have a significant effect making my sleep more restorative, however, I haven't seen much improvement beyond that initial shift. Another Buteyko strategy involves the use of an appliance called a Frolov device, which kind of reminds me of a hookah or nargilah (except without the smoke), because you use the resistance from a container of water to impede breathing, and increase the respiratory dead space (resulting in rebreathing more expired CO2). For a session of about 20 minutes to a half hour you breath with this device. The program initially recommends inhaling normally and only exhaling through the water, and then transitioning to both inhaling and exhaling through the container of water after about a week of daily treatment. You can also increase the volume of water to add more resistance as you build up your endurance. It is supposed to strengthen the diaphragm and be a much more concrete way to reduce hypocapnia (reduced CO2 in the blood) than standard Buteyko exercises. Anyway, I ordered a Frolov device and it should arrive in the next day or two. I'm not sure if it will come with English instructions since it is a Russian product. Exclusive nasal breathing is one of the tenants of Buteyko, but I am a little concerned that the device has a mouthpiece that you breath through for the session. I think I will use this initially, but I've considered ordering a CPAP nasal mask to replace the mouthpiece if I get comfortable and enjoy the exercises.

I guess I am settling into a schedule of turning the screw every 3 days. The expander has been feeling pretty tight still after 2 days and I have been deciding to delay for another day. I turned the screw again last night for the 11th time, to reach 2-3/4mm in 29 days. Reaching 3mm on my next turn feels like something of a milestone, as it will mark my intermolar width returning to what it was after my braces came off in high school (based on measuring my old retainer). I have been forgetting to mention that I bought a head of celery and I have been eating a couple ribs each day for the past few days. @allixa has been advocating chewing crunchy foods, and I have to agree that it gives a good feeling of activation slightly different than gum. 

Posted by: Allixa

Chewing tough foods like meats and gums is great for you, but I think that one of the real keys is chewing on crunchy foods. Carrots, celery, etc. All the research I have done into our evolutionary ancestors who had huge huge jaws shows that they were vegetation eaters. And so are most animals today that have jaws much bigger than ours. Think of cows, horses, etc. They don't chew gum or meat but their jaws put ours to shame.

You can just chew up half a stick of celery and leave it in your mouth for a long time, you don't even have to actually swallow it if you don't like to. Crunchy foods gives a great feeling as you chew through them and actually make contact with your teeth on each chew and they let you chew on both sides of your mouth at once which also gives a great feeling. Your tongue also gets naturally activated when chewing real food like this because it has to constantly move the food around in the mouth. I get a good burn in my tongue during these chewing sessions that mastic and falim do not give. Just give it a try.

 I have been biting into the celery with my incisors and then pulling my head and arm in opposite directions to tear off a bite before using my back teeth to chew it up. I think this pulling motion is partly responsible for the different sensation. I could feel it around my cheekbones especially a couple days ago, and I'm not sure why I couldn't reproduce that feeling yesterday. Maybe because I am getting down to the smaller ribs. I'll keep experimenting.

Total Expansion: 2-3/4mm (11 turns in 29 days)

Posted by: Apollo

The article is also of interest because it recommends a formula (albeit rooted in conventional orthodontics) to calculate the patient's ideal target width for expansion based on the sum of the widths of the four incisors. It also factors in if you have a long, narrow face or a short, wide face into the calculation (not acknowledging how expanding the palate could change the shape of the face). It gives a goal intermolar width but uses a convention between the pits of the teeth rather than the lingual edges, so I need to do some measuring and calculations before I can determine what it recommends for my ideal arch. I'll probably write more about that in the thread logging my routine.

I mentioned this article (  https://www.smlglobal.com/sites/default/files/PBB20.pdf ) yesterday in the thread about mandibular expansion. It presents what is called the Schwarz analysis, which is used by orthodontists to calculate the ideal goal intermolar width for patients undertaking palate expansion. 

The Schwarz analysis is a simple and easy-to-use formula that offers a good guideline as to how wide an arch should be for a given case. It compares the difference in millimeters between an arch’s actual measured arch width and a calculated ideal arch width for that patient. Schwarz calculated the ideal arch width by summing up the mesio-distal width of the four upper incisors and adding a fixed constant to that number. The constants used were dependent on the patient’s basic facial type. The three basic facial types are defined as follows:

Leptoprosopic. This type of individual when viewed frontally exhibits a long narrow facial outline with greater predominance
of vertical dimensions and less influence seen in the lateral dimensions. Correspondingly, the dental arches tend to be longer
anteropos teriorly and more narrow.

Mesoprosopic. This is the average type of individual whose facial outline follows a generally paraboloid pattern.
The dental arches tend to develop to a nicely shaped geometric Roman arch form.

Euryprosopic. This type of facial pattern is more dominant in the lateral dimensions than in the vertical dimensions and appears as a more
square and stocky facial outline. The dental arches tend to be shorter anterioposteriorly but more square or widened out laterally.

So I did this calculation for myself. The first step is to measure the total width of the four upper incisors. Mine are about 34mm. To that number you add 12, 14, or 16mm depending if your face shape is long and narrow, average, or short and wide. In truth, my face shape is probably average or "mesoprosopic," but since the formula doesn't recognize that we are trying to change the shape of the face, let's add the maximum 16mm to the width of my incisors. This gives 50mm as the ideal width between the pits of my first molars. The convention I have been using to track my progress is the intermolar width between the lingual edges of the first molars, rather than the center of the teeth. So I measured the current width between the pits of my teeth as about 48mm (about 11mm wider than the approximately 37mm between the lingual edges of the teeth). This means that I probably started out around 45mm. The formula suggests that I have already expanded to the goal width for an average "mesoprosopic" face shape, and that I should expand only 2mm more for a wide "euryprosopic" face shape. Expanding 2 more milimeters would bring me to just a 39mm intermolar width (between the lingual edges). 

It should be mentioned that I used a tailor's tape to measure both the combined width of my incisors and the current width between the pits of my molars, and both of these introduce some level of error. Nevertheless, I get the feeling that this formula will underestimate our goal. For kids, Dr. Mew recommended expanding to 42mm for girls and 44mm for boys. Also, I probably want to expand a little beyond my goal to allow for a degree of relapse. So I don't plan to stop expanding when I reach 39mm (as long as my expander still fits with adjustments to the acrylic).

I traced my expander onto a piece of paper and then mirrored the image to show the asymmetry of my maxillary arch. I just drew a line down the middle but there is actually now a separation of almost 3mm. The darker line is the real shape and the lighter line is flipped horizontally. You can see how I filed down the back of the expander to accommodate my torus palatinus. My anterior teeth are relatively symmetrical from one upper canine to the other. However, I've mentioned before how my right side is more curved out and U or "roman arch" shaped, and my left side is more straight back and V or "gothic arch" shaped. You can see this in the outline. The lingual edge of my right first molar is about 4mm farther from the midline than the lingual edge of my right canine, whereas the lingual edge of my left first molar is only about 1mm farther from the midline than the lingual edge of my left canine. In other words, my right first molar is about 3mm farther from the midline than my left first molar. The right bicuspids are also farther from the midline than the left bicuspids by about a couple millimeters. If my total intermolar width is currently almost 37mm, about 20mm of that width is on the right half of my mouth and only about 17mm of that width is on the left half of my mouth. What you can't see in the outline, is that this results in a steeper slope on the left half of my expander than the right up into the vault of my palate.

So I am beginning to wonder if there are any adjustments I could make to the acrylic of my expander to improve the symmetry of my arch. Ideally, I would like to make the left side curve out farther from the midline like the right rather than making the right side narrower. However, I can't add acrylic; I can only take it away by filing it off. Maybe I will expand as far as I can, and then allow targeted areas to regress. Soon I will need to file down much of the acrylic behind my anterior teeth to prevent further separation of my canines and development of a midline diastema. So by the time I reach my maximum expansion, the acrylic will only remain behind the bicuspids and the first molars. From there, I could file down a little acrylic behind the left bicuspids to allow them to regress closer to the midline than the left first molar, making that side more curved. This would also require filing down some of the acrylic against the palate to make the slope less steep on the left. Then I could file down a couple milimeters of acrylic from behind the bicuspids and first molar on the right so that they would be closer to the same distance from the midline as the left. I would make these adjustments incrementally, fractions of a milimeter at a time, every few days. Unfortunately, this would cause me to lose a significant amount of my overall expansion, but it might be worth it to gain improved symmetry. I will have to see how much expansion I am able to achieve overall, but for arguments sake, let's say I reach a total of 8mm expansion. This would put my intermolar width at 42mm. If I let my right first molar regress by 2mm, I would still be netting 6mm intermolar width to finish with 40mm and improved symmetry. Anyway, it's something to consider. It's possible that some of the asymmetry will correct itself if the left side shifts more than the right on its own.

Today is 3 days since the last time I turned the expander screw. It's still feeling relatively tight, but after I have worn it for a few hours this evening, I suspect I will be ready to advance.

How did you go about making your palate expander? I'm working on a mold of my teeth with some silicone and ceramic, but making the actual expander seems like it'll be trickier. I need something to attach and sort of pulling device to though and this seems like the best bet.

Also, does anyone have that pdf for self ncr? I absolutely can't find it anywhere 

Posted by: Lukas

How did you go about making your palate expander? I'm working on a mold of my teeth with some silicone and ceramic, but making the actual expander seems like it'll be trickier. I need something to attach and sort of pulling device to though and this seems like the best bet.

Also, does anyone have that pdf for self ncr? I absolutely can't find it anywhere 

I didn't make my expander. I purchased it. The process of pouring the acrylic into the dental cast with the screw mechanism and the wires in place is beyond my level of expertise. If you join the forum, I might be able to send you a private message with the self-ncr guide attached.

I turned my expander screw for the 12th time last night, reaching a total of 3mm in 32 days. My intermolar width is now 37mm. This is the same intermolar width that I measured on my retainer from adolescent orthodontics, and it feels good to have reversed that narrowing. My teeth don't look like they have tipped outward, so I think most (if not all) of the increased width is skeletal. I have to say that there aren't any drastic changes in my appearance or breathing. I guess it makes sense that only 1-1/2mm expansion on both sides of my mouth wouldn't dramatically change my smile. I think there might be some subtle changes, including minor improvements to symmetry. A few months ago, I recorded baseline measurements of the deviation of my dental midline and the bridge of my nose from my interpupillary midline ( /community/community/main-forum/my-routine/#post-378 ). My dental midline was 2mm right of center, and the bridge of my nose was 4mm left of center. My occlusal plane was canted about 3 degrees higher on my left side. Obviously there is the potential for significant measurement error when we are dealing with increments this small. That being said, it looks like the bridge of my nose is now about 3mm left of center and my dental midline is about 1mm right of center, although the cant looks roughly unchanged and the angle of my central incisors places the top of the teeth farther from the true midline than at the incisal edge.

Total Expansion: 3mm (12 turns in 32 days)

Posted by: Apollo

........My teeth don't look like they have tipped outward, so I think most (if not all) of the increased width is skeletal........

By skeletal you mean expansion in the suture vs dental movement in the alveolar ridge?

Posted by: abdul

By skeletal you mean expansion in the suture vs dental movement in the alveolar ridge?

By skeletal movement, I am referring to separation of the midpalatal suture, but potentially also limited bone remodeling (resorption and deposition) that some sources suggest can occur on the basilar bone of the alveolar process (perhaps changing the shape of the palate to be less vaulted). This is in contrast to dental movement which involves resorption and deposition of bone within the alveoli surrounding the roots of the teeth (as seen below). Since the mandible doesn't have a suture, there is only the potential for dental uprighting of lingually-tipped teeth, or the much slower process of remodeling the basal bone.

My Frolov breathing device arrived a few days ago, and I completed a ten minute session last night and the night before. To be clear, I'm not expecting this to have any direct effect on my facial form. Instead, I am hoping for better general vitality through improved tissue oxygenation. I have issues with stress/anxiety that make me receptive to the Buteyko mindset that I am chronically hyperventilated and hypocapnic. As I suspected, the instruction manual that came with the device is written entirely in Russian. I found an English language copy online ( http://www.avivahealth.com/files/pdfs/frolov-manual.pdf ). Their recommendations for the introductory period are slightly different than what I read from other sources, but I am following the manual's instructions including the duration of the sessions and the volume of water. The breathing pattern is supposed to be 2 seconds of inspiration and then 6 to 10 seconds of expiration, increasing the length of expiration, the session length, and the volume of water as you get acclimated to the exercise over weeks to months. I debated ordering a book with more details, but I think I will stick with the basic instructions for now. I'm not really sure what effect it is having after the first couple sessions. It's kind of calming. I've felt slightly lightheaded afterward. I have struggled to keep my inspiration to just 2 seconds, and this makes me suspect that I have been breathing too deeply and I'm not supposed to fully fill my lungs.

So apparently I had some relapse during the day yesterday, because I struggled to fit the expander in my mouth when I tried to put it in last night and once in place it was causing pain along the middle of my palate and at the back left corner where the edge of the acrylic presses against the alveolar ridge. I decided to back the expander off by one turn to avoid injury and help me get to sleep. It still feels pretty tight, but not as painful. This is strange because it was a couple days after I had turned the screw with no issues in the days prior. I don't know if my oral posture was particularly bad during the day yesterday, or what could have cause this relapse. I typically wear the expander for an hour here or there sometime during the course of the day before starting my overnight hours sometime in the evening. I didn't have time to get any hours during the day yesterday because of family activities, but I don't think missing one or two hours should have made such a difference, and I've missed the daytime hour(s) before without an issue. Based on my every-3-days schedule, I should be turning the screw this evening, but I don't think that will happen. I'll probably wait a couple days before turning the screw back to where it was, and I might need to change to turning every 4 or 5 days from here forward.

Note: This is not an April Fool's joke.

Do you think the breathing device caused the relapse? In another thread people were talking about how drinking through a straw might be bad for palate width and the breathing device seems somewhat similar.

Anything else you did differently?

Posted by: Allixa

Do you think the breathing device caused the relapse? In another thread people were talking about how drinking through a straw might be bad for palate width and the breathing device seems somewhat similar.

Anything else you did differently?

Yeah I debated if the mouthpiece of the Frolov device could have contributed to the relapse. I'm the one in the other thread who said I avoid drinking straws. Considering that I have had the expander in place when I have done the breathing sessions and that the relapse seemed to happen during the day before I put the expander in last night and before my breathing exercises that evening, I doubt that is the cause, but it is definitely possible. I think it is more likely that I could have relapse of upward and forward movement than the transverse expansion since I keep the expander in place, but I don't have my tongue pressing up against the expander during the 10 minute session like I typically do. I mentioned earlier that I want to purchase a CPAP hose with a nose attachment to use with the device rather than the mouthpiece. Maybe I will put the breathing exercises on hold until then. The only other thing that I can think of that I did differently yesterday was skipping the hour or two of daytime expander use because I was busy with family. It was a little demoralizing to turn the screw backwards. Thanks for helping me think through what could have happened!

It sounds like it isn't the Frolov device then. If you are wearing the expander during it, and especially if you noticed the relapse before you even did it, then I would say it's probably not contributing.

It might simply be because you were unable to wear the device during the day then, but perhaps with a small caveat. Did you do chewing on the day you had slight relapse? I ask because I think there is a chance that rotary chewing could push the upper teeth in the wrong direction for expansion just based on the way the lower jaw moves, and because you said you have started being diligent in rotary chewing just recently. Maybe a person that is expanding and rotary chewing needs to do more retention than normal to counterbalance inward forces generated by that chewing technique. Especially if your routine is normally to chew and then to put the expander in. Just a guess.

And yeah having to turn the screw backwards isn't ideal, but just keep at it, we're all learning and moving forward together. Most doctors don't even believe what we are doing is possible, and even the ones that do think that the expander has to be in all day and all night long. We are on the cutting edge here, so some slip ups are normal. Just have to learn and adapt.

I'm still not ruling out the Frolov device as the cause. The recession seemed to happen before I did the breathing exercises that day, but I had done a ten minute session on each of the two days prior. I was wearing my expander during all of the sessions, but I guess there's the chance that breathing through my mouth during the session, made me more prone to unconsciously breathe through my mouth during the rest of the day without the expander in place. I didn't use the Frolov device last night, and I think I am going to wait to use it consistently until I can get a nasal hose.

That being said, I think I have figured out the problem and it isn't the Frolove device. I think filing down some of the acrylic on the anterior part of the left side has concentrated the pressure from expander over the back part above the first molar where I was feeling pain. I only made a minor adjustment to an area behind my left canine that seemed to be a pressure point that day, and when I tried it on immediately after the adjustment it seemed fine, but it didn't want to fit right later that evening. If I put a hand mirror under my teeth and then look in the bathroom mirror, it is clear that the expander is now sitting slightly left of center (maybe less than 1mm). In other words, more of the gap between the two halves of the expander is behind my left central incisor than the right. I'm not sure how long it has been like that. It's a positive development because my left half is the narrower side. So I want more expansion in the back on the left side, but not if it is going to hinder my progress overall. I haven't decided if I should file down any of the acrylic above my left first molar to try and relieve that pressure, or if I should just wait a few days without expanding and hope that my mouth adjusts.

I decided to significantly file back the expander acrylic behind my front six teeth. The gaps between my front teeth are just starting to become noticeable, so I wanted to remove the direct force against my canines. I also thought that the pain I was feeling on the back left side could have been from a misalignment created by a minor adjustment I made to the acrylic in the front, so removing that area might balance out the force. Curiously the slight gaps between my central and lateral incisors are more visible than the midline gap between my central incisors (although the contacts between all of the front teeth have become less tight). If my expansion was really from separation of the midpalatal suture, I would have expected the midline diastema to be the most significant, but all of the gaps are roughly similar, and the central incisors started out with a minor overlap, so I'm not too alarmed. I wonder how the front teeth will shift without the acrylic behind them holding them in place. I didn't remove as much of the front structure of the expander as TGW did. I just filed it back far enough to remove any contact with the front teeth, so there is still a convex semicircle against the front of my palate. I left the labial bow in place for stability and to hold back some of the pressure from the lips. I will probably remove more acrylic soon, maybe even later today, so that the front of the expander curves in toward the screw mechanism. This would provide more tongue space, but I am a little worried that concentrating all of the exander pressure on the back section will cause discomfort.

I also wanted to leave more surface area for the extra-oral traction to press against the palate, but I am beginning to feel like most of the tension is loaded onto the teeth from where the elastics attach to the wires. Originally I figured the maxilla was getting enough of the protractive force even if it was mostly conveyed through the teeth, but after seeing how the FAGGA system seems to result in almost exclusively dental movement, and the lack of a significant change in Plato's profile pictures from his facepulling, I am beginning to rethink my extra-oral traction strategy. I want to go back and read about that guy who made a DIY facepulling mouthpiece without any connection to the teeth. Here is his website ( https://www.facepulling.com/ ).  I think I remember some posts about it on the BTM forum. There haven't been any recent updates or details about what material he used to make the pink framework for the mouthpiece. I'm guessing maybe it is the thermoplastic sometimes used for partial dentures and fake costume teeth.

I have some sores on my alveolar ridge above my left first molar and second bicuspid, where it felt like the pressure was concentrated. I filed down a little of the acrylic in that area and it feels better now. I find after I make an adjustment that I have to leave the expander in my mouth for a few minutes before I can tell if the issue is resolved. I think I am going to have to wait to start expanding again until I know I have the acrylic adjusted correctly so that the pressure is distributed evenly.

I have decided to uncouple my extra-oral traction from my palate expansion. Originally I thought they might have a synergistic effect, but as I mentioned in the post above, the traction seems to be loaded on the teeth rather than the bone. It feels entirely different for me to put my thumbs against the expander on my palate and pull up and forward than it does to pull up and forward on the wires that have to pass between the teeth to transfer the force to the acrylic. Maybe after I complete my palate expansion, I will develop a DIY mouthpiece that engages the palate. Until then I think correct oral posture will be most effective at shifting my maxilla up and forward. This is already easier with the minimal expansion I have achieved so far. Hopefully I will be able to get some more width from my expander before it becomes unworkable.

The sore on the alveolar ridge above my upper left first molar is still visible, but it isn't painful any more. I will wait at least another couple of days before resuming my expander routine. I've put the expander in place for a few seconds over the past few days and it is clear I have had some regression, but definitely less than a millimeter. I have been trying to take advantage of my improved oral posture with my increased intermolar width to prevent relapse. I think I have done a little better with mewing during sleep, but probably don't keep my posterior 1/3 of the tongue engaged. When I resume my routine, I might phase in increasing hours per day and observe if I have any sores returning before wearing the expander continuously through the night.

I wound my expander back down to 2mm separation and have worn it for a few hours today. After three days off, the ulcer on my alveolar ridge above my left first molar is still visible but doesn't hurt even with the expander in place. The expander doesn't feel tight so I think I have regressed less than 1mm. I plan to increase the number of hours I wear the expander over the next few days and watch to make sure the ulcer is still healing. Sometime next week I'll begin wearing the expander through the night again and then I will resume advancing the screw.

I turned my expander to 2-1/4mm this morning and have been wearing it on-and-off throughout the day. It feels a little tighter, but there's still no pain at the spot where I had the ulcer. That spot still looks red but doesn't have the central white spot that it had before. I'm going to try to get in a few more hours during the day today and I might even wear it for a few hours during sleep and then set my alarm to take it out. I am thinking about it like a bed sore pressure ulcer where they try to rotate or get patients up out of bed to restore blood circulation. Once the sore looks totally healed I'll go back to wearing the expander through the night. I will see how tight it feels in 3-5 days and decided if I am ready to turn the screw again.

Just when I thought I was getting back to my routine, this morning a wire snapped on my expander. I was removing the expander by pressing down with my fingers on the wires that wrap around the first molars when the right side snapped close to where it joins the acrylic between my first molar and second bicuspid. The wire still connects to the acrylic behind the first molar so it hasn't fallen off. I had already decided that I wasn't going to use the expander for face pulling anymore, so I guess it doesn't matter that the headgear tube is now useless. If I can keep the wire lined up, it doesn't interfere with using the expander, but occasionally it will now pop out of place between the teeth. I have to press on the labial bow or the wire between the bicuspids to remove the expander. I debated emailing customer service, but they haven't been very responsive in the past.

Do you think that facepulling using the wire in the past was what caused it to eventually snap?

Posted by: Allixa

Do you think that facepulling using the wire in the past was what caused it to eventually snap?

I guess it's possible, but the location where it snapped, entering the acrylic on the lingual side of the tooth, doesn't seem like it would bear much of the tension from the facebow pulling forward/up. The wire snapped when I was pressing down on the headgear tube to take it out and I suspect that might have been the repeated motion that weakened the wire. The force of the mandibular teeth pressing up on the wire could also have contributed.

I slept through most of last night with my expander in place, and the sore on my alveolar ridge still seems to be healing fine. It has been 2 days since I turned the expander to 2-1/4mm and it was feeling pretty lax in my mouth so I decided to turn the screw again to 2-1/2mm. It still doesn't feel very tight, but I am going to try to be patient and wait to turn the screw again.

I've been using the expander throughout the night and a few hours during the day, and the ulcer is essentially healed. I decided to turn the screw again today to 2-3/4mm. It's been 4 days since my last turn. I will be back to the separation before my setback on the next turn.

Posted by: Apollo

Posted by: Allixa

Do you think that facepulling using the wire in the past was what caused it to eventually snap?

I guess it's possible, but the location where it snapped, entering the acrylic on the lingual side of the tooth, doesn't seem like it would bear much of the tension from the facebow pulling forward/up. The wire snapped when I was pressing down on the headgear tube to take it out and I suspect that might have been the repeated motion that weakened the wire. The force of the mandibular teeth pressing up on the wire could also have contributed.

That's interesting. Sounds like I should be careful while removing mine so that it doesn't snap on me. I don't have the headgear tubes on mine, and it looks like those might put more force onto the metal wires, but still..

It's good to hear you're getting back on track after the setback too. Have you decided yet how far you want to go? I haven't started expanding yet but I will soon.

Posted by: Allixa

 

It's good to hear you're getting back on track after the setback too. Have you decided yet how far you want to go? I haven't started expanding yet but I will soon.

Posted by: EddieMoney

So I just measured my first intermolar post braces and it was 38mm. That was when I was 22 and braces came off. Fast forward to now and I am 31. I started this 6 months ago. I have increased my intermolar to 44 mm. 

This means that I want at least another 3mm of expansion from the appliance. In other words, I am about halfway to my goal. Is this feasible? I don't know. After my ulcer setback, I'm not sure how much farther I will be able to turn the screw while keeping the acrylic fitting my alveolar ridge. I'm also concerned that the snapped wire could become problematic. If I somehow get to 40mm and I'm not seeing side effects like teeth tipping or gum recession, I'll press ahead. I think the screw will only let me turn maybe 10mm maximum. I might stop at 8mm just to be safe. This would put me at 42mm. I'm a little worried that if I kept turning the screw the two halves of the expander might come apart, and I want to be able to keep using it as a retainer to cement my expansion for several months.

38-40mm of solidified molar width does seem like a good goal to shoot for based on what we know.

I'm not sure how much regression will actually happen in our cases based on the fact that we are mewing and using the expander as a retainer. Most of the cases I read online suggest doing overexpansion as a way to compensate for the tipping of the upper teeth, which is something that tends to reverse itself over time because of the fact that it is simply a dental change. If you are getting true expansion and minimal tipping then regression might not be a big deal as long as you keep good tongue posture and keep using the expander until the bone finishes growing in at the suture. Although your anecdote about equal spacing between all teeth and not just between the central incisors may point at something else going on.

Also I'm fairly confident that the expander we have maxes out at 8mm of expansion. I've read that this is standard in a few places, and I just measured the screw in my expander (it's clear acrylic) and it is 16mm long.. and if you take into account the fact that both sides of the expander have to travel on this same screw, you can divide the length by 2 to see how much total expansion the device can do, so 8mm.

Being halfway to your goal is a good milestone, but the fact that the acrylic is giving your skin issues is bothersome. Do you think you could put down a very thin layer of wax or something? There has to be something you can do...

Posted by: Allixa

 

Being halfway to your goal is a good milestone, but the fact that the acrylic is giving your skin issues is bothersome. Do you think you could put down a very thin layer of wax or something? There has to be something you can do...

I thought about trying denture adhesive like poligrip to act as a buffer that might even out the pressure points between the acrylic and my mucosa. However, I was able to file down the area that was causing the ulcer and I'm not currently having any issues with distribution of the force across my alveolar ridge. I'm sure I will encounter new fit issues as I continue to expand. I have noticed that the impression in my gums when I remove the expander in the morning after wearing it all night now seems to be more distinct on my right side, but it doesn't seem to be causing any irritation.

Anyone following along will remember that I purchased a Frolov breathing device, hoping that it will help enhance my parasympathetic tone. The main fault I had with the device is that it uses a mouthpiece despite the Buteyko method's mandate of exclusive nasal breathing. 

After trying a couple sessions with the mouthpiece, I ordered a nasal cpap hose as a replacement. 

The hose is a wider diameter than the one that came with the kit, so it doesn't fit perfectly on the lid of the Frolov cylinder. I made a quick fix by wrapping a rubber band around the nozzle of the lid and sliding the end of the hose down over the rubber band. It seemed to achieve a good seal. I might purchase some o-rings or come up with some other more-permanent way to connect the hose. I also noticed that the cpap hose has several little ventilation holes on the swivel adapter that connects the hose to the nosepiece. I covered these with a piece of tape. The Frolov device is intended to increase the respiratory dead space, but breathing through the nose has more dead space than breathing through the mouth, and the bigger hose also adds to the volume of dead space. For this reason, I decided to use the minimum amount of water for introductory sessions, and I stopped my session after 8 minutes rather than 10. I used the fabric harness around my head, but I also held the nosepiece with my hand to ensure a good seal between my nostrils and the "nasal pillows." I enjoyed this session more than the two other sessions I had tried with the mouthpiece. There seemed to be more of a humidifying effect on the air I was breathing, with condensation visible in the clear tube. I could also keep my tongue pressing up against my expander throughout the session and focus on my head posture. It is more difficult to rinse out the new hose afterward to keep it clean, but I think it is going to be worth the trouble. I will try to follow the manual's instructions for daily sessions of increasing intensity, and report back if I feel any positive effects on my energy or mental clarity.

8 min, 18ml, 10s

Posted by: Allixa

 

Also I'm fairly confident that the expander we have maxes out at 8mm of expansion. I've read that this is standard in a few places, and I just measured the screw in my expander (it's clear acrylic) and it is 16mm long.. and if you take into account the fact that both sides of the expander have to travel on this same screw, you can divide the length by 2 to see how much total expansion the device can do, so 8mm.

The color of my acrylic makes it a little difficult to see through and measure the total length of the screw, but mine looks to be about 14mm long. Factoring in the width of both 2mm brackets that move along the screw (i.e. the "body" of the mechanism in the picture below), I guessed 10mm might be the maximum expansion. Now that I think of it, I should probably also subtract the 2mm width of the center keyhole piece which would bring me to the 8mm you quoted. Maybe yours is different since you have the y-plate, but I'm not really following your logic for why you would divide the length in half. I hope the guide pins on either side of the screw will stop it from expanding too far and come apart. However, for some reason I've noticed that the guide pins on my mechanism are stuck in place on the right side so they are getting close to the body/bracket on the left side. Maybe once it reaches the end on the left, it will start shifting on the right. If a maximum of 8mm expansion is accurate, then 42mm intermolar width is the most I could achieve with this appliance (from my baseline of 34mm). I still suspect that fit issues or other side effects will keep me from expanding that far. I will be happy if I can get to 40mm.

I turned my screw again today (3 days after my last turn). I am now back to 3mm total expansion. Hopefully I can continue on from here without more complications.

I did my second Frolov session with the nasal hose last night. The best time is supposed to be evening before bed (a few hours after dinner). I increased the length of the session by 30 seconds, and I added 1ml more water, but I kept the length of inhalation and exhalation the same. According to the manual, the inhalation is always supposed to remain 2-3 seconds, and the exhalation is supposed to be prolonged starting at around 8 seconds and then increasing over several months up to above 30 seconds. I'm still struggling to inhale enough air in the first couple seconds to be able to taper out the exhalation long enough. The inhalation is supposed to be calm, and I don't think I'm supposed to totally fill my lungs, so maybe I just need to get better at pacing my exhalation. I had been counting out the seconds in my head, but I bought a breathing app to help with the pacing. I could only find one app that allows me to totally customize the number of seconds for inhalation and exhalation. It uses a graphic with a circle expanding and then contracting to represent the respiratory cycle, but this is a little ambiguous, and I wish it also had a clock or some other way to count the seconds. I am considering purchasing a book that might give more details about the rationale for the short inhalation and prolonged exhalation, or might recommend ways to adjust the protocol to my own needs. The manual also mentions the optional use of essential oils and warm water. I might try warm water, and maybe add a pinch of sea salt, but I'm going to wait until I get into the basic course of training after this introductory period before I start experimenting.

8-1/2 min, 19ml, 10s

With everything else going on, my chewing exercises have been shorter during the past few days. I need to remember to prioritize chewing to avoid teeth tipping. I still use the vibrating massager for at least a short session most days and it seems to help, especially when the expander feels tight. Curiously, the cracks/pops I hear while using the massager are still always in my right ear regardless where I place the massager on my face. I increased the length of my Frolov session last night by half a minute, but kept the water volume and length of inhalation/exhalation the same. The breathing app was somewhat helpful for pacing, but I also use the timer on my phone to keep track of the length of the session. I found that if I close the breathing app to check the timer, when I go back to the breathing app it has frozen and needs to be restarted to work again. Maybe I'll have to use a separate clock to keep track of when to finish the session.

9min, 19ml, 10s

People like Plato and Dean Howell claim that cranial adjustments can only occur when the body is in a parasympathetic state. The preparatory work during NCR sessions, before the endonasial balloon inflation, is intended to get the body into this relaxed condition so that it doesn't resist the realignment of the sphenoid. I've seen quotes from Howell that are critical of palate expanders because they put the body under stress for too long. This is also Plato's rationale for short facepulling sessions to avoid kicking the body into a sympathetic mode. Obviously I am skeptical of this philosophy since I am using a palate expander for as many hours as possible every day, and I was trying to maximize my extra oral traction hours until I decided too much of that tension was loaded onto my teeth with my current setup. That being said, in my experience, it does feel easier to get my expander to fit comfortably when I am in a relaxed, parasympathetic mindset. One example is pushing the expander against my palate with my tongue during the deep nasal breathing exercises I am doing with the Frolov device. When I started thinking about my breathing exercises in the context of parasympathetic tone and vagal stimulation, I began to explore other strategies to stimulate the vagus nerve. I'm intrigued by ideas like om chanting and cold exposure, but I'm confused by one strategy. I've seen several sources suggest that fasting stimulates the vagus, but this seems to contradict the "rest and digest" mode, and fasting is supposed to raise cortisol levels and induce stress. I am not strict about intermittent fasting, but I often only eat during about 8 hours of the day with two meals. I could further restrict my hours, if fasting for 18+ hours of the day would be helpful, or maybe I should spread out my eating to avoid the stress of fasting.

9-1/2min, 19ml, 10s

I turned my expander screw again today. It has been 3 days since my last turn. I'm now at 3-1/4mm.

I've been doing some research about supplements, so I want to use this post to help me reevaluate what I am taking. I've mentioned before that I am taking a multivitamin, magnesium, D3, K2, and fish oil. I think I am going to stop taking the multivitamin. There doesn't seem to be a lot of research supporting the utility of a multivitamin, and I've read suggestions that the ratio and quality of certain components is often bad. If I do this I need to be more mindful about eating a nutrient-dense diet and consider adding specific supplements according to my needs and goals. I feel relatively confident that I want to continue taking the D3, K2, and magnesium. I was relying on the multivitamin and my diet for vitamin A. I don't think I want to add a vitamin A supplement, but I might need to be more careful about incorporating it in my diet. My understanding is that the beta-carotene in plants is poorly converted into vitamin A. Maybe I should make organ meats a more consistent part of my diet, and maybe I should take cod-liver oil (which has a good balance of vitamin A and D). Most cod-liver oil has been processed in a way that strips out the vitamins and then synthetic vitamins are added back in. There seems to be some controversy about the "fermented" options that retain their natural vitamin levels, and I guess there are also virgin cod liver oil options. Unfortunately there seems to be a lot of ambiguity on this topic and all of the options are expensive with shipping costs. I'll hold off on this for now. B-12, folate, zinc, and copper are components of the multivitamin that I might want to think about supplementing or finding consistent dietary sources. I probably get enough vitamin C from food sources, but I could easily take a supplement without worrying about excess. Iodine is another ingredient of the multivitamin that I get fairly regularly from eating kelp granules. I'm going to continue taking my fish oil, but I've been reading some sources that tell me it is often low potency, contaminated, or oxidized, and that krill oil is better. The fish oil I am taking sometimes gives me diarrhea, especially if I take it on the same day that I eat salmon or other fatty fish. Although krill oil is more expensive, I think I will try it to see if it is friendlier on my system. Curcumin is something I've considered supplementing, but I get a lot of turmeric in my diet. Some other vitamins I'm currently looking at are L-tyrosine and PQQ. I'll keep researching this topic, but I'm going to quit the multivitamin starting tomorrow.

I discontinued my multivitamin today but I am still researching if I want to replace it with any specific supplements. I am continuing to take magnesium, K2, D3, and fish oil. I discussed some of these considerations in my last post. The high-vitamin fermented cod liver oil that I mentioned as a source for vitamin A and D is produced by Green Pastures. The best price I can find (including shipping) is around $46 for a 237ml bottle. The dosing on the Weston Price Foundation website recommends 1 teaspoon per day for most adults. There are just under 5ml in a teaspoon, so each bottle would last about 48 days. That means I would be spending almost a dollar a day. Radiant Life also sells the Green Pastures fermented cod liver oil, and they recommend 1/2-1 tsp per day for adults. So I could start with 1 tsp and then reduce the dose to 1/2 except during periods of sickness or acute stress when I would increase the dosage back to 1 tsp. This is still about 50 cents per day. Because the cod liver oil also contains omega 3s, I could reduce my fish oil or krill oil dose to one softgel per day, which would recoup a little of the expense. So I'm thinking I would probably make my cod liver oil maintenance dose 1/2 tsp per day and then try to get additional dietary vitamin A from organ meats, and consider continuing my D3 vitamin daily or every other day, especially during the winter months when I get less sun exposure. I am currently taking 2000 IUs of vitamin D3 per day. The fermented cod liver oil is not standardized, but it is estimated to contain roughly 1,000-2,000 IUs vitamin D per tsp.

10min, 20ml, 10sec

I am seeing just a slight buccal tipping of my right first bicuspid. I mentioned that I've been slacking a little on my chewing exercises recently as I have been trying to fit in more daytime expander hours. For the past couple days I've done my best to bring gum with me and chew whenever I can and I will try to focus on this better going forward to prevent more tipping. I think another factor is that I removed the acrylic from behind my canines and incisors, so the bicuspid is getting more direct transverse force than the canine in front of it, and my right side is less curved than the left so the first bicuspid is almost as far from the midline as the first molar. Tomorrow will be the end of my first introductory week on the Frolov protocol. After that I will start to incrementally increase the duration of the sessions, the volume of water, and the length of exhalation.

10min, 20ml, 10sec

It's been three days since I turned the expander screw, but it still feels pretty tight, so I will probably wait another day or two before turning the screw again. I completed the first introductory week using the Frolov breathing device. I'm beginning to feel like I could prolong my exhalation longer than my current 8 seconds. Inhalation is supposed to remain constant at 2-3 seconds. It's hard to say if I feel ready to increase the duration of the session above 10 min, or add more water volume resistance. Here is what the manual says about building up the intensity of the exercises after the first week:

Usually, during the first week the organism adjusts to the new respiratory conditions and then, starting from the second week of training, the parameters of training can be gradually increased. In the process of training, the water volume in the simulator inhaler can be increased by 1 ml every 3-4 days, PRA – by 1 second every 2-3 days, and the length of the training session – by 1 minute every 2-3 days. A more gradual increasing of training factors (PRA, water volume in the simulator inhaler and the time of the training session) is possible too. For example, if respiration with 20 ml of water in the simulator inhaler causes complicated breathing or strong resistance to breathing, you should not increase the water volume. Then, if after 3-5 days of training this water volume does not cause the sensation of complicated breathing, you can increase the water volume by 1 ml. If you breathe for 20 minutes and at the end of the session there is a sense of tiredness or slight fatigue from the training that means 20 minutes are enough for you. If there is no sense of tiredness, you can make the time of training 1 minute longer in 1 or 2 days. Also, control PRA. If, for example, PRA is 15 seconds, and you can breathe with this PRA all right during the whole training session, you can increase PRA by 1 second in 2-3 days. The length of the respiratory act is gradually increased in the course of training and with the lapse of time the length of one uninterrupted exhalation can be 25-30 seconds, and for healthy trained people – 40-60 or more seconds.

So I guess tonight, I should try exhaling for 9 seconds, with 21ml of water resistance, for an 11 minute session. I'll watch to see if it feels difficult or tiring.

10min, 20ml, 10sec

Today is four days since I last turned the expander screw. It is feeling a little less snug, but I think I might wait until tomorrow to turn the screw again. I got some good achy sensations along the middle of my palate last night. Sometimes I feel it more along the alveolar ridge, but I think it's a good sign that the suture might be separating when I feel it along the midline. I noticed that the impression the expander leaves in my gums has been more pronounced on the left side for the past few days since the last turn, especially the anterior border near the middle. My left side is more vaulted, so the acrylic is thicker. I probably need to file some off of the top, but I've been hesitating out of concern that I will throw off the fit again and cause another ulcer. Before I turn the screw again, I think I need to make at least some minor adjustments. I increased the intensity of my Frolov session last night. The extra second of exhalation and the resistance from the extra 1ml of water didn't seem challenging, but I noticed the session's extra minute. If tolerable, I am supposed to increase the water volume again in 2-3 more days, and the length of exhalation and session duration in 1-2 more days. So tonight I repeat last night's levels.

11min, 21ml, 11sec

My expander felt lax enough by yesterday evening that I decided to go ahead and turn the screw (4 days after the previous turn), but I needed to file down some acrylic off the top on the left side where it was really leaving an impression in my mucosa (to be clear this is an area near the midline that is pushing up into the roof of my mouth, not an area on the sides pushing out against the alveolar ridge). I turned the screw and I am now at 3-1/2mm of expansion. I was probably too conservative in how much acrylic I took off because that same area of the mucosa is still indented several hours after removing the expander this morning. I will try to fine-tune my adjustments today. Often when my expander is tight after turning the screw, I feel the need to remove it from my mouth, restore circulation to the tissue for a minute, and then put it back in place. I can't do this when I have my mouth taped shut, so I fell asleep without mouth taping last night. For my Frolov session this evening, I think I will increase the length of exhalation by 1 second, but keep the water volume and session duration the same.

11min, 21ml, 11sec

I had a bad headache yesterday and couldn't attend to any of my routine. My sleep was disrupted and cut short the night before and I think this is what caused the headache. The thought of having the force of the expander added onto my headache was unbearable, and I just wanted to sleep it off rather than taking time for breathing exercises, chewing, etc. This morning, the expander felt a little too tight, so I turned the screw back one turn to 3-1/4mm. After a couple hours it is fitting fine now, and I might advance it again by this evening. If I get around to my breathing exercises tonight, I will keep the same intensity as a couple days ago rather than lengthening the exhalation as I had planned.

Posted by: Apollo

Posted by: Allixa

 

Also I'm fairly confident that the expander we have maxes out at 8mm of expansion. I've read that this is standard in a few places, and I just measured the screw in my expander (it's clear acrylic) and it is 16mm long.. and if you take into account the fact that both sides of the expander have to travel on this same screw, you can divide the length by 2 to see how much total expansion the device can do, so 8mm.

Maybe yours is different since you have the y-plate, but I'm not really following your logic for why you would divide the length in half.

@apollo

You're right, my derivation method was wrong. What actually makes sense is to look at one half of the expander and try your best to measure how far it can travel on the screw before it would reach the end, and then multiply that by 2. When I do that on my device I get between 8-11mm depending on how far on the screw it can go before it stops (11mm would put it right before falling off, if it can get there).

I injured myself at work a couple weeks ago. Recovery has taken precedence over my routine. My body posture has deteriorated from the pain. I've largely neglected my chewing and breathing exercises and my mouth taping. I've continued to use my expander every night during sleep, but I've gotten fewer daytime hours, and I've only turned the screw twice. I'm currently at 3-3/4mm. I am beginning to worry that the first bicuspids are shifting and tipping too far to the side from the canines in front of them. Here's one of the results pictures from Dr. Lauson that I posted in the success stories thread, which shows prominent first bicuspids similar to mine.

I really want the second bicuspids and first molars to move farther than the first bicuspids to make my arch more curved. I've toyed with the idea of removing all of the acrylic from behind the first bicuspids so that it would only be pushing on the alveolar ridge above the second bicuspids and the first molars. The acrylic seems to be pressing hardest into the mucosa above my left first bicuspid. For now I have just been filing down the height of the acrylic behind the first bicuspids to help the expander seat correctly.

I advanced the expander screw today to 4mm. I'm not sure how many days it has been since the last turn, but I think it might be more than 5, so I decided that I should move forward, even though it still felt a little tight. I feel some orthodontic type pain in my first bicuspids when I first start to chew after removing the expander. Looking at adult palate expander cases like the one I posted above from Dr. Lauson or this one below from Dr. Mew, I think it is relatively normal for the first bicuspids to be pushed out since the expander moves all of the side teeth laterally by the same amount. 

Based on the feedback I got in the thread called Expander Adjustment (  /community/community/main-forum/expander-adjustment/ ), I think I will remove the acrylic from behind the first bicuspids soon to encourage a more rounded arch, but I am going to wait for another turn or two because I am worried that concentrating the force to the alveolar ridge above the second bicuspids and first molars might make side effects like pressure ulcers, teeth tipping, or gingival recession more likely.

I've noticed when I put the expander in recently that pressing up with my thumbs against the expander elicits a shifting sound in my right ear. This is the same ear that I sometimes hear cracks or pops when I apply the handheld massager against my maxilla. This is the side that is canted lower, so I hope that some of my asymmetry is correcting itself. I suspect that isolating the force to the posterior teeth might make it easier for the asymmetries in the anterior arch to work themselves out since the relative position of those teeth won't be locked in place by the expander.

The Dr. Mew case I posted above is interesting because of the posterior open bite that the patient developed. I started with a mandibular arch that was wider than my maxillary arch but with lingual tipping of the bottom teeth that prevented a cross bite. I'm not sure if I have achieved any uprigting of the bottom teeth. My upper canines and first bicuspids are now noticeably lateral to the opposing teeth, but the second bicuspids and molars still line up pretty well with the bottom teeth. Once I remove the acrylic from the area of the first bicuspids, it will probably start to move the second bicuspids and molars laterally beyond the mandibular arch. Hopefully the bottom teeth will eventually catch up or at least upright themselves.

What I was trying to explain in the previous post is that my maxillary first bicuspids are getting close to the point where their lingual cusps are almost opposite the buccal edge of the mandibular bicuspids. However the lingual cusps of my maxillary second bicuspids and molars are still close to the center of the bottom teeth. The presentation on adult palate expansion we have been using as a resource (  https://www.aaoinfo.org/system/files/media/documents/Handleman%20--%20Point%3B%20The%20Case%20for%20Nonsurgical%20Expansion.pdf ) includes the following advice:

Continue expansion until the palatal cusps of the maxillary molars or premolars are slightly in occlusion with the buccal surfaces of the mandibular teeth.

So considering that is my target, I think it makes sense to soon remove the acrylic from behind the first bicuspids and then continue expanding until the second bicuspids and first molars reach that stage.

Since I completed 4mm (16 turns) of expansion, I decided it is time to take stock of the changes I have observed so far. I've mentioned some of these along the way (  /community/community/main-forum/my-routine/paged/5/#post-1807 ), but now is a good milestone to list them all together. I haven't experienced the kind of life-changing results that some people have reported from using a removable palate expander. I guess I also haven't advanced as far as many of those people yet, so maybe the more dramatic effects are still to come. I have noticed:

- The bridge of my nose is still significantly deviated, but seems to be closer to my interpupillary midline than it was when I started. I measured the bridge of my nose to be initially 4mm left of center. At 3mm of expansion, I measured the bridge of my nose to be about 2mm left of center. Now, it might be incrementally less than 2mm left of center, but it's hard to say. I used to trim my eyebrows so that the space between them was centered somewhere between the midline of my nose and the midline of my eyes to camouflage the deviation. Now I've started trimming my eyebrows to match the midline of my eyes, and it looks better.

- My dental midline was initially 2mm right of center, now it appears to be less than 1mm right of center, but my occlusal cant angles the top of my incisors farther from the true midline.

- My occlusal plane was initially canted about 3 degrees higher on my left side. This hasn't significantly improved, but there might be some minor change. The flaring of my right first bicuspid seems to help level the occlusal plane but I suspect this is a dental rather than a skeletal change, whereas the canine (which no longer has the pressure of the expander on it and isn't tilted) still seems to be canted by approximately the same degree as my baseline.

- Changes to intraoral photography are most obvious around the first bicuspids, and much of this seems to be dental tipping. The contacts between my upper incisors are visibly spaced out from the starting position, but there aren't any obvious diastemas. The initial minor overlap (less than 1mm) of my central incisors is gone, but the right central incisors remains a hair back from the left.

- I think my torus palatinus looks about the same, but maybe the roof of my mouth around the torus has flattened out slightly closer to its level.

- I still have dark circles under my eyes, but I think they might be slightly smaller.

- I've gained a little weight in the past few months, which makes it harder to evaluate if my zygomas or cheek hollows are more defined. Maybe?

- I recently injured my back, so my overall posture has acutely deteriorated.

- I haven't really felt any changes in energy level, breathing, mood, etc.

- It is definitely easier to practice correct oral posture with my tongue firmly seated in the roof of my mouth.

I had to take the expander out of my mouth and reinsert it several times to get comfortable last night before falling asleep, and when I woke up this morning, it still felt tight and my mucosa was a little irritated. I started wondering if I should back the screw off by one turn. Looking at the key hole, I found it had somehow advanced itself by less than a full turn. The hole was not in the position it would be from making a full turn with the key. I measured the separation with a ruler and it was clearly more than 4mm, closer to 4-1/4mm. I backed it off all the way to 3-3/4mm and it felt relatively loose, so I turned it to 4mm where it should have been. It still feels a little tight, but much less uncomfortable than where it had somehow worked itself up to. I'm going to let my mucosa rest for a few hours and see how it feels later this afternoon.

It's been 4 days since I last turned the expander screw. It feels relatively loose, like I'm ready to advance again, but I have irritation in my mucosa at the back right corner by my second molar. I filed off a little acrylic in that area and it seemed to help, but the force still seems to be relatively concentrated there and it is leaving a deeper impression in the mucosa on that side when I remove the expander. I might try advancing and see how it feels, but turn the screw back if it is too tight. I think it is harder to tolerate the discomfort at night when I am trying to sleep and can't take breaks, so I might wait until tomorrow morning.

I advanced to 4-1/4mm this morning, and I've gotten a few daytime hours. It doesn't feel especially tight skeletally, but it is still irritating my mucosa and it feels good to pop it out every so often to restore circulation before putting it back in. We'll see how well I can tolerate it tonight. I'd like to get back to mouth taping, but I've been falling asleep without it to be able to remove the expander as needed.

I'm still at 4-1/4mm. I advanced to 4-1/2mm yesterday, but I had to turn it back to 4-1/4mm to get comfortable and fall asleep last night. I'll try turning it ahead again today and see if I can get enough daytime hours to be comfortable through the night. A couple days ago, I woke up to my own snoring with my mouth open, so I know this is still an issue, and I really wish I could go back to mouth taping. Maybe I need to file down more of the acrylic from the top of the expander to allow me to fall asleep without pausing for breaks. 

Posted by: Apollo

I've noticed when I put the expander in recently that pressing up with my thumbs against the expander elicits a shifting sound in my right ear. This is the same ear that I sometimes hear cracks or pops when I apply the handheld massager against my maxilla. This is the side that is canted lower, so I hope that some of my asymmetry is correcting itself.

I get this shifting sound just from pressing up with my tongue now. I'm also recently hearing a slight shift in my left ear along with the louder shift in my right ear that I have been hearing. I find that I can press up several times in a row and hear the shifting, but eventually it stops. Then if I take a short break, the sound will come back when I press with my tongue again. I suspect there is some play along suture lines, and I hear the sound until the bones reposition to the farthest point they can go and then I stop hearing the shift. If I take a break and reduce the tongue pressure, the bones shift back to a less protruded position and then I'm able to hear the shift as I push them out again. Anyway, at least it sounds like I'm doing something. I haven't tried an endonasal treatment since this shifting sound became frequent and bilateral, and I wonder if it would have a more significant impact with my sutures loosened up. I don't have a lot of extra time right now, but I might try to fit in a session to observe the effect.

I had a bad headache a few days ago, and I've had a slight headache every day since. My sleep schedule has been a little disrupted so I guess that could be the cause, but I am wondering if it could have anything to do with my expansion routine since I've been hearing more significant shifting in my ears recently. With the apparent increase in the mobility of my sutures, it seems like it would be a good time to integrate some extra oral traction. I have ideas for a better strategy to anchor the facepulling that I was doing before deciding that my teeth were bearing the vast majority of the traction from the headgear tubes on my expander. I just don't know when I will find time to build the new system. It could be several months before I have free time to tinker with it, and I might have completed my expansion by then and moved on to stabilization.

Last night was the first time I was able to sleep through the night with the expander screw turned to 4-1/2mm. I've tried advancing it that far on previous days but always had to turn it back to 4-1/4mm to get comfortable enough to sleep. I made some adjustments to the acrylic on the top, front portion of the expander and I think this helped spread the force farther back to the area of the molars. The wires between the teeth seem to be seating better. It still leaves a significant impression in the mucosa at the front of the expander. I still plan to eventually remove the section of acrylic behind the first bicuspids, but I want to put that off for at least a few more turns in case putting all of the force in the area of the second bicuspids and first molars ends up making side effects like pressure ulcers, gingival recession, and teeth tipping worse. My intermolar width is now approximately 38-1/2mm. I want to go at least 1-1/2mm farther, but I don't have much material left above the screw mechanism to be able to adjust the fit.

I was able to keep the expander at 4-1/2mm through the night again last night. I felt a little irritation to the mucosa above my first molars when I removed the expander this morning. For a couple days I was hearing a shifting sound in both my right and left ear when I pressed up with my tongue or thumbs. Now I'm back to only hearing it in my right ear. Before I started expanding, I estimated that my occlusal cant was about 3 degrees higher on the left side and that this might have been an improvement from 4+ degrees at my worst before I started mewing. My cant now looks to be around 2 degrees, maybe less. I'm not sure if this is real improvement or just an artifact of the teeth on my right side tipping to what is closer to vertical. The exception is my right upper canine, which still seems to tilted more lingually, closer to its original angle, and might have regressed back to that orientation after I removed the expander acrylic from behind the canines. 

I advanced my expander to 4-3/4mm last night and was able to sleep through the night with it in place. Yesterday I was hearing the shifting in both ears again when I pressed up with my tongue or thumbs. It's back to mostly the right ear for now.

So can you post about the differences from when you first started to now?

Posted by: Rockyp33

So can you post about the differences from when you first started to now?

I did a few weeks ago when I reached 4mm:

/community/community/main-forum/my-routine/paged/7/#post-3406

Since then, my occlusal cant seems to have improved a little more, but I'm still not sure if this is real improvement of the maxillary roll or just an artifact of the teeth on my right side tipping closer to vertical. When I smile now, the cant is probably something you'd notice only if you were looking for it. Recently, I'm also hearing more shifting sounds in my ears when I press up on my palate with my tongue or thumbs. Something I didn't note in that post is that the crowding of my mandibular incisors hasn't improved at all. Let me know if there are any changes you're curious about that I forgot to mention.

I'm still at 4-3/4mm of expansion. I've noticed that having the expander in place seems to elicit the shifting sound in my left ear when I push up with my tongue or thumbs, but when I've had the expander out for a while I only hear it in my right ear.

I wrote about changing my supplements a few weeks ago. I stopped taking a multivitamin. I've continued taking Vitamin K2, Vitamin D3, magnesium, and fish oil. I've added a B vitamin complex and Vitamin C to fill in for some of the multivitamin, but there are components that I still think I'm getting in inadequate amounts from dietary sources (vitamin A for example, and various minerals), and I would like to stop taking the B vitamin. I mentioned the idea of adding fermented cod liver oil for vitamin A and D, but it is expensive, so I haven't ordered it yet. I also debated changing from fish oil to krill oil because the fish oil sometimes gives me diarrhea, especially if I take it on the same day that I eat fatty fish. The krill oil might have the same effect and it is significantly more expensive, so I haven't made that change yet either. Other supplements that I've debated adding include curcumin, L-tyrosine, CoQ10, and PQQ. Curcumin is an anti-inflammatory from turmeric. CoQ10 and PQQ are both supposed to support the mitochondria for ATP production improving energy, and the L-tyrosine is a precursor for catecholaimes which should improve mood, and adaptation to stress. Since I haven't had the kind of mental impact from palate expansion that I was hoping for, I would like to experiment with some of these supplements, but for now I don't have the budget. I have found a few of these supplements on Amazon's "subscribe and save" feature, but not enough of them to qualify for the 15% off. Maybe I should go back to taking the inexpensive multivitamin for now. Something which might be cost effective would be to add more organ meats to my diet. Liver would especially help with vitamin A and the B vitamins and is supposed to have a kind of feel-good anti fatigue effect. I've been reading on the Weston A. Price Foundation website and elsewhere about methods to take raw grass-fed beef liver. There's some disagreement about how safe this is, even after the recommended 2 weeks freeze to kill parasites. I don't intend to start this practice any time soon, but I am intrigued and want to do more research.

im curious about your results since you started mewing to now unless thats what this is.

Posted by: Rockyp33

im curious about your results since you started mewing to now unless thats what this is.

I noted some of the changes that I saw before starting to use the expander in my first couple post on this thread:

Posted by: Apollo

I've been making concerted efforts to improve my oral posture and swallowing habits for over a year. During that time, I did a couple rounds of self-ncr/nasal release, every day for a week or more. I regularly chew gum with some tongue smashing motions mixed in. I've also tried to be more cognizant of my body posture and sleeping position, but not reliably. I believe I have seen some improvement. I think my dental midline was initially about 4mm right of my interpupillary midline. This seems to be down to about 2mm off. I also think my occlusal cant might be improved by a degree or two, but is still pretty obvious. The bridge of my nose remains notably skewed to the left. It has gotten easier to keep my tongue on the roof of my mouth, but I'm not engaging the posterior 1/3 as much as I would like, and I don’t trust that I am consistent while sleeping. Increasing my tongue space would help catalyze the other changes I want. 

Posted by: Apollo

I mentioned in my last post, that I think these figures show improvement from what I remember before I changed my oral posture. I believe my dental midline used to be about 4mm off center (an improvement of 2mm), and my cant used to be about 4 degrees (an improvement of 1 degree). I didn't measure the deviation of my nose previously, but I think it looks to be about the same.

So I believe I had already achieved some minor improvements to my asymmetry from mewing, posture, chewing etc, before starting the expander, but it seems to have accelerated my progress. I still don't think I've had much forward growth or change in my cheekbones/cheek hollows, but hopefully my improved oral posture with more tongue space will make that more feasible. I'll probably wait until I get to 6mm to write up another summary of my changes and evaluate if I want to continue expanding or switch to stabilization. I would be around 40mm intermolar width at that point.

yeah i dont know much about expansion but i would think that i woould expand it as far as it can go then focus hard on tongue posture so it doesnt regress.

I advanced my expander to 5mm (20 turns) today. It's been 4 days since my last turn. It doesn't feel too tight. I'll try to get in a few daytime hours today so that it will be comfortable enough to sleep tonight. This brings my intermolar width up to approximately 39mm. My preliminary goal has been 40mm, but I will continue on if fit issues and side effects don't stop me. Ronny Ead expanded to 6.5mm on his transverse and sagittal screws before he quit the removable palate expanders due to side effects ( /community/community/main-forum/cautionary-palate-expander-case/#post-1983 ). Since I am only expanding transversely, my side effects shouldn't be as bad, but I have some dental tipping and some minor recession of my gingiva on the lingual side of my left first molar. I'll continue to monitor these things closely. I've debated purchasing Uncle Harry's remineralization powder in the past to help strengthen my enamel (  /community/community/main-forum/alternative-dental-hygiene-and-remineralizing-teeth/#post-2317 ). I wonder if it might help with my gums since it includes marshmallow root which is supposed to sooth mucus membranes. I might go ahead and order some. I might also try oil pulling again.

I was able to sleep through the night at 5mm last night. I tried oil pulling again yesterday. It's hard to say if it reduced my gingival inflammation, but I'm going to keep it up for a while. I don't like that the swishing activates my buccinators, but I haven't had much success atrophying them anyway, so maybe it doesn't matter. I think part of the cause of my gingival inflammation is that the contacts are now looser between my teeth from expansion and from the wires of the expander separating the teeth. This makes it easier to trap food between my teeth. Maybe I need to start flossing twice a day instead of once.

I haven't resumed my breathing exercises since I injured myself at work and haven't had time for all of these extra activities. I want to get back on track with that, probably starting at the beginning of the protocol. I've also been meaning to try a self endonasal release session since my sutures have started making more frequent shifting sounds. Maybe I will get around to that tonight. I think I am going to inflate through my narrower right nostril only, reasoning that it might help align the deviation in the bridge of my nose. I've been debating if I should have the expander in or out during the inflation.

I woke up in the middle of the night and found that I had taken out my expander at some point. When I tried to put it back in it was uncomfortable, so I slept the rest of the night without it. This morning, I turned the expander back to 4-3/4mm and wore it for several minutes and then turned it ahead again to 5mm. It fit, but it felt like the left side was putting disproportionate pressure at certain points. I filed down those areas and it is more comfortable, but might require further adjustment before I try to sleep with it tonight. I have been thinking that I will remove the section of the expander behind my first bicuspids when I get to 6mm. I've mentioned before my concern that it could exacerbate my gingival recession and potentially cause more teeth tipping or ulcers to concentrate all of the force on the area of the second bicuspids and first molars. I'm also concerned that it is difficult to take the expander out by pressing only on the wires between the bicuspids. The wire around my right first molar is broken so I can't press on it, and I would be removing the labial bow. This would leave only the wire around my left first molar and the wires between the bicuspids to pry out the expander when it is tight. I am currently doing my oil pulling session for the third day in a row. I go for about 20 minutes with about a teaspoon of coconut oil. I've read that it is better to do the session first thing in the morning, but I haven't had time and have been waiting until the afternoon.

I had to remove the expander during the night again last night to sleep comfortably. Thinking about how to adjust it this morning, I realized something about the way my expander was made. The left side of my palate started higher than the right. During the course of expansion, it seems to have leveled off a little, but the left side is still a little higher. When my expander was made, they put the screw mechanism level with the roof of my mouth rather than level with the occlusal plane. This means that when I turn the screw, most of that distance goes toward separating the halves of the expander laterally, but a small component of the distance goes toward raising the left side up relative to the right. I think this is why I need to keep filing down acrylic from the top of the left side, but haven't needed to remove much material from the top of the right, except in specific locations. This could become problematic, because the screw mechanism will soon become exposed if I keep filing down the acrylic. It has been three days since I turned the screw to 5mm. I need to be able to comfortably sleep through the night with it before advancing again.

The expander was too uncomfortable to sleep with again last night, so I made some more adjustments this morning. I had to file down the acrylic so much on the left side that the wire where the labial bow is anchored in the acrylic is now exposed. It feels a little better while I am wearing it now, but if I can't sleep with it again tonight I will remove the whole section behind the first bicuspids including all of the labial bow.

Yesterday, I went to a local organic farm and purchased some pasture-raised beef liver. It was already frozen, but I plan to keep it in my freezer for at least an additional 2 weeks to kill pathogens, then partially thaw it to cut into pill-sized pieces, and refreeze them. I'll take a few every day to replace some of the vitamin A, B vitamins, and minerals that I used to take in my multivitamin. Here are a couple websites that describe the kind of method I plan to follow:

http://www.shawnmynar.com/raw-liver/

http://www.primallyinspired.com/friday-favorites-frozen-raw-liver-pills/#

I went ahead and removed the section of the expander behind my first bicuspids (cutting along the dashed line).