[UPDATE as of May 7, 2020] Progress Photos with Proper Tongue Posture

Excellent! How old are you?

@silberman

27

Thank you. Very impressive for an adult.

And you achieved this expansion through tongue posture alone? Did you have any dental treatment done previously?

Also, could you do a rundown of your routine? Technique, chewing, sleeping position, chin tucking etc. 

No, I actually never had any treatment done. I was considering it in the past for that minor dental crowding...but I am so glad I didn't do it at the time. The first thing I need done is expansion and then treatment.

In my case, I've always had a little crowding between my upper and bottom incisors and canines. It's most likely due to a little improper tongue posture at some point during my developmental years. The crowding equates to a degree of transverse maxillary deficiency...which is why I am considering a skeletal expander because mewing can only get me so far.

From my experience...mewing for sure works. It's not some hocus-pocus mumbo-jumbo. But what I also believe is that mewing works to an extent; the magnitude and reach of your results is dependent on your age and how consistent you are. 

@Pame Honestly I don't have a routine but I can give you a rundown of what things I am cognizant of. Nasal breathing isn't just natural, but it's healthy. So ever since I got my tonsils and adenoids yanked out, my life changed completely.  No more anxiety, panic attacks or any of that. Because of how much nasal breathing has helped me, I am also more cognizant of my swallowing physiology...resting face when I am at work, alone or reading something. When I think of mewing, I really think of it as proper tongue posture. Because the models and movie stars you see today with their perfect jaw structures...they weren't thinking "mewing" but they simply had good tongue posture, good diets and a good environment that allowed them not to have stuffy noses all the time from allergies. 

The other two big ones are walking/sitting posture and sleep oral posture. When I walk past mirrors in public and glass window panes I look at myself to keep my posture in check which is supportive of good head and tongue posture. When I'm sleeping, nasal congestion is mega huge. If you aim to breathe through your nose, you need to be able to breathe deeply through the nose without congestion or nasal airflow resistance. Blow your nose, check for allergies, deviated septum, turbinates, and get those over the nose nasal strips. The nose plugs that dilate your nostrils didn't work well for me because they are uncomfortable and fall out during the night. 

Amazing.  Have your teeth moved forward at all, or is it mostly just the palate expanding horizontally?

@DrMario Do you have any tips or ticks to getting the proper technique down? Are there any sensations or other signs you sense or feel that lets you know your technique is correct? Has the sensation of having your tongue against the roof changed as your palate expanded? 

Also, you mention dedication being important to achieving results, how big of a percentage of the day would you say you are in good posture and have correct oral posture?  Are you able to mew at night?

you didnt had a proper lip seal, correct?

@drunkwithcoffee

My teeth have not moved forward. It's really transverse expansion that occured. As soon as I had T&A surgery + turbinate reduction, I was able to breathe nasally without any issues. It's really the turbinate reduction where I experienced a dramatic difference in my ability to breathe through my nose. It's worth noting that if you have ANY issues breathing through your nose, see an ENT doctor immediately. Because when you breathe through your nose, your tongue will always be seated at the roof of your mouth no matter what. If your palate is too narrow and your tongue can't fit, then SARPE or MARPE might be something you ought to discuss with your physician. Once your palate is mechanically expanded, you'll have enough room for your tongue and you can start mewing from there. Achieving proper tongue posture is doable if your tongue can fit on the roof of your mouth.

@dm222

I actually have always had proper lip seal, due to the fact that I never had a crossbite or any malocclusion to begin with. It's just bad habits, poor posture, improper swallowing, allergies and swollen tonsils that attributed to my inadequate nasal breathing, which preferred me to be a mouth breather...which is how I landed with a not-so-wide palate.

@Pame

If by "mewing at night" you mean while I am sleeping, then it's hard to tell if I am mewing during my sleep. But I have been using an iPhone app called "SnoreLab" which is an app that records the noises I make while I sleep. It even constructs waveform from the noises it records. Advice: Turn your fan off and keep your phone close to you as much as possible if you use this app. Before my tonsil surgery, I sounded like Bowser experiencing defeat...but now I don't hear any snoring and it doesn't sound like I am breathing through my mouth anymore...which is cool. But I can tell there is a degree of nasal breathing resistance and I can probably improve that with a skeletal expander. The wider your palate is, the wider your nasal floor is which improves the maximum volume of air you can take in with every breath through your nose. 

As far as how often I mew, I really don't stress it. I will hard mew maybe every other morning at my desk while I am at work for 2-3 hours and that's it. When I mew, I press my entire tongue against my palate. I start by saying the word "SING" and when I get to the "NG" part, I know where the position of my tongue should be and lay the rest of my tongue flat from there. When mewing, keep in mind not to get the forces confused between clenching your upper + lower teeth with the forces exerted against your palate by your tongue. Your teeth will be touching lightly if you're doing this correctly; if your teeth are clenched, you're probably not.

But whether I am mewing or not, I am always breathing through my nose, which means my tongue always sits on my palate the entire day...and that alone makes a huge difference. Mewing is basically proper tongue posture but being pushed to a higher gear for accelerated results. And then Skeletal expansion is like a Gameshark code....gives you 5-8mm or so of expansion...in about a month. Having proper posture and breathing habits...like I wrote above and in another post...changed my life for the better.

your front teeth were tilted forward and now are normal, thats why I ask

did you use braces or did a treatment at any point in time between 2014 and 2019?

also what is your age?

@dm222

Wow, thanks a lot for pointing that out...I did not notice that until I read your message! I guess those teeth did shift.

I actually never had any ortho done and I'm 27. I'm strongly considering getting a skeletal expander and then braces.

You would be wise to look into Maxillary expansion.  Your case doesn’t look too severe, probably because of all the effort you have put into your myofunctional habits.  Did yourself a great service clearing out your airway.  You have done all the preliminary stuff right, so why not complete your case and get into an ALF or MSE?

The x rays seem much wider than your pallete which one is your progress

Sorry for the late reply.

@Rhoste
Yes, I agree that my case isn't too severe but two different orthodontists told me that my IMW is rather narrow at 33mm. The orthodontist that I am currently working with talked about achieving 10mm of transverse expansion using the MSE with 9 months of retention.

I just got my spacers removed today and he went ahead and scanned my mouth and sent the images over to the lab for the MSE appliance. It should be installed hopefully before the end of this month.

@Rockyp33
All those CBCT x rays are the recent ones from February of 2019. The first (wider) arch is actually the lower arch, then the narrower arch is the upper arch. I apologize for the confusion.

did you measure your intermolar width before and after? What was the difference? 

@mscottxy

Great question. The ortho I was at in 2014 didn't bother measuring the IMW...but in the after photo, at the narrowest points was measured at 33mm. Stay tuned because hopefully before this month is over I should have my skeletal expander installed! And he predicts 10mm from that alone...and I will be mewing....so I am hopeful for some good changes coming.

I updated my original post. I installed the skeletal palate expander! I am currently expanding at one turn a day.

Good stuff...who is your doctor?

UPDATE: January 5, 2020:

Looks nice! How much expansion are we at right now?

@oatmeal

I will find out the actual amount later this month, as my orthodontist will measure and take a new CBCT.

Can anyone tell me if my changes are purely skeletal or is it just me that thinks that some teeth tipping occured? I don't really see a change in my nose after expansion. I'm not sure if the palatal split was parallel as I hoped for. Because I have yet to see diastema formation.

how did they put it the MSE in was it like just by your orthodontist with just under anaesthesia so you don't feel a thing

or in surgery under narcosis? so like in a sleep

@mr-mewing

great question. i was not sedated, a topical anesthetic was used for the installation of the appliance (i think it was novocaine) my orthodontist injected a certain amount of novocaine into the palatal tissue, then proceeded with the micro piercings of my suture to weaken it and then installed the MSE.

after 2 hours, i was in an incredible amount of pain, i had to leave work. i couldn't think straight

i didn't feel anything at all. there was no pain until the 2 hours elapsed to which to novocaine wore off

Posted by: @drmario

@mr-mewing

great question. i was not sedated, a topical anesthetic was used for the installation of the appliance (i think it was novocaine) my orthodontist injected a certain amount of novocaine into the palatal tissue, then proceeded with the micro piercings of my suture to weaken it and then installed the MSE.

 

after 2 hours, i was in an incredible amount of pain, i had to leave work. i couldn't think straight

 

i didn't feel anything at all. there was no pain until the 2 hours elapsed to which to novocaine wore off

Jesus that sounds horrible that one of the reasons why I don't wanna do MSE, MARPE or SARPE I hoped they did brought you like asleep in anesthesia

and the horrible pain after man.

but how do they remove it after it expands?

and another question how are you going to expand the mandible?

and now your maxilla is expanded is your mandible going to shift forwards?

@mr-mewing

i have to admit, there were moments when i regretted doing it. the pain was so excruciatingly bad 2 hours after the novocaine wore off and the pain was really bad for the next week. 

the reason why there was so much pain was because of tissue impingement. dr. moon himself warned me tissue impingement would occur from the acrylic pad they used when fabricating this appliance. so i always had that sharp pain on my palate because of the acrylic pressing against it.

In the end, i do and don't regret doing it. reason i regret doing it is because i should have waited until 2020 when dr. moon releases his latest version of the MSE. this version is designed for smaller palates to begin with, like mine. BUT...can you fault me? how on earth am i supposed to know? the lab didn't have the won moon MSE that would fit my mouth, so they custom made this. if you can see from my pictures....there is a noticeably big amount of expansion, but it's not parallel expansion...which is the most desirable direction of expansion. i can tell it's not parallel due to me not having any diastema to form at any point during my expansion. nasal breathing is sort of the same...i mean if there was a difference it's barely noticeable. what's done is done...and i'm not sure if we can go for another around of expansion using MSE. i will see what my cbct looks like.

as for the mandible, there are two surgeries used to expand the bone and in my case i got a little lucky. my mandible looks like it grew in fine but my teeth are tipping inward on the lower arch while my teeth on the upper arch are tipping outward. my orthodontist is going to tip my upper teeth inwards and my lower teeth outwards to harmonize occlusion after expansion.

@DrMario You say MSE, so does that mean that something is screwed into your palate? It doesn't seem like it. You personally told me in another thread that in adults, expansion devices need to be bone borne in order to cause maxilla expansion.

@jelly

Yes it is screwed into my palate. Those four blue points you see on the surface of the appliance is dental wax covering the screws.

@drmario

Great. And you didn't need a surgery with it, just this screws installed by your orthodontist? I'm wondering if it's just as effective as the type of surgery where they install screws and cut the suture. Did you feel your suture split? How did you find your orthodontist? I can't find any in my country that does bone borne expansion.

Posted by: @drmario

 1

dr. moon himself warned me tissue impingement would occur from the acrylic pad they used when fabricating this appliance. 

2

In the end, i do and don't regret doing it. reason i regret doing it is because i should have waited until 2020 when dr. moon releases his latest version of the MSE. this version is designed for smaller palates to begin with, like mine. BUT...can you fault me? how on earth am i supposed to know?

3

the lab didn't have the won moon MSE that would fit my mouth, so they custom made this.

Thank you very much for sharing.

i was hoping you might share some of your experience selecting your orthodontist to oversee the MSE process.

im considering flying into California to work with Dr. Ting at Ting Orthodontics.

However I haven’t done a thorough review of MSE practitioners.

Dr. Ting advised that Won Moon had retired as a practitioner, moving on to the MSE development and lecturing around the world. 

1 

who is your orthodontist?

where are they based?

what is their experience with MSE?

what convinced you to work with them?

was Won Moon involved?

2

how did you hear that Won Moon was developing a smaller appliance?

has that appliance now been developed?

if so, is there any information you could link us to or direct us to?

3

which lab designed your custom appliance?

did they work with Won Moon and/or his team in designing your custom appliance?

was the need for the custom appliance centred on your palate being too narrow for the MSE appliances currently widely available, or was it to fasten the acrylic pads—and what is the thinking behind having the pads vs not having the pads? I would think that the pads & the teeth Anchorage is purely in having the screws inserted into their correct positioning, from their the anchorage would be purely bone born, rendering the acrylic pads moot? Is it to avoid screws tipping? 

Feel free to message me if you’d prefer to keep anything confidential. 

Thank you again for sharing.