Hello, i am 22/M. I have been mouth breathing since i was born(deviated septum) and never closed lips.
At 19 i fixed deviated septum sith surgery. Also at 19 i had teeth protuding my upper lips with recessed chin far down which had wierd dots if i try to close my lips (uneven downswung and recessed maxilla with narrow palate i think?)
Parents found me cheap orthodontist and she extract four molars since it was overcrowded and put braces, i found that it was not making my face look better. Found about tongue posture and bad effects of extraction. Stopped my braces treatment.
My teeth relapse and right side of upper palate open around 3mm where teeth was extracted(which is more up and forward). Left side of palate(more downswung and recessed) open around 1mm at tooth extraction space.
Lower palate extraction space both side is open 1mm if im being generous
Upper palate intermolar i think is 33-34mm
Lower palate intermolar is 28mm
My mew line indicator is 55-58mm i think.
My chin is 45-50mm behind upper lip.
My zygo width is 14-14.5cm
I have tried tongue posture but it is hard because i do not have space to fit tongue and if i try to force it it goes to more forward and upward side of maxilla which make asymmetry worse and may cause TMJ i think because i have uneven bite right now and hear clicking jaw lock sounds. I have tried open mouth chewing it doesnt work, i cant feel anything on recessed side ( i thought chewing might fix asymmetry)
Also i do not have any orthtropic practicioner/ALF nearby(i live in hong kong). I have some functional orthodontist i dont know if they will work but i am scared to make any other mess of my face. If i go to other country for treatment i am afraid i cannot afford all the flight tickets and the treatment cost together.
I am not sure what to do. I think i should get ALF to fix asymmetry first. Then expand upper palate (i dont know the expansion rate i should go with). I dont know what can we done for lower palate expansion (i want to avoid surgery). Then reopen extraction spaces and get implants.
Extra questions i wanted to ask.
Does expanding palate with ALF or appliances move the teeth upward too? Or only horizontally outward.
How will the practicioner fix asymmetry(i think one eye is lower than other).
Should i stop mewing because it is just make asymmetry worse?
How does chin come forward by expanding upper palate intermolar width?
What are effects of expanding intermolar width?(wider zygo, wider nose?) What else?
How does chin come forward with expanding upper intermolar width?
What are effects of expanding lower intermolar width?
If i reopen lower palate extraction and get implants, will my chin protude? (I had strong square wide jaw and wide big chin as 3 year old) i can feel it with my hand but there it too much skin on it
How can i expand lower intermolar?
What is swallowing posture expansion rate? I find it hard since i cant fit my tongue and also palate is uneven.
Will opening upper extractions move maxilla forward only or also upward? I have gummy smile.
What are the realistic expectations and how much progress can i make in about 2 years?
Realistically how much can i expand my upper and lower palate in a year? What is recommended expansion rate and form?
What should i do?
Please take it seriously. I am depressed i used to be happy toddler, it all got ruined when i was 12years old. I feel like my parents neglected me. They knew i cannot breathe through nose. My uncle said he will get me treated but then my parents refused.
I started with 34mm intermolar width like you. Over the past few months I have expanded to just under 40mm intermolar width. This has made it much easier to achieve correct tongue posture, and it has improved (not totally corrected) my asymmetries.
Dr. Mew's note in the comments of his video on intermolar width is interesting:
"Important note; 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, and as a rule of thumb when I finish therapy any one who can maintain 38mm or more without retainers tends to maintain good alignment almost indefinitely, with a minimal effort. During childrens treatment expand to 42mm for a girl and 44mm for a boy, clearly some of this is tipping of the molars. Ancient man had an inter-molar width in the high 40's to low 50's."
Since our starting intermolar widths are so narrow that correct tongue posture is infeasible, a palate expansion device is a good place to start. If I were you, I would contact one of your local functional orthodontists and use whatever type of palate expander they recommend. I used just a conventional schwarz-style expander. Dr. Mew recommends expanding at a rate of about 1mm per week for "semi-rapid expansion." However, I think the rate depends on several factors including your age. I turned my expander screw 1/4mm when it no longer felt tight in my mouth, but no fewer than 2 days and no more than 5 days between turns. It got harder to turn later in the process, requiring adjustments to the fit of the acrylic framework to fit my changing palate. Once you get adequate tongue space, it is much easier for oral posture to achieve the desired effects. That's when you might see some forward/upward maxillary growth/movement with mandibular upswing/remodeling. At least that's what I am hoping. I am still using my expander to help stabilize my progress for the next few months, but I have finished turning the screw.
Thank you for replying. I am worried because i have asymmetry which i want to fix and am worried that functional orthodontist may mess it up. Since i have different space in open extractions spaces(one on right has 3-5mm) on left extraction space it has 1mm, i think i should reopen extraction spaces first since it will balance the forward growth from opening extraction spaces, then maybe it will be wiser to expand palate to fix asymmetry?
What are all the effects of expanding palate? How do i go about expanding my lower palate? I want to avoid surgery. Will opening lower palate extraction space push my chin forward?
About expansion rate, what are the pros cons of expanding at rapid/semi rapid/slow rate? What about holes in front teeth when expanding fast? What would it mean? I want to expand in a way it moves my maxilla upward and forward. I am not sure if its possible. How should i go? Expand palate for tongue posture first? But i still cant fit entire tongue without reopening extraction spaces. Will expanding also move my eyes width? What about zygo width? Will zygo go horizontally expand or will it also move upward when expanding? Since it will be going from v arch palate to U, will zygo also move forward?
If anyone can please also answer as many questions possible and guide me on my next steps.
Thank you for replying. I am worried because i have asymmetry which i want to fix and am worried that functional orthodontist may mess it up. Since i have different space in open extractions spaces(one on right has 3-5mm) on left extraction space it has 1mm, i think i should reopen extraction spaces first since it will balance the forward growth from opening extraction spaces, then maybe it will be wiser to expand palate to fix asymmetry?
What are all the effects of expanding palate? How do i go about expanding my lower palate? I want to avoid surgery. Will opening lower palate extraction space push my chin forward?
About expansion rate, what are the pros cons of expanding at rapid/semi rapid/slow rate? What about holes in front teeth when expanding fast? What would it mean? I want to expand in a way it moves my maxilla upward and forward. I am not sure if its possible. How should i go? Expand palate for tongue posture first? But i still cant fit entire tongue without reopening extraction spaces. Will expanding also move my eyes width? What about zygo width? Will zygo go horizontally expand or will it also move upward when expanding? Since it will be going from v arch palate to U, will zygo also move forward?
If anyone can please also answer as many questions possible and guide me on my next steps.
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