Hey folks! I’m finally getting around to sharing my long-awaited before/after pics from AGGA. These are not final before/afters, because I still have to go through the CAB (braces) phase, but CAB shouldn’t give me any significant additional expansion, so I don’t expect the final photos to be much different aside from no more gaps and (hopefully) better posture.
Things to note:
- I realize the lighting is inconsistent. When we do FINAL final pics, I’ll ask them to make sure they match it up better. (And will try to match hair/clothes, etc etc)
- I started AGGA May 22, 2019, and finished (and moved onto CAB) on June 9, 2020, so almost exactly a full year of expansion
- I was 25 years old when I started, now 26
- Final measurements were 10mm expansion on both sides
- My first AGGA broke around November/December 2019, so I was in a retainer for a month while they made me a new one, which means I averaged just under 1mm of expansion per month
- I admittedly have not been nearly as dedicated to tongue/posture exercises during this process as I should have been, but am redoubling my efforts for the CAB phase and trying to cement better habits. Although you can see my posture has improved somewhat, there’s still lots of improvement to be had!
- Looking better was never the reason for taking on this absurdly expensive, somewhat unpleasant, and slightly risky process, but it’s a definite side-benefit. It’s an inescapable fact that with human bodies, physical beauty is often very closely tied to proper function.
Now, onto the pictures. Scroll to the bottom for additional commentary from yours truly re: my goals for the treatment and whether I’m happy with the results so far.
No room for tongue = double chin 
Less double chin, more lip support 
It’s super obvious in this pic how recessed my upper dental arch was. Thanks childhood braces. 
Better! Honestly could probably use more expansion, but I think that would be pushing my luck. 
I look like I’m having an existential crisis 
Kinda looks like my face got MORE asymmetrical, but could also be the lighting. Still in the habit of almost always chewing on the right side, but this should improve after my teeth actually touch on the left so I can chew more evenly. 
Existential crisis = resolved 
Even with the giant gaps, my smile definitely looks better now! Nifty. 
10mm gaps on either side 
Had small gaps from prior expansion attempt, which closed naturally over the course of AGGA (nice side benefit!) 
Gum recession on canines. Dr. Suh isn’t worried – says this happens to everyone and should resolve. 
Again, gum recession apparent. 
Are you happy with your results so far?
Provisionally, yes! It did the thing that I wanted and expected it to do, which was to create more space in the front of my mouth.
In my previous post “Why I Decided to Try AGGA (plus some lingering concerns)”, I listed out all the things I was hoping to address with AGGA. Here’s my assessment of whether these goals have been achieved yet.
- Clenching/grinding at night: No. Of course there’s no way to know for sure what happens while I’m asleep, but I still find myself involuntarily clenching while I’m awake, so I’m fairly certain I still do at night. My guess is that my masseters are so used to being overactive, and my tongue underactive, that I’ll need to strengthen my tongue quite a bit more before those unconscious habits fully resolve.
- Poor occlusion (front incisors hit end-to-end): Yes! Absolutely resolved. I got 10mm of forward growth, so my jaw can come as far forward as it wants now.
- Poor occlusion (only my right molars touch): Not yet. The bite pads have given me some ability to chew on my left side, since we make them much larger on the left than the right to account for my uneven bite, but it’s still not the same as having proper tooth-on-tooth occlusion. This should be resolved in the braces phase that I’m in now.
- TMJ concerns: Sort of. Because I don’t have a proper stable bite yet, I don’t think I’m necessarily chewing optimally yet, HOWEVER, I certainly no longer have to pull my jaw back in order for my teeth to fit together. I can feel the muscles gradually settling into a more natural bite, and I haven’t noticed jaw soreness recently, but I never had too much to begin with, so I don’t want to frame this as any kind of revolutionary thing. That said, I have full confidence that once the whole process is over, I have proper occlusion, and I’ve successfully re-trained my jaw/cheek/tongue muscles, I won’t have any remaining concerns about TMJ health.
- Lack of tongue space: Mostly? I have 10mm more forward space than I used to, which is HUGE, but it’s still not the same as if my facial bones had developed properly in the first place. But I’d say I now have enough space to keep decent tongue posture, and am optimistic that good posture habits over a long period of time will further improve structure and increase tongue space.
- Better profile: Heck yeah. It is now moderately less horrifying to see pictures of myself from the side. Score.
Did your lower jaw come forward as you created space? Or do you have an overbite now?
It did, in fact! More so than I expected. And no – no overbite, although I did have an overbite at a few points during my expansion.
Granted, the main reason I did this treatment to begin with was because my lower jaw wanted to be more forward than it was allowed to be, but what felt like my “natural” bite at the start of treatment was where my incisors touched end-to-end. If that was actually my natural bite, I would’ve only needed a few mm of forward expansion to accommodate that.
What actually happened is exactly what my dentist said would happen: with the new leeway to freely shift around (provided by the bite pads), my jaw gradually moved into a more forward position as my upper teeth moved forward.
Towards the end of the expansion process, there were times where I consciously had to push my jaw forward to avoid having a crazy overbite, but now my jaw seems to have very gratefully accepted all 10mm of extra space we’ve given it, and is settling nicely into its new forward position. Keeping proper neck posture helps with this as well.
Do you still have concerns about gum recession or losing teeth?
Definitely. In fact, after posting a video recently on this topic, Ronald Ead himself reached out to me privately to express concern and warn me about the dangers of AGGA. He personally has loose/unstable front teeth that he attributes to AGGA, and knows several people who have actually lost teeth (and with no chance of implants – aka my worst nightmare).
On the other hand – my dentist isn’t worried, my front teeth don’t feel loose, and no matter how many horror stories surface, there are plenty of success stories too. At the end of the day, it’s a risk I just have to accept, and hope that I’m one of the success stories.
That said, I do plan to ask my dentist at my next appointment how he monitors the health of those front teeth, and in what situations he would abort the mission. Just because a risk can’t be fully mitigated doesn’t mean I should just sweep it under the rug and not monitor it or come up with contingency plans. (Although I have to say…I’d much rather just live in denial and hope that nothing bad happens…)
My jaw is the same way. Pushed too far back by Orthodontics, like my incisors get in the way of my mandible being where it should be.
You are looking a lot better after your treatment. Seems like your canthal tilt improved like crazy in the smiling photos!
It’s nice to know that Ronald Ead has spoken to you. I was thinking of sending him your blog haha
Thanks Danielle!
I think Ronald has pushed the FAGGA anterior growth expectations too far and that could be a possibility that explains why he has had alveolar bone density loss.
He was also unfortunate to have undertaken the plastic palatal expansion device before the AGGA. He has had massive amounts of orthodontic “trauma” consecutively.
Modern humans have deficiencies in Jaws from the lack of developmental stimulus from our diets and poor muscular postures of the entire cranio-facial apparatus. My opinion is that AGGA practitioners should attempt only as much forward growth that is necessary to safely achieve a functional dental occlusion with cranio-facial improvements that support good jaw positioning and alleviation of TMD symptoms.
I too have been undertaking the FAGGA and CAB for approximately 3 years now and have huge improvements in my quality of life. Epigenetically it was explained to me that I would have had 18mm of extra anterior growth of the maxilla if I lived in pre-historic times, however this was noted by my practitioner to be unachievable when you balance in modern human facial aesthetics and mandibular length and angulation. We come to orthodontic practitioners already broken and damaged from a lifetime of poor oral function and environmental stimulus. My practitioner safely settled on the goal of 6mm forward growth that was calculated to give relief from symptoms of TMD and reduce the risks of complications. I think we achieved around 8mm of forward growth just guessing from self taken photos of the upper dental arch during the expansion phase. In Ronald’s case his anterior growth of his maxilla has likely exceeded the length and angulation capabilities of his mandible causing an anterior displacement of his mandibular condyle when he aligns his bottom teeth with his top teeth (the Temporal Mandibular Joint). The AGGA appliance does not claim to increase mandibular forward growth or length but the entire process aims to free the tension associated with the cranio-cervical-temporal musculature chain that over time is causing a posterior retraction of the mandibular apparatus. This posterior retraction is what causes all of the problems with facial development, airway occlusion and tongue thrusting swallow patterns. (or has resulted from this poor stimulus during formative years.)
Once the muscle tension is eased the mandible can then re-position itself forward in a more natural alignment where muscle tension is eased. This in turn opens the posterior oropharynx and airway due to the anterior repositioning of the tongue concurrently with the mandible.
I’m due to have the braces removed in 2months time. I can’t thank my practitioner enough for the profound impact the AGGA and CAB has had on my well being and quality of life.
I think it is imperative that practitioners of AGGA and patients alike have respect for what is physically attainable without inadvertently risking detrimental catastrophic consequences of trying to push the device too far. Our genetics may not have changed much since prehistoric times but our modern lifestyles and diets have. I for one will assure that my children are exposed to better oral habits, postures and developmental environmental stimulus that will facilitate great jaw development.
Hey Luke – thank you for this comment! I totally agree. It’s frustrating to me that issues like this always polarize into black and white – either AGGA has some magical mechanism by which it can grow new bone infinitely until full genetic potential is reached with no risks…or AGGA is dangerous and is always a bad idea for everyone. I think everyone would be better served if the community were able to openly acknowledge the risks, address the factors involved in cases with bad outcomes, and have a clear and frank assessment of risks vs. benefits for each individual case to decide where that balance falls.
For me, both aesthetically and based on my jaw position, I could ABSOLUTELY have used more forward expansion. But given that I already had a full cm on each side, I didn’t want to push my luck, and my dentist was happy with where I was at. I’m hoping I can encourage more growth throughout the rest of my life by practicing proper tongue posture and such (which is much facilitated by the room the AGGA has already given me), but I don’t expect perfection! I’m happy with progress.
Very happy to hear that you’ve had a positive experience, and good luck with your last couple months! Would love to see before/after photos once you get them off, if you want to share!
PEOPEL in this facebook group seem to take the CBCT and consult with orthodontists, periodontists to decide whether or not they should abort mission
https://www.facebook.com/groups/259482145180556
Oh, thanks for this! Had no idea there was a FB group for failed AGGA cases. I’ll have to check it out – might be interesting to see what people have to say.
have you tried counting number of times you chew to break that habit ? like chew 5 times on the left, chew 5 times on the right, etc.
Thanks, that’s an idea! I should try that.
Hey Alyssa! I’ve been following your journey with AGGA. Just wondering if there are any updates as of October 2020? Hope it’s going well.
Hey Tyler! Yes, all is well! I have my next appointment next week, so I’ll try to make an update video after that. Only reason I haven’t updated more recently is because nothing eventful has happened – just trucking right along with the CAB 🙂