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Alyssa Luck

Alyssa Luck

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AGGA Before & After – 10mm Expansion

Alyssa Luck · Jul 17, 2020 · 10 Comments

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…)

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Comments

  1. Danielle Holland says

    August 9, 2020 at 5:37 pm

    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

    Reply
    • Alyssa Luck says

      August 18, 2020 at 7:03 pm

      Thanks Danielle!

      Reply
    • Luke Sturt says

      February 22, 2021 at 5:44 am

      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.

      Reply
      • Alyssa Luck says

        February 22, 2021 at 10:22 pm

        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!

        Reply
  2. camille says

    August 18, 2020 at 1:43 am

    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

    Reply
    • Alyssa Luck says

      August 18, 2020 at 5:15 pm

      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.

      Reply
  3. CAMILLE says

    August 18, 2020 at 1:51 am

    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.

    Reply
    • Alyssa Luck says

      August 18, 2020 at 7:02 pm

      Thanks, that’s an idea! I should try that.

      Reply
      • Tyler says

        October 22, 2020 at 6:49 am

        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.

        Reply
        • Alyssa Luck says

          October 28, 2020 at 5:53 pm

          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 🙂

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Hi! I’m Alyssa. I like thunderstorms and cats, hate wearing shoes, and enjoy devising extensive research projects for myself in my free time. This is me in Bali with a monkey on my shoulder. And this is my blog, where I muse about health-related topics and document my relentless self-guinea pigging. If you want to know more about me, click here!

alyssa.luck

alyssa.luck
Photo dump from the last year. Thanks to everyone Photo dump from the last year. Thanks to everyone who made 28 the best yet - excited for 29🥰

(PS. In case anyone wants to know what it’s like in my head, I was going to write something like “year 28” or “my 28th year” but then I realized that the year between your 28th and 29th birthdays is not your 28th year of life, it’s your 29th year. I am turning 29 because I have been alive for 29 years. So then I had a whole thing about how to word it without being inaccurate and ended up going with what you see above which is vague and weird but the point is it was a good year and I love all the people in my life dearly)
Biology of Belief (2005) was written by Bruce Lipt Biology of Belief (2005) was written by Bruce Lipton, who earned a PhD in developmental biology in 1971 and was an anatomy professor and academic researcher in the 70s and 80s. Despite the book's presentation and Lipton's background, this is not a science book. It is an exposition of an ideology, supported by haphazard and poorly contextualized nuggets of evidence, rhetorical leaps, and a mind-boggling overuse of analogies. 

The book largely failed to deliver on its promised content. What it does is argue for the primacy of the environment over DNA in controlling life; propose that the cell membrane rather than the nucleus is the "brain" of the cell; invoke quantum physics to explain why modern medicine fails; explain that our behavior is largely controlled by our subconscious mind; inform parents that they therefore have a great deal of control over the destiny of their children; and conclude that humans must become nonviolent protectors of the environment and of humanity because Everything Is Connected.

It’s not that these points aren’t relevant to the topic at hand - they are. But they were not connected in a coherent way that would explain how “belief” actually works (like…biologically), and the treatment of scientific concepts throughout was careless, or perhaps disingenuous.

I think he's correct about many things, some of them being common knowledge. For instance, the "new" science of epigenetics is now old news, as is the critical role of parenting and early environment in shaping a child’s future. But however important these and attendant concepts may be, the book did not do a good job explaining, supporting, or connecting them. 

As far as practical guidance, he refers the reader to a list of resources on his website, which is fine, but I expected some scientific insight into how/why those modalities work. None was given. 

On the plus side, the book was quite thought-provoking, and I came away with loads of references and topics to follow up on. My favorite line? "There cannot be exceptions to a theory; exceptions simply mean that a theory is not fully correct."
Friedrich Nietzsche, The Gay Science (section 382) Friedrich Nietzsche, The Gay Science (section 382), as quoted in the introduction to Thus Spoke Zarathustra because I like the translation better.
This paper totally changed the way I think about e This paper totally changed the way I think about early nervous system development and the relationship between physiology and sociality. 

The authors propose that newborn babies are not inherently social, and have just one goal in life: physiological homeostasis. I.e. staying alive. This means nutrients, warmth, and regulation of breath and heart rate, i.e. autonomic arousal (it’s well-accepted that newborns sync their breathing and heart rate with caregivers through skin to skin contact). 

All these things are traditionally provided by a loving caregiver. So what the baby experiences during the first weeks of life, over and over, is a shift from physiological perturbation to homeostasis (a highly rewarding event inherently) REPEATEDLY PAIRED with things like the sound of a caregiver’s voice and seeing their face. Thus, over time, the face/voice stimuli become rewarding as well. 

The authors argue that THIS is the beginning of humans’ wiring for sociality, and may explain why loving social interactions can have such a profound regulating effect on physiology throughout life: because the brain was trained for it at an early age. 

This framework holds all kinds of fascinating implications for what happens if that initial “training” isn’t so ideal. What if the return to nutritional homeostasis via feeding is paired with negative expressions and vocalizations rather than loving ones, perhaps as could occur with PPD? What happens if the caregiver has poor autonomic regulation, such that social stimuli become paired with cardiorespiratory overexcitement in the baby? Could that have potential for influencing later introversion vs extroversion? (Because if social interaction is paired with autonomic overexcitement, that could lead to social interaction literally being more energetically draining, which is what introverts experience. Thoughts?)

For my energy metabolism enthusiasts: Table 1 in the paper draws a link between metabolic rate and sociality across species. Swipe for a screenshot. 

Anyway, check out the paper! It’s free, just google “growing a social brain pdf.”
I’ll be under general anesthesia in a couple day I’ll be under general anesthesia in a couple days to have two tooth implants placed, and I think I’ll take the opportunity to have a little heart-to-heart with my subconscious mind. A bit of medically-assisted self-hypnosis, if you will. 

I randomly stumbled upon these papers a couple months ago - an RCT showing reduced post-op pain in patients who listened to recorded positive messages while under general anesthesia, plus a post-hoc analysis of the same data that found reduced post-op nausea and vomiting in a subset of high-risk patients. 

The full review paper from the first slide is unfortunately in German, but it has long been recognized that even when unconscious, the patient is listening (for better or for worse). 

It boggles my mind that it isn’t standard of care to have patients listen to recordings like this while under sedation, considering that almost nothing could be easier, safer, or cheaper, and we have at least some evidence of significant efficacy. I mean c’mon, what more could you want from an intervention? 

(Yeah, I know. Profit. If anyone still thinks that our medical system operates with patient well-being as the foremost goal, you’re deluding yourself.)

“There should be a fundamental change in the way patients are treated in the operating room and intensive care unit, and background noise and careless conversations should be eliminated.”

“Perhaps it is now time to finally heed this call and to use communication with unconscious patients that goes beyond the most necessary announcement of interventions and is therapeutically effective through positive suggestions. When in doubt, assume that the patient is listening.”
If you've seen "vagus nerve exercises" that have y If you've seen "vagus nerve exercises" that have you moving your eyes or tilting your head, you've probably encountered the work of Stanley Rosenberg. The exercises he created and introduced in his 2017 book now appear in instructional videos all over the internet. 
 
The book itself has much to recommend it: it's accessible, it's practical, it's inspiring. But it has one major flaw: the solid practical and informational content regarding the cranial nerves is framed in terms of the scientifically dubious polyvagal theory. 
 
I particularly enjoyed the book as an introduction to the therapeutic arena of bodywork, of which Rosenberg is a skilled practitioner. His book is full of case reports that demonstrate how immensely powerful extremely subtle movements and physical manipulations can be. These do need to be kept in perspective: it's a small sample size of the most remarkable cases, and the results were achieved within the supportive clinical environment of a skilled practitioner. You can tell from his descriptions how refined his technique is. But nevertheless, it was a paradigm-shifting read for me, and the exercises give you something concrete to play around with. 
 
The book also brought the cranial nerves and the concept of “social engagement” to the fore as arbiters of health. Rosenberg has a solid background in cranial nerve anatomy and shares many interesting tidbits and considerations that you don’t typically hear; for instance, the potential impact of dental and orthodontic work on cranial nerve function.
 
So, is it worth reading? If any of the above piques your interest, go for it! Just read my post on polyvagal theory first – you can use the book to practice separating the wheat (solid informational content) from the chaff (pseudoscientific framing). If nothing else, the book is a nice reminder that genuine healers who get lasting results for their patients do exist.

But if you just want to try the exercises, you can easily find them all on YouTube. 

“You learn techniques to understand principles. When you understand the principles, you will create your own techniques.” -Stanley Rosenberg
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