Functional Orthodontics & Orthotropics

Hi friends! Today I bring you the news that after 1.5 years in controlled-arch braces (CAB), and over 2.5 years since beginning my AGGA journey, I have decided to quit CAB.

It’s not quite as dramatic as it sounds – I do have to finish up treatment somehow, after all – but this decision did come about in concert with a decline in confidence with the CAB process in general, so I want to share my rationale and current thoughts.

If you’d rather watch/listen to my updates, you can check out the two videos at the bottom of the post. (As a reminder, I do try to post updates to YouTube regularly, and I’m usually a bit delayed posting them to the blog, so subscribe on YouTube if you want to see updates right away.) I also linked all my AGGA update posts/videos to date at the bottom of this post.

[Read more…] about Quitting Controlled-Arch Braces [AGGA 2.5-year update]

Hey friends! Latest AGGA/CAB video update is up on YouTube, and as promised, below is a snapshot from my CBCT scan.

First, to summarize the video: this was supposed to be the appointment where my dentist showed me my CBCT results, told me that I had plenty of space and bone for implants (as expected), and referred me to the implant dentist for an initial consultation and to get on the books.

INSTEAD, he told me that despite having 7mm gaps in my mouth, I do not have 7mm gaps between the roots below the surface, which means not enough room for implants.

This was a huge bomb drop, since we’d been aligned from the beginning that the plan was to do implants, and he never once had any doubts that that would be possible for me. Up until he looked at the CBCT.

[Read more…] about CBCT Results: An Update on Implants [AGGA/CAB Update]

Monthly video update below!

I did ask my dentist about the concerns I expressed in my last update, and he was very reassuring. I share more details in the video, but he said that the regression I noticed is likely tooth tipping, and that will be corrected (ie my teeth will be tipped outward again) before I get my braces off. He also said my bite will certainly be corrected using rubber bands before getting my braces off. Was still a bit confused about the spacers, but he seemed confident and not concerned, so I’m just going to trust him!

Hi friends! Posted another video update on YouTube (see below).

Cliff notes: Things are still going smoothly, although I do have a couple concerns that I plan to raise with my dentist at my next appointment.

First, I’m worried that I’ve lost some of my forward growth during the braces phase, but I’m hoping it’s just a matter of tooth tipping (which can be corrected) and not true growth loss.

Second, I need to confirm his plans to fix my occlusion. At my last appointment, they put spacers between my bottom molars to “encourage the teeth to erupt until the bite is closed.” But that seems like a strange thing to do when I still have bite pads on the left. Why would you use spacers to prompt teeth to settle into an uneven bite? Wouldn’t it make sense to remove the bite pads, THEN use spacers??

Not a huge deal either way (they can always put in spacers again), but it definitely triggered my paranoia/trust issues. I’ll keep you guys posted!

Hi! I recorded a video (below) musing on this topic, and thought I’d give you all a text version as well, both because I’m not very concise on video and so you can see the alien face pics a bit better (ha).

I recently tried one of those “face symmetry” apps where it takes a picture of your face and shows you what it would look like if it were perfectly symmetrical, either using the right or the left side. This really highlights any facial asymmetries you might have, and I found my results super interesting (for a few reasons), so wanted to share!

[Read more…] about Can Chewing on One Side Cause Facial Asymmetry?

Just a quick progress update after my last ortho appt. Also – I really struggle with how to name these videos…please excuse the absurdly long title.

Tl;dw (too long didn’t watch…that’s a thing right?): everything is good, premolars are almost all the way forward (left one is, right one still has a tiny gap). Next they’re gonna put me in a new wire, tweak aesthetics/occlusion, then do a CBCT scan to prepare for implants, do implants, then after they settle pull the molars forward.

Just a quick update here at the 7-month mark of my controlled arch braces! Showed progress with the premolars moving forward, and talked about next steps/timeline updates. Spoiler: I’ll probably have braces until the end of this year. Probably implants by early summer, but then several additional months for them to settle and to tweak my occlusion.

Things I talk about:

• progress (braces, head/neck posture, tongue exercises, jaw position)
• why I don’t want to do a “bump out”
• more thoughts on AGGA/CAB safety

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.

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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…)

Ramblings on the risks of AGGA, from my personal perspective. Also, yes, not only did I not manage to make this video five minutes, as intended, but the second take was actually LONGER than the first. Video: 1 Alyssa: 0

Below are the blog posts I mentioned in the video that touch more on this topic. And to add – since I published this video a week or so ago, Ronny Ead reached out to me privately with further warnings about the dangers of AGGA. He had a negative experience towards the end, and knows several more people who have had even worse experiences (i.e. losing their front teeth with no chance of implants).

So let this just be a reminder to anyone reading this that AGGA/CAB isn’t something that should be undertaken lightly or without just cause, and I would encourage anyone considering this treatment to check out the videos/posts Ronny has published on the topic for a different perspective. It’s always good to keep in mind that the entities who financially benefit from a treatment may not always be totally unbiased and objective when evaluating the risks.

Palate Expansion Update: Concerning CBCT Scan Results

Why I Decided to Try AGGA (plus some lingering concerns)

Everything You Need to Know about AGGA (but not really because I need to update this page…)