[Theory} Bite Position in Overbite

Bump 

I spent 15 minutes writing an answer, and then when I submitted it disappeared…sigh. Maybe I”ll come back to this later and give is a second go for a full response, but right now I don’t have the energy. But, a short summary:

you’re missing foundational knowledge about the head/jaws (just stating fact; it’s true of most dentists/doctors so don’t feel insulted). There aren’t two bites. It’s about systems biology. One system on top of another. Occlusion, temporomandibular joints, airway – separate and yet interrelated systems all doing their best to achieve balance in a broken system (craniofacial underdevelopment). Which system is dominant is conditional. Dentists have been arguing about which to treat to (teeth, joints, or airway) for ages. Airway/soft tissues seems to be winning out as the most important, with joints second, and occlusion third. Good airway supports but does not grant good relationships between the joints/teeth, joint/teeth position can be shifted to support airway, but also make airway worse. The Autonomic nervous system will destroy the teeth and joints to preserve the airway, thus airway is king. Not breathing is stressful and stimulates the brain stem/HPA-Axis/Limbic systems. The brain stem/limbic/hpa-axis doesn’t distinguish well between stressors, and will engage airway related compensatory behaviors (bruxing, forward head posture) to stressors that are psychosocial/physiological/etc.

Saw a youtube video of a man who went for a walk, and his brain told him the pr1ck he felt on his leg was some brush. So, he shakes his leg and keeps walking, and not long after he collapses in pain. Turned out to be a brown snake and he almost died. Six months later, he’s out for a walk again, and he feels a  pr1ck and this time his brain causes him to grab his leg in excruciating pain because ‘brain has learned what this means’. Turned out to be a stick…

What’s going on with bites is more complicated than dentists have been thinking because of airway. Very few are trained in understanding this.

The short of it is, with craniofacial underdevelopment there is no ‘right’ position for the masticatory system. The ‘ideal position for things’ is just the position in which all systems engage in the least amount of compensation. While these are all adaptable systems, the less they have to adapt, the happier they’ll be.

Thanks for making the effort a second time! First of all: no offense taken. I’m fairly new to this area and I’m just starting to connect the dots. 

Actually I’m 23yo and noticed how underdeveloped my jaw looks from the side just a few weeks ago for the first time. I thought this can’t be right and the more I read the more it dawned upon me that the braces I used to have just kind of aligned my teeth without addressing core issues. As a kid I’ve always avoided chewing, had trouble speaking due to poor tongue function, open mouth breathing due to allergies, developed asthma etc. All the good stuff lol. 

So while I’m not REALLY having any problems right now (besides the Asthma), just knowing that something isn’t right bothers me a lot. I still have a slight overbite and of course there’s also the aesthetic aspect of my jaw being recessed. I’d just need a couple more mm of forward shift.

So ive been looking into non-surgical ways to fix this. And ran into mewing and my described problems with jaw position while “doing mewing”.

So what I’m getting from you is: it’s too complicated for me to predict an outcome. Either way my body’s gonna compensate and it’s probably not gonna be in a beneficial way. At least not without other areas suffering. Correct me if I got that wrong!

While theoretically this makes perfect sense, I’m not too sure where it leaves me concidering the (tbh mostly aesthetic) Improvements I’m seeking. My intermolar width seems to be fine, I can easily get my tongue up there. It’s just my jaw that seems to be locked behind by my bite. 

I’d be really greatful for help from more knowledgeable people!

I’m in Germany btw, which does make finding a competent doctor in this relatively new field really hard. Open for recommendations!

I’ve heard of some doctors in Germany that are paying attention. I didn’t make an effort to remember names though. Just that I recall seeing a few Deutschlanders undergoing non-surgical and surgical treatment for a deficient airway/facial growth. I’m recalling seeing two cases of the AGGA/controlled arch, and a few instances of recommendations to a neuromuscular dentist to some TMD patients (on other forums/reddit). So, I know there’s someone over there, just not sure who and where.

One dentists description of what happens to the tongue when the jaws are too small is that the tongue is a “Six foot tiger in a three foot cage”. It’s the title of his book, in fact. It wasn’t a book I’d recommend reading, but it’s a good metaphor. No matter how you try to position the tiger, it’s going to be cramped. You can find the ‘best’ position for it within those confines, but what the tiger (soft tissues) really need is a bigger cage.

How much this may be influencing your case would require more in-depth study of your jaws and profile, but modern faces are quite underdeveloped compared to the anthropological norm (hunter-gatherers). Even if you have pretty good growth, that fact you needed ortho suggests crowding, which suggests the jaws didn’t develop large enough to fully accommodate your dentition. How much that affects the airway really depends. If you needed to have wisdom teeth taken out, I’d say your craniofacial underdevelopment is quite likely having an adverse impact on your health and well-being. If you still have your wisdom teeth, I’d say your airway might be somewhat affected, but not so significantly that it should be a reason to pursue radical treatment (such as surgery).

Anyways, everything right now is case by case. It’s not that treatment outcomes are completely unpredicatble, there’s a lot that can be done to model what’s going on and infer what’s possible with treatment, it just requires a detailed analysis which only a trained dentist can perform. However, If you posted two pictures of a front view (one with ‘show teeth smile’ and the other with a relaxed closed mouth) and side view of your head/neck/shoulder, we could give better feedback. If you could measure your intermolar width (in millimeters) that’d provide more detail too. It won’t be anywhere near the comprehensive assessment a trained clinician can provide, but there are some of us on this forum that have been staring at these problems long enough that our feedback can be quite useful in figuring out  first the core issues that are present.

That in turn can help aid you in finding a doctor that can fix your specific problems – a lot of dentists will claim to be able to help with problems that they are undertrained in; they think they understand the problem ( in their mind: teeth don’t fit, jaws need moving to fix bite) because they don’t understand it’s more about airway than how teeth fit together (need to fit teeth together at a position that supports the physiology of breathing and proper tongue posture). Some don’t understand that things like obstructive sleep apnea aren’t really sleep problems, but breathing issues. Dentists will often segregate themselves from the airway problem by saying “I’m not a sleep doctor, treating sleep has to be done by a medical physician”, when the reality is, dentists are dealing with problems that are airway related everyday in practice (bruxism, tooth erosion from acid reflux, mouth breathing causing decay, TMJ problems, pain the jaw/head/neck). It’s just that when you treat the airway problem, you also fix the sleep and so becoming eduated in it is highly beneficial to treating patients airway. Becoming educated on sleep intimidates most dentists and deters them from including airway in their practice.

Well, I didn’t mean to write so much, but it’s my hope it’ll help you be more prepared to working at finding a provider to meet your needs. If you can post those front/side pics I and others could clue you in better as to what’s going on.

I want (A). I will persist in asking for it as my airway and joints do not object. I see no reason why my upper incisors should win in the conflict it sets up with the lower incisors in my post knife and fork mouth. My tongue on my incisive papilla is on the side of the lower incisors. My concern is only to be sure that any pressure  from adopting (A) is light. Something in your description sounds like you are adopting it with some force. Some people find they have to adopt (B) to be able to mew effectively. It does not sound as if that is the case with you,

Posted by: LastQuestion

I’ve heard of some doctors in Germany that are paying attention. I didn’t make an effort to remember names though. Just that I recall seeing a few Deutschlanders undergoing non-surgical and surgical treatment for a deficient airway/facial growth. I’m recalling seeing two cases of the AGGA/controlled arch, and a few instances of recommendations to a neuromuscular dentist to some TMD patients (on other forums/reddit). So, I know there’s someone over there, just not sure who and where.

 

One dentists description of what happens to the tongue when the jaws are too small is that the tongue is a “Six foot tiger in a three foot cage”. It’s the title of his book, in fact. It wasn’t a book I’d recommend reading, but it’s a good metaphor. No matter how you try to position the tiger, it’s going to be cramped. You can find the ‘best’ position for it within those confines, but what the tiger (soft tissues) really need is a bigger cage.

 

How much this may be influencing your case would require more in-depth study of your jaws and profile, but modern faces are quite underdeveloped compared to the anthropological norm (hunter-gatherers). Even if you have pretty good growth, that fact you needed ortho suggests crowding, which suggests the jaws didn’t develop large enough to fully accommodate your dentition. How much that affects the airway really depends. If you needed to have wisdom teeth taken out, I’d say your craniofacial underdevelopment is quite likely having an adverse impact on your health and well-being. If you still have your wisdom teeth, I’d say your airway might be somewhat affected, but not so significantly that it should be a reason to pursue radical treatment (such as surgery).

Anyways, everything right now is case by case. It’s not that treatment outcomes are completely unpredicatble, there’s a lot that can be done to model what’s going on and infer what’s possible with treatment, it just requires a detailed analysis which only a trained dentist can perform. However, If you posted two pictures of a front view (one with ‘show teeth smile’ and the other with a relaxed closed mouth) and side view of your head/neck/shoulder, we could give better feedback. If you could measure your intermolar width (in millimeters) that’d provide more detail too. It won’t be anywhere near the comprehensive assessment a trained clinician can provide, but there are some of us on this forum that have been staring at these problems long enough that our feedback can be quite useful in figuring out  first the core issues that are present.

 

That in turn can help aid you in finding a doctor that can fix your specific problems – a lot of dentists will claim to be able to help with problems that they are undertrained in; they think they understand the problem ( in their mind: teeth don’t fit, jaws need moving to fix bite) because they don’t understand it’s more about airway than how teeth fit together (need to fit teeth together at a position that supports the physiology of breathing and proper tongue posture). Some don’t understand that things like obstructive sleep apnea aren’t really sleep problems, but breathing issues. Dentists will often segregate themselves from the airway problem by saying “I’m not a sleep doctor, treating sleep has to be done by a medical physician”, when the reality is, dentists are dealing with problems that are airway related everyday in practice (bruxism, tooth erosion from acid reflux, mouth breathing causing decay, TMJ problems, pain the jaw/head/neck). It’s just that when you treat the airway problem, you also fix the sleep and so becoming eduated in it is highly beneficial to treating patients airway. Becoming educated on sleep intimidates most dentists and deters them from including airway in their practice.

Well, I didn’t mean to write so much, but it’s my hope it’ll help you be more prepared to working at finding a provider to meet your needs. If you can post those front/side pics I and others could clue you in better as to what’s going on.

 

Happy to hear that there are some doctors here, I’ll have to do further research on that.

Also I kinda wanna thank you for engaging in this rather long conversation! I’m really happy about this Forum and how it approaches things. My first contact with orthotropics was Mike Mew, however, I then found myself in the Lookism Forum which is just not a good place to be at in general I think. This left quite the weird impression of Orthotropics for me. 

I actually do love this kind of concept. If you are interested in Epigenetics, seeking health in a “back to nature” approach, function influencing form and all that kinda stuff, then you should check out Functional Patterns. It’s a training / therapy system based on how the human has volutionary developed  and moved accordingly. It’s basically the same thinking, just for your whole body. These guys fix cases of scoliosis with their neuromuscular and technical movement approach that have been diagnosed as “lost causes” by doctors. Not much scientifically reviwed tbh and the founder can be quite an interesting character but they do show amazing results and change lives.

Back to Orthotropics: Since you clearly made the case for analyzing the situation individually, I’ll post a couple pictures and my dental history in the following posts. Maybe someone can then determine what the problems seem to be and what options there are in my particular case.

Btw: Still searching for experiences / recommendations concerning German specialists. 

Posted by: Odys

I want (A). I will persist in asking for it as my airway and joints do not object. I see no reason why my upper incisors should win in the conflict it sets up with the lower incisors in my post knife and fork mouth. My tongue on my incisive papilla is on the side of the lower incisors. My concern is only to be sure that any pressure  from adopting (A) is light. Something in your description sounds like you are adopting it with some force. Some people find they have to adopt (B) to be able to mew effectively. It does not sound as if that is the case with you,

Okay I definitely get where you’re coming from. Especially with the active forward push against the incisive papilla and not applying too much pressure. For my case it’s actually easier for me to mew in (A) as I seem to be able to get the back of my tongue even further up.

Okay, here we go.

Problems:

Right now I do not have any real problems other than a mild overbite and aesthetically underdeveloped jaw. My jaw feels “trapped” behind my overbite.  Also the left side of my face does look different from the front as well from the side. From the front it seems to be lower, from the side the receided jaw seems to be a little bit more underdeveloped. Also my masseter muscle seems more developed on the left. I did suffer from enormous forward neck posture but I’ve been actively working on this for a year. However, I did and still do have asthma.

Dental History:

I’ve been born with torticollis (wry neck) to my left side, which has been treated and resolved at very young age. I still do favor my left side though and therefore I’ve always accounted the drooping of my left side as a late consequence of the torticollis.

I’ve always had an overbite which I think was fairly deep. I did have braces and appliances from 11 til 15.
My orthodontist corrected the overbite with:

1) increasing the width of my upper jaw (Device in Picture 1)
2) Rubber bands attached to the braces

So I think he actually didn’t do that bad of a job.

However, they had to pull all my wisdom teeth. One tooth was missing since birth, which leaves me with only 13 upper teeth (Picture 2). I do still have a retainer wire on my lower incisors and canine teeth. 

Concluding thoughts:

So while I obviously had some treatment done I still (or again?) have a slight overbight and a recessed jaw. Don’t know about my maxilla to be honest. I’m aware that my problems aren’t especially severe but I’m still worried about aesthetics and health implication in the long run since I’m only 23.

Would be happy if you guys could tell me more about what I’m dealing with, if I should fix it and which options there are. Or if I’m making this a way bigger deal than it is lol.

Thanks a lot!

(Sorry for the weird picture but it didn’t allow me to upload more than one picture. You should be able to zoom in quite well.)

Great pictures. Side profile it looks like your lower jaw is recessed quite a bit. This tends to correlate with constriction of the pharyngeal airway space (throat area). Between the history of asthma and forward head posture airway is definitely involved, the question is how much of that is related to constriction or obstruction within the airway and how much is asthma. A forward head posture could be sleep breathing, or it could be asthma – it’s a compensatory behavior that arises when there’s some type of insult to the airway that compromises breathing.

It’s worth noting that it’s somewhat common to hear of children getting their airway treated with orthotropics or orthodontics who have their asthma resolve. Asthma isn’t my forte, but I do understand the diagnostic criteria has rather egregious shortcomings. I recall Roger Price offering some very specific criticism of Asthma DX in Dr. Steven Parks Breathe Better, Sleep Better, Live Better podcast. 

When airway affects sleep, problems snowball into some very complex systems biology. I would float out that maybe your asthma is related to breathing issues that arise from your craniofacial anatomy and treating the anatomy has a chance of resolving the asthma, or at least putting your health in a position in which it improves or other interventions might then ‘cure’ the asthma. I think Patrick Mckweon’s (author of “The Oxygen Advantage”) story of his struggle with asthma and fixing it with buteyko breathing reinforces the asthma link and that how one breathes  can really help one cope with deficient anatomy and have a significant impact on one’s health. I’ve also heard of diet fixing asthma, as well as extended fasting. An interested documentary on Amazon Prime titled “The Science of Fasting”.

Your maxilla has an appearance that makes it seem okay, but the palate does seem like it might be a little high arched and the fact your mandible is recessed like it is suggests the maxilla did not grow as much as is needed. Maybe the ortho did a good job making stuff look better? Measuring your inter-molar width would give better info. Ideal is about 42-44mm for men. If you’re at 38mm I’d say you’re okay, but below that I believe is where people tend to start having problems. I’m at 34.5mm and have had a really hard time. Even after two ENT surgeries I had problems, and found that extensive self-care strategies (diet, nasal saline rinses, breathing exercises, getting mouth/gut bacteria in order, etc) have helped immensely in getting my nose to work well enough to breathe through it. Still not fixed, figuring out what to do to treat the jaws/face, but I do much better now.

Facial asymmetries indicate your development experienced some difficulties, which has me wondering what a ceph analysis/tracings would show in terms of where your growth is compared to what’s normal. Your nostrils seem a bit small from the picture, which also has me wondering if your maxilla is narrow and the ortho just did a good job making stuff fit. The angle of your upper lip and nose suggests the maxilla is quite underdeveloped in terms of forward growth. Your head posture seems to be tilted forward and angled downward; this is something I’m less sure of, but my impression is that head position and eye level should be a position that lifts it up and rotates the head into an upright position. My minds ability to conceptualize and model this aspect of the head/neck is somewhat weak still. I Imagine I would have to do quite a lot more study, learn more about tracing and the cervical/mandibular relationship, to offer better insight there. Just know, that the neurology of keeping the eyes level is involved not just with moving around but also has social aspects (presenting your face to fellow humans) and your autonomic nervous is involved in both of those as well as maintaining the airway. It’s juggling all three, and shifts in head posture typically occur as a result of the airway issue, and then the gait/social aspect gets layered on top.

Another note about head posture. I’ve found, that personally, efforts to correct it with exercises only go so far and every night I sleep my body goes back into a forward head posture as if I didn’t spend all day trying to work on it. Further, that the amount of adapation involved in very difficult to learn to override. It’s not as simple as ‘just do chin tucks’. the way the muscles get recruited is by the ANS, it’s involuntary, learning to override that involuntary habitualized muscle recruited has taken me years of trial and error. For the longest, trying to do chin tucks and other physical therapy exercises would make my pain and dysfunction worse, because it’s like the muscles were ‘stuck’. It takes a lot to get those muscles to relax, and then when I get out of forward head posture I feel like I can’t breathe. So while my efforts have helped, I find myself fighting against a nervous system that demands I position my head forward. So, fixing the anatomy to satisfy the nervous systems is my current approach to this problem. I suspect after fixing the anatomy, chin tucks will work. Until them…all I can really advise one do is try to manage as best they can. I’ve some it work for some, and others they struggle like me.

To be clear, some people breathe well with small airways, and some people breathe poorly with large airways. How much your anatomy contributes varies case by case and assessing this requires looking at both the anatomy and the problems one dealing with which suggest breathing difficulties. So, while your anatomy suggests airway is a factor, and I would suggest addressing it would improve your health, it wouldn’t be clear how much it’s influencing your health without a comprehensive workup. That’s really something a dentist/doctor should do. The comorbidities of breathing issues affecting sleep are vast, and it takes someone to really sit face to face and ask the right questions. I have some of the knowledge to do that, and you could learn the same by making a study of matters, but it would be most expedient to find a dentist who is trained on this.

Thank you for the elaborate answer!
I’ll try to reply to each point seperatly as I go on. 

Asthma

As for the asthma and the question which was there first, I can’t tell you either tbh. 
All I can remember is that I’ve struggled with pretty severe asthma attacks since I was 5. The interesting thing is that while I do still have asthma, it has gotten a lot better during puberty / adolescence. Doctor kept saying that in some cases patients just “grow out of it” a little and I seem to be one of the lucky ones. I think this also speaks volumes to the shortcomings of the understanding of asthma in a very complicated system which is the human body. Now I wonder if the orthodontic work I had done could be partially responsible for my asthma relieve. The time frame would definitely be a match. It would also explain why it has gotten significantly better, but is not gone all the way. Since my craniofacial problems aren’t either. 

Actually I’ve just purchased The Oxygen Advantage a couple days ago, didn’t get around to read it yet though. Very interesting stuff. I’m already doing intermittent fasting and some 24h water fasts here and there but I’ll have a look at the documentary!

Face & Posture

I feel like “the ortho made stuff look better” is quite accurate. I think he did align my teeth  and bite quite well but I don’t think he treated the underlying causes enough to where I would be without any major dysfunctions now. 

I already feared that my mandible was reccessed. What I’m not quite sure of is how the high arch plays into all that? Is a high arched palate linked to a narrow palate? I didn’t read as much about the problem of a high palate and where it stems from yet. 

After looking at the pics again I noticed what you were pointing out concering the angle of my head. My eyes do seem to be faced downwards more than straight ahead. I think this is also due to the picture, I think my unconcious head position (when not taking pictures) might involve a little more forward head and therefore my head tilts upwards a little more. Which then again makes my eyes look straight ahead. Not a good thing of course since it’s still compensating but I think the eyes facing downards is a problem that’s very present in this picture but not in real life. 

Treatment

So I know that without my intermolar width it’s gonna be hard to answer this question. But do you – based on the cases you have seen – think that my case is “severe” enough for treatment? I honestly kind of feel bad for going to an orthodontist and saying “okay so listen up, I don’t have any real issues besides some asthma every now and then, my obession with self-care and perfect holisitc health AND my vanity”. 

I found an American orthodontist in Germany working with the DNA / mRNA Appliance. Charles A. Smith DDS in Heidelberg. I think he’s been the first one to work with this stuff in Europe. I’m contemplating to go for a consultation. I just hope my case is worth treating, because then health insurance in Germany will cover it. If it doesn’t, I have no way of paying for any of the treatments that are out there. 

So I guess my questions are:
1) Would DNA / mRNA Appliance make sense in my case, which is mainly the recessed mandible (and possibly underdeveloped maxilla)? Because I’m sure as hell not gonna get surgery. The only really bothering factor as of right now is basically the look of my recessed jaw and that’s definitley not enough for me to take such risk.

2) And the question above. Judging from the cases you’ve seen, do you think my case is enough for a treatment to be advised by a professional? Cause that’s the only way I can afford anything anyway. Without that I can just go on mewing and hope for the best lol.

Self-care strategies

Now obivously I’m not skilled in this area yet. Still 34.5mm intermolar width seems problematic. Unfortunately I can’t measure mine right now. I really hope you’re gonna find a way to resolve your issues though. I think your strategy of self-care is the one to go with. Of course not as the one and only treatment, but I think it’s of tremendous importance. While I’m new to orthodontics / orthotropics, I’ve been in the (“alternative”) health game for a long time lol. Everything that involves the body working as a whole is just too facinating to me. If you don’t start there, then all you’re doing is treating symptoms, over and over again. 

Worth seeing a professional.  Typically in U.S. the initial consult is free.  It’s always good to seek opinions!  🙂

Asthma: Seems like you understand this and are on track to learn more. I don’t have much more to add there.

Face & Posture: high-arched palate is different things based upon which literature you read. Some say it’s primarily something that occurs in pregnancy (babies do get born with this), others say it can be mostly environmental or developmental (i.e. you mouthbreath so the palate doesn’t get developed properly). Essentially, high-arched is simply describing the shape of the palate. High-arched palates tend to come with significant narrowing, because when the palate get’s wide is tends to drop the roof the palate down (flattening it) and then it’s no longer high and arched. When the palate is underdeveloped and narrow the tongue doesn’t have the space needed to fit there properly. Thus proper tongue posture isn’t possible in some cases, and in others cases is very difficult. Also, the palate being so high means there’s less space for the nasal passages, and that can cause flow limitation in the nose. The flow limitation causes negative pressure in the rest of the airway which requires more respiratory effort. This can irritate the tissues, or increase airway collapsibility, or lead to mouth breathing habits. The short and sweet though, is that high-arched palates are associated strongly with breathing difficulties due to the way that anatomy influences the rest of the airway.

This paper is a good example of showing a somewhat severe case of a high-arched palate (pre-treatment picture) compared to a wide palate (the post treatment picture): https://www.researchgate.net/publication/318214932_Distraction_Osteogenesis_Maxillary_Expansion_DOME_for_Adult_Obstructive_Sleep_Apnea_Patients_with_High_Arched_Palate

High-arched palate can be more severe than in that example, and less severe as well. Mine is less severe. Dr. Christian Guilleminault published some literature on pediatric OSA in which the children had been misdiagnosed and died – all of them have very severe high-arched palates.

Treatment:

I really don’t have a clear answer to this. If you really don’t have many symptoms of sleep breathing difficulties then treatment gets viewed as being cosmetic. Some common symptoms of airway issues are grinding or clenching the teeth during sleep, waking up throughout the night repeatedly, waking gasping for breathing, snoring, needing to urinate multiple times during sleep, waking up feeling unrefreshed/tired/fatigued, it’s a long list that you can find more information on if you look in Upper Airway Resistance Syndrome and sleep apnea. A lot of TMD/Fibro seems to be misdiagnosed airway issues too.

The DNA appliance shows promise, but it’s very unclear to me if it’s really providing the benefit that is claimed. I’ve been looking at it for some time now and used to recommend it as an option to people (i.e. DNA shows promise, I think you should consider it and look into it further). Today though, I hesitate to recommend it. My attempts to ask for more detailed information from Vivos corporate didn’t get anywhere. I had concerns the published literature did not answer, and despite voicing this was referred to the published literature by Vivos corporate. The DNA/Vivos providers I’ve consulted with in-person had large knowledge gaps that in my opinion should not be present if the training Vivos was giving was truly comprehensive. Some of the Vivos providers are very knowledgeable and know airway quite intimately though. It may be the provider near you is one of those, or it could be he’s just starting and still undertrained by my standards. In either event, it might be useful to consult with him and hear what he has to offer. Then find other local doctors focused on airway and get additional opinions until you’re satisfied. I think presenting yourself to them, showing your awareness, concern and interest in learning more will go over well even if they end up concluding they don’t see any cause for concern regarding your airway.

If you don’t have ongoing medical issues indicating a sleep breathing problem or chronic pain condition I would agree that treatment might not be worth the current risks. Yet, by the photos it seems quite possible there’s some compromise to your airway and figuring that out isn’t always easy.

If I had the option, I would prefer to wait until better research and techniques are available before tackling cosmetics/optimal health and breathing. I, however, have breathing problems and other medical issues (depression/mood disorders, TMD, digestive problems, long list) that I’m convinced are airway. So, I’ll probably end up being one of the many guinea pigs that help everyone sort out ‘how do we fix anatomy driven airway issues’.

Could the asthma resolve via treatment? maybe. But Patrick Mckweon managed to resolve his asthma just by improving his breathing habits. I’ve improved my own breathing a lot using similar techniques. So, going with conservative care first seems the prudent course given how much there is to try to treat the asthma.

As to cost, for me in the U.S. despite my health issues related to my airway it’s proving quite difficult to get it covered. Maybe it’s different in Germany. Typically, if you have OSA, it’s easier to get it covered. And I’ve heard of people with UARS, TMD, psychiatric issues, and others getting treatment covered. But, for cosmetics, it would be out of pocket for sure. Even if all costs were out of pocket, I think you might find it worthwhile to consult with some dentist and get a 3d Conal-Beam Computed Topography scan (CBCT) and having your anatomy explained to you from an orthodontic perspective. In the U.S. that would cost about 300-500 USD. Someone in private practice would likely be willing to sit and talk over what they see in it without much charge, but doing full diagnostics would be charged for. Academic insitiations (oral surgery department f.ex) would likely charge less for the scan, but you’d be stuck with a resident (surgeon in training) to provide information. In my experience, that’s not all that insightful. The scan I got there though has proved useful in consults with private practice orthodontists (you can put the CBCT on a thumb drive, and they usually package it in a viewer you can load up on your computer to look at the scan at home/at an office).

Is the asthma really your only notable health issue? No difficulty concentrating, daytime fatigue, mood issues, head/neck pain, digestive problems, etc? Some things that don’t seem related to airway really are; just wondering if you elected to leave something out.

I’ve honestly been quite impressed by how articulate and quick to understand you have been. It makes sense that you’ve been in alternative health for some time. Understanding the need to look past symptoms and see the underlying systems biology has been key to me figuring out my own health issues. I struggled with it though, because the entire time I was connecting the dots I was skeptical and even dismissive of ‘alternative/holistic medicine’. I think you’ll be able to sort through figuring out if you have airway related issues far better than most. If you can find local dentists/doctors to help it’ll be even easier on you though.

There are some resources out there to learn from, but they’re scattered. I really like Dr Steven Park’s podcasts series (breathe better, sleep better, live better). You can find some okay info at Airwayhealth.org and AAPMD.com as well. Podcasts meant for dentists have a lot info too. Dentistry Uncensored has some interviews I liked (there’s on dentaltown and uploaded to youtube, going by memory I’d say search the uploads for Jeff Rouse, Martha Cortes, ‘airway’ ‘sleep’). I honestly can’t really recall all the sources to learn from. Too many bits and pieces. It’s my goal, and I think of others here as well, to one day find the time and energy to start bringing content together. I think most of us are too busy caught up in figuring out our own issues first to have time to perform that service just yet.

Update: It’s been a while but I didn’t feel like answering without actually bringing something new and useful to the topic.

So I’ve seen a dentist who’s very well educated and specialized in holistic treatment. He’s been using both DNA and AGGA Appliance in his practice multiple times.

After my visit there’s no doubt about my maxilla being recessed. He did all the x-rays and measured everything.

Mew Line is 43, palate width is 41 (upper) and 42 (lower). 

He was kinda surprised I didn’t have any problems since my airway seems to be quite restricted. Also my nostrils close when breathing in, which is (to my surprise) not normal.

He presented me with the opportunities of surgery, AGGA and some kind of nightly mouth guard. He then recommended AGGA since surgery would be too invasive. If I didn’t want to commit to AGGA I should at least get the mouth guard so my lower jaw can come forward at night and I wouldn’t run into airway problems while asleep.

All in all, this seemed very reasonable to me. Since surgery is too invasive and I don’t want temporary solutions, I’m leaning towards the AGGA. 

The price is insanely high for my income though and I’m still wondering if my case is severe enough to take that route. Since I can get my tongue up and in between my teeth I’m wondering if simply keeping proper oral posture (mewing) would be enough and maybe give me the same effect AGGA would, just over a longer time period.

Also I’ve read a couple of times that AGGA actually grows the maxilla into the direction it’s already facing, so there’d be forward growth but no upswing.

I’ll keep you informed and am happy about thoughts and any kind of help! Thanks!

I’ve actually started another topic including xrays since the title of this one didn’t really match anymore.
For xrays see here: https://the-great-work.org/community/case-discussions/help-me-understand-my-case-prognathism-and-retrognathism/