Dr. Scott Solomons

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The Shrinking Face Epidemic Is Happening Right Under Our Noses and It is Killing Us!

I want to share a shocking brief digital simulation showing how our faces have been drastically shrinking over several hundred years. I got it from Dr. Michael Gelb DDS in NYC, who got it from best-selling author James Nestor. Please concentrate on the lower face; you will see how the jaws are shrinking and moving back toward the throat. This causes the tongue to partially or fully occlude the airway, especially when we sleep. You should also notice how the face is less attractive now. In fact, it is rare to see someone who has realized their potential for full facial development. People with properly developed faces will always have straight teeth, room for their wisdom teeth, superior beauty, and better health. Whatever they do for a living, they appear to be actors and models. Since most of us have underdeveloped faces, this epidemic has gone primarily unnoticed by us, including most physicians and dentists. This needs to change because, as you will see in this post, it is one of the major contributing factors for many, if not most, of our modern health problems. 

Chances are you are saddened by what you have just seen. We have lost our birthright to more attractive faces and healthier lives. Please share what you have just seen as much as possible, especially with those about to start families. Improper growth is easy to prevent and correct, especially in young children. I highly recommend you read James Nestor's book Breath; it covers in detail how we got here and what to do about it. In the meanwhile, here is my brief intro to the story of our shrinking faces. I will cover what we can do about it at the end of this post if you are interested. 

The Craniofacial Respiratory Complex

Dentists are experts in the craniofacial respiratory complex. Dr. Kevin Boyd was the first person to use the phrase. The craniofacial respiratory complex (CFR) comprises the head and neck structures, and the jaws, nose, and pharynx are a few of the prime components. As dentists, we are in a unique position to assess the health and functionality of the CFR. My friend and colleague Dr. Boyd and others noticed that breathing is more difficult with an underdeveloped CFR. He features prominently in Nestor's book. In essence, when the jaws are too small, it is harder to breathe, especially when we sleep. He also recognizes that this was not always the case. He and Dr. Marianna Evans have been studying the extensive skull collection at the University of Pennsylvania. They are unsurprisingly finding that the oldest skulls have the largest jaws, containing perfectly straight teeth with enough room to hold fully erupted wisdom teeth. In other words, they have perfect CFR's. 1

Early Modern Humans Had Perfect CFR's

Researchers have long understood that our fully modern human paleolithic ancestors possessed superior jaws and teeth. They all looked like they had the teeth of Hollywood stars. Fossil evidence of human skulls shows a clear evolutionary trend for smaller jaws since we started using tools for hunting, cooking, and preparing foods. This trend goes back millions of years, way before we evolved into our current form Homo Sapiens Sapiens. Since we have been relegating some of the work our teeth used to do to tools and cooking, our jaws have had to do less work. As a result, our fully modern teeth and jaws are smaller than they were in our distant not-fully-human ancestors. However, the trend has been slow, and evolution has been in the driver's seat. By the time modern humans evolved, our craniofacial respiratory complex was still adequate even though we had smaller jaws and teeth.

It's Rapidly Getting Much Worse

Unfortunately, the trend towards smaller jaws (worse CFR's) continued faster than evolution could keep up with. Around 10,000 years ago, we suddenly gave up hunting and gathering for farming. As a result, the foods we grew and prepared were much softer than before. One study of medieval skulls from Norway showed that 36% had terrible bites, compared to 65% of modern Norwegians. 2 Flash forward to today, and almost 50 to 70 percent of U.S. children will have some form of corrective orthodontics before adulthood. The epidemic of small jaws and inadequate CFR's is so bad today that Dr. Boyd limits his practice exclusively to treat children suffering from the consequences of small jaws, crowded teeth, and limited breathing.

The Physical Consequences Caused By Small Jaws

The Medical Consequences Caused By Small Jaws That Are Often Missed By Physicians and Dentists

Apnea and poor sleep which lead to:

  1. Exhaustion, daytime sleepiness, and fatigue

  2. Moodiness

  3. Anxiety

  4. Anger

  5. Social withdrawal, temper tantrums, and aggressiveness-especially in children

  6. Bedwetting in children and frequent nighttime urination in adults

  7. ADHD

  8. Depression

  9. Memory loss

  10. Accident proneness

  11. GERD and acid reflux-related to improper swallowing, leading to air in the stomach

High cortisol-the stress hormone which causes additional issues like:

  1. Metabolic syndrome (low HDL, high triglycerides, high blood sugar, visceral fat, and high blood pressure)

  2. Heart disease

  3. Poor blood flow and blood vessel health

  4. Strokes

  5. Pre-diabetes and diabetes

  6. Inflammation and elevated CRP (a marker for inflammation)

  7. Low blood oxygen-this is associated with cell and tissue death

Grinding at night from our attempt to move the jaw to breathe; this causes:

  1. TMJ Pain

  2. Tooth wear

  3. Tooth pain to pressure and sensitivity to cold

  4. Gum recession

  5. Notching of the teeth near the gums called abfractions

I could go on with this nightmarish list, but you get the picture, and it is ugly. Since there are so many problems associated with inadequate CFR's, and most of them have other causes, properly addressing them takes multiple specialists, including dentists, ENT's, allergists, endocrinologists, pulmonologists, and more. For example, many physicians may approach heart disease from a diet and exercise standpoint, not realizing that their patient has small jaws and can't breathe. I can't blame them; the shrinking face epidemic is still mostly unrecognized for the disaster it truly is.

What We Can Do To Prevent and Correct This problem

Whole books like "Breath" have been written on the subject, but let me keep this brief. You have taken the first step in that you now can recognize that most of us suffer from some level of poor facial development. 

Some Preventive Measures

  1. Eat a whole foods diet many months or years before starting a family. This ensures proper fetal development.

  2. Address your own illnesses before starting a family.

  3. Assume preterm babies to be at much greater risk for poor facial development.

  4. Breastfeed for up to three years.

  5. Introduce hard foods shortly after when babies wean.

  6. Look for tongue ties. Your dentist and pediatrician can help.

  7. Don’t use pacifiers.

  8. Try to break finger and thumb-sucking habits.

  9. Make sure your child keeps their lips closed and can place their tongue on their palate when not eating or speaking.

  10. Make sure your child sleeps with their mouth closed.

  11. Make sure your child does not snore. No amount of snoring is normal.

  12. Watch for behavioral issues, night terrors, and bedwetting past potty training.

  13. Watch for speech problems.

  14. Cultivate the correct posture in your child.

  15. Have a dentist identify jaw size issues and crowding as soon as teeth erupt. These problems will not self-correct!

Dentists can correct growth problems as early as possible. This is ideally before age eight! Don't wait until your child is in their teens to expand their arches! It can be done, but it is much better to do it early. They should not have to wait until they are older to breathe properly!!!

 Some Corrective Measures

First and foremost, get the proper diagnosis. This may involve a few different specialists, including qualified dentists, physicians, orofacial myofunctional therapists, and more. A good resource is the American Academy of Physiological Medicine and Dentistry. I am a proud member. The members all speak the same language and, most importantly, work as a team. Once your team has identified your areas of concern, you will receive a proper treatment plan. The treatments can vary and, as always, need tweaking and reassessment as things progress.  

Treatment Can Include:

  1. Allergy treatments.

  2. ENT assessments and treatments like Tonsil and adenoid removal.

  3. Orofacial Myofunctional therapy- a kind of physical therapy to assess the coordination of your ability to swallow, speak, chew, breathe, and more.

  4. Dental work to restore and replace teeth.

  5. Orthodontics.

  6. Oral surgery, including jaw repositioning. 

  7. Sleep Studies.

  8. Oral appliances like expanders, grinding guards, and sleep apnea appliances.

  9. CPAP devices.

  10. Invisalign treatment.

  11. Endocrinology treatments.

  12. Dieticians and health coaches. 

 

You can find more information in my posts:

As you can see, I am really more than just a dentist. I examine the craniofacial respiratory complex and relate my findings to the patient's overall health status. Once I have identified problems, I will most likely need the help of other healthcare practitioners for the best comprehensive treatment approach. But, as always, prevention is the best medicine.