March 6th, 2018
Day 1 with Scans, Comprehensive Cleaning, and Spacers
Hi, I'm Daniel, a patient of Dr. Randi Green's. I am keeping this blog in addition to posting videos of my facial growth treatment with Dr. Green.
Day number one! We are prepping for my AGGA growth appliance. Digital scans of both my top and bottom arches were taken with the iTero digital scanner. To scan both top and bottom arches took about 5 minutes with no goopy impressions!
Once complete the scans were sent to the only lab that will make my customized growth appliance with the press of a button on the iTero.
The lab that makes the AGGA makes each one totally custom, and it takes about a month to get it back.
The purpose of the anterior growth guided appliance will create space and grow my maxilla (top jaw) forward and create more space for my airway and give me a mini dental facelift at the same time. My mandible (bottom jaw) will also move forward to match teeth up correctly.
I hope that AGGA treatment helps me to lessen the severity of my obstructive sleep apnea. I will re-test and share the results from my initial sleep study and compare against a study done towards the end of treatment.
Update | 12/5/18: My sleep test score is lower than the initial test. Yay! However, it is not as low as I want it, but I’ll take any improvement. I will be the recipient of a posterior tongue tie release soon, and this should help. In conjunction with that, I will need to re-start myofunctional therapy to continue working towards better oral posture. It’s really hard for me to keep my tongue at the roof of my mouth where it’s supposed to stay in the daytime, but at night it’s falling back creating issues. The good news is that AGGA is making room for my tongue to finally fit! I need to double down on retraining my tongue and will post more about this soon.
Now it’s up to me to schedule the tongue tie release and continue multi-factorial treatment to keep seeing sleep score improvement. I likely will see an ENT in the near future to look at my sinuses too. I have avoided this like the plague but it is something else I can do too. In the meantime, I am using NeilMed nasal products to help loosen and clear my sinuses.
My apnea and hypopneas are 2x higher when sleeping on my back - I’m naturally a side sleeper, but to work on this, I’m going to try wedging a pillow behind my back. My score would have been lower had I stayed on my side all night; something I can’t control without something blocking me from turning over.
The outcome *5 points lower* than my initial test shows me there is more to do and attack this from every angle. I will likely need a sleep appliance after AGGA + Controlled Arch orthodontic treatment.
I’m hopeful as the retest shows me that progress has been made, but there are other factors I need to work on in-tandem during treatment to maximize my efforts while in AGGA treatment. Definitely more to come!
Here is a quick background into my previous orthodontic treatment and childhood sleeping problems.
In addition to having crooked teeth, I have endured postural problems from hunching in front of multiple computer screens for half my life. I also learned that I have obstructive sleep apnea.
I had traditional retraction orthodontics twice, three times if you count my first appliance as a kid, but I digress, my teeth never stayed in their corrected place.
After my first orthodontic appliance, my parents wouldn't let my orthodontist perform a jaw surgery. What I know now actually would mean shortening my lower jaw to match the top would have made my problems a whole lot worse and potentially more predisposed to TMJ pain symptoms. My main problem is that I don't have enough room for my tongue to stay positioned at the top of my mouth. This incorrect tongue position is one of the leading culprits of a mouth breather and most people with mid-face deficiency due to breathing through their mouths instead of noses have crooked teeth.
AGGA day is here!
At this first visit I was also due for my six-month comprehensive cleaning, so Jyssica also gave me a top-notch cleaning with the Ultrasonic Piezo (high-pressure water scaler) It's so much better than the old way of hand tools.
I'm pretty good with flossing and using a Waterpik daily, so I did not make her job more difficult. I recommend the Key Lime Pie Flavor if you're looking for a new polish flavor.
April 18th, 2018
First day and Anterior Growth Guidance Appliance (AGGA) insert
May 8th, 2018
20 Days Into Facial Growth Orthodontic Treatment
I want to share some updated photos of my profile throughout my journey. I'm starting to see changes in my mid-face, and I'm less than one month into my AGGA treatment! In addition to helping lessen sleep apnea, this treatment should help to square my jaw and give my face more fullness, like a cosmetic facelift without the surgery.
May 18th, 2018
30 Days Into Facial Growth Orthodontic Treatment
June 27th, 2018
70 Days Into Facial Growth Orthodontic Treatment
The treatment involves putting ones self into correct posture. One of the ways in addition to AGGA that helps make this correction is using a posture pump device. Here is me right before my last adjustment using it to help my neck and spine re-align. The cool thing is Dr. Green had one for me as a new patient and I walked out with it on my first day.
Yes, more photos are coming soon. I took more than one every month and intend to share my entire journey within this post. ;)
November 7th, 2018
202 Days Into Facial Growth Orthodontic Treatment
Bone Formation with AGGA Remodeling
Daniel presents with Class III malocclusion and has been through previous orthodontic treatment. He has bouts of vertigo and dizziness in addition to scoring quite a high number of sleep apnea events during a recent sleep study screening. He has forward head posture out of necessity and bad postural habits formed from many years at a computer desk.
We determined that he was a good candidate for a sleep and snore device but with his current facial growth treatment he shouldn't need a nighttime sleep appliance.
He was also not a good sleeper as a young child and led to early habits of mouth breathing which kept him breathing improperly for many years leading to worse malocclusion.
He had expansion appliance therapy to widen his arches as a pre-teen, and his parents were given the option of jaw surgery. They never consented to orthognathic surgery to cut his jaw and waited until he was old enough to have braces.
Surgery is not the only option to correct a bad bite, crooked teeth, or mandibular hyperplasia.
He is thankful as an adult and credits his parents for not allowing traditional orthodontic philosophy to enable a surgeon to remove bone.
Fast forward. Traditional orthodontics and Invisalign treatment have both straightened his teeth, and both orthodontic treatments gave him a smile he wanted, but as a teen, his teeth have never been put into the proper occlusion. In essence, the root problem was never addressed and fixed until now.
In Daniel's lifetime, he has gone through three different rounds of orthodontic treatment. One expansion appliance as a pre-teen, braces as a teen, Invisalign as an adult, (now with permanent lingual bar bonded to the back of his teeth) and now round four, facial growth expansion to finally fix the root of his problem. Nasal breathing and proper tongue posture.
This facial growth treatment will grow his maxilla 6-8 millimeters forward. He will regrow bone helping his jaw move forward and out of his airway also bringing the mandible forward. This treatment will help to eliminate forward head posture and improve posture, help to reduce obstructive sleep apnea, resolve any TMD signs and symptoms and of course help straighten his teeth.
Daniel will post updates of his journey with facial growth orthodontics on this blog. Stay tuned!
See Dr. Green’s answers to the top three most frequently asked questions about AGGA facial development orthodontic treatment.
Forwardontics with AGGA grows the top jaw forward and can start at any age.
See some of Dr. Green’s recent jaw growth cases. Fuller lips, improved posture, and a non-surgical facelift appearance are but a few benefits in addition to straight teeth!
Contact the Smile Team to see if you're a candidate for
Dr. Randi Green's Facial Growth Orthodontics.