Tomorrow my family, staff and I will be heading down to the annual American Association of Orthodontists (AAO) national convention in Orlando, Florida. I will be busy with responsibilities for my position on the College of Diplomates of the American Board of Orthodontics. Additionally, there is the opportunity to catch up with the latest technology available in orthodontics, and the decisions that follow of whether to implement this new technology into Meadows Orthodontics. There are also hundreds of lectures and continuing education classes to choose from for myself and our staff. I thought I would highlight some of the things I will be doing and checking out at the convention.

• I will spend the entire day Friday as the instructor of the preparation course for the American Board of Orthodontics (ABO) Exam. I will be teaching two sessions to orthodontists and orthodontic residents who are preparing and studying to be Board Certified. Becoming Board Certified is important for our profession, and helping others with this process not only helps relieve some of the stress they are feeling through the long preparation process, but is also an opportunity for me to remain as sharp as possible (I study several times a year to prepare to teach the course).
• On Sunday morning I will be judging over 400 finished braces cases submitted by residents from programs across the country. The competition involves accessing quality of finish of the completed cases (patients that have been treated with braces), taking into account the difficulty of the case and the severity of the initial misalignment of the teeth and jaws. It is always inspiring to see our future orthodontists striving to attain such a high level of quality in treating patients.
• We have had an optical- digital scanner that replaces most impressions needed in our office (reducing the amount of goopy impressions needed), but there is a new generation out that we will be receiving soon that is multiple times faster and smaller. For those of you that have had this scan, it takes the scan time down from about five minutes to well under one minute!
• There are numerous lectures and research presentations on a technology that has been out for a while- using specific frequencies of vibrations to accelerate tooth movement- that I will be looking into. Many offices across the country offer this technology, but the problem has been a lack of credible evidence of it’s effectiveness, and a very steep price that is transferred to patients. I will look into the latest evidence and cost-benefit for my patients.
• And of course, we will spend several days at Disneyworld while we are there!

Dr. Dan Rejman is the owner of Meadows Orthodontics in Castle Rock, CO. There are two convenient Castel Rock locations- one in the Meadows, and one near Founders/Terrain and  close to Parker.

I see many patients that have been informed that they have what is called a “tongue thrust”, and that it is causing issue with their teeth and bite. Specifically, tongue thrust has been claimed to be the cause of open bites (front teeth that are separated from one another), and front teeth that are excessively proclined (tipped forward). I would like to present the key points from an article by Robert M. Mason, D.M.D, Ph.D. from the International Journal of Orofacial Myology, titled, “Myths that Persist about Orofacial Myology”. The key question is- can tongue thrusts move teeth?

• A tongue thrust is different than the resting posture of the tongue. Tongue thrusting is an opportunistic behavior, that finds and fills spaces available in the dentition (such as existing open bites), sometimes when swallowing. There is no proof that tongue trusting causes malocclusions, or misaligned teeth. However, there is much data to support the relationship between abnormal resting posture of the tongue with misaligned teeth and malocclusions.
• A tongue thrust when swallowing does not move teeth! Moving teeth in humans requires a minimum of approximately six hours of continuous pressure. Even if you were to swallow thousands of times a day where the tongue pressed forward against (or between) the teeth, this is not nearly enough to make teeth start to move. Biochemical studies of Davidovich and colleagues demonstrated that hours of continuous forces against the teeth are required for significant amounts of specific enzymes to built up, which activate sequences of periodontal activities that result in tooth movement. Intermittent pressing motions of the tongue, no matter how strong, do not move teeth or cause open bites.
• If the tongue rests in a forward position between the teeth for long periods of time, this continuous position can absolutely cause open bites and protrusion of the front teeth. The key is that the force is continuous, even if the pressure exerted is very light (this is how braces work!). The same can be said for thumb sucking – hours of constant pressure can move teeth dramatically.

If you have any questions about your child and the position of their tongue, please feel free to contact me. Often this is something that can be addressed very successfully. More persistent cases may require the help of an orofacial myologist.

Dr. Dan Rejman is a Board Certified orthodontist, and is the owner of Meadows Orthodontics in Castle Rock, Colorado. There are two locations to serve the residents of the Castle Rock area, one in the Meadows, and one near Founders/Terrain. 

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