to overall aesthetics. Think of it as if cosmetic dentistry is like painting a house. We all want our houses to have a great paint job. But what if the house is off its foundation and it is tipping to one side, or the doors and windows are not set right. Assessing the entire house should be the domain of a larger group of dentists, but, unfortunately, it is not being taught. We get caught looking only at the paint. In my practice, when I see children, my first focus is to look at the facial structure, the proportions of the face and development of the jaws. Then, it is to notice if the child breathes through the mouth or nose. Then I need to assess the child’s airway: Is there upper airway blockage? If so, could it be from a deviated septum, enlarged tonsils, or allergies. This data is key because if a child is chronically breathing through the mouth due to airway blockage, this will dramatically affect the way the face develops. Jaws will drop back, upper archforms will narrow and teeth will crowd. It will put the child at PHOTO COURTESY OF BOB PERKINS a higher risk for sleep disordered breathing and ultimately behavioral issues like ADD, ADHD, anxiety and depression. The science is very clear on this, and just a Google search will help you see the connection between sleep disordered breathing in e are barely scratching the surface. The children and behavioral issues. dental community, as well as the medical community, has a great deal of new (and old) facts We should be making sure that our children that are not yet getting incorporated into patient (and adults) breathe exclusively through their noses care. We need to see the forest and not just the with lips together. When you breathe through the trees. nose, you get much better oxygen saturation and a release of anti-bacterial, anti-fungal and anti-viral As dentists, we have been trained to look at components. Two studies have shown that mouth teeth—usually individual teeth. We have made breathers have higher Covid rates. People who great strides in tooth replacement (dental implants), breathe through their noses with lips together and porcelain veneers and bonding protocols (among the tongue postured at the roof of the mouth will others)—but we should be seeing a bigger picture. have a much lower likelihood of sleep apnea and TMJ. As a dentist who treats TMJ and sleep apnea, Yes, the individual teeth are important, but I I can emphatically support this: Nose breathing would say a person’s “bite” and their airway is with lips together can—as much as anything else much more central to general health as well as you can do—make you healthier, less likely to
Dentistry Beyond Teeth Why the ‘bite’ is central to both aesthetics and health By Bob Perkins, DDS
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22 | M A L I B U T I M E S M A G A Z I N E | # M A L I B U T I M E S M A G
MTM Spring 22 FRONT.indd 22
3/4/22 7:19 PM
