Dentistry Beyond Teeth

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.

We are barely scratching the surface. The dental community, as well as the medical community, has a great deal of new (and old) facts that are not yet getting incorporated into patient care. We need to see the forest and not just the trees.

As dentists, we have been trained to look at teeth—usually individual teeth. We have made great strides in tooth replacement (dental implants), porcelain veneers and bonding protocols (among others)—but we should be seeing a bigger picture.

Yes, the individual teeth are important, but I would say a person’s “bite” and their airway is much more central to general health as well as

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 PHOTO COURTESY OF BOB PERKINS will crowd. It will put the child at a higher risk for sleep disordered Dentistry Beyond Teeth 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 Why the ‘bite’ children and behavioral issues. is central to We should be making sure that our children both aesthetics (and adults) breathe exclusively through their noses and health with lips together. When you breathe through the nose, you get much better oxygen saturation and a release of anti-bacterial, anti-fungal and anti-viral By Bob Perkins, DDS components. Two studies have shown that mouth breathers have higher Covid rates. People who breathe through their noses with lips together and the tongue postured at the roof of the mouth will have a much lower likelihood of sleep apnea and TMJ. As a dentist who treats TMJ and sleep apnea, I can emphatically support this: Nose breathing with lips together can—as much as anything else you can do—make you healthier, less likely to

contract sleep apnea, less likely to have TMJ and much more likely to have attractive, healthy and balanced facial proportions with upper front teeth that show.

The problem, I feel, is that as dentists, we are trained to look at someone’s bite (the way their jaws come together) and treat it as something sacred and inviolate—a genetically programmed position. It is not. The bite is, perhaps more than any other part of the body, remarkably impacted by environmental and developmental factors (mouth breathing, thumb sucking, allergies, etc.).

Sleep apnea goes 80% undiagnosed by the medical community. Virtually everyone should be getting screened for sleep apnea by their medical doctor. Currently, in our office, we screen all our patients for

Dr. Perkins transformed my smile...I had no idea that your whole face structure could be changed by changing your bite and realigning your jaw! I couldn't be happier!

Di T.

sleep apnea and, if needed, we can set them up with a Home Sleep Test administered and interpreted by a board certified sleep physician. Sleep apnea is very treatable, and, in most cases, it can be treated with an appliance and not a CPAP device.

With both children and adults, we can expand the airway and establish a new “bite” position where both aesthetics and structural needs are addressed.

Lastly, for adults, if you want to look younger, healthier, with tighter skin and improved facial proportions, then you can do this by non-surgically changing your bite. We do this on a temporary basis first to make certain that it is comfortable and giving the desired results. This will, almost invariably, improve airway as well. bobperkinsdds.com, socaltmjandsleepcenter.com | (310) 456-5700 ▪

Editor’s note: Dr. Perkins is in his Malibu office on PCH where he does dental cleanings, and general and cosmetic dentistry.