Debunking myths: Single jaw braces

 Often times in our practice, we meet patients who desire to only fix teeth in either of their jaws, but not both jaws. Proponents of the treatment often say it cuts down on the total treatment time by half, while others claim that the teeth moved do not sit nicely with the opposing teeth and sometimes, the patient is left with a less than desirable outcome.

What is single jaw braces? It is when teeth on one jaw are more crooked than the other jaw, giving the patient an impression that only these teeth need fixing. Its a type of treatment where the patient perceives teeth in one jaw fixed, without the necessary need for the teeth to meet the other teeth opposing them. 

Why is it important that teeth meet each other? Teeth are designed to chew food, support the face, and reduce food to digestable material, for absorption (or intake of benefits from food into the body, from amino acids, proteins, carbohydrates – the basic needs of the body). Teeth meet eachother in unison, under a specific design, called CLASS I (ONE) design. This design is where the teeth should land and hit eachother with every bite, so the food is propely reduced. It is also why the teeth are arranged so they give the best smile, the best support for the face.

Therefore Class I relationship between the teeth, offers also the most stable position the teeth can be in, because they fit eachother so well, there is little chance for one tooth to just veer off the pack and strike where it shouldn’t on closing. How is that possible? If you played Abacus as a child, you would know that the beads in the middle are positioned by the rest of the beads at the ends.

Lets consider these beads if we had two rows of them closing normally on eachother. The bead would likely go in the space between the opposing beads. Think about it. If you wanted to crush something between the beads, would it not be more efficient if the beads had little spaces between them? Mind you, the beads would function alot better if they had alternating pattern, like a gear!

Class I is when the teeth are “geared” to reduce the food. Can we bring about one set of gears to interlock and “teeth” another gear, without moving both? It may be possible but not in the majority of cases. But what if the gears had stopped on one hand and the other gear moved. Trouble! One of the gears eats the other and the clock is now stopped. So much for that timepiece!

Back to our teeth, when a patient asks us to fix and move one tooth in a whole jaw, that is like warping gears! Imagine how hard that might be! To warp a perfectly formed gear so that one tooth can get in line with the others! Isnt that bad? The gear, is kaput.

So is it correct to fix teeth on one jaw, while purposefully neglecting the teeth on the opposing jaw, just because the patient felt like it? Yes! Absolutely yes! Its their teeth! 
BUT

Convincing the patient that both sets of teeth needs to move and align is another matter. What is even more important, is that the patient needs to know that while the teeth are moving, the movement happening at this diet of treatment has a toll on the teeth moving. And is it not better to be tolled once as teeth, with all the pain and time it takes to get into that new position, than to be tolled twice to fit the teeth together on a second diet? Yep. 

That is where we as practitioners must arrive with the patient, BEFORE having their braces installed. Before anything!

In summary, single jaw treatment is feasible, as long as predictable results can be made, and the patient must understand the risks of undertaking such treatment, in both the complexity and time, as well as the disadvantage to the left out jaw.

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