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Our Integrative Approach

Our Integrative Approach

West Roxbury Smiles- Our Integrative Approach

West Roxbury Smiles- Our Integrative ApproachOur orthodontic approach is about more than straight teeth. We focus on the “healthy” alignment of teeth so that your child may achieve the most functional and aesthetically pleasing alignment possible. Our practice philosophy is to achieve balanced function of all components of the mouth, jaws, and associated structures.

We diagnose and evaluate early oral habits (finger/thumb sucking, overuse of pacifiers) and the inability to breathe through the nose (chronic nasal airway obstruction). Chronic nasal obstruction has been shown to have profound effects on the growth of the face and jaw. Environmental impact on the growing face has proven to be extremely significant. We pay close attention to any factor that may contribute to one’s inability to breathe, for this results in a directional change in facial form/anatomy from its genetically programmed potential.

At West Roxbury Smiles, our orthodontists diagnose the root causes of these growth alterations, looking specifically at diet and specific allergy triggers. Working closely with pediatricians, pediatric allergists, naturopaths and pediatric ear, nose and throat specialists, our aim is to restore proper growth.

All orthodontic treatment at our office begins with a thorough diagnosis which includes an examination, dental/bite impressions, facial and dental pictures, x-rays, and a detailed computer-aided assessment of key structures of the face, jaws and teeth.


At West Roxbury Smiles, we believe that lack of jaw development and crooked teeth are partly nutritional in origin.

A whole food nutrient dense traditional diet is encouraged, especially during pregnancy and while breastfeeding to prevent pre-and post-natal nutritional deficiencies that lead to facial and dental deformities, poor jaw development, narrow dental arches, and crowded and crooked teeth.

There is a link between modern diet and chronic mouth breathing, which leads to facial and dental deformities.

Without essential nutrients in the form of minerals and vitamins A, D, and K2, the jaw and palate cannot form to their maximum potential and resulting in narrowing of the face and crooked teeth.

Arch Development

The upper jaw is ground-zero source for many health issues and the biggest cause of most orthodontic problems. When the upper jaw is too small, teeth are forced out of proper alignment.

The idea of arch development is to expand the upper and lower arches. Traditional orthodontists solve the problems of crowded teeth by extracting as may as four permanent teeth, leaving the arch forms narrow. At West Roxbury smiles we limit permanent tooth extraction with expansion therapy.

An underdeveloped upper jaw can lead to:

A weak receded chin because the narrow upper jaw can cause restrictive trapping of the lower jaw in its growth stage

“Buck teeth” or teeth too far forward

Reduction to the nasal breathing capacity, which in severe cases can result in a mouth-breathing habit.

Poor chewing, gum disease, sinus conditions, TMD neck pain, and eye and ear problems.

The goals of expansion therapy:

Assist and modify bone growth

Provide enough skeletal base in the mouth to allow the permanent teeth to erupt

Preserve all permanent teeth

Guiding teeth into the right position as they erupt will create more stability than repositioning them later once they are already misaligned.

Expansion helps widen nasal passages to allow better airflow

Unobstructed Nasal Breathing

A person’s ability to breathe properly through his or her nose, without obstruction, is critical to his or her health and vitality in many ways. Mouth breathing can lead to many problems, including poor facial and dental development.

What Causes Nasal Obstruction?

Allergic Rhinitis

Inflammation caused by the presence of an allergen resulting in swelling of the mucus membranes on the inside of the nasal passageways, which reduces the opening of the nasal passageway, causing an obstruction leading to nasal stuffiness or mouth breathing. If the condition is severe, we refer to a naturopathic doctor, allergist or ear nose and throat specialist.

Deviated septum

This condition is very common in people with narrow upper jaws. Widening the upper jaw to an ideal dimension can eliminate the deviated septum that causes nasal obstruction.

Tonsils and Adenoids

Enlarged adenoids are a main culprit of severe childhood earache. If a child suffers from persistent pain inside the ear, it is a red-flag warning to look for enlarged adenoids.

Mouth Breathing

  • Opens the door to throat irritations (including bacteria and viruses)
  • Alters the proper placement of the tongue. With the mouth open, the lower jaw is lower, pulling the tongue away from its proper placement, which is up against the roof of the mouth
  • The dropped tongue posture and subsequent under-stimulation to the upper jaw leads to underdevelopment (or narrowing) of the upper arch.
  • This narrowing of the upper jaw leads to trapping effect of the lower jaw, by putting it into a retruded position (too far back in the face)
  • Can lead to obstructive sleep apnea.
  • Dry airflow through teeth cause gum redness and swelling. A dry mouth dries up saliva, the body’s natural decay-preventing substance, and tooth decay is likely.
  • Oxygen doesn’t reach the body as efficiently when breathing through mouth, causing children to be listless.

Functional Jaw Orthopedics

Functional jaw orthopedics has at its foundation on balanced function of all components of the stomatognathic system. A key factor is the lower jaw to be in balance with the fully developed upper jaw.

  • An underdeveloped or narrow upper jaw can cause lower jaw to be trapped in a retruded position.
  • Enlarged tonsils and adenoids can create a mouth breathing habit, or an adverse oral habit such as finger or thumb sucking, can also cause this trapping effect.
  • The trapping of the lower jaw causes actual posterior placement of the entire jaw. This is a primary factor in the resulting TMD (TMJ dysfunction)
  • It is very important to un-trap or free up the lower jaw for development at an early age.
  • The use of a functional appliance, such as a Rickinator can be used to guide the lower jaw forward to create a better balance with the rest of the face.

Elimination of Adversal Oral Habits

Adverse oral habits like thumb or finger sucking and pushing the tongue against the front teeth (tongue thrust) can have a negative impact on the growth of the upper jaw. At West Roxbury Smiles, we use a variety of appliances to help correct these habits.

Whether you are interested in Invisalign for yourself, or clear ceramic braces for your child, please feel free to contact us at 617.327.4321.