737 Holly Lane, Suite 1 • Westampton Township, NJ • 08060 The Art of Creating Beautiful Faces and Smiles Yosh Jefferson, DMD & Associates (609) 261-1199 Yes, We Can Beautify Faces! There is only one Jefferson Dental, and You’ve Found It

Orthodontics versus Functional Orthodontics

Copyright (C) 2010 Yosh Jefferson

Dr. Yosh Jefferson and his associates are general dentists, who among many other dental services, offer Functional Orthodontic treatment for their patients. However, there is an enormous difference between Orthodontic treatment versus Functional Orthodontic treatment. Orthodontic treatment is treatment of just straightening the teeth whereas Functional Orthodontic treatment is reshaping and repositioning the upper jaw and lower jaw to a more harmonious position as well as straightening the teeth. Obviously, Functional orthodontic treatment is more complicated and more involved; however, if done correctly, it can enhance facial profile and facial appearance.

Functional Orthodontic treatment can, not only enhance and harmonize facial appearance, but it can often help to alleviate multitude of medical problems. Vast bodies of literature research as well as Dr. Jefferson’s many years of clinical observations have shown that multitude of medical problems may be related to poor facial profiles, poor jaw alignments, and narrow mouths.  By correctly harmonizing the facial-skeletal structures through Functional Orthodontic treatment, medical problems such as temporomandibular disorders, migraine headaches, neck-shoulder-back pains, dizziness, ringing in the ears, hearing problems, upper airway obstructions/mouth breathing, sleep disorders/sleep apnea, and other problems may be alleviated.

There are many examples of problems associated with facial-skeletal  disharmony and medical problems. For example, individuals with narrow mouths and high palatal vaults often have narrow and compressed sinuses. By expanding the mouth with expansion appliances, the sinuses widen and allow more efficient airflow. Other examples can be found with individuals who tend to have recessed, small weak chins. Oftentimes, the chins are recessed because of bad bite causing the lower jaw to bite too far back. This can cause the jaw joints to impinge against the skull joint area called glenoid fossa. This condition can cause temporomandibular disorder, migraine headaches, popping and clicking of the joints, and many other symptoms. In severe cases, damaged jaw joints can lock preventing individuals to open their mouths normally. Furthermore, when the jaw is recessed back, it can press against the throat area, which can cause airway obstruction in the throat. The inability to breathe efficiently can often cause individuals to suffer from sleep disorder/sleep apnea. Functional appliances can permanently reposition the lower jaw forward and allow more efficient airflow and proper oxygenation in the circulatory system.

Upper airway obstruction/mouth breathing can cause sleep disorder/sleep apnea in both children and adults. Poor respiration and poor oxygen exchange can cause less concentration of oxygen in the circulatory system. The heart must pump and work harder to circulate the blood more to bring enough oxygen to vital organs such as the brain. This can cause many individuals to suffer from high blood pressure and heart disease. Over time, the overworked heart enlarges causing a condition called cor pulmonale. Many of these individual can die from  heart attacks, often in their sleep. Sleep apnea can, not only negatively impact on total health and wellness and quality of life, but can reduce life expectancy on the average of 8 years. It can be life threatening.

Children with mouth breathing problems often have sleep disorders. Sound sleep is crucial for growth and development. Growth hormones are produced during deep sleep, delta phase sleep. Without proper sleep, children are often small and slight. Poor sleep can also contribute to inattentiveness and poor academic performance. These children are often frustrated and exhibit behavior problems. They are often diagnosed with ADD and hyperactivity. Dr. Jefferson and his associates treat mouth-breathing problems. They can screen for mouth breathing in children and adults, and this condition can be treated.

One may wonder why all orthodontic practitioners do not treat all patients with Functional Orthodontic treatments. It is because currently there are two schools of thoughts. One school teaches that abnormal facial and dental features are caused by genetics. These practitioners feel that the facial skeletal structures are genetically determined and therefore cannot be changed. The other school teaches that abnormal facial and dental features are caused by environmental factors. Since environmental factors, and not genetics, caused the abnormal facial and dental growth, then the facial-skeletal structures can be changed to a more ideal and harmonious shape and position. Dr. Jefferson and his associates firmly believes that many unattractive facial and dental features are predominantly caused by environmental factors, and he treats all his orthodontic patients with Functional Orthodontic therapy.

Many patients seek orthodontic treatment because of crowding and crooked teeth. Oftentimes, the teeth are crowded because the mouth is narrow. Those practitioners that believe that the mouth is narrow due to genetics and believe that the shape of the mouth cannot be changed will often extract 4 teeth, usually four  premolars to make room for the crowded teeth. This is called ‘’traditional 4 bicuspid extraction techniques.’’ Those practitioners that believe environmental factors caused the mouth to become narrow will use expansion appliances to widen the mouth. When the mouth is widened, space is gained and the teeth then can be aligned. This is called “non-extraction , functional appliance technique.”

Some practitioners do not feel that orthodontic treatment can affect facial appearance and the health of the temporomandibular joints, while others feel otherwise. Dr. Jefferson feels that moving teeth alone and/or moving the upper and/or  lower jaw with functional appliances can affect facial appearance and the health of the temporo-mandibular joints. Two patient cases will be presented here to show how different treatment technique may affect facial appearance and TM joints.

Case 1 is a patient that was treated by traditional 4 bicuspid extraction by another orthodontic practitioner. Dentally, note the smallish, narrow smile. Facially, note her flattened profile. Her lower jaw is also pushed back and/or is vertically short (short face syndrome), causing the TM joints to compress against an area of the skull called glenoid fossa. This joint compression may cause temporomandibular disorder (TMD), headaches, dizziness, ringing in the ears, neck-back-shoulder problems, and many other problems.


Case 1. Traditional, 4 bicuspid extractions tend to maintain a narrow face, and a flattened profile.


Case 1. Note 4 bicuspids missing. Note that the dental arch and smile to be narrow.

Case 2 is a patient treated by Dr. Jefferson using the Functional, non-extraction technique. This patient came to his office, so pretreatment and post treatment photographs can be shown. The following picture shows patient's actual models. First set is pretreatment models. Note the narrow mouth and crooked teeth. The second set in white models show the upper and lower Schwarz appliance to widen the upper and lower jaws. The third set of models show post treatment models. Note widened mouth and nice alignment of teeth. Three sets of Schwarz appliance and braces were used to obtain this treatment result. No permanent teeth were extracted.


1st model, pretreatment. 2nd model, Schwarz appliance. 3rd model post treatment.

Case 2, shows pretreatment facial and dental photographs.


Case 2. Pretreatment facial photographs.


Case 2. Pretreatment dental photographs.


Case 2. Post treatment facial photographs, treated via Non-extraction Functional Orthodontics.


Case 2. Post treatment dental photographs.

Dr. Jefferson published an article in the Australasian Dentist, describing a technique he developed to treat crowded teeth, retrusive lower jaw, and short face syndrome, using a technique called Fix-A-Nator. It is a non-extraction Functional Orthodontic therapy using a "fixed" functional appliance. This treatment does not use removable appliances.

Please be advised that in no way, is Dr. Jefferson implying that one technique is better than the other. However, it is up to you, as potential orthodontic patients for yourself or your child, to know that there are different orthodontic techniques. There is enough information in the public domain, most notably through the internet,  for you to read and find out which treatment technique is best for you. There are treatment options, and you should be well informed to make proper decision as to which treatment option is best for you or your child. Dr Jefferson and his associates do the non-extraction, functional appliance technique. In some cases, he may recommend second molar replacements which has been found to be more stable with less relapse if patients stop wearing retainers.

If you would like to learn more about Dr. Jefferson's treatment philosophy, please check out his other website: facialbeauty.org. If you would like to make an initial consultation with Dr. Jefferson, please call 609-261-1199. There is no charge for initial consultation.