steve's story

As a kid I had a severe overbite – or what looked like an overbite, with my front teeth pointed outward. It was difficult to eat and close my mouth, so my parents took me to an orthodontist when I was nine. He treated me with braces and a headgear to restrict the growth of my upper jaw, so that my lower jaw could “catch up.” I remember an aunt commenting that my older cousin had had an overbite and had grown out of it by adulthood. This was an important clue, but none of us had the context to understand it at the time. My parents took the “cautious” approach and proceeded with the treatment.

From then on, I don’t remember sleeping well. A few days a year, I would wake up feeling rested and full of energy, but otherwise I was lethargic, anxious and depressed. I also started experiencing strange headaches. I would feel enormous pressure in my head and had trouble processing information. Everything was swimmy and slow. It was often difficult to understand conversations. These headaches would last for hours and continued into my early 20s. I never knew how to explain them to anybody, so I said nothing.

Within two years of starting orthodontic treatment, my teeth were straight. But I still had an overbite. My lower front teeth rested behind my upper teeth, with my jaw sitting back in my head. My face sloped downward in a way it hadn’t before. I thought my face shape was natural, genetic. To be honest, I’m not sure I understood then that my upper jaw had been constricted in its growth.

While I always had bags under my eyes and never felt energetic, my memory was excellent in my youth. I devoured books and excelled in school through high school and into the first years of university. But as I entered my 20s I felt rougher and rougher. My ability to concentrate and remember declined. I arranged my class schedule so I only had to go in three days a week and could sleep in the other four. I’d sleep until midday, pick up a book to study, and startle awake when it dropped out of my hands. I couldn’t read more than a few paragraphs before nodding off. And I couldn’t recall much of what I read, anyway.

At the time I had no way to understand my poor sleep or what I could do about it. My grades fell off a cliff and I came within an inch of flunking out of my final year. In desperation, I went to my family doctor: I was tired, unmotivated, couldn’t concentrate. He nodded. I was depressed, he said, and scratched out a prescription for antidepressants.

In fact I really had sleep apnea, but it wouldn’t be properly diagnosed for another decade. My 20s slid by in a haze of exhaustion, anxiety and depression.

At 30 I finally began treating my sleep apnea with CPAP. It helped somewhat, but only marginally improved my sleep, memory and focus. It took a long time for me to understand that I’d been experiencing symptoms as early as high school, and likely even earlier.

It was only after discovering Right to Grow that I began to understand the contribution my headgear might have made. My jaw still sits back, and I’ve never been able to breathe comfortably through my nose. It’s impossible for me to get enough air through my nose when exercising.

It’s possible I would have developed some level of sleep apnea regardless of any misguided orthodontic intervention. But when I flip through old photos, it’s clear that my downward sloping face only appears after the headgear. Even with my buck teeth before headgear, my face and chin pointed forward. I now believe that my headgear changed my facial anatomy in a way that predisposed me to sleep apnea and breathing problems. The headgear straightened my teeth, but destroyed my sleep.

I wonder what my life could be like if my parents hadn’t tried to help me based on the best understanding they had at the time. There is no doubt that my chronic sleep deficit has shaped my life, my relationships and my career, such as they are. I’m now trying to figure out what I can do to alleviate my anatomical complications affecting my breathing and sleep in the hope that I can salvage something from the next few decades.

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  • Curtis Brookover DDS, FAGD, AFAAID
    followed this page 2021-08-25 12:43:09 -0700
  • Kim Henry
    commented 2020-02-04 07:17:30 -0800
    First of all, if your upper teeth stuck out too far, this is EXCESSIVE OVERJET, not excessive overbite. Get your terms straight.

    Not sure what you mean by a “downward sloping face.” I could tell more by a profile photo of you.

    In a crowded case with excessive overjet causing poor lip seal, if the maxilla was normal width, the treatment was to extract first or second premolars, use PART-TIME ANCHORAGE headgear, and retract the anteriors to a pleasing position. If the palate was constricted, perhaps the room could have been made by expansion via hyrax, but there is a limit to the amount expansion we can achieve.

    You have no way of knowing if your orthodontics contributed any to your sleep apnea or not. Chances are it played a very minor role.

    Like everything else in the body, face/jaw/skull morphology is primarily determined by genetics, but can be affected by enivronmental factors. Some genetic face types, like an overly long mandible, are virtually impossible to influence.

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