In this panel discussion from the 2014 Biobloc Orthotropics mini‑residency, several clinicians reflect on their early orthodontic training focused on aligning teeth through retractive, extraction‑based methods and the resulting negative impacts on facial growth, airway, TMJ health, and patient well‑being. They collectively acknowledge that traditional approaches often pull the facial skeleton backward, leading to compromised aesthetics, sleep‑disordered breathing, and chronic pain. The speakers advocate for Biobloc Orthotropics, a philosophy that emphasizes forward facial development, proper tongue posture, and airway‑centric treatment. They share case anecdotes—including a pediatric obstructive sleep apnea patient whose condition resolved after mandibular advancement using the Biobloc protocol—and discuss the challenges of treating patients who have already undergone extractions, such as reopening spaces to restore tongue space. Throughout, the clinicians express a deep ethical commitment to revisiting past treatment decisions, empowering themselves and their peers to offer etiologic, health‑focused orthodontic care rather than merely cosmetic tooth alignment.
Chapters
You know, when you start out in orthodontics, you're focused on the teeth. Your goal is to line up teeth. Your experience was with— maybe you wore braces, maybe you, you know, that was your thing. Oh, I want to do that. It looks like a lot of fun. And so you want to do that, and you focus on the teeth. But even back when I did that, I could look, and I read books long before I even went to orthodontic training. I read some orthodontic textbooks and I would look there at the faces and stuff and I'd say, it looks like everything is back and no one's talking about doing anything to develop it forward.
I think just the realization that a lot of the things that we've been taught to do, it becomes now a conviction, was wrong. To admit that it was wrong and that we did it And so the emotion of, man, you really messed up maybe some people's lives and didn't even know it, you were doing it, but it was the standard of care at that time. And for some reason, this particular weekend, it just hits so close to my heart, you know, just because most of the guys that are in this group, they really want to do a good job and to serve their clients with everything that they know how.
They go back and they understand that retractive orthodontics isn't okay. I don't think it's okay, but they've figured it out on their own. They've connected the dots themselves. They've looked back and seen the cases where they saw what happened to the faces. They took out the teeth maybe years earlier, then they've seen the change in the face. They don't like what they see. Maybe it even haunts them. They keep seeing this person come back And the face is damaged, and maybe the patient doesn't sleep well at night, maybe they have a pain pattern, then it's more than just learning the mini residency. And we're talking about biobloc orthotropics, which is wonderful. Then we expand out into everything else about what else do you do for these people? What do you do when they're past the age of biobloc orthotropics? What do you do when the teeth have been taken out already? Then we start to talk about reopening the extraction spaces and what does it take to give the person their tongue space back.
I wish that I could turn back the clock and treat my 2 children differently than what they were treated. You know, my daughter had something, some appliance in her mouth for 6 years and was an incredibly compliant patient. She got a nice result. She's a beautiful girl. She has pretty teeth. But at 16 years old, she's already starting to develop some minor pain here and there because of all the manipulation and all the posterior forces that were placed on her. She had a forces appliance in her mouth. She's already had some gum grafting in the way that everything was handled, and I wish that I could go back and change the way she was grown. So, you know, as a father, how could I not want that for my daughter? And then as a dentist, how could I not offer that to my patients? You know, this is one of those things that once your eyes are opened up, if you have a heart and you care, I don't know how you could look the other way.
So you've got the TMJ, you've got the airway issue, and the facial aesthetic issue. You know, who doesn't want to look better? And mothers particularly can see any little change in their kid's face. They see these little things, and they— when they see a face come forward, the eye is programmed to say, oh my gosh, that looks great. And you have the people come in, and they've described how the traditional orthodontics has pulled everything back, and they're not happy. And maybe they talk to the orthodontist about, well, Aren't you moving the lower jaw forward? Because that's what they wanted. Oh, yes, we're doing that. But nothing was done that would have any power to do that. And so I've had some parents come in that are really not happy at all, because they were thinking things were being done that moved the lower face forward, and yet nothing was being done. And I, of course, go back now over 30 years using other approaches, for instance, the Herbst appliance, to try to develop the lower face forward. And now I realize That's not developing a lower face forward, it's bringing the upper back. There is no quick fix. BioBlock Orthotropics requires hard work, but the results are there when you get it.
I used to use a lot of functionals, and I used to think that it was the greatest thing because it was bringing the jaw forward and things like that. But I never thought of the reciprocal effect of pushing, you know, the upper jaw back. So that has totally changed how I feel, and I just don't go use those appliances anymore. So that's, yeah, definitely changed.
The people who are coming to my mini residency now, they connect the dots. I don't have to connect the dots for them. I do, but they're bright enough to connect the dots themselves. They go then look at their own family history. They look at people that they've treated before. They look at adult patients who come into their practice. They look at the adults who've had serious problems bringing the kids in with the same problems that they themselves had as a child. They see what's gone on for the parent and, and how that's adversely impacted the parent's life. And here they have a chance to treat the kid in a different way and really make an impact on their life. Now you're getting to a completely new level of commitment to this, and the people that I have are very committed.
I have never felt more empowered to help other people than I do now. And I've loved orthodontics all along, giving people beautiful straight teeth. You know, it definitely is a nice thing, and they do appreciate it. The day you take the braces off, it's very Very exciting and they feel great, right? But suddenly I've been handed a tool, maybe even the power to help people in a way that I've never been able to do before, which is helping them with their health, their growth, their development, their future. It's no longer a symptomatic Now it's an etiologic treatment. I'm not just making a correction, I'm helping them find a cure. I am not just working for the prom picture, I'm now working for how they're breathing for the rest of their lives. I mean, that's pretty powerful stuff for orthodontics.
When I had the patient from Chicago come with a diagnosis of obstructive pediatric obstructive sleep apnea, and he'd been treated with some expansion, but that didn't do any good. So what did we do? We advanced the teeth with the biomarker orthotropics protocol, got him forward, the mandible forward. He was a great cooperator, 5-year-old boy, pediatric sleep apnea, failure to thrive. And when he got a sleep test done that was no apnea, no hypopnea, and the sleep doctor who had referred him to me calls me on the phone and he's elated, then I think we're really onto something here. Someone recognized in the medical profession, a pediatric sleep doctor with a textbook out there that he's authored himself, recognizing the value of Bioblock Orthotropics in helping his patient, and he then gets up in front of A large group of sleep physicians and starts to talk about BioBlock Orthotropics as being the biggest thing that he's seen happen in his whole career. Wow, I'm listening, I'm listening. It's nice to have me be part of that.
Just deep down feeling like there was something different out there, and then it led me ultimately to BioBlock Orthotropics, which I'm glad it did because this is definitely the answer. I mean, you look at the results, you look at the airways, it's so much I mean, straightening teeth is just a tiny part of this. And it started off as orthodontic treatment. I mean, in my life, it started off as I wanted to do better orthodontic treatment. Now, you know, I'm doing more sleep medicine or dentistry. You know, it just broadened the perspectives and broadened my horizons so much. And I feel like I can offer my patients so much more because, yeah, you're looking at the overall health of the patient. Yeah. And just straightening teeth is just not really even the main issue. You're looking at airway, you're looking at the health of the patient, you're looking at the quality of life. I mean, there's just so much more we're doing.
