In this 2012 YouTube interview, orthodontist Dr. Bill Hang critiques the orthodontic profession’s long‑standing habit of extracting four bicuspid teeth and retracting the anterior teeth without considering the downstream effects on patients’ airway, tongue posture, and overall health. He argues that this practice is “grandfathered” and lacks the rigorous safety testing applied to other medical procedures. Dr. Hang explains how, in certain cases, the extraction spaces can be reopened non‑surgically to move the teeth forward, restore proper lip and tongue position, enlarge the airway, and thereby alleviate symptoms such as snoring, obstructive sleep apnea (OSA), TMJ locking, chronic headaches, and fatigue. Patient Stephanie shares her personal experience: after having four bicuspids extracted at age 21, she suffered from TMJ problems, chronic headaches, severe snoring, and terrifying sleep‑related dreams. Following Dr. Hang’s treatment, her airway opened, snoring stopped, headaches vanished, and her sleep quality dramatically improved. Throughout the conversation, Dr. Hang emphasizes listening to patients, setting realistic expectations (under‑promise, over‑deliver), and calls for the orthodontic field to adopt a more medical, evidence‑based mindset, citing historical criticism from anatomist Melvin Moss and recent validation from a leading TMJ specialist. The interview blends technical explanation, patient testimony, and a professional appeal for change.
Chapters
Unless I'm missing something, and I try to keep up on what's going on in the profession, I don't think a whole lot has changed in the orthodontic training programs. There's— it's still focused on straightening teeth, and no one really wants to ask the question of what happens to the patient afterwards. It's as long as everyone else is doing the same thing, Well, it must be okay. But sadly, I don't think that people have asked the significant questions that need to be asked in the profession. Any kind of a medical procedure today, to get it approved as safe and effective, or to get FDA approval of anything, you have to go through a lot of hoops and hurdles to prove that something is safe and effective. Extraction of teeth and retraction of the teeth has been around for, you know, 100— more than 100 years in the profession. And essentially, I think it's kind of been grandfathered in. Nobody ever, you know, asked the right questions. In a hospital situation, if body parts are removed, they have to be, you know, examined by a pathologist. I'm pretty sure that's the case. Otherwise, a report has to be rendered. You don't just take out body parts and throw them in the trash. There's a reason for taking out body parts, and yet it would appear in dentistry that 4 bicuspid teeth are optional body parts because they're routinely taken out and no one asks the question.
In extracting the teeth, the 4 teeth that were extracted, extracted originally when I was 21, 2 on the top, 2 on the bottom, Basically, my upper jaw recessed, so as in recessing, it crowded. My tongue had nowhere to go, and in pushing them back, in pushing the front teeth back, it basically caused the whole problem. I did not mention that I had a very bad, bad bout in 19— '88 or '89 of TMJ, where my jaw actually got locked at one point. So I think that was truly the beginning of all the major problems at that point. That's because my whole jaw was displaced. It was displaced and, you know, recessing back.
Given the fact that 40% of the people over age 40 in this country snore, The health implications are amazing of that. And when you, you know, connect that up with the fact that we can reopen extraction spaces, push the teeth back forward, get the lips out there where they're supposed to be, get the teeth out there where they're supposed to be, and then the patient gets their tongue to the palate and opens their airway up and they don't snore anymore. It's amazing what happens. But you have to listen to your patients. Because they'll know what's going wrong. They know, and intuitively most of them know what's going wrong with themselves.
I've always been a very good sleeper, hard sleeper, and I just woke up in the morning constantly tired and feeling I had never went to sleep at all. I believe that is one of the signs of sleep apnea. What I knew is, I knew for a fact that my teeth had recessed. And the choking had to come because, as I described to Dr. Hang, I had no room in my mouth for my tongue. And he said, well, Stephanie, that's exactly true. You know, your observations are very accurate.
What makes me think I can gain enough space by reopening spaces nonsurgically? Well, first of all, I'm never going to promise anybody anything other than I'm going to do my best. So I don't promise a result. But if I see the patient where the chin is forward nicely and the face is basically in pretty good balance, but the midface area, the lip bearing— the tooth bearing area is sunken back, well, that's the case for me where I think we really will hit the ball out of the park. And we have our best chance of success. And sometimes a very, very minuscule amount of movement is all that's necessary to get rid of the problem.
Well, I went to his website, I viewed his videos, I read up, I did a little research on my own. I felt very, very comfortable with him. His knowledge— he spoke to me in very technical— he knew I was an engineer, so he could talk to me in engineering terms that I could understand. When I had questions, he was very detailed in answering the questions. And I said, oh, how lucky. I left the office saying, how lucky am I that I can actually drive to him? That's what sold me was his, you know, his presentation of prior case studies and being very, very honest with me. I think I can help you. I knew I was not a clear-cut case, so being that he was willing to take me on, I was certainly willing to give it a shot. He had no guarantees of when I'd feel better, but I was surprised that, you know, the patterns of headaches and the snoring basically ended so quickly upon his treatment. And that once again proved how little additional tongue space I needed to actually be comfortable again.
I didn't know that I could get her done non-surgically, but I strongly suspected that I could because her face, her chin and her nose and her cheeks were in really, really, really good balance. They were well-developed forward. And the only thing that was really not where it ought to be was this section right in here. It was pulled back. I mean, we put the profile norm over her face and we did all our measurements, and I thought, if ever there's a case we can knock this one out of the park, this would be it. But again, you know, I would never— all I promised her was, hey, I'm an Eagle Scout, I'm gonna do my best here. That's it. And you just go with that. I'd rather— Under-promise and over-deliver every time. And if the patient's willing to start treatment that way, great. If not, you know, I'm not starting. I don't want to be in that, in that place where someone has unrealistic expectations and they're mad at me because I didn't solve every problem in their life.
What was so terrifying is the dreams just became, oh, More and more real that I was drowning, that I could not breathe. So when I'm waking up, you can imagine day after day waking up and feeling you were drowning. It's just a terrifying experience. 3 months after Dr. Hang's treatment began, the snoring ended and the headache pattern subsided. Today I barely ever get a headache. Very, very infrequent.
I think it's time that the orthodontic profession needs to look at themselves and say, hey, are we really part of the medical community or not? Back in the '70s, there was a very famous lecturer whose name was Melvin Moss from New York City, and he was really an anatomist, but he used to call the orthodontic profession, the silly millimeter profession, and all you guys do is get girls ready for the marriage market. And I was straight out of orthodontic training when I heard him speak, and I thought— I was kind of offended by that. And as the years have gone by, I have to think, here was this guy who was an anatomist and a PhD and a researcher, and I was offended by him because here I was, a clinician, And I thought, you know what, maybe he's more right than wrong, because as I've educated myself over the whole last decade about sleep apnea, I just see a clear relationship here. And, you know, I gave a lecture at the American Academy of Craniofacial Pain on the anniversary, their 20th anniversary of their founding, and I let it all out there. I talked about not removing teeth and not retracting back and talking about how this is really related. And, you know, probably the most famous TMJ doctor in the world came up from the back of the room and said to me, you know, that was a great presentation. I believe everything you say. I wish you practiced near me. That was really confirmation for me of what I was saying. It only made common sense to me. And that the size of the airway matters a lot, and you can't just willy-nilly violate the tongue space.
But what my personal dreams are— oh, I dream about seeing my son graduate from high school and can't wait to see what he'll be when he grows up. And I dream about a world without war and You know, I'm very active environmentally. How are we going to clean up this planet? You know, so I'm really, you know, looking forward. I'm a civil engineer and that's what I do for a living, and I always, you know, look for ways to improve our daily lives through our surroundings. I believe— I'm not a pessimist. I believe all this is You know, we can change everything.
