CASE STUDY Figure 1: The case of Brenda S. with her expressed and kind permission. Figure 3: Epigenetics making physical change while genes remain unchanged. Figure 2: The airway suffers when jaws fail to grow, hence, look for an impaired mouth underlying the airway and sleep-related complaints. Figure 4: Presenting complaints are in black font; clinical findings in blue. This author has put the above epigenetic research into Clinical Epigenetics: a novel clinical dental practice involving prescribed changes in individual patient behavior and oral environment to redevelop deficient maxilla and mandible through fuller gene expression without gene alteration. Figure 3 shows an example of Clini-cal Epigenetics. 10 Epigenetics can bring on fuller oral facial growth without drugs, surgery or pain. Fuller gene expres-sion comes from the patient’s own body, not the doctor’s chairside performance. That is a new paradigm in airway dentistry and orthodontics. Significant points in this new paradigm include: • Failure of jaws to grow can lead to airway obstruction. 9 • Bruxing stops when CPAP is titrated optimally. 11 • Bruxing also stops when jaws are sufficiently grown epige-netically. 12 Figure 4 shows Brenda’s list of symptoms in the order of impor-tance to her. It’s prudent to suspect deficient jaws and thus Impaired Mouth Syndrome in the presence of a narrow airway in the left half of the color scale: black, red, orange. common medical, dental and mood symptoms, including but not limited to sleep bruxing, TMJD, UARS, OSA, HBP, diabetes, obesity, depression, anxiety, brain fog, PMS, ED, chronic pain and fatigue. 13 Could Impaired Mouth contribute to Brenda's symptoms listed in Figure 4? In my experience, 50-90% of presenting complaints fade away, often within the first few months or weeks when a struc-turally impaired mouth is treated with Clinical Epigenetics. Impaired Mouth Syndrome Impaired Mouth Syndrome is a term I coined in 2017 to highlight oral contributions to a vast set of Step One In Clinical Epigenetics My first task is diagnosis to answer this question: Is her mouth impairing her total health? Airway www.orthodontics.com Winter 2024 7
Journal of the American Orthodontic Society JAOS Winter 2024: Page 7
