Mike Wiegenstein: The appliances we talked about, being able to help kids and change things but one thing you really made a point to me was, as a parent, if we have a child that has a condition like this and we know about it obviously people don't know there is something you can do, but we have a choice to make. We can either help them to get treatment now and you said after 6, 7, months, 8 months they can correct the problem, so for the rest of the life they don't have a challenge or allow them to grow, grown on their own and they'll spend the rest of their life working to fix it. Why as parents, do you think more are bringing their kids into get fixed.Dr. Brock Rondeau: I think the parents are bringing them and they get fixed, but it just depends on whether those dentists have been trained to evaluate those problems and whether the orthodontists that they refer them to want to treat early. Some orthodontists prefer to wait until all are permanently dropped. I am of a different school of thought. Like the Europeans, I like to treat early. Why not solve the problem, when the patient is actually be growing and try to do with once they are -- all they are permanently dropped. I mean the early treatment.Mike Wiegenstein: Is just having orthodontics done enough to ensure, you don't get these problems?Dr. Brock Rondeau: I would say no. Orthodontics is just basically straightening the teeth. It's important for orthodontists or general dentists, whoever is doing the orthodontics to make sure that they have a healthy temporomandibular joint. If no attention is paid to the temporomandibular joint and you just give straight teeth, some of those patients could have problems later on. The patient have some worse problems are the deep over-bites and the jaws that are intrusive, it make tense.Mike Wiegenstein: With that being said, let pull up your first case that we are going to go over here.Dr. Brock Rondeau: Okay.Mike Wiegenstein: Now tell me about this little girl. She is ten?Dr. Brock Rondeau: Ten years old.Mike Wiegenstein: Then I mean, when I started talking to you, I see they have the kids at school, my children go to school have this profile.Dr. Brock Rondeau: Yes.Mike Wiegenstein: I mean is this a pretty - Dr. Brock Rondeau: This is a very serious problem in our society. Most kids have an underdeveloped jaw and they need to be brought forward when they are actually be growing. So that little grow would probably have some jaw problems. She could have ring in the ears, she could have headaches.Mike Wiegenstein: Now, we talked, you said, neck pain?Dr. Brock Rondeau: Yes.Mike Wiegenstein: Okay, she came in because she had neck pain, was that one of this? Dr. Brock Rondeau: Yes.Mike Wiegenstein: Then the young child unless they just had a dramatic injury, they shouldn't normally have back pain.Dr. Brock Rondeau: No, they shouldn't.Mike Wiegenstein: Soreness, anything like that. So tell me what you did for her?Dr. Brock Rondeau: Well, basically because her jaws were intrusive.Mike Wiegenstein: That means just back?Dr. Brock Rondeau: Back.Mike Wiegenstein: Okay.Dr. Brock Rondeau: When the jaws are back too far, she got forward head posture, so her head tips forward and for every one inch their head tips forward, it puts ten pounds of pressure on muscles in the neck.Mike Wiegenstein: Okay, let's look at picture real quick. You told me that their ear should pretty much line up right over their shoulders.Dr. Brock Rondeau: Yes.Mike Wiegenstein: You can see her shoulders put her ear about half way back overhead.Dr. Brock Rondeau: May be four inches.Mike Wiegenstein: Okay, so that means that her neck is holding up an additional 30-40 pounds in weight.Dr. Brock Rondeau: That's right.Mike Wiegenstein: Which is why it's sore.Dr. Brock Rondeau: That's right.Mike Wiegenstein: Okay, so what would you, what did you do to help her?Dr. Brock Rondeau: When I bring a jaw forward -- bring the next picture up. Mike Wiegenstein: Okay.Dr. Brock Rondeau: I bring her jaw forward. You can see her head up right over her cervical spine, her head went right up, so I brought the jaw forward -Mike Wiegenstein: Hold on. I am going to back up to that first picture with just a second. Dr. Brock Rondeau: Yeah.Mike Wiegenstein: Her head seems to be almost angled down.Dr. Brock Rondeau: That's right.Mike Wiegenstein: Then the second picture - we'll open up there side by side. You can definitely see that her head is up, it's square. Her jaws now altered, and you're telling me this all because --Dr. Brock Rondeau: All because I used a functional appliance to bring her jaw forward and the cause was her lower jaw was deficient.Mike Wiegenstein: I mean if you even look at her eyes, her eyes look more alive. I mean she has -Dr. Brock Rondeau: Well, plus self esteem. If you have weak chin, the kids will make fun of you. Because then if you have weak chin, you got back teeth, because there is a difference between the upper and lower teeth, it's called an overjet. So the kids make fun of them, calling the back teeth, and so their self esteem suffers. So when I am talking about the reason I use this is not just for self esteem but also they help their health. Just remember when I bring the jaw forward, I help the TMJ problem, help the jaw problems because many jaw problems and we show some videos later, are of the jaw being back too far.Mike Wiegenstein: Okay.Dr. Brock Rondeau: So I am bringing the jaw forward. I am also bringing the tongue forward, which is going to help prevent snoring and sleep apnea because when the tongue falls back and blocks the airway, that's what causes the snoring and the sleep apnea.Mike Wiegenstein: Okay, now you brought this little girl's jaw forward using just an old appliance.Dr. Brock Rondeau: Her headaches are gone, neck problems are gone, she is a happy little girl. Then I'll put the brace on to straighten your teeth. So fix the bone problems first.Mike Wiegenstein: So you fix the structural problem?Dr. Brock Rondeau: Structural problem first, then I fix the teeth.Mike Wiegenstein: Then you fix the teeth. Alright, let's go to your - I believe your next.Dr. Brock Rondeau: He was sevenMike Wiegenstein: Seven?Dr. Brock Rondeau: Seven years old. And for sure those kids were making fun of him. You can see his jaw is way back.Mike Wiegenstein: what you do for him?Dr. Brock Rondeau: I bring his jaw forward with one of those twin block appliances like I showed you earlier.Mike Wiegenstein: Same thing?Dr. Brock Rondeau: Same thing.Mike Wiegenstein: And this is this kid.Dr. Brock Rondeau: This is him, about ten months later. Looks like a completely different individual. Nobody is making fun of him now.Mike Wiegenstein: Now let's take a look at his teeth real quick. You can tell me -- can you tell me what's going on here? This is the picture of his teeth.Dr. Brock Rondeau: You can see that his back teeth are 9 millimeters behind his upper front teeth.Mike Wiegenstein: So, now this is looking at him from the side.Dr. Brock Rondeau: That's' right.Mike Wiegenstein: The two teeth on the right hand side that are puking almost straight out of his -Dr. Brock Rondeau: Top teeth.Mike Wiegenstein: Top two front teeth.Dr. Brock Rondeau: Yeah.Mike Wiegenstein: That's' incredible. And with -- now the oral appliance moves the jaw, now is this kid has orthodontics also?Dr. Brock Rondeau: Yes, after I moved his jaw, you will see there is the position his jaws in after 12 months.Mike Wiegenstein: Okay.Dr. Brock Rondeau: Then I just waited till all of rest of his teeth erupt and then put braces on it, to give him straight teeth.Mike Wiegenstein: But now he is -- you brought that lower mandible out to match where it should be.Dr. Brock Rondeau: Right.Mike Wiegenstein: Then you brought the teeth back to some degree.Dr. Brock Rondeau: Yeah. We brought the lower jaw forward.Mike Wiegenstein: Okay.Dr. Brock Rondeau: And we fixed the structural problem because he had a bone problem. His lower jaw was deficient. You can't fix lower jaw deficiencies with just braces, you have to use functional appliances. I've been doing this for last twenty five years and I really like the results I get. A lot of parents that once I talked to want their children to be treated early, they don't want to wait till problems developed, when they are more expensive to treat later on.Mike Wiegenstein: Alright Doc, we almost at a time but with TMJ you mentioned it, take a moment and just explain what it is and how it works? It's basically this function, your jaw joint, yes?Dr. Brock Rondeau: The public call the TMJ.Mike Wiegenstein: Alright.Dr. Brock Rondeau: But the medical and dental professions call it TMD, Temporomandibular Joint Dysfunction.Mike Wiegenstein: Okay.Dr. Brock Rondeau: It's a disorder of the TMJ. Mike Wiegenstein: Alright, you brought a clip. Let's take a look at it real quick and kindly explain to me what it is? This is a clip of -- that's a jaw joint, right? Dr. Brock Rondeau: That's a jaw joint. Mike Wiegenstein: The bottom is your jaw bone, your mandible that you chew and the top is the joint at its end. Now okay, so under normal conditions, it just kind of goes back and forth nice, what's the orange part?Dr. Brock Rondeau: The orange part is a disk, that's the protective piece of cartilage between the two bones, which allows that the jaw to move nice and smoothly and protects the two bones.Mike Wiegenstein: Okay.Dr. Brock Rondeau: The yellow part is the nerves and blood vessels behind the jaw and you don't want that jaw to go back too far. That's the problem with those little kids with those back teeth. Your jaw is back too far and that's why you have to move them forward with those functional appliances.Mike Wiegenstein: So they goes back too far, it presses on the blood vessels in the nerves back there, kind of like stepping on the garden house, shuts off the blood, so they get the headache, they get tense, there head goes forward to try to relieve that and then they start getting those neck problems and things.Dr. Brock Rondeau: Right.Mike Wiegenstein: So over a time now, is it's a progressive problem that'll continue to get worse?Dr. Brock Rondeau: Yes, it is. There is five stage of this displacement. We'll show the disc going out of position shortly. Mike Wiegenstein: Okay.Dr. Brock Rondeau: The disc is out of position now.Mike Wiegenstein: Okay.Dr. Brock Rondeau: You can see the patient is going onto the disc, see how much thinner it is.Mike Wiegenstein: Alright.Dr. Brock Rondeau: When they go onto the disc, that's a clicking here. So the clicking is bad. You hear any noise in the joints, it's bad, any noise in the elbow, any noise in the shoulder is bad, noise here is also bad.Mike Wiegenstein: And eventually it breaks through.Dr. Brock Rondeau: Breaks though, then you get a perforation and hear a cracking noise, called as crappy disc, not good. It's then as born and born and then the top of the jaw almost starts to wear down. Those patients will have a lot of pain because frequently too what happens is the nerves and bloods vessels get very compressed on that.Mike Wiegenstein: Can you help them also?Dr. Brock Rondeau: They are more difficult but we can help them.Mike Wiegenstein: We are out of time here. If everybody can take home one message from today about sleep apnea or TMJ. What would you want it to be?Dr. Brock Rondeau: Get your kids in early, any child that has back teeth or has their jaw too far back, get them in early, get them wearing a functional appliance, get that jaw forward.Mike Wiegenstein: What if your kid snores?Dr. Brock Rondeau: Well, that will help too because and look at the adenoids and tonsils, get those adenoids of tonsils out.Mike Wiegenstein: When you open your child's mouth up and look in it, should you be able to see down?Dr. Brock Rondeau: Yes, you shouldn't see tooth meat but also the back of the throat.Mike Wiegenstein: Or the tongue and the drape meeting together.Dr. Brock Rondeau: Right.Mike Wiegenstein: I want to thank you for coming in you, you've been very, very informative.Dr. Brock Rondeau: It's my pleasure Mike. Thank you very much.Mike Wiegenstein: You've watching Medical News Network, I'm Mike Wiegenstein. For future information on this subject or any other, please visit our website at medicalnewsnetwork.info. Until next time, I wish you good health.