 Good morning, thank you very much for the invitation to come and speak the topic of my conversation the The evolutionary mismatch I present is very different from most of the other angles that I see here It started with a Simple question as many things do start it start with the question. Why are teeth crooked? so I'm an orthodontist I Deal with crooked teeth. It's my profession and I think it's very important to understand the cause the etiology of what you're doing and of course science often starts with the question why a Member meeting a German engineer and he was taught to ask the question why I think six times But you need to ask why why why? It's my favorite word now We have a problem crooked teeth and at the moment the solution seems to be straighten them well We do prefer simple answers a Concern has been that teeth don't seem to stay straight I mean I'd ask a poll here. How many people here wearing retainers of some sort? So quite a few wearing retainers of some description like so teeth aren't staying straight the next answer is hold them straight now The scientific evidence would suggest That this is an evolutionary disease so It's predominantly the environment with a sort of genetic flavor to it and the vast weight of quality publications in peer-respected journals suggests that it's an environmental disease or Predominantly environmental disease and yet we seem to be treating this as if it were a genetic disease and this is My issue Now there are no real alternative theories. There's no real decent returnative research the Image on the bottom left is taken from someone called William Prophet his book that is the predominant textbook of orthodontics and there he suggests a known cause of about five percent now those are the syndromes the pathologies Diseases and other things so you know those ones clearly and obviously so for most children Most of you who have had orthodontics There was no known cause they didn't know what the problem why the problem existed now This is my Bible. It is not the easiest read but this man cartini he has spent his life researching this and And He has there's a lot of important information that that's where I gained have gained a lot of interesting facts Now when we look at the etiology the cause So you don't find malocclusion present throughout our evolution until civilization for the masses the average person There was very little crooked teeth till about 250 years ago then You don't really see it in any of the other 5,400 species of mammals and There's a lot of other species of mammals. I mean we've got You know a huge number of and you can also talk about those that have been dead or extinct Although interestingly you are seeing some malocclusion present in the domesticated Cats and dogs and of course in England. We have this each situation with cities being infested with feral foxes that live off our Waste and we're seeing crooked teeth aka malocclusion within these groups now What we do See is this pattern Sorry, I will do first We don't see malocclusion either or we see less malocclusion in the indigenous populations So the indigenous populations are alive today, and they're not living such an indigenous lifestyle And yet there's a significant tendency for them to have less of a problem This is an issue some images of Inuits This was from war who was a contemporary interestingly of Western price Who observed the Inuit population and they're an interesting case because you have a group of Inuits who? At the stroke of a pen became Canadian citizens there were then eligible for social housing and food stamps and some groups chose that option and within two if not one generation of a pure bred sample who Until that point had had near ideal occlusion You got severe malocclusion similar to the indigenous population So that was very telling But of course, I draw a graph here, and that's a logarithmic graph Following you Homo sapien and anatomically correct Homo sapien now you could probably extend I know we've got this find in Algeria now We think we can extend that back 350 or 320 thousand years, but We had a fairly constant five percent and that harks back to that pathological group But didn't really start until we started farming until we went through the second second epidemiological transition we moved from subsistence sorry from hunter gathering to subsistence farming and Notice these two lines I've drawn here the yellow lines The industrial revolution so at the industrial revolution malocclusion seems to pick up notably the black line courses when we took our X-ray normative data Now that worries me that we've got the normative data taken So recently in a disease of modern society You can then look a little bit at the epidemiology and I put a slide that shows the distribution of sickle cell anemia That's a proper genetic disease If you have sickle cell anemia, you will be related to someone from those areas I've heard it suggested that it could be interbreeding that's caused malocclusion That doesn't really hold up. I mean you can crossbreed a great dain and a choice Chihuahua One of the canine teeth of the great dain weighs more than the head of the Chihuahua All of the offspring Have a range of sizes between mother and father their teeth match So clearly it's not such a simple relationship and People talk about a time change some of our ancestors had bigger jaws Sorry, not our ancestors some of the species we evolved from I Think there's and that's about as scientific as a fairy tale really. I don't think that cuts the ice now Epidemiologically it seems that wherever Civilization has raised has been raised Whenever civilization has raised in complete isolation And to whomever Regardless of that being related Malocclusion has occurred and has occurred in proportion to the level of civilization And you ask anthropologists and archaeologists. They'll always say Malocclusions disease of modern civilization now the two main factors I think is the reduction in muscle usage and These experiments of nature here show a Good example of how reduction in muscle usage can affect facial form in general The slide on the right is a proper muscular dystrophy and the template laid over the top Shows how a norm would be but remember those were norms taken and a much more modern era So I don't think that really relates to how good growing ancestors were And of course, we've had a huge change in master Catery effort It was not unusual That in your fourth decade of life You would wear your first molar tooth number six Down to it broke into its roots And that's a lot of wear And that was true right up until the medieval period now posture Seems to also play a large role this young boy gained a complete blocked nose because he had a gerbil in his bedroom and It has affected how his face has grown and of course Harvold has done some Interesting work on monkeys in one case he blocked the noses to force oral respiration and gained a very similar result to that boy but then trying to Tease a little bit deeper. He simply put a sharp object in the roof of their mouth So he's not affecting the breathing. He's not affecting the way the air goes, but is forcing a lower tongue posture Because the tongue quickly ulcerated from this object in the roof of the mouth forcing a low tongue posture and That caused equally severe malocclusion You know, you had your control set with near ideal occlusion You have your experimental group with severe Skeletal change and dental change in every case Just from lowering the tongue and of course if you have to breathe out of your mouth You're forced to lower your tongue. So in essence What seems to have happened are? Muscle tone has reduced We've gained blocked noses. So we've Move from good body posture with our mouths closed to poor posture With weak muscles and our faces have elongated and to give an illustration of that if you have strong muscle tone You're biting heavily together and your tongues up on the roof of your mouth Your face tends to grow forwards like this And you have good facial growth What I refer to as an upswung face If you have weak muscle tone and your tongue is low within your mouth Stimulated by nasal obstruction, which then becomes a habit Your face is going to tend to downswing and then interestingly It will reform because there's only a certain passageway that that back of the mandible can access Into your head Now your mandible has only a certain space a certain avenue Passing lots of vital structures now this is on Australian Aboriginal compared to a good growing modern human who has naturally straight teeth and You see how the faces down swung It's a little bit like all of modern Humanity have had a mild bilateral stroke Everyone here has had a mild bilateral stroke and of course as that occurs The cross-sectional area reduces you have less space for the teeth and that you get crooked teeth malocclusion and Depending how you respond depending how you decide to comfortably place your tongue and mandible So that you can breathe normally Will determine what type of malocclusion you get because it's all about breathing It's the most important thing in most people's lives and as The face Down swings as it lengthens it affects your airway this whole cross-sectional area gets compressed And what can get compressed? Well the easiest thing to get compressed is your airway So you then respond in different ways Now So what I'm suggesting is more complex than just crooked teeth crooked teeth aren't happening in isolation We're having a general change in facial form There's leading to crooked teeth and of course this change needs a name You need to name things to understand things. So I've come up with the term cranio facial dystrophy Dis-bad or wrong trophy development. So we have bad wrong development now It's interesting in medicine we seem to lack Theorists we have experimenters observation Experimenters and they seem to do all the thinking We don't Have people who just think who you know speculation on ideas is not encouraged in medicine Particularly not if you come up with an idea that doesn't fit the current paradigm It is not encouraged I think that's a great shame and that old phrase of prove it Because you know, there's not much evidence on function. It's hard to get and Posture well, that's function over time You know you'd need to follow someone around all the time and Are they really gonna act normally when you're following them around are they gonna act normally when you've got them wired up to machines? It's a difficult thing to really study and understand And you've got no evidence Is not well no evidence is not the same as being wrong It means you have no evidence but My concern of course is a face that is not the right shape Doesn't work correctly and you can say well What in what important functions does the face do? Well quite a few really and of course the face is connected to the rest of the body So it's probably knock on implications From having a face that isn't the right shape Well, certainly if the faces down swung the upper jaw is going to be narrower. That's going to influence the nasal airway and We have I think I said deviant knife anyone's got a deviant nasal septum do tell me Deviated nasal septum wonders of spell check But of course if you've got less space you're going to get sinusitis You're going to get more inflammation and also I think a normal level of inflammation With an a narrow nasal airway is likely to lead to blockage Where if you had a wider nasal airway that normal level inflation wouldn't have left led to blockage Of course, you're going to get glue here The if the face is truncated, it's developed less horizontally Your use state the opening of your use to use station tube is not going to regularly open when you swallow as it should do leading to what we call gluia otitis media and blocked use, you know the reduction of patency of the use station tube and Of course, you're breathing air through your Mouth not through your nose. You're going to get tonsillitis adenoids will flare up and Of course, but the big one really is sleep apnea And with that snoring The most statistically significant measurement the sleep apnea is the distance from the insertion of junior glosses to the posterior pharyngeal wall as demonstrated here and If your face down swings, it's carrying your tongue down into your airway now. Yeah, I know obesity is also a major factor But there's a lot of skinny people who've got sleep apnea And if you look at people with sleep apnea, they're down swung usually not always But a significant proportion are and the significant portion are very down swung. Of course, you could also ask do fat people become sleep apnic or Do sleep apnics become fat? If you have a bad night's sleep and you're feeling terrible first thing you're going to reach for as those comfort foods And if you're sleeping badly all the time That's going to have a constant effect Then sleep Sleep apnea is highly implicated with Cardiovascular disease diabetes and of course as some people are thinking that ADHD Is Sleep ap is is a lack of sleep. You know, you've been with kids who haven't slept well. They're Pretty difficult and What do we give people with ADHD and Fetiments Keep them awake Seems to work and as I often say if you're snoring today, you're going to get sleep apnea tomorrow You shouldn't be snoring But if you are snoring, I've got sleep apnea. We'll give you one of these lovely devices The ones on the top Are the cheap and expensive version of holding the mandible forwards The bottom left is a seat back Bottom right. Well, this is what's called the considered the gold standard for sleep apnea treatment Moving both jaws up and forwards well Newton wasn't wrong if you're holding the mandible forwards You're going to be pulling the maxilla backwards and see Pat. Well that directly pulls a maxilla backwards so these are all Nice methods of slowly killing yourself Except of course for our gold standard Which is really? Making the face upswing Making more space for the airway. That's what you're doing You're getting an upswing in facial form and All of that seems I could probably prove most of that but You know, I've seen a lot of Implications, I've seen a lot of evidence that leads me to think further and Soon as I qualified I went to Thailand Hard enough qualifying took me long enough and I've been going back to Thailand every once in a while ever since the first time I went was in 93 And what I observed was how beautifully straight everyone's teeth was were Also how beautiful their skin was and as I've been going back I've noticed that People's teeth are getting more crooked Lots now wearing braces a lot now wearing braces and often those individuals Suddenly lost that beautiful skin they had They've got acne Now the acne seems very well localized just to the facial area. That's always made me wonder But then it harks back to a little bit where I'm saying as the face downswings What can get compressed? Well, we're going to compress the airway Well, what else could get compressed? Well, you could compress the venous that Lymphatic drainage and let's look at it a little bit further and Putting together a lot of other tit bits of information. I won't go into it in detail, but You've got the carotid sheath as Marketed by the blue arrow and Something seems to be going on at the level of that yellow arrow as the face downswings and often it's not in people who are the most downswung is Sometimes and the people who are less downswung who are trying to fight it and It would seem related to movement functions of the lower your hindbrain and My suggestion is that we're getting an obstruction of the venous drainage out of the hindbrain. I don't think this is causing the first three I Think it's probably just Increasing the rate of which these things occur But if the back of your brain is sitting in stagnant blood Any other form of pathology is going to be accelerated But there's a lot of tit bits and odd bits of information that back up that Multiple sclerosis Parkinson's and Alzheimer's is related To craniofacial dystrophy and of course also in that carotid sheath. You've got your vagus And we all talk about the fact Modern humans are engaged in some sympathetic hyperdrive Or on the go all the time Well, of course, if you're compressing your vagus You're gonna get some sympathetic hyperdrive. You're on the go now The future where's this going? Well, I gave a lecture in Philadelphia about two years ago and I I Was saying to have people there that I felt that 10% of people over 60 in the westernized world were gonna die 10 years early due to sleep apnea and its consequences and Everyone said back to me might That's Probably an underestimation. I think that's gonna be more Now I've put an image up there of spanned our ballet and spanned our ballet was a pop group in The 80s that makes them 60 now Now I know they're pop group. They're biased group. So yet they're slim. They've got good facial development But just Google beach Google faces go into a university start looking back at the yearbooks Facial form was better We seem to have everyone agrees we're getting fatter But look we're getting more down swung as well Faces are melting down It's occurring slowly slowly Beneath our noses and we're not even noticing it now That leads me on to the inconvenient truth These cases were treated by orthodontic treatment What do you think that may have done for their facial form? Upswung it or downswung it. I see this a lot now We call this Unfavorable facial growth. We call these people poor growers But do you think they're gonna live as long I don't think so now my father in 1998 went on national television in the UK To say that he thought modern orthodontics was causing facial damage Notably in about 20% of patients That got his career destroyed quite nicely And no one ever actually sat down and asked him what his concerns were And I see this all the time and I think it's collateral damage And I think these are responsible. I think these are not good for you These are causing damage to people not everyone But I think these are shortening lives now if you look on The on the web your VP talking about Retractive and non-retractive orthodontics Why why are they talking about this? Why are we talking about there is an issue with retractive or non-retractive orthodontics? people talking about Airway orthodontics Why were we considering about airways and orthodontics clearly? Someone's concerned there may be a problem Well, my problem is if you don't understand the pathology, you're likely to mess up and almost always Roots is shortened when you have orthodontics almost always Sometimes it's alarming now We get long in the tooth You can't as you get older you can't afford to get very long in the tooth when you don't have much length on your teeth And if you need a root filling well That is going to be a lot more difficult if you've got roots like that with open ends on them And then who remember those people here wearing retainers Well recently in Britain we had a campaign keep that smile Because teeth don't stay straight because you don't understand why they were crooked and you haven't fixed the problem So we're holding teeth straight with retainers forever now if your facial form changes so our faces drop as they often happen in a modern society We don't have enough force a faces gentry length them and if you're holding those fate those teeth in a mechanical device that you wear every night as The face changes the teeth don't change And you see how these teeth are bulging out the bones moved the teeth are now outside of the bone How long are those teeth gonna last and remember mass orthodontics only started about 35 years ago Even old enough beyond that to remember we didn't have kids all these kids embraces before then It wasn't happening now That's normal occlusion That's how our teeth looked for hundreds of thousands of years all 32 teeth Everyone who had wisdom teeth Before about the medieval era from several researchers have them working in function. There's been no genetic change There's none this idea that we don't need them anymore. That is nonsense If you have had if you don't have space for wisdom teeth Something's wrong. I mean I've got space for my fingers on my hands Damn it. My legs aren't the same length. I'm I just lucky Now we can't go back in time, but what can we do now? This is what I'm doing And I believe I'm getting the best facial results or the best facial change Ever achieved anywhere by anyone But this is not easy But look at that result that boy is not going to get sleep apnea where there was a high chance he was going to And that's up swung the face. It was set back with the jaw set back Here we've up sung us waste with the upper jaw set back She was told by a surgeon that there was nothing they could do till she was 18 years old How's that for consent how would her life have been if She was growing like The picture on the left because that would have got a lot worse She would have gone through her formative teenage area era With what we could call a suboptimal view Nice improvement, but hard work, and I'm trying to extend this to an older age group Almost non-growing. It was 16 when we started but This does not make money the amount of time and effort I put into this is ridiculous So I've had a 10-year campaign to grain debate on this subject. I Started in 2009 with an article the black swan I've then written to the British orthodontic society I've gone to the government every department I can think of The Minister of Health the general dental council I've set up a social media site. I mean try typing orthotropics in and This concept of mewing has been set up. I've I'd have been this phenomenal success on the social media I wasn't expecting this. I mean it gets a little bit scary Yeah, okay, let's move on but now Because of this I Am getting into trouble So the British orthodontic society has been through my videos with a tooth comb They don't like them and they've reported me to the general dental council Clearly this profession doesn't want to change And it's so far. I have had no engagement at any level. I'm saying we don't know what causes the problem We need debate. It's all I'm calling for is debate Discuss why teeth are crooked the normal scientific process and now I Seriously risk losing my license to practice For me trying to raise debate and get information out to people in the wider community And I face going in front of a board Who all believe in the status quo? having to quote literature based on the status quo and Having to choose from a range of experts who are based their careers on the status quo That is not a good not good odds on staying in business Now what really annoys me is I think this could all be prevented. I think with good quality Hard I tough bulky food. I don't really know all the answers, but definitely food. Do you have to work on to eat? prolonged breastfeeding Baby-led weaning if you're familiar with the concept, but also an hour's post your exercise a day and hours Resistance training a day and I think that wrapped up in a personal a public health message could minimize or eliminate all of those symptoms that I quoted to you and The one-hour chewing just chew gum one hour a day from about three or four years old and this one-hours Exercise well, we wrap this up with eating The simple rules sit up straight elbows off the table Chew your food properly swallow with your mouth closed Not exactly new really. I've just reinvented the wise tradition of stand up straight and shut your mouth now on the 28th of July I am Gonna start a petition in the UK and I will ask government to ask the General Dental Council to repeat the debate of 1936 on why our teeth crooked. I Need signatories I Need letters to government and I need signatories on this petition. I need collaborators I need volunteers and I need donations. I want the truth The whole truth and no dogma and I don't have all the answers, but I am asking the right questions And right now I am putting my career on the line Before I get it taken away Now if people are watching this lecture and they have kids with braces on I'm saying get the braces off Either the top or the bottom molar and premolar teeth Because I think it's where you've got the brackets on the back teeth upset the bite You don't want to bite as hard and of course that's one of the major causes I'd say take good records. I'd say to all of you here Write something in your own field That relates to what I'm saying But please don't put it out till the 28th. Have a small embargo till then if you can And why am I doing this? Well, I said I've done this mission when I was 14 years old My father's been talking to me about this since I could talk His great he can remember where he was when his grandfather said oh John I've just read an interesting book by this guy called Western Price before my father even left school and I think I need I want to benefit mankind and We were not born to be ugly. We were not born to be unhealthy and Right now. I've done it. I have worked so hard. I worked 10 12 hours a day every day often seven days a week I Have Everything I've burnt house inheritance everything, but I've built a clinic that is getting amazing results But I need the spotlight of modern medicine to focus on this In the UK. I'm a pariah In the national health no one talks to me. No one returns my calls. I can't get involved in science. I Can't get anything So I'm gonna push for change before I die So thank you very much All help would be appreciated And that's the campaign title why our teeth crooked Okay. Well, that was kind of inspiring So if anybody has any questions the microphone is over there Why So The academic world is sort of What about Society Well, it's it I think within anthropology and Peter Unger are very clear they they follow the science They're aware of the science. They're following the science. The science is all there This can just be ignored You know the orthodontic community Choose to ignore the science I didn't say that I Yeah, I have a feeling they don't want to lose their incomes. They don't want to lose their status Okay, so if you want to come closer here I think we have more you're talking about lots of different methods of rearranging the deck chairs and the Titanic That's all they're doing. They're rearranging the deck chairs when they're young They're rearranging the deck chairs when they're old. That's it You're not affecting the causes medicine is about affecting causes of the problem. That's affecting the muscle tone That's affecting the posture. None of what you're saying is affecting either generally