Controlled Arch Orthodontics



What is the Controlled Arch System?


The Controlled Arch system of braces makes necessary tooth movements to the patient’s anatomy and facial characteristics. This system offers an alternative to traditional orthodontics for some patients. Controlled Arch orthodontics do not simply straighten the teeth in a narrow mouth. Controlled arch orthodontics are usually preceded by AGGA, Anterior Guided Growth Appliance to develop the natural pathways of bony and soft tissues structures of the face and palate and jaw to not only create the desired facial growth for the teeth but to also improve TMJ dysfunction and airway and breathing concerns.


What are Controlled Arch Orthodontics?


Our teeth do not simply develop on their own. Teeth develop in conjunction with our chin, jaw, skull,  and other facial features. This combined growth and development means that people who have crooked or crowded teeth often find they are also unhappy with the appearance of other facial features such as a retruded chin or asymmetrical cheeks, lips or eyes. With Controlled Arch orthodontics, Dr. Coats can utilize the shared development pathways of the face and jaw structure to straighten your teeth and influence the size, shape, and configuration of some facial features. Controlled Arch orthodontics can also be used to address important functional changes that can improve symptoms of TMJ, snoring and sleep apnea.


What is AGGA?


An AGGA, called anterior growth guided appliance, is essentially a device that expands the upper jaw and restructures the midface to reach the proper face, jaw structure and teeth harmony. AGGA does not only expand the width of the dental arch but more importantly the bone and soft tissue of the face forward. The development of the midface means that one can see change in profile such as a more symmetrical nose to upper lip to chin balance and development of space to have the required space not just for crowded teeth but for the face to support the tmj jaw position that alleviates tmj pain and symptoms


How does the structure of my jaw cause health issues?


The structure of your jaws plays a huge role in the health of your entire body. Examples related to health are breathing space at the back of your throat for avoiding snoring and sleep apnea, tmj position not pushed back towards you each avoiding ringing of the ears and also muscle tension from clenching from improper teeth, muscle and jaw position . Unfortunately, we live in a time when abnormalities in the structure of the face and jaws have become common due to soft diets, tongue ties and mouth breathing. The contribution of poor facial structure to some of our society’s most common illnesses of snoring, mouth breathing, fatigue, jaw pain, and headaches could be the most misunderstood and underreported topic in all of dentistry and medicine.One reason for this is that it is not immediately obvious how the jaws can impact the entire body, but actually, it is quite straightforward: jaw issues mean airway/ breathing issues.

Your throat and neck houses your windpipe. When your jaws are too set back, your airway can be obstructed and hinder your ability to breathe thus causing underlying health issues. The most alarming health concern caused by a recessed jaw can be obstructed breathing, or OSA (obstructive sleep apnea), also known as the silent killer. There is a long list of symptoms that result from OSA which are well-studied researched and acknowledged by all health professionals such as sudden death, brain fog, depression, weight gain, heart disease and others.

Breathing requires your airway to be open freely. When your airways is narrow and pushed back, the muscles that control the position of the jaws and the opening of the throat must work harder to reposition the jaws to keep the throat more open. This can lead to muscle fatigue and soreness that can result in teeth clenching, neck aching, and jaw pain.


How does a small jaw contribute to OSA, Obstructive Sleep apnea?


Small jaws can result a small airway, and it has been shown that patients with obstructed breathing tend to adopt a compressed neck posture as a way of opening that airway. This chin-forward, compressed neck posture does improve breathing, but this is achieved at the expense of the muscles, nerves and muscles at the back of the neck. Over time, compressed neck posture results in an accumulation of nerve damage in the neck and scalp. A small recessed jaw can also lead to teeth grinding that most people complain about at night. The reality is that the combination of a recessed jaw and the gravity of sleeping allows our jaw to relax even more, resulting in one’s airway or breathing space being compromised and it might be the reason your bed partner tells you sound like you are choking in your sleep.


How can AGGA, Anterior Growth Guided Appliance Help?


If the jaws are too small, can we work to expand them? Yes! We can work to expand the jaws three-dimensionally to reach their full genetic potential so that the airway can be opened and normal, healthy breathing can occur. AGGA allows for our growth potential of the jaw structure and mid face to develop  3-dimensionally  from the side profile the lower jaw follows the upper jaw development forward. For a long time, people with concerns of a set back jaw, a retruded or no chin, and severe teeth crowding had very few options and most successful treatments included  only included surgery. Highly invasive surgical procedures, especially in adults, were needed to correct and achieve forward growth of the jaws. While surgery is still sometimes necessary depending on the amount of jaw deficiency, AGGA can be used to control development of the mid face without surgery.

AGGA is a small, painless orthodontic appliance the faces of children and adults of all ages can be grown to their full genetic potential in about one year. Once the  bones and tissue of the midface and airway are grown to their genetically potential, patients are able to experience the levels of health and beauty that nature intended. The desired growth is unique to each patient determined from studying 3D Cone beam imaging that measures the  correct angles needed for the face to achieve a better TMJ integration, jaw positioning, and airway opening.


What is AGGA treatment?


An AGGA is an orthodontic device that expands the upper jaw and restructures the midface to reach the proper facial harmony. AGGA can change the position of the teeth and develops bone of the midface and upper jaw, called the maxilla. By placing pressure in the right areas, an AGGA stimulates overall facial bone development. The results of AGGA are better facial symmetry, develop room for the crowded teeth to straighten and also improve the bite by allowing the mandible lower jaw to have room to reduce TMj pain.


What can an Anterior Growth Guided Appliance Treat?


AGGA, or an anterior growth guided appliance, can treat headaches, TMJ pain, and can develop space in the mouth by growing the bone support needed to balance the bite, jaws and face. The results can also improve the side profile by creating better facial proportions. AGGA can improve the profile of the face by advancing a retruded chin,  evening out the imbalance of eyes, and making what might seem like a larger nose seem more proportional.  The AGGA helps develop the bone of the midface that lies under the nose so that the bone and soft tissue supports the face and makes the lips, chin, and nose look more proportionate.


How much does AGGA cost?


Dr. Coats usually charges from $3,000 to $15,000, depending on whether the case will also require controlled arch braces to complete the case. The duration of treatment can vary depending on the patient’s needs such as the amount of bone development needed and the degree of teeth crowding, together with the amount of TMJ pain and dysfunction. These fees include the cost of AGGA + the Controlled Arch orthodontics. Orthodontic treatments can vary from 18 -24 months of care.


How Does Controlled Arch Orthodontics Work?


Controlled Arch orthodontics look a lot like traditional braces, however the¬† function¬† is much different. Controlled Arch uses similar brackets and wires to apply force to your teeth, but the pattern of forces and the desired structural¬†end point¬†is different. Controlled Arch orthodontics is based on the action of muscles in the mouth that stimulate the growth and movement of the teeth and bone of the jaws. We know that crowded teeth are related in part to our softer diet, which means we are not required to chew as much as our ancestors did on harder foods. Environmental¬†and food allergies have played a role in children’s breathing by causing more children to breathe through their mouth, thus creating a population of underdeveloped jaws.¬† Toddlers usually have a diet of soft pouch food that does not stimulate the bone of the jaws and face. Therefore, AGGA and Controlled Arch orthodontics combined are designed to combine¬†the natural forces of tongue, face and jaw muscles along with the bony and soft development of the midface to create a more efficient movement of mechanics that is designed not just to move the teeth, but to also stimulate the development of other tissues around the teeth. The results are¬†not only straight teeth, but also changes to the appearance and function of related structures such as TMJ position and airway, breathing and development of¬† space for crowded teeth. The Controlled Arch system can improve your overall health, adjust your facial proportions, straighten your smile, and also address symptoms of¬† TMJ, headaches, and sleep apnea.¬†¬†