Hey there. Thanks for the video. Did expanding with the MSE make your mouth and nostrils wider? I see that both your mouth and nostrils are quite wide, which is great! I'd love for both my mouth and nostrils to be slightly wider, which I assume the MSE does as it's expanding the maxilla and nasal cavity. I can only imagine how one's breathing must improve too. I've been doing a bit of research and Dr. Marianna Evans in Philadelphia seems great. She uses a double MSE device... it's basically a two in one. One more to the front of the upper palate and one towards the back of the upper palate so there's a split all the way from front to back. Others usually just use on MSE and may only get a split more towards the front of the palate. Here's a picture of the double MSE in a mouth: img.th-cam.com/users/vi1WVoKQc789c/maxresdefault.jpg
Hi Ashely, do you know anything about bruxism and how to stop it? I have TMD and will probably get a sleep study. Im 21 so I dont want to do MMA if I don't have to. I'm a normal weight but I think it has to do with my airway and jaw, starting the diagonstic process.
Bruxism is typically caused by some combination of stress, malocclusion, and/or an airway issue. I have seen it decrease with many patients by doing oral motor therapy. Many of these patients also had TMD and sleep-disordered breathing. May I ask where you are located? There is an at-home sleep study on Lofta.com. The WatchPAT is the study you want. You can order one without going through your doctor. I highly suggest doing this considering your symptoms. Email me directly if you have specific questions. sommerspt.com
Hey Ashley. Can MSE/MARPE/EASE potentially wear out the TMJs or condyles? I'm worried that with MSE and then MMA, the TMJs might be in really rough shape. Does expansion usually favor the weaker side or the better side? Generally, I feel it just exaggerates asymmetries but are there cases where it undoes asymmetries?
Good questions. I am not aware of any studies published that show increased wear on the condyles post-skeletal expansion of the maxilla. Additionally, I have not seen this clinically. I imagine that it could increase OR decrease wear on the condyles simply due to the orientation of the mandibular fossa changing and thus altering the force applied through the TMJs. I believe we don't know the answer to this because we haven't had enough to study these cases long-term. "Weaker side" and "better side" are a bit vague so it's difficult for me to answer this question. Can you rephrase this question to be more specific? I have never seen a skeletal expander un-do asymmetries. This does not mean that it is not possible, I just haven't seen it or read about it.
Before and After MSE treatment pics if possible. Also, I wanted to ask does MSE improve assymetry face (includes one side of droopy cheek bone, eyelids, lips) ?
You look great, I just turned 17 and I am currently practicing keeping my tongue on the roof of my mouth. I have been practicing since September last year and I have not seen major improvements. My palate is narrow but i am still able to suction my tongue on the roof of my mouth . I am hoping to improve my tongue space by doing this and improve nasal breathing, are there any tips that you can give to maximise my results? Thanks.
Hello Ashley! Thank you for this demonstration it helped me a lot! So, i can do suction well and can click well but because i have been hard mewing, my palate become too high arched making it hard for me to hold the suction and swallow correctly. How do i get my palate back to normal without having it shrinking in terms of width? Also, when i do my suction to collect the saliva, my tongue pushes against my bottom teeth and my 4 bottom teeth got crooked in the span of 3 days! Please give me any tips to help my circumstances and fix this high arched palate issue. I tried to gently rest my tongue on the palate but there is endless saliva. I think there is a correlation to high arched palate and saliva production.
How old are you? If you are young and consistent with habit changes you may be able to get some palate shape change by habitually having your tongue on your palate. Bone remodels based on forces placed upon it. Though I cannot tell you that this will certainly work.
Typically a genioplasty is a superficial fix for a deeper issue. I have seen people with marked airway issues get a genioplasty and still have lip incompetence (and still have an airway issue since a genioplasty does not impact the size of the upper airway). Oral motor therapy is likely needed in either case to retrain the lips/tongue.
Morning! I no longer offer free consultations as I had too many people scheduling these and canceling last minute which didn't allow other patients to get onto my schedule. I do offer 30-minute Zoom consultations for $125. You can find this on my website by clicking "schedule an appointment".
I'm not sure exactly how many turns. The back screw I turned daily, and every 3rd day I didn't turn the front screw because they were not the same distance per turn. I have it written down, but haven't totaled it as I think this is irrelevant because each case will vary substantially. Part of the reason my speech is so bad is that I have acrylic connecting the two expanders at the top of my mouth. If you have a traditional MSE, your speech will not be this bad. I also have a thick wire holding my lower dental arch in place post-dental expansion, which is contributing to my poor speech. Can't wait until I have all this out of my mouth! :)
@@Colin-cb8hv I have a regular MSE (1 turn-screw and 4 vertical screws into palate) connected with acrylic to another turn screw with 4 horizontal screws into my palate. I did this because I have very thin cortical bone and there was less chance of screw drag with this design.
Thank you. Long story short, I have pretty severe sleep-disordered breathing. I was planning to get double jaw surgery and expanded my teeth in preparation for this. When I expanded my teeth (tipped them slightly outward), I started barely being able to breathe through my nose. Also at this point, my upper teeth were now narrower than my lower teeth. In an attempt to avoid doing a segmental maxillary osteotomy (the more invasive version of double jaw surgery) during surgery, I decided to do an MSE to potentially get my upper teeth wide enough to fit my lower teeth and to improve my nasal breathing. If you'd ask me whether I'd do it this way again... I'd probably say no. But you don't know until you know :).
@@allsleepashley Hi Ashley, thanks so much for these videos, they're really useful. Above you said you you expanded your teeth and your upper teeth became actually narrower, how does that happen? And why do you think your breathing got worse? Thanks again!
@@marygleeson352 I had tooth-borne expanders on both the upper and lower teeth. My upper teeth tipped outward less quickly than my lower teeth (specifically molars) and I believe my lower teeth were also starting from a more tipped-in position (middle school orthodontia) and were able to safely tolerate more outward tipping than my upper teeth so the width of my upper arch became relatively more narrow than my lower arch. No one has been able to give me a great explanation of why my nasal breathing got worse. One hypothesis is that even tooth-borne expanders increase nasal volume to some degree and often times after nasal breathing improves from an increase in nasal volume subjective nasal breathing gets worse in the following months (potentially due to turbinates enlarging).
Hey there. Thanks for the video. Did expanding with the MSE make your mouth and nostrils wider? I see that both your mouth and nostrils are quite wide, which is great! I'd love for both my mouth and nostrils to be slightly wider, which I assume the MSE does as it's expanding the maxilla and nasal cavity. I can only imagine how one's breathing must improve too. I've been doing a bit of research and Dr. Marianna Evans in Philadelphia seems great. She uses a double MSE device... it's basically a two in one. One more to the front of the upper palate and one towards the back of the upper palate so there's a split all the way from front to back. Others usually just use on MSE and may only get a split more towards the front of the palate.
Here's a picture of the double MSE in a mouth: img.th-cam.com/users/vi1WVoKQc789c/maxresdefault.jpg
Have you heard of postural restoration institute? if so what are your thought on them?
Hey, how much improvement did you get in your sleep after MSE expansion, if any?
Super random question, do you work at the OB water store in San Diego? You look exactly like someone that works there. Anyway, great videos!
No sir! :)
Hi Ashely, do you know anything about bruxism and how to stop it? I have TMD and will probably get a sleep study. Im 21 so I dont want to do MMA if I don't have to. I'm a normal weight but I think it has to do with my airway and jaw, starting the diagonstic process.
Bruxism is typically caused by some combination of stress, malocclusion, and/or an airway issue. I have seen it decrease with many patients by doing oral motor therapy. Many of these patients also had TMD and sleep-disordered breathing. May I ask where you are located? There is an at-home sleep study on Lofta.com. The WatchPAT is the study you want. You can order one without going through your doctor. I highly suggest doing this considering your symptoms. Email me directly if you have specific questions. sommerspt.com
Great advice thank you 😊
Hey Ashley. Can MSE/MARPE/EASE potentially wear out the TMJs or condyles? I'm worried that with MSE and then MMA, the TMJs might be in really rough shape.
Does expansion usually favor the weaker side or the better side?
Generally, I feel it just exaggerates asymmetries but are there cases where it undoes asymmetries?
Good questions.
I am not aware of any studies published that show increased wear on the condyles post-skeletal expansion of the maxilla. Additionally, I have not seen this clinically. I imagine that it could increase OR decrease wear on the condyles simply due to the orientation of the mandibular fossa changing and thus altering the force applied through the TMJs. I believe we don't know the answer to this because we haven't had enough to study these cases long-term.
"Weaker side" and "better side" are a bit vague so it's difficult for me to answer this question. Can you rephrase this question to be more specific?
I have never seen a skeletal expander un-do asymmetries. This does not mean that it is not possible, I just haven't seen it or read about it.
hi ashley im here to figure out if mse helps for aesthetic reasons i would like more under eye support or cheeck bone support would this do that ?
Before and After MSE treatment pics if possible. Also, I wanted to ask does MSE improve assymetry face (includes one side of droopy cheek bone, eyelids, lips) ?
I've typically seen it make any pre-existing asymmetry worse. Or in some cases create asymmetry when it didn't exist before.
You look great, I just turned 17 and I am currently practicing keeping my tongue on the roof of my mouth. I have been practicing since September last year and I have not seen major improvements. My palate is narrow but i am still able to suction my tongue on the roof of my mouth . I am hoping to improve my tongue space by doing this and improve nasal breathing, are there any tips that you can give to maximise my results? Thanks.
I recommend what I mentioned in the video and then doing everything you possibly can to minimize local and systemic inflammation (video to come).
Hello Ashley! Thank you for this demonstration it helped me a lot!
So, i can do suction well and can click well but because i have been hard mewing, my palate become too high arched making it hard for me to hold the suction and swallow correctly. How do i get my palate back to normal without having it shrinking in terms of width?
Also, when i do my suction to collect the saliva, my tongue pushes against my bottom teeth and my 4 bottom teeth got crooked in the span of 3 days!
Please give me any tips to help my circumstances and fix this high arched palate issue. I tried to gently rest my tongue on the palate but there is endless saliva. I think there is a correlation to high arched palate and saliva production.
How old are you? If you are young and consistent with habit changes you may be able to get some palate shape change by habitually having your tongue on your palate. Bone remodels based on forces placed upon it. Though I cannot tell you that this will certainly work.
@@allsleepashley thank you for your reply. I have given up as of right now
asthetic changes before and after? Would you say there has been any? And were they good or bad?
The lateral sides of my maxilla are more full. I'm not a fan of how it looks, but I don't fixate on it.
Any change to the width of your nose/nostrils?@@allsleepashley
Hello, I have a question. What are your thoughts on genioplasty in relation to lip incompetence? Will it reduce the strain?
Typically a genioplasty is a superficial fix for a deeper issue. I have seen people with marked airway issues get a genioplasty and still have lip incompetence (and still have an airway issue since a genioplasty does not impact the size of the upper airway). Oral motor therapy is likely needed in either case to retrain the lips/tongue.
do you have any thoughts on the myobrace thanks
Not at this point. Sorry!
How does the MSE work with aesthetics? Is it a plus or minus?
It depends on the case. Outcomes are not yet predictable.
Hello ms. Sommers. Do you still offer free 1st consultation? I can't find it on your website:)
Morning! I no longer offer free consultations as I had too many people scheduling these and canceling last minute which didn't allow other patients to get onto my schedule. I do offer 30-minute Zoom consultations for $125. You can find this on my website by clicking "schedule an appointment".
How many turns did you do? Your speech is quite noticeably affected, does it not get much better than this?
I'm not sure exactly how many turns. The back screw I turned daily, and every 3rd day I didn't turn the front screw because they were not the same distance per turn. I have it written down, but haven't totaled it as I think this is irrelevant because each case will vary substantially. Part of the reason my speech is so bad is that I have acrylic connecting the two expanders at the top of my mouth. If you have a traditional MSE, your speech will not be this bad. I also have a thick wire holding my lower dental arch in place post-dental expansion, which is contributing to my poor speech. Can't wait until I have all this out of my mouth! :)
@@allsleepashley you have two MSE’s that you expanded simultaneously with? Why?
@@Colin-cb8hv I have a regular MSE (1 turn-screw and 4 vertical screws into palate) connected with acrylic to another turn screw with 4 horizontal screws into my palate. I did this because I have very thin cortical bone and there was less chance of screw drag with this design.
What exactly is the reason you got the MSE?Your teeth and smile to me where nigh perfect .
Thank you. Long story short, I have pretty severe sleep-disordered breathing. I was planning to get double jaw surgery and expanded my teeth in preparation for this. When I expanded my teeth (tipped them slightly outward), I started barely being able to breathe through my nose. Also at this point, my upper teeth were now narrower than my lower teeth. In an attempt to avoid doing a segmental maxillary osteotomy (the more invasive version of double jaw surgery) during surgery, I decided to do an MSE to potentially get my upper teeth wide enough to fit my lower teeth and to improve my nasal breathing. If you'd ask me whether I'd do it this way again... I'd probably say no. But you don't know until you know :).
@@allsleepashley Hi Ashley, thanks so much for these videos, they're really useful. Above you said you you expanded your teeth and your upper teeth became actually narrower, how does that happen? And why do you think your breathing got worse? Thanks again!
@@marygleeson352 I had tooth-borne expanders on both the upper and lower teeth. My upper teeth tipped outward less quickly than my lower teeth (specifically molars) and I believe my lower teeth were also starting from a more tipped-in position (middle school orthodontia) and were able to safely tolerate more outward tipping than my upper teeth so the width of my upper arch became relatively more narrow than my lower arch. No one has been able to give me a great explanation of why my nasal breathing got worse. One hypothesis is that even tooth-borne expanders increase nasal volume to some degree and often times after nasal breathing improves from an increase in nasal volume subjective nasal breathing gets worse in the following months (potentially due to turbinates enlarging).
This sounds terrible. Why do they do these to people.
ᑭᖇOᗰOᔕᗰ