The “cures” for the jaw epidemic are simple in outline. First, we must return childrens’ diets to much chewier foods, perhaps even supplementing them with special tough chewing gums. We must also modify some current orthodontic techniques to emphasize forward movement of both jaws and avoid extractions. In a new co-authored book, biologist Paul Ehrlich describes the connection between underdeveloped jaws, modern life and myriad health and quality-of-life issues. (Image credit: L.A. Cicero) E. Josefsson, K. Bjerklin, and R. Lindsten. 2007. Malocclusion frequency in Swedish and immigrant adolescents—influence of origin on orthodontic treatment need. The European Journal of Orthodontics 29: 79–87. Image 5. Nobody would dispute that these two kids are drop-dead-gorgeous. Caretakers need to be trained to notice the subtle sign—their gummy smiles—that growth is not progressing in the right direction. (Photo by Gorete Ferreira.)

The first 3 chapters cover the origins of malocclusion (crooked teeth) from a evolutionary perspective. In particular, they go into great detail about George Catlin’s book, Shut Your Mouth and Save Your Life. Catlin was a civil war era naturalist and painter, who had an interest in painting native Americans in their natural habitats. He noticed that those who kept their mouths closed had broader faces and were much healthier, whereas these who kept their mouths open hand more narrow and long faces, and were much more prone to illnesses. You can see many of his paintings at the Smithsonian museum. They also note that many paleontologists have demonstrated that ancient skulls usually have very good teeth and essentially no dental crowding. No book talking about shrinking faces and smaller airways is complete without mentioning Dr. Weston Price’s classic book, Nutrition and Physical Degeneration. Price was a dentist who traveled the world in the early 1900s, showing that across the board, cultures that ate naturally without modern Western influences had broad dental arches with a full set of teeth, beautiful smiles, and essentially no cavities.After several weeks of dinner club discussion, the importance of Sandra’s work became evident to Paul, as did how it fit into his long-term interest in human evolution and the environment. It even took Sandra a while to see why he was so excited about the connections among chewing, stuffy noses, and smiles. But he had spent his life connecting things such as population, food, toxins, resources, water, weather, war, and politics into a unified picture of the human future. When we finally took our idea for Jaws to an editor, he said, “Let me get this straight: no orthodontist is practicing this, you are the only ones who know about this, and you think that everyone needs to beware of a ‘huge public health issue’ right under their own noses?” Yes! The clincher for him, and many others, was Image 4, showing what a hunter-gatherer’s jaws look like, with roomy perfect arches of well-aligned teeth, with no impacted wisdom teeth—a movie star’s dream jaw, 15,000 years before movies! Kirsi Pirilä-Parkkinen, Pertti Pirttiniemi, Peter Nieminen, Heikki Löppönen, Uolevi Tolonen, Ritva Uotila, and Jan Huggare. 1999. Cervical headgear therapy as a factor in obstructive sleep apnea syndrome. Pediatric Dentistry 21: 39–45. Despite the massive evidence that these problems are primarily environmental in origin, we discovered that many dentists still believe that jaw shrinkage is somehow genetic, even citing family resemblance and twin studies in support of that view. It is not necessary to revisit the massive literature on “heritability” demonstrating the fallacies of that approach. The problem is the “poor oral posture”, argue Kahn and Ehrlich, which is exacerbated by the fact that we spend most of our lives indoors where concentrated allergens help stuff up our nasal passages and further constricting our vital breathing pathway. Smaller jaws, constricted air pathway, and sleep disrupted by snoring, a cause of sleep apnea, are “linked to serious lifelong health problems” including “ADHD, depression, cancer, and heart disease.” Image 2. Proper facial structure and posture. This young man has had a very active life with minimal processed foods. He currently has all his teeth, including wisdom teeth, and did not need orthodontic treatment. (Photo by Steven Green.)

The broader scientific community has largely deemed the underlying abnormality behind these problems as hereditary and untreatable, and opted to deal with symptoms through medical devices and after-the-fact interventions.In his lecture “The melting face”; retrieved on February 20, 2016, from www.youtube.com/watch?v=NvoX_wEtwDk. What we do have are natural experiments, anecdotal evidence and speculation. For example, in Jaws, we show pictures of a grandfather who was raised in a traditional habitat with traditional diets, then his son who moved into an industrialized area – with much softer foods – and you can see the deterioration of the son’s face and jaws. His grandchild then had even more problematic jaws. I have certainly never spent more time thinking about my breathing and the position of my jaws and tongue while reading than I did while reading this book. This epidemic has important consequences for heart health. I'm delighted Jaws is bringing it home to both citizens and health care professionals." Author: Dr. John S. Schroeder, Professor of Cardiovascular Medicine Source: Stanford University

There is a common and serious misapprehension about malocclusion. As one friend said, “We take it for granted that malocclusion is genetic—we’ve always considered my son got his crooked teeth from my wife.” As you will see, virtually all the evidence shows that the oral-facial epidemic can be traced not to our genes but to changes in our culture, particularly to ones in how and what we eat and where we live. These have changed greatly from those of the Stone Age, in complex patterns starting around the time people began to settle down and practice agriculture. 17 As anthropologist Clark Larsen put it: “There has been a dramatic reduction in the size of the face and jaws wherever humans have made the transition from foraging to farming.” 18 This manuscript looks beyond the flashy smile that so many of us pay our orthodontists for and asks the hard question: Why is it we are almost all born with the faces of angels, yet so few maintain that face value of our innate and inborn beauty? The answer revealed is intriguing, thought provoking and a much needed call to action to fight for the fullest physical potential for all our children. A must read!" Author: Simon Wong, BDSc. Source: London School of Facial Orthotropics You’ll discover the widespread consequences of how you carry out such seemingly mundane, automatic, and repetitive acts as breathing, smiling, and sleeping – and how your ways of doing those things affect peoples’ perceptions of you. Read, enjoy, learn, and prepare to be astonished!” We know a smaller jaw makes you more susceptible to sleep apnea and so it relates to an area Robert Sapolsky has pioneered: the importance of stress. We now know clearly that having your sleep interrupted is a big stressor and can lead to greater susceptibility to infections and diseases.Humblest apologies to the authors for any harsh criticism, but thank you for writing this. I want to say that I am on your side. But the material needs to be taken to much, much further depth even for myself as a general audience. I hope this succeeded in planting the seed for change, and I am sure this is only one among your many commitments to health in our times. This epidemic has important consequences for heart health. I'm delighted Jaws is bringing it home to both citizens and health care professionals." In short, Jaws is designed to introduce you to the vast problems of oral-facial health, which, like issues of gluten, might have once seemed as simple and insignificant as sliced bread and which now are as significant as sliced bread. And it is designed to help you decide what, if any, personal actions you can take to improve your health and well-being. It’s a guide for thinkers, not a recipe book. So read on and make up your own mind. Notes Available evidence points to the jaws epidemic arising as humanity underwent sweeping behavioral changes with the advent of agriculture, sedentism (settling in one place for extended periods) and industrialization. One obvious factor is the softening of diets, especially with the relatively recent invention of processed foods. Also, less chewing is needed nowadays to extract adequate nutrition – our ancestors certainly did not enjoy the sustentative luxury of slurping down protein shakes. But in a new study, Stanford researchers and colleagues argue that all these issues and more are actually relatively new problems afflicting modern humans and can be traced to a shrinking of our jaws. Moreover, they maintain that this “jaws epidemic” is not primarily genetic in origin, as previously thought, but rather a lifestyle disease. That means the epidemic is largely the result of human practices and akin to obesity, type 2 diabetes, heart disease and some cancers.