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Oral Surgery/tongue, no room in my maxillary arch

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QUESTION: I am crying out for help and I am really running out of where to go.  For as long as I remember I have had problems with my articulation, everybody else said I am fine but I knew it is not right.  My tongue is not the right shape for my mouth it never has been.  People do not understand but it feels I am trapped in a body because of my this.  My tongue is to wide, I have a high palatal arch and a narrow maxillary arch this is restricting the mobility of my tongue and is effecting my articulation.

There is nothing on the internet I can find but I know my own body and I know it is not right.

This is all I can find, this really gets me down so much.  I know where the tongue needs to go for the muscles but it can not get near the upper palate the sides go up because the tongue will not fit in the maxillary arch.

I am 31 now and live in England, I have tried everything, palatal appliances to widen my upper jaw in my mid twenties this tipped my upper teeth out and messed up my bite  I had orthognathic surgery to correct my bite hoping this would fix this but it hasn't I had maxillary hypoplasia growing up and my upper maxilla was underdeveloped, the maxillofacial surgeon said everything is ok now and would not listen to my concerns.  This is a disorder which I cannot find anything on I don't know anybody who specialises in measuring the maxillary arch the palate and the tongue during speech.  I saw a speech therapist about 10 years ago and she said nothing was wrong.

I hope you can help me I am running out of options, I don't know any fields or terms or the disorder the closest I have found today is linguistic disorder.

Thank you for your time in reading this email.

Regards

John

ANSWER: John - What you are describing is handled quite a bit these days.  Over the past twenty-five years, a procedure called rapid palatal expansion has evolved to correct the narrow maxilla you describe.  This situation is quite common, but yet often overlooked.  Palatal appliances will not widen an adults maxilla.  It will only work until the end of puberty, when the bony sutures fuse.  

The maxillofacial surgeon who examined you and feels everything is fine, may not be addressing the deep maxilla that seems to be crowding and not giving you a sensation that the tongue has enough room.

It might be a good idea to get a second opinion from a different maxillofacial surgeon near you.  The question is; do your teeth come together correctly when biting.  Your maxilla, mandible and separately your bite needs to be completely evaluated. I don't know surgeons near you, but I assume there are others.  

I wish you well and hope you can find a doctor who properly listens to you and helps.

---------- FOLLOW-UP ----------

QUESTION: Hi thanks for your reply I really appreciate it,

My teeth comes together correctly when I bite and there is no crowding any more due to the palatal expander that tipped my teeth out, this has not resolved the deep maxilla or the tongue space.

I had the surgery 2 months ago I think it takes about six months for this to heal, as soon as the braces come off I will start looking for other surgeons.

Answer
John - But that is really part of the problem.  A palatal expander placed on an adult does not expand the palate, but actually just wrongly tips the teeth.  That makes the bite seem correct, but the movement is not stable and the teeth will eventually return to the original position.  The rapid palatal expander procedure helps to position the teeth correctly, but provides an expanded palate.  The expander used without surgery does not do that.

Maybe you had the rapid palatal expander.  I'm not sure from what you say.  Get that second opinion.

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Joel S. Teig, DMD, Diplomate ABOMS, retired

Expertise

I am a board certified oral and maxillofacial surgeon available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.

Experience

Board Certified Oral and Maxillofacial Surgeon practicing for over 20 years. Assistant Clincal Professor at State University School of Dentistry.

Organizations
American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

Education/Credentials
BA- University of Connecticut DMD-University of Pennsylvania School of Dental Medicine Oral and Maxillofacial Surgical Residency - Roosevelt Hospital, NYC

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