Jaws: The Story of a Hidden Epidemic

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The symptoms of the epidemic of smaller jaws are everywhere. Children are walking around with their mouths open, unable to close them. Adults are snoring. Teenagers are having their misnamed “wisdom” teeth extracted, sometimes with traumatic results. And so many people now have obstructive sleep apnea (OSA) that sterilizers for continuous positive airway pressure machines are being advertised on television. Why wait? I don’t think most of the experimental research you’d need to further support the theory would be ethical or change our basic conclusions. But many important scientific issues don’t involve the sort of ritualized scientific method that kids learn. On the Origin of Species hasn’t got a single experiment in it. 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 It’s also fantastic if you are well aware of the effect tongue ties have on the body as a whole, because you get answers as to the why, as well as an answer to the question: what do I do next?

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 goes to show that in many cases, lifestyle choices can have just as powerful if not more of an influence on human traits than underlying genetics. “A genetic contribution to a trait, if there is one, does not necessarily sentence you to a life with that trait,” said Feldman. “In almost all cases, you cannot intervene medically to alter a genetic contribution; it’s not actionable. But what is actionable are the things talked about in this study, as well as Paul and Sandra’s book.” Contributing factorsThe major claim of the book is that you and Sandra Kahn have unearthed a hidden epidemic in which people’s lifestyles are affecting how their jaws develop, with many downstream health consequences. What do you feel is the most convincing evidence of that? Wanting to convince others to the benefits of nose breath, Caitlin wrote a short book, The Breath of Life (1861), which later retitled as Shut Your Mouth and Save Your Life. In this he “condemned the mouth breathing and assigned an array of ills to it, including ‘derangement’ of the teeth. George Caitlin and his book have been forgotten, but, as later research show he was onto something. Assuming that genetics are chiefly responsible for the sudden modern rise of these dental maladies does not make sense, said Ehrlich. “There’s not been enough time for evolution over the span of only several generations to have made our jaws shrink,” said Ehrlich. Nor is there any evidence of selection pressures that would have favored smaller jawed-people producing more offspring – and thus perpetuating the trait – than regular-jawed people. In their book, Kahn and Ehrlich make the case that crooked teeth (and braces) are a modern problem caused primarily by eating soft foods, living in confined spaces with allergens and poor posture, including mouth breathing. The authors declare this an epidemic, linking undersized jaws to increased risk of heart disease, hyperactivity, sleep deprivation and other issues that are endemic to modern life.

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) In Jaws , the authors present the biological, dietary, and cultural changes that have led to a rapid shift in oral evolution towards smaller jaws and crooked, crowded teeth. They explore the serious health implications of such afflictions including sleep deprivation and heart disease before concluding with simple adjustments that people can actually follow! A. Qureshi, R. D. Ballard, and H. S. Nelson. 2003. Obstructive sleep apnea. Journal of Allergy and Clinical Immunology 112: 643–651 A. Sheiham. 2005. Oral health, general health and quality of life. Bulletin of the World Health Organization 83: 644–644; A. Sheiham and R. G. Watt. 2000. The common risk factor approach: A rational basis for promoting oral health. Community Dentistry and Oral Epidemiology 28: 399–406; R. G. Watt and A. Sheiham. 2012. Integrating the common risk factor approach into a social determinants framework. Community Dentistry and Oral Epidemiology 40: 289–296; and Matthew Walker. 2017. Sleep the good sleep: The role of sleep in causing Alzheimer’s disease is undeniable; here’s how you can protect yourself. New Scientist October 14–20: 30–33.Image 8. The child on the left was told that she needed surgery to correct her receding chin. Orthotropic treatment with Biobloc and posture exercises produced the dramatic stable results in the right. Orthodontics or orthopedics is not known to produce any jaw changes remotely as impressive as these. (Courtesy of John Mew.) 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. 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. 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.