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Key t o a healthy smile

HSC orthodontists hold the key to a healthy smile

May 2004

by Natalie Gutierrez

It was a dark, cool evening on Easter Sunday in 1980 when Sgt. Orlando Navarro of the San Antonio Police Department spotted a car weaving in and out of traffic. He suspected the driver was drunk and signaled him to stop. Just moments after Sgt. Navarro approached the vehicle, four passengers jumped out and began to wrestle with him, fighting furiously to remove his gun. If it hadnít been for a special holster he was wearing that night, Sgt. Navarro could have lost his life. A button, no bigger than a quarter, hidden in the leather seam of the holster was the key to releasing the gun. Sgt. Navarroís attackers were foiled by the concealed key and arrested. And Sgt. Navarro was glad to be alive.

"Sometimes, itís the small things that make a huge difference," he said.

Twenty-four years later, Sgt. Navarro is still a police officer. He has lived through some very dangerous experiences. Not much makes him squeamish - except the thought of surgery. When Sgt. Navarro learned he had a constricted maxilla (constricted upper jaw), he said he would have avoided correcting the problem if it meant surgery. Luckily, another small device came into his life just in the nick of time.

Thanks to a device, about an inch wide, called a Bonded Rapid Maxillary Expander (RME), 50-year-old Sgt. Navarro and many others have found relief from a constricted maxilla without surgery. Patients with a constricted maxilla experience crowded, crooked and protruding teeth. The problem may contribute to cavities, periodontal disease and difficulty chewing, eating and speaking. Compromised aesthetics may also contribute to psychosocial problems for the patient.

For years, orthodontists were able to correct the problem in children and adolescents up to age 16 using the RME. Adult patients with mature maxillary bones, however, had to wear the RME as well as undergo surgery to expand the jaw.

A Dental School study conducted by Gregory Coakley, D.D.S., M.S., a graduate of the orthodontic residency program at the Health Science Center; C. Lynn Hurst, D.D.S., M.S., clinical associate professor and director of the orthodontic residency program; John Rugh, Ph.D., professor and chairman of the department of orthodontics; and John Hatch, Ph.D., professor in the department of orthodontics and psychiatry, has shown that patients ages 16 and older with a constricted maxilla can be treated successfully without surgery.
orthodontic device
A patient is fitted with an RME that is bonded to the maxillary teeth and bridges the palate. The patient is given a tiny key he must insert into the center of the Bonded RME and turn as directed by his orthodontist (see photo).

When the key is turned, the Bonded RME moves a quarter of a millimeter, expanding the upper jaw over time to create more room for the teeth.


A Bonded RME is part of a comprehensive orthodontic treatment plan. Most patients wear the device anywhere from four to six months, depending upon the severity of their condition. After the device is removed, patients must wear braces to align the teeth and complete orthodontic treatment.


Shirley Martinez
Shirley Martinez, 34, lived with a constricted maxilla since she was a child. Her parents couldnít afford to send her to an orthodontist to correct the problem. As an adult, she decided to seek help at the Orthodontic Clinic at the Health Science Center.


"Theyíre miracle workers," Martinez said, referring to the orthodontists and residents at the clinic. "Iím not embarrassed to smile anymore because my teeth look and feel great," she said. Martinezís teeth were so crowded and misaligned that she was not able to touch the roof of her mouth with her tongue. She had difficulty speaking clearly. Martinez said she was thrilled to learn that she would not need surgery. "I was able to save thousands of dollars and I avoided the time and risk involved in surgery," she said. Martinez said she no longer has difficulty chewing food. "Sometimes I just enjoy hearing myself speak because I sound so much better."

Both Sgt. Navarro and Martinez said theyíd recommend wearing the device to others. "You experience a little discomfort and some pressure when you turn the key," Sgt. Navarro said. "But itís a small price to pay for a healthy smile in the long run."

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Updated 7/30/14