Bed-Wetting, Ear Infections? Fix the Jaw

July 17, 2003 (Nashville) -- Intriguing but controversial new research suggests that jaw size and position may be to blame for two of the most common medical conditions of childhood -- chronic bed-wetting and ear infections.

Supporters of the theory say simple, nonsurgical procedures that enlarge or realign the jaw are proving to be far more effective than accepted medical interventions for treating these problems.

Widened Jaw = Dry Bed

In a presentation delivered Thursday at the annual meeting of the Academy of General Dentistry, orthodontist Derek Mahony, DDS, reported that four out of five children included in his study of 100 chronic bed wetters had upper jaws that were too narrow.

In a study reported in 1998, seven of 10 chronic bed wetters who did not respond to traditional treatments either stopped wetting the bed or wet the bed less frequently within months of having their upper jaws widened. And a 1990 study found that all 10 of the chronic bed wetters included in a larger jaw-widening study stopped wetting the bed after having the procedure.

"There is absolutely no doubt in my mind, from the literature and our research, that the jaw expansion stops the bed wetting," Mahony tells WebMD. "When you expand the upper jaw, breathing improves, and that results in all sorts of other improvements."

One theory is that bed-wetting can be caused by decreased production of an antidiuretic hormone (ADH) known as vasopressin. The hormone helps the body retain water. Mahony says children with narrow jaws are typically mouth breathers because they have trouble breathing through their noses. Mouth breathers have lower levels of ADH because the hormone is produced during deep sleep and they do not sleep as deeply as nose breathers.

Mahony says as many as 80% of chronic bedwetters might be cured by upper jaw expansion -- a relatively simple procedure in which an expandable plate is fitted to the top molars. Each day the plate is widened with a key, and the upper palate expands over three or four months.

Baltimore dentist David C. Page, DDS, says he believes that even more bed wetters could be cured with procedures designed to open blocked airways.

"The combination of palate expansion and taking out the tonsils and adenoids could probably help 99% of bed wetters," he tells WebMD.

The Ear-Jaw Connection

Page, who has written a book about the health implications of jaw problems, says he believes upper jaw misalignment is the cause of chronic ear infections in 90% to 95% of kids. He tested the theory 15 years ago on his own middle son, who had more than 20 ear infections before the age of 3. His pediatrician recommended putting tubes in his ears. Instead, Page tried changing his bite using dental plastic bonding materials.

"The whole thing took about an hour, and he never had another ear infection," Page says, adding that he has performed roughly two dozen similar procedures with good results since then.

"I do believe that, to a very large extent, the current ear treatments will become obsolete in the near future," he says. "Once more people understand the ear-jaw connection, we won't be putting $2,000 to $4,000 sets of tubes in kids ears two to four times."

SOURCES: Academy of General Dentistry annual meeting, Nashville, July 17-20, 2003. Derek Mahony, BDS, MS, orthodontist, Sydney, Australia. David C. Page, DDS, Baltimore.