The Mewing Manifesto: Dr. John Mew's Quest for Natural Facial Development

35 Q&As

At 94 years old at the time of this 2023 interview, Dr. John Mew speaks with the unflinching conviction of someone who has spent a lifetime swimming against the current. The father of "mewing" and creator of orthotropics has endured professional ridicule, licensing challenges, and near bankruptcy while championing a fundamental reimagining of orthodontic care. His central premise – that malocclusion (crooked teeth) stems from environmental factors rather than genetics – has rattled the foundations of conventional orthodontics for decades and created a growing movement of practitioners and patients seeking a more natural approach to facial development.

In this wide-ranging conversation, Dr. Mew delivers a masterclass in orthodontic rebellion, challenging virtually every cornerstone of modern practice, including the routine extraction of wisdom teeth and premolars that he sees as part of an efficient but misguided approach to treatment. From his advocacy of ultra-gentle forces to his passionate defense of extended breastfeeding, Dr. Mew presents a holistic vision that treats the face as a living landscape to be carefully cultivated rather than a mechanical problem to be forcibly corrected. As his son Mike faces disciplinary proceedings from the UK's General Dental Council, the elder Mew remains undaunted, certain that his approach will eventually prevail even if, as he acknowledges with characteristic bluntness, he "will probably be dead by then.”

With thanks to Dr John Mew.

Analogy

Imagine a young tree growing in your garden. When planted correctly with proper support, sunlight, and care, it naturally grows straight and strong, developing a beautiful canopy and deep roots. This represents a child developing with proper oral posture, adequate breastfeeding, and a natural diet.

Now imagine a different scenario: the same tree begins to lean sideways due to constant wind from one direction (like a tongue pushing incorrectly), poor soil (soft diet), and being kept in a greenhouse that limits natural air flow (modern living conditions). There are two approaches to fixing this leaning tree:

The conventional orthodontic approach is like tying the tree tightly to stakes with wire, forcibly pulling it straight, and even cutting off some branches (extracting teeth) to make it look better. This approach may create a superficially straight tree quickly, but damages the bark where the wires dig in (root resorption), weakens the trunk by forcing it rather than letting it strengthen naturally, and requires permanent stakes (retainers) to maintain its position. Once the stakes are removed, the tree gradually returns to leaning because the underlying causes weren't addressed.

Dr. Mew's orthotropic approach is like gently guiding the young tree with minimal pressure, addressing the environmental factors by adjusting the wind exposure (tongue posture), improving the soil (diet), and providing a more natural growing environment. It takes longer and requires changing the tree's entire growing conditions, but results in a naturally straight tree with strong roots that stands tall on its own without permanent supports. The tree not only looks better but is fundamentally healthier and more stable.

Dr. Mew is essentially saying we shouldn't just straighten teeth, but instead should create the conditions for the entire face to grow properly—just as a good gardener doesn't just tie up a plant, but creates the right environment for it to thrive naturally.

12-point summary

1. Orthotropics vs. Traditional Orthodontics: Dr. John Mew developed orthotropics as an alternative to conventional orthodontics. While traditional approaches often extract teeth and use heavy mechanical forces (40-100+ grams per tooth) to straighten teeth, orthotropics uses extremely gentle forces (1-2 grams per tooth) to guide facial growth in a forward and upward direction, focusing on proper oral posture rather than just tooth alignment.

2. Environmental Causes of Malocclusion: Dr. Mew firmly believes malocclusion (improper teeth alignment) is caused by environmental factors, not genetics. He identifies three main causes: insufficient breastfeeding (less than 2.5-3 years), soft modern diets that fail to exercise jaw muscles, and living in houses that create allergies leading to mouth breathing.

3. The Importance of Breastfeeding: Extended breastfeeding (30-36 months) is crucial for proper facial development. When breastfeeding, babies actively pump the breast, pushing their tongue firmly against the palate, which establishes the correct swallowing pattern. Without this, children develop a "sucking swallow" that collapses the dental arch, creating narrow jaws with insufficient room for teeth and tongue.

4. Damage from Fixed Appliances: Dr. Mew asserts that conventional braces routinely damage teeth, causing root resorption (shortening) in "almost every patient in almost every tooth." He shares an example of a young woman who lost her front teeth before age 30 due to severe root shortening from orthodontic treatment. He believes treated teeth may be lost 10+ years earlier than untreated teeth.

5. Pain as an Indicator of Damage: Dr. Mew emphasizes that pain or discomfort during orthodontic treatment always indicates tissue damage. Heavy forces compress the periodontal membrane, cut off blood and oxygen supply, and kill cells. His approach using 1-2 gram forces causes no discomfort while still moving teeth, preserving their long-term health.

6. The Miastantlos (Breast Pump) Hypothesis: This hypothesis, which Dr. Mew considers even more crucial than his Tropic Premise, explains how breastfeeding creates proper swallowing patterns. He's frustrated that orthodontic journals have refused to publish it, limiting its influence despite its importance in explaining why 90% of modern humans have malocclusion.

7. Expansion vs. Extractions: Dr. Mew describes how orthodontics shifted from expansion (widening the dental arch) in his father's era (1914) to extraction-based approaches by his training (1948). His father's records showed expansion sometimes didn't relapse but continued widening even after appliance removal, revealing factors influencing development not recognized by conventional orthodontics.

8. The Role of Alveolar Bone: Dr. Mew explains that alveolar bone (which supports teeth) forms about 80% of facial supporting structure, while basal bone is minimal - "not much more than the width of a pencil." This means tooth position largely determines facial shape, making orthodontic decisions critical for facial aesthetics, not just dental alignment.

9. The Stage Three Bioblock Appliance: This unique appliance trains proper oral posture by creating discomfort when the tongue isn't on the palate or when the jaw drops. By wearing it nightly, patients develop subconscious proper oral posture that becomes permanent. Unlike traditional treatment which universally relapses requiring permanent retainers, Dr. Mew claims his results remain stable without retainers.

10. Professional Resistance: Throughout his career, Dr. Mew has faced ridicule, license challenges, near bankruptcy, and rejection from colleagues. He attributes this resistance to institutional inertia, financial interests in conventional methods, and universities' inability to teach what they themselves don't know. Despite this opposition, he has maintained his approach is correct.

11. Adult Treatment Limitations: Dr. Mew acknowledges orthotropics has limited effectiveness after age 25, though significant improvements can occur up to age 20. His Stage One Bioblock study showed adults aged 22-49 achieved 7mm expansion in three months, challenging the notion that only surgical approaches like MSE can expand adult arches and improve nasal breathing.

12. The Current Situation with Dr. Mike Mew: Dr. John Mew's son, Mike, faces disciplinary proceedings from the UK's General Dental Council for sharing orthotropic principles with patients. John believes this process is fundamentally unfair, with "the judge and jury against him," and will set back orthotropics by another decade in the UK, though he maintains "the argument will still continue" beyond this case.

Wisdom Teeth Extraction

Criticism of Wisdom Teeth Extraction: Dr. John Mew, a pioneer of orthotropics, strongly opposes the routine extraction of wisdom teeth, viewing it as part of a broader, flawed orthodontic practice that prioritizes tooth removal over addressing underlying causes of dental crowding. He attributes the perceived need for extractions to underdeveloped jaws, caused by environmental factors such as soft diets, short breastfeeding durations, and poor oral posture (e.g., mouth breathing or improper tongue placement). Mew argues that conventional orthodontics, influenced by a historical shift (post-1914) towards extraction and retraction (promoted by figures like Tweed and Begg), relies on removing wisdom teeth to manage crowding within a constrained jaw space. He contends that this approach, driven by the efficiency of high-volume practices, fails to address the root cause and can harm facial structure, airway health, and dental stability when combined with poor oral habits.

Harmful Effects of Extraction: Mew asserts that wisdom teeth extractions, particularly when paired with improper oral posture, can negatively impact facial development and jaw function. He warns that removing teeth, including wisdom teeth, reduces the dental arch size, potentially leading to compromised aesthetics, airway constriction, and long-term dental issues like root resorption from subsequent heavy-force orthodontic treatments. While mainstream orthodontists often justify extractions for impacted or crowded wisdom teeth, Mew argues that these interventions are "really bad" for facial and dental health, a claim he acknowledges lacks robust scientific backing and remains controversial. He highlights that conventional orthodontics overlooks the broader implications of extractions, focusing instead on short-term alignment without considering the potential for relapse or structural damage.

Orthotropic Alternative: Mew’s orthotropic philosophy emphasizes preventing the need for wisdom teeth extractions by promoting natural jaw growth and proper tooth alignment through gentle, non-invasive methods. He advocates using appliances like the Bioblock to achieve maxillary expansion, citing cases where adults gained 7mm of jaw width in three months, creating space for all teeth, including wisdom teeth. Central to his approach is correcting oral posture—maintaining the tongue on the palate, lips closed, and teeth lightly touching—to guide jaw development from an early age (5-7 years). By applying light forces (1-2 grams per tooth) instead of the heavy forces (40-50 grams) used in conventional orthodontics, Mew’s method minimizes damage to teeth and bones, aiming for stable, long-term results that preserve natural dentition and enhance facial aesthetics and airway function.

Preventive Lifestyle Measures: To eliminate the need for wisdom teeth extractions, Mew emphasizes early intervention and lifestyle changes that support healthy jaw development. He promotes breastfeeding for 2.5-3 years to establish proper tongue posture and swallowing patterns, as outlined in his "Mastantlos Hypothesis," which links incorrect swallowing (common with bottle-feeding) to malocclusion. Additionally, he recommends eating harder foods to strengthen jaw muscles and minimizing allergens (e.g., avoiding overly enclosed living spaces) to reduce mouth breathing. By addressing these environmental factors and encouraging proper oral habits, Mew believes crowding can be prevented, allowing wisdom teeth to erupt naturally without the need for extraction, thus fostering better facial development, airway health, and dental longevity.

35 Questions and Answers

Question 1: Who is Dr. John Mew and what is his contribution to orthodontics?

Dr. John Mew is an orthodontist who developed orthotropics, a treatment philosophy that challenges conventional orthodontic practices. He is the father of "mewing" and brought to light the idea that malocclusion (improper alignment of teeth) is caused by environmental factors rather than genetics. His core belief is that orthodontists should guide growth of patients toward healthy facial development rather than simply straightening teeth through extraction and mechanical methods.

At 94 years old, Dr. Mew continues to advocate for his approach despite facing significant resistance from the orthodontic establishment throughout his career. He's had his license challenged, been ridiculed by colleagues, and nearly went bankrupt defending his beliefs. Despite this opposition, he has maintained that proper oral posture using gentle forces is the key to healthy facial development and alignment of teeth, an approach now carried forward by his son, Dr. Mike Mew.

Question 2: What is orthotropics and how does it differ from traditional orthodontic approaches?

Orthotropics is a treatment philosophy centered on the premise that teeth alignment is controlled by very gentle forces from the tongue, lips, cheeks, and opposing teeth. It uses extremely light forces (1-2 grams per tooth) to guide development, while encouraging proper oral posture with the tongue on the palate and lips closed. This approach aims to guide facial growth in a forward and upward direction, improving both aesthetics and function.

Traditional orthodontics, by contrast, typically uses mechanical forces through fixed appliances that Dr. Mew believes are excessively heavy (40-100+ grams per tooth). While conventional orthodontists often extract teeth to make space and then use mechanics to align the remaining teeth, orthotropics aims to expand the dental arches without extractions, preserving or improving airway dimensions and facial aesthetics. Dr. Mew believes traditional approaches damage teeth, restrict proper facial development, and create problems that eventually lead to relapse after treatment.

Question 3: How did Dr. Mew's father influence his thinking about expansion in orthodontics?

Dr. Mew's father, who was also an orthodontist, introduced him to the concept of expansion. His father had studied dentistry and orthodontics beginning in 1914 under Harold Chapman, who taught expansion techniques for children at ages 4-5 if they didn't have spaces between their upper front teeth. This early influence planted the seeds for Dr. Mew's later work, though by the time John Mew began his training in 1948, expansion had been largely abandoned as a technique.

After his father died, John Mew studied his father's records and discovered something remarkable – while he had been taught that expansion always relapses, his father's cases showed that sometimes expansion not only stabilized but the jaws continued widening even after appliances were removed. This observation "blew his mind" and led him to realize there were factors affecting facial development that weren't being considered by mainstream orthodontists, setting him on his path to developing orthotropic principles.

Question 4: What historical changes occurred in orthodontic practice between 1914 and 1948?

Between 1914 and 1948, a radical shift occurred in orthodontic practice, particularly regarding expansion. When Dr. Mew's father trained in 1914, expansion was a common technique taught by influential practitioners like Harold Chapman, who would expand children's arches at ages 4-5 if they lacked proper spacing between teeth. By 1948, when John Mew began his training, expansion had been "completely excluded" and "virtually no one did it."

This shift was primarily influenced by the teaching of Tweed and Begg, who were students of Edward Angle. These practitioners found that expanded cases often relapsed, so they decided to extract teeth and use mechanical methods to align the remaining teeth instead. Their approach became dominant in British universities, and expansion was largely discredited as a viable approach. This change established extraction and mechanical alignment as the new orthodontic standard that Dr. Mew would later challenge.

Question 5: What are the key differences between light and heavy forces in moving teeth according to Dr. Mew?

Dr. Mew advocates for extremely gentle forces of only 1-2 grams per tooth when moving teeth, which he considers the natural force exerted by the tongue, lips, and cheeks. These light forces cause no discomfort or damage to the periodontal membrane and allow for healthy movement. When expanding arches, he increases width by tiny increments - 1/16th of an inch per day in children, or 1/32nd of a millimeter twice daily in adults - creating frequent, intermittent, gentle pressure.

In contrast, conventional orthodontics typically uses forces of 40-50 grams per tooth, with many orthodontists applying over 100 grams. Dr. Mew believes these heavy forces "squash" the periodontal membrane, cutting off oxygen and blood supply, causing cells to die. This leads to "hyalinization" (damaged cartilage) around teeth, requiring even more force to achieve movement. The pain and discomfort patients experience with conventional braces indicates actual tissue damage is occurring, potentially shortening the lifespan of treated teeth by years or even decades.

Question 6: How does Dr. Mew describe the damage caused by traditional fixed appliances?

Dr. Mew asserts that fixed appliances invariably damage teeth, describing root resorption (shortening of tooth roots) as "routine" rather than occasional, affecting "almost every patient in almost every other tooth." He states that all orthodontists acknowledge this damage but justify it by claiming it's the only way to straighten teeth. Additionally, fixed appliances universally cause recession of the front of the face by 1-2 millimeters as soon as they're placed, negatively impacting facial aesthetics.

Dr. Mew shares a personal anecdote about a young female tennis partner in her early twenties who complained of loose front teeth after orthodontic treatment. X-rays revealed severe root shortening to only 7 millimeters, resulting in her losing her front teeth before age 30. This example illustrates the potentially severe consequences of conventional treatment that Dr. Mew believes most practitioners downplay or accept as an unavoidable side effect, despite these teeth being crucial both functionally and aesthetically.

Question 7: What is the relationship between pain during orthodontic treatment and tooth damage?

Dr. Mew is adamant that pain during orthodontic treatment directly indicates damage to teeth and supporting tissues. He states plainly, "discomfort actually means damage," explaining that pain serves as a natural warning system in the body. When patients experience pain with fixed appliances, it signals that the periodontal membrane is being compressed, blood and oxygen supply is being restricted, and cells are dying as a result of excessive force application.

Dr. Mew advises that patients should be aware that "if ever they feel pain or even discomfort their teeth are being damaged." This is particularly evident when orthodontists bend heavy wires into an ideal arch form, then twist them to pull teeth into this position, causing significant pain. Dr. Mew contrasts this with his approach using extremely gentle forces that cause no discomfort, which he believes allows teeth to move without damaging supporting structures or shortening their lifespan.

Question 8: What is root resorption and why does Dr. Mew believe it's a significant concern?

Root resorption is the shortening of tooth roots that occurs during orthodontic treatment, effectively reducing the tooth's foundation in the jaw. Dr. Mew describes a severe case where a young woman's front teeth roots had shortened to just 7 millimeters, leading to her losing these teeth before age 30. He emphasizes that root resorption is not a rare complication but happens "in almost every patient in almost every other tooth" treated with fixed appliances, though severity varies.

The significance of this damage, according to Dr. Mew, is largely ignored by the orthodontic profession. He points out there's been no research on how orthodontic treatment affects tooth longevity, but he's "quite sure" that root-damaged teeth must be lost "several years early, maybe more than 10 years." This represents a serious but unacknowledged trade-off: straight teeth achieved at the cost of potentially decades of tooth longevity, particularly troubling since patients are rarely informed of this risk.

Question 9: How does Dr. Mew's approach to expansion differ from conventional methods?

Dr. Mew's expansion philosophy relies on extremely gradual, gentle forces that mimic natural pressures. With his "Bioblock" appliance, he expands at incredibly slow rates - 1/16th of an inch daily for children or 1/32nd of a millimeter twice daily for adults. This gradual approach produces about 10 millimeters of expansion over three months, which he considers sufficient for most patients. The gentle forces of "one or two grams" allow teeth to move without damaging supporting structures, and bone naturally adapts to support the new tooth positions.

Conventional expansion methods typically use much heavier forces applied through fixed appliances. Dr. Mew believes these methods damage teeth, periodontium, and facial aesthetics. He disagrees with rapid approaches like MSE (Maxillary Skeletal Expander) that deliberately split the mid-palatal suture, arguing they fracture bone and destroy cells within the suture. While these approaches may achieve faster results, Dr. Mew considers them unnecessarily traumatic and potentially harmful to long-term facial development and dental health.

Question 10: What are Dr. Mew's concerns about Maxillary Skeletal Expander (MSE) treatment?

Dr. Mew expresses strong opposition to MSE treatment, describing it as "a very powerful mechanical appliance which requires surgery" and considers the idea of "screwing tads into the bone" to be "appalling." His primary concern is that MSE deliberately fractures the mid-palatal suture and likely destroys cells within it. He believes this trauma is unnecessary, as gentler approaches can achieve adequate expansion without such damage.

Dr. Mew also points out that MSE often creates uneven results, with "unilateral changes" where "one side will split whereas another will move." He acknowledges MSE can improve nasal breathing but argues his Bioblock appliance achieves similar improvements without the associated trauma. Even in adults, he claims to achieve 7mm expansion in 3 months with his Stage One Bioblock, questioning why patients would choose the more traumatic MSE approach when gentler options exist that might better preserve facial aesthetics and structural integrity.

Question 11: How does proper tongue posture ("mewing") affect facial development?

Proper tongue posture, which Dr. Mew calls the "Tropic Premise" (though popularly known as "mewing"), is the foundation of facial development. The alignment of teeth is controlled by the gentle forces of the tongue, lips, cheeks, and opposing teeth. When the tongue rests properly against the palate, it provides natural expansion forces of 1-2 grams per tooth, guiding growth in a forward and upward direction. This correct posture ensures the maxilla develops properly, which is crucial for facial aesthetics and function.

The Stage Three Bioblock appliance Dr. Mew developed specifically trains proper tongue posture by making it uncomfortable when the tongue isn't on the palate or when the jaw is dropped. By maintaining correct tongue posture during growth years, the face develops with ideal proportions, the airway remains open, and teeth align naturally without crowding. Dr. Mew emphasizes that proper tongue posture not only creates better facial aesthetics but also prevents TMJ problems and sleep apnea while ensuring treatment results remain stable without relapse.

Question 12: What is the connection between airway health and orthodontic treatment?

Dr. Mew identifies a direct relationship between orthodontic treatment and airway health, expressing surprise that most orthodontists don't consider airway structure in their treatment planning. When teeth are extracted and the dental arches are retracted, the face is pulled backward, reducing airway space. This can contribute to breathing difficulties and sleep apnea, as the backward positioning of the jaws leaves less room for the tongue and can partially obstruct the airway.

Research cited by Dr. Mew shows that maxillary expansion is more effective at improving breathing than traditional ENT interventions like tonsillectomy and adenoidectomy. The widening of the maxilla increases nasal volume and improves airflow. Dr. Mew sees this airway-focused approach as fundamentally important, noting that conventional orthodontics may actually worsen breathing problems by narrowing arches and pulling facial structures backward, while his orthotropic approach prioritizes maintaining or improving airway dimensions through forward growth and expansion.

Question 13: How does Dr. Mew explain the relationship between facial development and dental alignment?

Dr. Mew emphasizes that facial development and dental alignment are inseparable, with alveolar bone (the bone supporting teeth) comprising about 80% of the bone that forms the face. He explains that "the basal bone is small" - about "the width of a pencil" - while the rest develops to support teeth. Therefore, the position of teeth directly determines facial shape, and any treatment affecting tooth position will inevitably affect facial aesthetics, for better or worse.

When conventional orthodontics extracts teeth and retracts the remaining dentition, Dr. Mew believes this invariably damages facial aesthetics by pulling the face backward. His research with identical twins treated differently demonstrates that once fixed appliances are placed, "the face is damaged" by moving backward "one or two millimeters." In contrast, orthotropic treatment aims to guide growth forward and upward, producing what Dr. Mew considers dramatic positive changes to facial aesthetics "under the eye and in the cheeks and everywhere else."

Question 14: What is the "miastantlos hypothesis" and why does Dr. Mew consider it crucial?

The "miastantlos hypothesis" (which Dr. Mew translates as "breast pump hypothesis" in Greek) proposes that proper infant suckling during breastfeeding is fundamental to developing correct oral posture and swallowing patterns. Dr. Mew considers it "even more crucial than the Tropic premise" in explaining why approximately 90% of the modern population has malocclusion. Despite its importance, he notes that orthodontic journals have "flatly refused to publish it," with only a Japanese journal accepting it, limiting its influence.

According to this hypothesis, babies who breastfeed properly for 30-36 months develop a pushing swallowing pattern, where the tongue pushes firmly against the palate. This establishes proper tongue posture that continues through life. In contrast, babies who don't breastfeed long enough or use bottles develop a sucking swallowing pattern, where they "suck on their upper jaw when they swallow," which collapses the maxilla and creates narrow arches without enough room for the tongue. This fundamental difference in early development sets the trajectory for facial growth and dental alignment.

Question 15: How does breastfeeding duration impact facial and dental development?

Dr. Mew identifies insufficient breastfeeding (less than 2.5-3 years) as one of the three primary causes of malocclusion. During proper breastfeeding, babies don't merely suck but actively pump the breast, pushing their tongue firmly against their palate. This action, when continued for 30-36 months, trains the correct swallowing pattern where the tongue pushes upward rather than sucking inward. The extended duration is crucial, as it establishes proper tongue posture as an unconscious habit that persists throughout life.

Modern shortened breastfeeding periods, or replacement with bottle, spoon, or cup feeding, fail to develop this proper tongue action. Dr. Mew states that "more than 90 percent of modern humans suck when they swallow," which leads to collapsed, narrow maxillary arches with insufficient room for the tongue. He emphasizes that bottle feeding is "very bad for you" in terms of facial development, and that this early developmental pattern sets the stage for lifelong problems with dental alignment, facial aesthetics, and potentially airway issues.

Question 16: What are the three main factors Dr. Mew identifies as causes of malocclusion?

Dr. Mew identifies three primary environmental factors causing malocclusion. First is "living in houses because you get allergies," which can lead to mouth breathing and improper tongue posture. Allergies force children to breathe through their mouths, preventing the tongue from resting against the palate and guiding proper development. Second is "eating soft food because that fails to exercise your muscles," as modern processed diets don't provide the vigorous chewing necessary to stimulate jaw development and bone growth through muscle activity.

The third factor is "breastfeeding for less than two and a half maybe three years." Dr. Mew emphasizes that extended breastfeeding is essential for developing proper swallowing patterns and tongue posture. Shortened breastfeeding periods or bottle feeding lead to improper tongue function, where children develop a sucking rather than pushing swallow. Dr. Mew suggests that almost all malocclusion stems from incorrect tongue posture resulting from these three modern lifestyle factors, rather than from genetic causes as conventionally believed in orthodontics.

Question 17: How do sucking versus pushing actions in infant feeding affect development?

Dr. Mew distinguishes between two feeding actions in infants: sucking and pushing. With proper breastfeeding, babies don't merely suck but actively pump the breast, where "the whole jaw will go up and down on the breast" and they "push the milk out." This pushing action trains the tongue to press firmly against the palate, establishing the correct swallowing pattern that continues throughout life. This action creates proper dental arch development with spaces between teeth to accommodate permanent dentition.

In contrast, bottle feeding or insufficient breastfeeding leads to a predominant sucking action. When children develop this sucking swallow pattern, they "suck on their upper jaw when they swallow," which Dr. Mew identifies as the mechanism that "collapses the teeth and the palate." This incorrect swallowing pattern continues into adulthood, creating narrow maxillary arches "with no room for the tongue at all." Dr. Mew believes this fundamental difference in early oral function explains why malocclusion has become epidemic in modern populations.

Question 18: What is Dr. Mew's perspective on modern women's hormonal changes and breastfeeding capability?

Dr. Mew suggests that modern lifestyle factors have disrupted women's natural hormonal processes, affecting breastfeeding capability. He observes that when women delay pregnancy for education and careers rather than having children in their youth as would be "natural," it can potentially "damage the psychology of the individual" and disrupt hormonal development. He believes this interference with natural reproductive timing may explain why many modern women have difficulty breastfeeding.

As evidence for this hormonal disruption, Dr. Mew points to physical characteristics he considers abnormal: "flat-chested women," "women who have narrow hips," and "women who grow hairs on their face." He attributes these to "hormone disruption" from "our unnatural lifestyle." While acknowledging this isn't his area of expertise, he suggests these observations support his view that modern women may struggle with breastfeeding partly because society has created conditions where "girls were never intended to enter the world of work" and delay childbearing until their late twenties or beyond.

Question 19: Why does Dr. Mew believe relapse occurs after traditional orthodontic treatment?

Dr. Mew views relapse after traditional orthodontic treatment as inevitable because it addresses only the symptom (crooked teeth) rather than the underlying cause (improper oral posture). He states that "literally all traditional orthodontic treatment relapses," requiring permanent retainers to maintain results. He finds it remarkable that orthodontists never seem to question why relapse occurs, stating, "To me there has to be a reason for everything."

The fundamental reason for relapse, according to Dr. Mew, is that the underlying poor oral posture remains uncorrected. When the same forces that created the malocclusion (improper tongue position, mouth breathing, incorrect swallowing pattern) continue after treatment, they inevitably push teeth back toward their original positions. Dr. Mew's approach specifically addresses this by training proper oral posture through his Stage Three Bioblock appliance, which he claims creates results that "will stay like that the rest of your life" without retainers because the underlying cause has been corrected.

Question 20: What is the Stage Three Bioblock Appliance and how does it train proper oral posture?

The Stage Three Bioblock Appliance is Dr. Mew's unique device designed specifically to train proper oral posture by creating physical consequences for incorrect positioning. The appliance is adjusted to "deliberately hurt if you drop your jaw and don't keep your tongue on the palate." This discomfort creates a powerful subconscious training mechanism as patients wear it "all night every night" and must maintain correct tongue and jaw position to avoid pain.

Initially difficult to adapt to, Dr. Mew explains that patients gradually learn to sleep comfortably with the appliance, which means they're maintaining proper oral posture throughout the night. He claims this extended training creates permanent change: "once you can sleep all night wearing a Stage 3 Appliance you will, I think, forever adopt the correct subconscious oral posture." This addresses the core cause of malocclusion rather than just straightening teeth, which is why Dr. Mew believes his results remain stable without retainers while conventional treatment invariably relapses.

Question 21: How does alveolar bone differ from basal bone, and why is this significant in orthodontics?

Alveolar bone is the specialized bone that supports the teeth, while basal bone forms the fundamental structure of the jaw. Dr. Mew emphasizes that alveolar bone "actually forms about 80 percent of the bone that supports the face," while the basal bone is comparatively minimal – "not much more than the width of a pencil." This distinction is crucial because alveolar bone adapts to tooth position; it forms to support teeth wherever they move and disappears when teeth are removed.

This relationship between teeth and bone development challenges conventional orthodontic thinking. Since teeth largely determine bone structure, and bone determines facial shape, tooth position becomes critical to facial aesthetics. Dr. Mew's approach leverages this relationship – when teeth are guided with gentle forces, the alveolar bone follows, adapting to support them in their new positions. This understanding explains why extractions and retraction can damage facial aesthetics by reducing alveolar bone development, while expansion can enhance facial structure by promoting alveolar growth in a forward direction.

Question 22: What evidence does Dr. Mew cite regarding the effectiveness of his approach?

Dr. Mew references his studies with identical twins treated with different methods, which demonstrated that conventional fixed appliances cause the "face to go back one or two millimeters" immediately upon placement. He also cites cases of patients who were told they required jaw surgery but were successfully treated with orthotropics instead, claiming success in "about 30 patients" with only one exception. These records were submitted to the General Dental Council, though he states they "refuse to even look at them."

For adult treatment, Dr. Mew references a recent paper testing his Stage One Bioblock Appliance on 18 patients aged 22-49, which achieved "expansion of seven millimeters in about three months." He also mentions research comparing the effectiveness of tonsillectomy/adenoidectomy versus maxillary expansion, finding expansion "far more effective" for improving breathing. However, Dr. Mew laments the lack of research on tooth longevity after orthodontic treatment, suggesting this represents a significant gap in understanding the full impacts of different approaches.

Question 23: What professional resistance has Dr. Mew faced throughout his career?

Dr. Mew has endured extensive professional opposition throughout his career, describing being "ridiculed, ignored," having his "license taken away," and nearly going "bankrupt" defending his ideas. His orthodontic colleagues view him as "a traitor" rather than "a reformer," believing he's "trying to damage the orthodontic profession" rather than improve it. This resistance has been particularly strong in "English-speaking universities" where his ideas are "completely rejected."

The professional animosity stems from Dr. Mew challenging fundamental orthodontic practices taught to generations of practitioners. He explains that what doctors learn as students, "by and large you go on believing all your life," creating institutional resistance to new concepts. Universities have "no idea how to treat with orthotropics," making them reluctant to incorporate his methods. Dr. Mew believes his certainty about being correct "annoys a lot of people," but maintains that decades of clinical experience have validated his approach despite the profession's unwillingness to seriously examine his evidence.

Question 24: What is happening with Dr. Mike Mew and the General Dental Council?

Dr. Mike Mew is currently facing disciplinary proceedings from the General Dental Council in the UK. According to Dr. John Mew, this action stems from Mike telling people "how he thinks they should be treated," which orthodox practitioners consider inappropriate. John believes the process is fundamentally unfair because the General Dental Council consults orthodontists for expert opinions on Mike's claims, and orthodontists naturally reject approaches that challenge their practices.

Dr. John Mew predicts that while they may not "remove his license," they will likely "reprimand him," which will "set back the introduction of orthotropics for another 10 years in the UK." He describes the process as having "the judge and jury against him" since "the judges on that Court are provided by the General Dental Council." The proceedings are "damaging Michael severely," who John describes as "much more sensitive" than himself and "a very sincere clinician" who "hates damaging people." John sees these actions against his son as extensions of the professional resistance he himself has faced throughout his career.

Question 25: How does Dr. Mew respond to the argument that orthotropic expansion doesn't improve nasal volume?

Dr. Mew firmly rejects the assertion that orthotropic expansion fails to improve nasal volume, stating, "I just think it's because they never tried." He argues that "you don't need to split the suture" to improve nasal breathing because "if you simply widen the arch the bones will widen." This challenges the prevalent assumption that only surgical-assisted rapid expansion like MSE can meaningfully affect nasal passages in adults.

To support his position, Dr. Mew references research comparing the effectiveness of ENT interventions (tonsillectomy and adenoidectomy) with maxillary expansion for improving breathing. He states the study found "maxillary expansion was far more effective than tonsillectomy and adenoidectomy" for breathing improvement. This evidence contradicts the notion that only mid-palatal suture splitting improves nasal volume, suggesting that the gentler expansion methods used in orthotropics can still provide significant breathing benefits while avoiding the trauma associated with surgical approaches.

Question 26: What is Dr. Mew's position on double jaw surgery?

Dr. Mew states he has "absolutely not" ever referred patients for double jaw surgery, believing it unnecessary and traumatic. He specifically sought out cases that had been recommended for jaw surgery, treating "about 30 patients" with orthotropics instead, with success in all but one case. He expresses grave concerns about the procedure's invasiveness, noting they "saw the lower jaw into three bits" and "saw the upper jaw away from the skull," creating risk where "occasionally people die."

Beyond the immediate surgical risks, Dr. Mew emphasizes that "over half of all jaw surgery relapses afterwards," yet patients are rarely informed of this high failure rate. He believes that if patients were told about the relapse rates, "they would never have it." While acknowledging that some adults might look "more attractive by having their bones manipulated," he generally considers it "not worthwhile" due to relapse. His exception is for severe sleep apnea cases in adults where orthotropic treatment would provide insufficient improvement.

Question 27: What are the limitations of orthotropic treatment in adults?

Dr. Mew acknowledges clear limitations with orthotropic treatment in adults, stating, "you don't get much improvement certainly not really after the age of 25." While he can achieve "surprising amounts" of change up to age 20, beyond 25 the changes become much more modest. This reflects the decreased growth potential and reduced adaptability of facial bones in adulthood compared to childhood.

Despite these limitations, Dr. Mew maintains that orthotropic principles still offer benefits for adults. He notes that "at any age your face will slowly improve" with proper oral posture, as will "your General Health." This suggests that while dramatic structural changes may not be possible in adults, adopting correct tongue posture and using gentle expansion can still yield gradual improvements in both appearance and function. For adults with severe cases requiring significant expansion, particularly for airway improvement, Dr. Mew recognizes that more aggressive approaches like MSE might sometimes be necessary.

Question 28: How does Dr. Mew explain the persistence of traditional orthodontic approaches despite his findings?

Dr. Mew attributes the persistence of traditional orthodontics despite evidence of its drawbacks to several factors. First, there's professional inertia: "what you're taught as a student by and large you go on believing all your life." This creates an "inherent drag on new ideas" where examination systems are run by people who learned their subject decades ago who believe what they were taught even earlier. Second, universities lack training in orthotropic methods, creating a cycle where they cannot teach what they themselves don't know.

Financial interests also play a role, as the conventional approach allows orthodontists to see more patients with shorter appointments. Additionally, orthotropics requires longer treatment periods (potentially 6-7 years starting from ages 5-7), which many find impractical. Dr. Mew also suggests that his approach's certainty "annoys a lot of people," while acknowledging that despite institutional resistance, he has "thousands of patients begging for treatment" with insufficient trained orthotropists to meet demand. He believes change will eventually come but fears he "will probably be dead by then."

Question 29: What are the differences in facial changes between orthotropics and traditional methods?

Dr. Mew describes dramatically different facial outcomes between orthotropic and traditional treatments. With orthotropics, "the facial changes are dramatic," with visible improvements "under the eye and in the cheeks and everywhere else" as the face grows forward and upward. These changes enhance both function and aesthetics, improving airway dimensions while creating what Dr. Mew considers more attractive facial proportions.

In contrast, conventional fixed appliances cause the "front of the face to go back one or two millimeters" immediately upon placement, regardless of the orthodontist's intentions. Even with expansion approaches like MSE, Dr. Mew believes the results are inferior to orthotropics because rapid forces cause "unilateral changes" where "one side will split whereas another will move." Traditional approaches focus on aligning teeth rather than optimizing facial development, which Dr. Mew believes results in compromised aesthetics and fails to achieve the comprehensive improvement in facial structure that orthotropics provides.

Question 30: What device does Dr. Mew's interviewer propose for mimicking natural breastfeeding?

The interviewer proposes creating artificial breasts (jokingly calling it "the rack") designed to mimic the mechanics of natural breastfeeding. This device would be developed by a multidisciplinary team including lactation consultants, physicians, dentists, mechanical engineers, and fluid engineers to recreate the action a baby's mouth takes on a human breast. The goal would be forcing infants to use the same mechanics as in breastfeeding—actively pumping rather than passively sucking—to develop proper tongue posture.

The interviewer suggests this could overcome practical limitations preventing many women from extended breastfeeding, allowing "husbands to breastfeed, babysitters to breastfeed, mother-in-laws to breastfeed." He proposes leveraging advances in realistic textures developed for sex dolls to create skin-like polymers in various colors to accommodate different ethnicities. Dr. Mew agrees this approach has merit but cautions it would be challenging to "create a really realistic breast which crushes as a pump" and notes a previous attempt called the "look nipple" was unsuccessful.

Question 31: What is Dr. Mew's perspective on the ideal age to begin orthotropic treatment?

Dr. Mew believes orthotropic treatment should ideally begin at ages "five, six, or seven" when children's growth potential is optimal and habits can be effectively changed. Starting early allows guiding development during the most active growth periods, preventing problems rather than correcting them later. The treatment continues until growth completion, potentially taking "six years, seven years" for full results.

Early intervention is crucial because it addresses causes rather than symptoms, training proper oral posture when patterns are still forming. Dr. Mew acknowledges this creates practical challenges, as it requires longer treatment periods than conventional orthodontics. However, he maintains this approach delivers superior results with stability that conventional orthodontics cannot achieve. The extended time investment pays dividends through lifetime benefits in facial aesthetics, dental alignment, TMJ health, and sleep quality, with results that remain stable without retainers.

Question 32: What books has Dr. Mew written and what do they address?

Dr. Mew has written "The Cause and Cure of Malocclusion," which he describes as containing "exactly all that needs to be said" about his approach, though he laments that critics haven't actually read it. More recently, he's published "What Will My Baby's Face Look Like," which provides practical advice for parents wanting to ensure healthy facial development in their children, complete with photographic examples showing potential outcomes.

His newer book specifically addresses the three primary causes of malocclusion: living in houses (which creates allergies leading to mouth breathing), eating soft food (which fails to exercise jaw muscles properly), and insufficient breastfeeding (less than 2.5-3 years). Dr. Mew recommends this book for "almost every mother" as it costs "less than ten dollars" for the ebook version and provides guidance that could help parents prevent developmental problems rather than needing to correct them later.

Question 33: How does Dr. Mew characterize his personal experience of challenging orthodontic conventions?

Dr. Mew describes his experience challenging orthodontic conventions as "very disparaging" but maintains he's "a very tough nut" who "knew I was right and wasn't going to bow down" even when threatened with losing his license. Despite facing ridicule, licensing challenges, near bankruptcy, and being viewed as "a traitor" by colleagues who trained with him, he has persisted in advocating his approach, believing "the truth is the truth" and cannot be debated.

Dr. Mew draws parallels between his experience and those of other scientific reformers, noting that "almost every reformer in history has suffered as I have." He points out that he has "gained nothing" from his knowledge in material terms, suggesting his motivation has been advancing understanding rather than personal benefit. At 94, he continues to advocate his ideas, believing that without his persistence, "mewing would have never become established" and "the idea that oral posture can influence growth would have never become established."

Question 34: What does Dr. Mew believe is the future of orthodontics?

Dr. Mew believes orthodontics is currently "staying still" rather than progressing forward or backward. He sees some practitioners gradually incorporating elements of his approach, particularly understanding the importance of positioning the upper front teeth "about seven or eight millimeters up and forward" to guide proper development. However, many apply these principles improperly due to insufficient understanding of "what factors to be careful about," leading to complications like teeth being "pushed out of the bone."

While Dr. Mew is confident his methods will eventually be accepted ("I'm sure that orthotropics will be accepted"), he believes this change will be slow and may not occur during his lifetime. He sees the greatest resistance in "English-speaking universities" where rejection is "complete," while noting more acceptance in Asian countries where "several hospitals" are training in orthotropic methods. This geographic variation suggests the future may see orthotropics adopted unevenly across different regions as cultural and institutional factors influence acceptance rates.

Question 35: How does Dr. Mew view his legacy and the continued work of his son?

Dr. Mew views his legacy primarily through the establishment of key concepts rather than personal recognition. He believes that without his persistence, "mewing would have never become established" and "the idea that oral posture can influence growth would have never become established." He acknowledges these ideas would have emerged eventually, but "not for a long time," suggesting his work accelerated understanding by decades.

Regarding his son Mike, Dr. Mew expresses both fatherly pride and concern about their professional differences. He supports Mike despite disagreements over techniques like MSE, noting wryly, "have you ever met a son who does all the things his father suggests?" His greater concern is the impact of the General Dental Council proceedings on Mike, who is "very depressed" and "completely off work." Dr. Mew believes these actions are "destroying his life" and will delay the advancement of orthotropics, though he maintains confidence that "the argument will still continue" and truth will eventually prevail.

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