How the Face is Supposed to Work

Episode #336 with Dr. Michael Gunson

Faces have multiple functions. It needs to breathe, eat, and communicate. But while a face may excel at these tasks, it may not be aesthetically pleasing — and vice versa. And to talk about how to achieve a functional and aesthetic result with treatment, Kirk Behrendt brings in Dr. Michael Gunson from Spear Education to teach you how the face works and how to redefine normal. For the best practices on treating the face for form and function, listen to Episode 336 of The Best Practices Show!

Main Takeaways:

The face has three key functions: to breathe, eat, and communicate.

Understand why something looks good in a particular location.

“Normal” is just the average of what has ever been observed.

Using standardized normals won't always make a face aesthetic.

Understanding why something looks good will help you adjust for people who are not “normal.”

Connect with patients. Help them understand the problem, and they will accept treatment.

Quotes:

“My partner was at the forefront of figuring out how to move the teeth and jaws in a way that's aesthetic for the face. Because prior to him, for the most part, people were just going by cephalometric normals or, ‘Let's just put the teeth together, and that'll make a good face.’ And that was not true. So, he devised a way of measuring and treating the face aesthetically. But as I did that, I discovered you don't always hit the bullseye going by these standardized “normals.” And what I started to discover is that “normal” is a bad word. None of us should be trying to make anything normal. Normal is just the average of what has ever been observed.” (07:17—08:14)

“My partner, Dr. Arnett, says, ‘Put the chin here. This is the location where the chin belongs.’ So, I started asking questions like, ‘Well, why? Why does the chin belong there? Why does that look good?’ Because if I understand the why behind it, then I can make adjustments for people who are “not normal” or not underneath the bell curve. So, I started asking all these “why” questions.” (09:59—10:26)

“There are some functional keys to the face. In other words, the face has a job to do, and that job is to do three main things: the face needs to eat, it needs to communicate, and it needs to breathe. And what I discovered looking at all kinds of data, all kinds of articles, is that the brain is in charge, and the brain will override just about any aspect of the face in order to accomplish those three goals. So, does the brain care that the teeth wear down when somebody chews or talks? No. The brain only cares that we eat and that we communicate. Does the brain care that posture can be deformed in the neck and hurt if growth is incorrect? No, the brain doesn't care if the neck hurts. The brain’s actually responsible for the neck hurting as the patient cocks their head forward, has bad posture, in order to breathe.” (10:32—11:46)

“In me speaking with my patients and having a connection with my patients, I felt like I was not connecting with them based on, ‘Oh, let me just explain to you that your jaw is in the wrong place, and we need to put it in the right place.’ And the patient’s like, ‘Okay?’ So, the patient has to believe me, at that point. That's far different than sitting with a patient and listening to them, ‘Well, what is the problem?’ ‘Well, my neck hurts. My jaw hurts here. My mom’s always yelling at me to stand up straight. I drool.’ It’s like, ‘Yeah. I'm sorry you're going through that. Do you want to know why you're doing those things?’” (13:03—13:52)

“I'm connecting with the patient’s story. This is their life story, and I'm connecting with their life story, and they're feeling me connect with that. They're feeling me understand that life story so that now we’re on this same level;...