With all due respect to Dr. Buren, and the thousands of other dentists and orthodontists who believe that adult arch development is not possible, I (and thousands of other dentists and orthodontists who perform adult arch development) believe (and have actually proven time after time) adult arch development is very much possible. I was taught in dental school exactly what Dr. Buren states below, i.e. that adult arch development is not possible. However, I subsequently was taught, and have verified through 25 years of experience, that indeed adult arch development is possible. I personally achieve remarkable levels of adult arch development with ZERO tipping of the teeth, no tissue recession and no pain. I have NEVER had teeth moved off the dental bony ridge (verified with CBCT scans). I have had exactly two patients (out of 100's) in 25 years who did not respond to adult arch development; one was a female in her 50's, the other was a male in his 80's! I am currently treating a female in her late 70's who is responding nicely to treatment.Why is this such a controversial subject in dentistry? I can't tell you the answer to that question but what I can tell you is that the ramifications of non-treatment can literally be deadly. How else, for example, are you going to permanently improve a patient's airway who suffers from sleep apnea and can not tolerate a CPAP machine? Untreated sleep apnea is deadly. How else can you treat a patient suffering from symptoms of TMJ Dysfunction that are the result of an underdeveloped maxillary arch?Adult arch development is achieved using simple, comfortable, removable dental appliances. These appliances must be worn 12-16 hrs/day to be effective and the average case requires 12 months of treatment. Braces or clear aligners are almost always required after arch development but because sufficient space is now available to straighten teeth (thanks to arch development) most cases can be completed in less than 12 months using braces or clear aligners.Good luck!