Abstract Contemporary humans are living very different lives from those of their ancestors, and some of the changes have had serious consequences for health. Multiple chronic “diseases of civilization,” such as cardiovascular problems, cancers, ADHD, and dementias are prevalent, increasing morbidity rates. Stress, including the disruption of traditional sleep patterns by modern lifestyles, plays a prominent role in the etiology of these diseases, including obstructive sleep apnea. Surprisingly, jaw shrinkage since the agricultural revolution, leading to an epidemic of crooked teeth, a lack of adequate space for the last molars (wisdom teeth), and constricted airways, is a major cause of sleep-related stress. Despite claims that the cause of this jaw epidemic is somehow genetic, the speed with which human jaws have changed, especially in the last few centuries, is much too fast to be evolutionary. Correlation in time and space strongly suggests the symptoms are phenotypic responses to a vast natural experiment—rapid and dramatic modifications of human physical and cultural environments. The agricultural and industrial revolutions have produced smaller jaws and less-toned muscles of the face and oropharynx, which contribute to the serious health problems mentioned above. The mechanism of change, research and clinical trials suggest, lies in orofacial posture, the way people now hold their jaws when not voluntarily moving them in speaking or eating and especially when sleeping. The critical resting oral posture has been disrupted in societies no longer hunting and gathering. Virtually all aspects of how modern people function and rest are radically different from those of our ancestors. We also briefly discuss treatment of jaw symptoms and possible clinical cures for individuals, as well as changes in society that might lead to better care and, ultimately, prevention.

中文翻译：

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下巴流行病：认识、起源、治疗和预防


摘要 当代人类的生活与其祖先的生活截然不同，其中一些变化对健康产生了严重后果。心血管问题、癌症、注意力缺陷多动症和痴呆症等多种慢性“文明疾病”十分普遍，导致发病率不断上升。压力，包括现代生活方式对传统睡眠模式的破坏，在这些疾病（包括阻塞性睡眠呼吸暂停）的病因学中发挥着重要作用。令人惊讶的是，农业革命以来下颌萎缩，导致牙齿不齐、最后一颗磨牙（智齿）缺乏足够的空间以及气道狭窄，这是造成睡眠相关压力的主要原因。尽管有人声称这种下颌流行病的原因在某种程度上是遗传性的，但人类下颌变化的速度，特别是在过去的几个世纪里，速度太快了，不可能是进化的。时间和空间的相关性强烈表明，这些症状是对大规模自然实验的表型反应——人类物理和文化环境的快速而剧烈的改变。农业和工业革命导致下颌变小，面部和口咽部的肌肉也变得不那么健壮，这导致了上述严重的健康问题。研究和临床试验表明，变化的机制在于口面部姿势，即人们在说话或吃饭时，尤其是睡觉时不主动移动下巴时保持下巴的方式。在不再狩猎和采集的社会中，关键的休息口腔姿势已被破坏。事实上，现代人的生活和休息方式的各个方面都与我们的祖先截然不同。 我们还简要讨论了颌骨症状的治疗和可能的个人临床治疗方法，以及可能带来更好护理并最终预防的社会变化。