Physiological Orthodontics

Facial muscles, tongue, and jaw usage have a crucial role in the jaw and forward facial development. Muscles develop from proper usage of the lower jaw during chewing. The tongue is a very strong muscle that guides the face forward during development. In order for the tongue to do this-this very important role during development, the child must keep their mouth closed, proper lip seal and swallow properly. But this is a big problem for children today in modern society…why?

Bottle feeding has become more prevalent among industrialized families. Artificial nipples force a baby to alter their proper tongue position from high in the palate, to low in the mouth so they can let air in to get milk out of the bottle. In contrast, when baby nurses on a mother’s nipple, the mouth is completely sealed to form complete suction and a negative pressure, forcing the baby to 100% nasally breathe. Bottle nursing teaches the baby to oral breath, which carries on through childhood causing mouth breathing later in life.

Orofacial Development and Early Intervention

orofacial development

Modern lifestyle infants are fed pureed, “mushy” baby foods very early on before they are ready for solid food. The swallow reflex to properly swallow solid foods doesn’t develop until around 12-15 months. When prematurely introducing solid foods by spoon or pouch feeding baby food as early as 4-6 months, we unintentionally teach the baby to swallow improperly. A proper swallow requires the tongue to be positioned high up on the palate, with no activity of the facial or neck muscles. A proper swallow enhances a forward and outward force on the upper jaw, encouraging the forward growth of the face. However, during an improper swallow, when introducing soft mushy solid foods too early, the tongue postures low in the floor of the mouth and doesn’t support the upper jaw and over time, the cheek and facial muscles begin to push inward, resulting in a narrowed upper jaw which causes an incomplete forward facial development. Once a baby or toddler learns this type of abnormal swallow, it is very difficult to retrain. It is estimated that 80% of our modern populations has some form of infantile swallow pattern.

Another effect of pureed “mushy” baby foods is the lack of muscle usage of the jaws during the function. Jaw muscles, when not put to use at an age when the baby is ready to wean, will cause weak muscles. Underused jaws will not develop to their full genetic potential and will result in a long face look and open mouth posture. Our tribal ancestors all had big jaws, wide dental arches, straight teeth and superior forward facial development compared to modern humans today. Our ancestors’ babies weaned from nursing on mother, straight to solid foods when a baby was ready. Ancestral tribal babies were fed a tougher, fibrous diet of wild game, fruits and vegetables, which they chewed developing strong muscles of the jaws, ensuring the forward development of the face. Babies need to learn to chew and swallow properly when they are ready without suckling solid foods down before they are ready. They need to swallow with their teeth together and their tongue on the roof of their mouth, at the same time training jaw muscles from an early age.

For more information on weaning baby from breastfeeding to solid foods, please reference the book Baby Led Weaning by Gill Rapley and Tracey Murkett. OR, call our office today for a parent consultation with Dr. Hughes and receive a free copy of Baby Led Weaning.

Nasal Breathing Vs. Mouthbreathing

Environmental allergens or food allergies to casein/milk and gluten/wheat create chronic inflammation of the lining of the nasal passages and adenoids. Nasal breathing is our #1 physiologic way of breathing. Mouth breathing should be a secondary or emergency way to breathe if one is unable to breathe through their nose. If a child is unable to breathe through their nose due to blocked nasal passages, they must posture their tongue lower in the mouth to allow them to breathe through their mouth.

The midface stops developing forward and begins to develop downward creating a longer faced look. The lower jaw has to accommodate to the underdeveloped upper jaw, often resulting in TMD symptoms and/or OSA. Mouth breathing is NOT normal and will affect facial development, causing incomplete development of the midface and dental crowding. The #1 destroyer of facial beauty, cause of crowded teeth and smallmouth is open mouth breathing. If open mouth breathing has already begun in your child, please see Dr. Hughes for an evaluation and advice.

When the tongue is in the proper position, high in the palate, with a lip sealed posture, the teeth will align nice and straight around the border of the tongue which creates a broad, beautiful U shaped jaw.

Proper tongue posture, lip posture and swallow pattern will ensure the child will develop a forward face with a beautiful jawline, wide palate, and superior facial beauty with broad features. Improper tongue and lip posture and swallow pattern will lead to a child developing a narrow palate, incomplete development of the midface, teeth crowding, a small jawline- no chin look, and a longer, unaesthetic appearance of the face.

15 Things to ensure proper orofacial development (and prevent TMD/OSA)

  • Breastfeed, not bottle feed if possible.
  • If you must bottle feed, use NUK nipples. Must be right size for child.
  • Avoid Pacifiers.
  • If you can’t avoid pacifier use, use NUK pacifier. Avoid thumb sucking.
  • Avoid soft baby food, wean them into solids. Reference: Baby Led Weaning by Gill Rapley and Tracey Murkett
  • Don’t give your child cow’s milk. It’s perfect for baby cows, not baby humans.
  • Avoid using Sippy Cups with straws or valves, use the trainer cup lid only.
  • Ensure your child is a nose breather not a mouth breather. CRITICAL!
  • If a mouth breather, test for allergies. Try removing milk from diet as #1 allergy cause. #2 gluten.
  • If can’t control allergies, have enlarged tonsils and adenoids removed.
  • Have your child (age 2-5) use a soft dental chewing appliance with a handle.
  • If teeth are crowded, DO NOT allow any dentist to extract teeth to make room.
  • Discuss the orthopedic development of the mid-face with Dr. Hughes using a Removable AGGA orthopedic appliance (ages 6-11) or Fixed AGGA orthopedic appliance (age 12+)
  • Have Dr. Hughes evaluate your child for a myofunctional disorder and train your child for proper tongue position and proper swallow pattern with Myofunctional Therapy
  • Consult with Dr. Hughes about Physiologic Protractive Orthodontics to ensure the teeth are straightened taking into consideration the TMJ and muscle physiology.
  • If nasal patency (child can breathe through the nose), consider lip taping, with discretion, to train them to be nose breathers. Please discuss lip taping with your physician prior to attempting.

Oxygen Deprivation in Children

Parent Questionnaire:

Does your child exhibit any of the following:

  • Snoring?
  • Teeth Grinding?
  • Nighttime Awakenings?
  • Nightmares or Night Terrors?
  • Restless Sleep?
  • Hyperactivity?
  • Bed Wetting?
  • Daytime Fatigue?
  • Lack of Energy?
  • Feeling Irritable?
  • Frequent Melt Downs?
  • Severe Mood Swings?
  • Inability to chew food with mouth closed?
  • Last one done at the dinner table?
  • Inability to focus on tasks?
  • Inability to focus on learning?
  • Mouth Breathing?

OXYGEN DEPRIVATION in children can cause restless sleep, bed wetting, night terrors, nighttime awakenings, daytime fatigue, mood swings, ADHD, issues with focus and attentiveness, teeth grinding and behavior issues in school. Snoring in children is serious and needs to be addressed immediately. There is help for children who snore or have the above behaviors, please call Dr. Hughes for a consultation to have your child evaluated. 303-666-8820

Our Goals With Orthodontic Treatment

Our #1 goal is to prevent the need for braces in the first place! We want to ensure the Big 3 are in place for your child to maximize the potential for genetic forward face growth.

  1. Nasal Breathing
  2. Proper tongue position and swallow pattern
  3. Proper lip seal.

treatment for mouthbreathing boulder co

Proper tongue posture, lip posture and swallow pattern will ensure the child will develop a forward face with a beautiful jawline, wide palate, and superior facial beauty with broad features.

Dr. Hughes recommends a soft dental appliance with a handle for toddlers through age 6 to stimulate natural chewing and jaw muscle usage to aid in the proper jaw and facial growth at an early age. To see if your 2-6 year old would benefit, please call our office to schedule a consultation with Dr. Hughes.

If we catch something going awry at an early age, we can help you and your child correct it….releasing a lip tie or tongue tie, myofunctional therapy, prescribing a functional orthopedic appliance or referral to an ENT or allergist are a few examples of how we accomplish getting the Big 3 in place.

Dr. Hughes will help your child achieve a lifetime of good nasal breathing, posture, function and maximize their genetic capabilities for facial and dental development. Call today for a consultation 303-666-8820