Changing the Face of Dentistry
Facial Meltdown – Birth to Death – and How It Affects Your Overall Health
Asked why he would not appoint a person who sought a particular job, Lincoln said, “I don‘t like his face.“ “But Mr. President, he can‘t help that.“ Replied Lincoln, “Every man after age 40 is responsible for his face.“ Indeed we are and it starts at birth.
What do you most value for yourself and family? What would you pay for the following traits in your children and how would your lives improve socially and economically were you to maximize these?
What Do Crowded Teeth Tell You?
At least 75% of all children have incorrect oral posture that leads to crooked teeth and poorly developed airways and faces. There is a constant battle between teeth, bone, and muscles! Muscles move bone. This battle is often overlooked by traditional orthodontic therapies.
In most cases, orthodontic therapy treats one symptom of a facial collapse that occurred during development. It generally ignores the root cause of crowding – poor oral posture. Straight teeth can be the goal of orthodontic care, but they should never be the point, because crowded teeth are your last indication your child’s face is not developing as it should. Not always obvious, a collapsed airway is first and leads to a broad range of health problems most people would never imagine are related. If you do not correct oral posture, orthodontic therapy takes longer when it is successful and relapses ninety-four percent of the time without lifetime retention. In fact, ignoring oral posture and accepting traditional orthodontic treatment dramatically adds to underlying health problems and often makes a person less attractive.
Consider for a moment how orthodontic therapy works: guided gentle pressure on teeth slowly reshapes the jaws under the direction of an orthodontist. Take it a step further and realize intricate muscles also remodel facial bones over time. If facial posture is incorrect, facial form is incorrect.
For instance, the tongue can exert 500 grams of pressure on teeth, yet only takes 1.7 grams of pressure to move a front tooth. Certainly incorrect tongue positions can cause problems, but what if you use your tongue correctly to help you?!!!
What if you took back the power to help your children shape their own faces – and futures – with three simple, but critical oral postures? Don’t ignore these for yourself, since faces remodel throughout a lifetime. Effects are simply less dramatic and take longer after age 12.
Three Oral Postures Critical to General Health
1. Keep lips sealed together unless eating, talking or using them during intimacy. A mouth is not a breathing tube even during exercise; bad things happen when you use it that way. Your nose exists for a reason!
2. Keep your tongue should be plastered front-to-back to the roof of your mouth, never resting on the floor. Your tongue tip should not touch your top front teeth, but be about a half inch behind them.
3. A normal swallow is calm and relaxed. Your tongue should not move forward and you should be able to swallow easily with your lips apart in a grimace. Place a fingertip gently on your chin to check for muscle movement. Lip and chin muscles never activate during a normal swallow. An incorrect swallow is often called a “tongue thrust” or a “reverse swallow.” The following video shows another variation of an obvious reverse swallow:
The Tragic Consequences of Mouth Breathing
“The tongue can be a six hundred pound tiger in a three foot cage.”
Just sealing your lips adds about 30 IQ points to people‘s perception of your brainpower. What else is at stake?
As I’ve indicated, before age twelve, children’s bones are malleable. If a child consistently mouth breathes for any reason, often because of unresolved allergies to foods like milk and wheat, but also from an undiagnosed tongue tether, this habit can create a 3-dimensional facial contraction. The tongue is a quizzical and selfish muscle. It is also strong. When the tongue rests on the floor of the mouth, as it must in order to mouth breath, the face falls prey to the cheek muscles. Without the counterbalance of the tongue as a template to guide wide arch development, the cheeks “squish” the arch. The face becomes narrow, so front teeth crowd. The lower third of the face including upper and lower jaw grows down and backwards. Often top front teeth look protrusive, but it is only in relation to an even more underdeveloped lower jaw.
Unfortunately many still call this an overbite or “buck” teeth and the top teeth are retracted backwards to make it match the lowers. Sometimes teeth are even extracted to make space for teeth that look like they are crowding, a terrible idea and a shortcut that shouldn’t be taken.
Underdeveloped jaws crowd back teeth and lead to wisdom tooth impactions. As the lower jaw line trends from horizontal to vertical, it assaults tongue space and airway space. The tongue becomes a “Suburban in a Mini-Coop garage,” as Dr. Ben Miraglia quips. Not only does this lead to relationship-breakers such as snoring, but also to life-threatening apnea.
Why Horizontal Facial Growth Matters
- Sisters: Left: This child generally breathes through her mouth. Right: Her sister predominantly nasal breathes. Note differences in muscle tension, facial angles, proportions – and beauty.
Before orthodontic “correction,” a mouth breather’s top front teeth often appear too far forward, but this is almost never the case. “Buck teeth” only look protrusive relative to an underdeveloped lower jaw. Find an orthotropic orthodontist either in the United States and Canada or internationally who will encourage forward development of both jaws. Orthotropic orthodontist Bill Hang suggests you ask for an “Airway Impact Statement” before you opt for the common practice of moving top teeth back to match a “weak” lower jaw. Again, start young. When timed correctly, a functional orthodontist gets best and fastest results when he surfs along the growth curve!
How Vertical Facial Development Leads to Snoring, Apnea and Jaw Joint Problems
Why You Want an Optimally Developed Upper Jaw
As you can see by studying the green section of this skull, the upper jaw, the maxilla, is not merely an anchor for upper teeth. It occupies a third of the face and extends back into the skull. It forms part of the eye socket and sinus spaces. Air enters the body here. More air enters when a person develops a wide face. Avoiding airway obstructions is one more important reason we should all breathe through our noses. If a person continues to mouth breathe throughout life, all airway spaces continue to decrease. Crowded teeth are the last indication there is a problem. Airway problems occur first.
Eighty-five percent of Westerners have underdeveloped faces and airways.
Shaq has Apnea, Could You?
The head and neck are supposed to be two separate entities, not a funnel! In profile, the lower jaw can look like a bump in the neck; many men grow beards to camouflage a weak lower jaw.
Males with a 17 plus inch neck (measure from the “V” notch of the clavicle) and females with a 16 plus inch neck have increased risk for sleep apnea.
Why Do People Clench or Grind Their Teeth?
Is Sleep a Waste of Time or is Time a Waste Without Sleep?
WAKE UP! The Problems of a Sleepy Child; The Silent Airway Problem. Watch this incredible story and how sleep apnea, snoring and other sleep issues can affect a child.All children referred to orthodontists should be evaluated for sleep disorders.
Does Your Jaw Joint Click or Pop?
The jaw joint can fail sometimes because a person consistently puts the jaw in a different position in order to breathe. While clicking and popping is an early stage functional problem, over time, the jaw joint remodels in a backwards position. The three-branched trigeminal nerve traverses right through the jaw joint, so it shouldn’t be surprising the an unhealthy joint can lead to pain, dysfunction, and sometimes debilitating movement disorders as it pinches critical nerves and reduces blood supply. Headaches, poor digestion, lower back pain, cold hands and feet and other symptoms can be almost as debilitating. Equalizing pressure in ear canals during flying or scuba diving is difficult in these cases, if not impossible.
Correction of trigeminal nerve disturbances most often involves jaw therapy that includes a combination of myofunctional therapy, orthodontics, and various dental appliances. The lower jaw can remodel so far back within the jaw joint socket, it can lead to movement disorders that mimic Tourette’s Syndrome Parkinsons’s Disease and others.
Below are videos of movement disorders helped with dental appliances such as the Oral System Biology. There are many other appliances that can help with jaw joint problems. Usually these appliances allow your head to lift and decompress cervical vertebrae.
The Missing Link in Poor Health Outcomes
You may know that a person’s acid/base balance (pH) rules health – and that unbalanced conditions favor disease via unfriendly germ populations and excessive blood clotting. Inflammatory diseases such as heart disease and gum disease become more prevalent as acid conditions reign. Alkalizing diets are popular.
Could proper breathing matter more? Mouth breathers typically have low carbon dioxide levels because their breath rate and volume is double that of nasal breathers. They over-breathe and blow off excessive carbon dioxide. Carbon dioxide contributes to our bicarbonate buffering system, which guards against pH swings. If we are short on this buffer, our saliva or urine may register as too acidic or too alkaline. A smorgasbord of health problems surface as a result.
A Simple Self-Test Indicates Your Body’s Buffering Abilities
To see if your body retains enough carbon dioxide to maintain health, try this simple test: Inhale, then exhale through your nose, holding your breath on exhalation. Begin to time the seconds. When you start to feel an “air hunger,” but your next nasal intake is still calm, stop timing. This is called your “Control Pause.” If your Control Pause is between 1-20 seconds, you will likely show some of the symptoms in the following list. If your Control Pause is between 20 – 40 seconds, symptoms are not apparent, but can quickly surface during stress. When the Control Pause is in this range, your body’s buffering capacity is limited. A Control Pause of over 40 means you can ignore the following list of symptoms:
What Else Contributes to Over-Breathing?
If you eat processed foods, over-eat, are constantly stressed, don’t exercise, use a CPAP, or keep your home temperatures elevated, you likely over-breathe and so have low carbon dioxide levels. Public speakers often over-breathe. Asthmatics also over-breathe and live with a vicious cycle. The more they mouth breathe, the worse their asthma. Look also for a barrel chest as this is a sign of the shallow breathing that often happens in conjunction with mouth breathing.
One wouldn’t think so, but muscle power diminishes during exercise when we mouth breathe compared to when we nasal breathe because oxygen releases from the blood stream into muscles and organs only when enough carbon dioxide is present. Without enough carbon dioxide to release oxygen into tissues, organ function is sub-optimal. It is likely this also plays into cancers, since cancers thrive in sub-optimally oxygenated tissues. It is not how much oxygen we breathe in, it is whether we get to use it.
If your breath is audible at rest, you sigh or sniff regularly, your breathing is irregular, you take large breaths prior to talking, yawn often, or breathe using your upper chest instead of your diaphragm, you likely have low carbon dioxide levels. People who use the various continuous positive airway pressure machines like the Cpap to treat nighttime sleep apnea also over-breathe.
A well known functional orthodontist relayed to me that he had once had asthma for decades that progressed to COPD (chronic obstructive pulmonary disease). He was given a 10 year maximum sentence to live. He changed his breathing patterns with Buteyko breathing and now considers himself free of respiratory diseases. Since he accomplishes Iron Man competitions – while nasal breathing (!) who can argue?
Why You Should Keep Your Tongue Plastered to the Roof of Your Mouth
If you mouth breathe, your tongue must rest on the floor of your mouth, though it should lock onto the palate front-to-back. When it does:
• It naturally expands facial width by stimulating stem cells along the palatal midline. A triple benefit results: a wide airway plus more room for teeth and tongue. Teeth erupt in a wide pattern around the tongue. Front teeth are not crowded
• The tongue is “toned“, thus compact and less likely to choke off the airway.
• When the tongue undulates gently against the roof of the mouth during a proper swallow, eustachian tubes twist and their internal pressure changes. These constant pressure changes clear them and aerate the middle ear. Children suffer less middle ear infections!
• During a correct swallow, pressures build on a chain of bones that milks the pituitary gland of its important growth, thyroid, sex, and blood pressure regulating hormones. Why skip these free, critical hormones? Along that line, a more expansive face opens up many other pathways from the head to the rest of the body.
• Together with a lip seal, it allows the tongue to naturally suspend the lower jaw in space, relieving the need to clench even while sleeping. Many dentists build splints to protect the teeth of their clenching customers, however if oral posture is correct and facial development is not too far from optimal, the tongue is a natural splint.
Early Actions Parents Should Take to Help Their Children Develop an Airway
It should be clear diagnosis and treatment of adult obstructive apnea, while important, is like the Dutch child sticking his finger in the dam. We should address airway/facial collapse much earlier. As a nation, we should be much more aware of teaching proper oral postures and guiding children to get appropriate help for optimal facial growth. Here are a few things you can do for your children:
Breast-fed infants also learn to work their lips, cheeks and tongues differently than bottle-fed babies. The coordination required for an infant to swallow and breathe while breastfeeding is a critical step in learning correct swallow patterns. The tongue earns the milk only when breast-feeding.
Parents should discourage non-nutritive sucking, whether it be a pacifier, finger, arm, or cheek. The tongue only acts as a catcher when using a bottle or pacifier and it teaches the tongue to rest on the floor of the mouth. Non-nutritive sucking also influences facial development by creating a strong vacuum within the mouth and teaching babies an incorrect swallow pattern.
If you must bottle feed, keep your infant in a nearly vertical position and the hole in the nipple as small as possible so your baby must work at receiving milk.
- Toddlers should switch to a regular cup as early as possible, since sippy cups are also a problem. The book, “Baby Led Weaning“ guides parents how to help their babies explore solid foods. Pureed foods are not recommended are actually detrimental. It is important children learn to use their facial muscles to chew hard foods early. Modern soft diets work our jaws about 95% less than the firm diets of our hunter-gatherer ancestors. Poorly chewed soft diets in infancy leads to:
- Poor quantity and quality of jawbones that can’t be completely reversed in adulthood
- Smaller, weaker face and neck muscles and a recessive chin.
- Unstable jaw joints and thus an unstable chewing complex somewhat like an unsteady three-legged stool
- A sluggish digestive system. Incomplete digestion and an unbalanced microbial gut population leads to food allergies and a wide array of health problems. Gut health and excellent nutrition is foundational for all health. Chewing fiber stimulates the parotid salivary glands and releases digestive enzymes and other secretions necessary for complete digestion. (This is why chewing gum is best just after a meal. Any other time and it erroneously signals the gut food is coming even if it isn’t.)
Chewing also starts peristalsis, the synchronized rippling of digestive tract muscles that moves food along the digestive “disassembly” line. For all you smoothie drinkers out there, the more you chew, the more digestive enzymes you secrete and the more efficient your digestion. I purposely create textured smoothies so I will make sure to chew them as though each sip is a bite of food. This has implications in nursing homes and for others who must be tube fed. They should at least try to go through the motions of chewing. It also applies to most people who wear dentures.
The three-branched facial nerve (trigeminal) runs right through the jaw joint (TMJ), so it shouldn’t surprise you that chewing activates an enormous number of body functions – how you collect food in a ball prior to swallowing, saliva production, and preparing the gut for digestion in other ways. All the muscle changes and new positions required for a solid diet change much more quickly when babies switch directly to solid foods from nursing, instead of being fed the common intermediate pureed foods.
3. Watch for flattened cheeks or unusual mouth shape. These conditions almost always worsen. Dark circles under the eyes and slumping shoulders can indicate allergies, poor sleep, and poor oral posture. Do not ignore allergies, large tonsils or adenoids. Blocked noses lead to open mouth postures.
4. Look for parted lips or chewing with an open mouth at any age as it indicates a person is breathing and chewing through the same space. One‘s face continues to change throughout life. It may grow downwards to such an extent a child may struggle to close his lips at all. Once this happens, it is very difficult to correct by means other than surgery. Persuade your child to keep his or her mouth closed at rest.
5. The tongue should not be obvious when your child talks. The only time you should see tongue is during the “th” sound.
6. There should be spaces between the front baby teeth by age five if your child’s airway is developing sufficiently. Their permanent successors, which arrive at about age six, are much larger. If there is insufficient space, they will crowd. It is easier to prevent crowding by creating space than to correct it afterwards. If lower front teeth are crowded at six years of age, do not wait and see what happens. At the very least, your child may need to improve his oral posture.
7. The tongue should be in the palate for most sounds. If it protrudes sideways or forward between the teeth, the teeth are likely to displace. A lisp usually indicates the tongue is incorrectly between the teeth. The lips should contact between most syllables. Ask your child to count to five and see how far apart their lips are after the ‘five’. If more that 3mm apart, there is a moderate problem; if more than 7mm, a severe problem.
8. Release tight tissue attachments that anchor the tongue and lips, prevent a proper tongue rest position and swallow. SELECTING-A-FRENUM-RELEASE-PROVIDER Sometimes a tight frenum can cause nursing difficulties and speech impediments. Frenum releases also release shoulder girdle muscles. All babies should be screened for this as they do in Brazil! Here are a few examples of tight frenums:
What You Can Do If Airway Development is Off Track or You Have “Aged Out” of the Development Window?
It is all too likely you or a loved one needs help. The first order of business is to solve allergy problems and release tight frenums as needed. Large tonsils and swollen adenoids may subside when you stop mouth breathing as the nose takes over filtering functions. Orofacial myofunctional therapy is usually necessary to repattern muscles and stop noxious habits such as thumb-sucking. Myofunctional therapists often work with cranial-sacral therapists, chiropractors, and osteopaths to relieve postural issues. There are so few therapists, if you can’t find one locally, many therapists Skype sessions, though for best progress, the child and parent must be motivated. You may also find this video offering helpful if you have limited access to care for whatever reason:
Your Mouth Matters! Myofunctional Therapy Companion Guide. I believe in self-empowerment. Your goal may be to help guide your child to attain the forward facial growth he deserves. As an adult, you may want to increase your own airway space, ease snoring or jaw joint problems, or to tone head and neck muscles. Remember, 40% of those with mild to moderate sleep apnea no longer need C-Paps or dental sleep appliancces once they successfully complete myofunctional therapy. It is always best to have your own personal therapist. Please use the Academy of Orofacial Myofunctional Therapy’s database for a practitioner near you. Many Skype therapy if you cannot find a therapist in your area. If that is not possible for whatever reason, you can probably accomplish much with the Myofunctional Therapy Companion Video (produced because so many my clients begged me to). In these cases, I can set up an initial consult/evaluation and then consult occasionally when necessary. Begin your journey of metamorphosis as I guide you through two weeks of jaw stabilization exercises and 16 weeks of intensive therapy designed to re-pattern face, head, and neck muscles. This journey will likely surprise you as you reap benefits. Use the video-embedded password to download and print helpful Myofunctional Therapy Companion Video Charts and Word Lists to track your progress if you choose this option.
Enjoy 18 weeks of intensive therapy assistance, then finish off your year of neuromuscular training with ideas to help you incorporate postures you’ve learned into every day – and night – habits. Bonus segments cover pill-swallowing plus head and neck stretches to ease shoulder and neck pain associated with Forward Head Posture. A final bonus covers two weeks of post-frenum release therapy, also available separately.
Find a dentist in the United States or Canada, or internationally who practices “full face” orthodontics. These practitioners prefer to start around age four to guide proper forward facial growth. Treatment must start early to avoid surgery, certainly before age ten. Properly done, an expansion will open the airway. Forward growth guidance allows enough room for an excellent airway and normal wisdom teeth eruption. Full face/orthotropic orthodontic techniques never involve tooth extraction or retraction because the tongue never adapts to its downsized house. Whatever orthodontic style you choose, ask how the plan will impact the airway.
Adults may orthodontically expand their palates to experience relief. As the palate expands, lower teeth upright and the airway expands laterally. If the lower jaw releases from a trapped backwards position, as mine did, this releases pressure from the airway in the other dimension, opens eustachian tubes for easy clearing, and helps ease jaw joint discomforts. Along with myofunctional therapy, it may be enough to stop deadly apnea.
These dentists can also help adults correct the TMJ/breathing/apnea problems associated with the “extraction and retraction” orthodontics they had the first (and sometimes second) time around. Quite often, the best results require oral surgery to correct damage from a lifetime of poor oral posture. More and more industries realize poor sleep quality resulting from apnea affects performance and mandate employee testing.With jobs like airline pilot and truck driver at stake, not to mention personal relationships, adults see the value of correction
Do You Breathe Upside Down? Why It Matters
Orofacial Myofunctional Therapy
Adults as well as children benefit from correcting oral postures – neuromuscularly repatterning oral and facial muscles as needed. Evaluating and appropriately referring children who are still developing has the potential for the greatest health gains. Children also develop new neuromuscular pathways faster!
Nonetheless, it is estimated that for those adults with mild to moderate sleep apnea, myofunctional therapy may benefit thirty-nine percent of them to the exclusion of other, more invasive therapies. For others needing help, orofacial myofunctional therapy works in concert with all other treatment modalities including CPAP, lower jaw advancement positioners, and orthodontics. Since faces remodel throughout life, it is important at minimum to learn to exclusively nasal breathe. All of us should attain a Control Pause of at least forty seconds. Other hints may help you realize you may have a compromised airway and apnea. Here are a few:
- Take a profile picture with ears exposed. Observe if you have a forward head posture wherein the ear canal does not line up directly with the shoulder, but is forward of it. Look also for the telltale backward tilt of the head. You can also back up against a wall and measure the number of inches between the wall and your neck. It should be less than three inches.
- Notice if it is your upper chest (incorrect) or abdomen that rises during breathing, if you sit with your spine in a C-shape, whether you draw breaths from the mouth or nose, and whether you maintain a lip seal when not talking or smiling. Sometimes it takes months to figure out breathing patterns. Do not ignore sleep hours. If you snore, or wake up with a dry mouth, you are likely mouth-breathing.
- Look for allergy indications: dark circles under the eyes, sunken cheekbones, large tonsils, and small, unused nostrils. Modern dairy and wheat products are common allergens.
- Do you show signs of asthma? Yawn or sign often? These are signs of low CO2. Reset your brain’s respiratory rate and strengthen your diaphragm muscles by using Buteyko breath training exercises or you may train with a Frolov Breathing Device. (I use the Frolov Respiratory Trainer. It is BPA-free/made in the USA, and is more economical. Available in the Store.)
- Do you snore? Wake up rested? Feel energetic all day? Consider evaluating yourself with an Apnea-Screening.
For more complete information, refer to Mouth Matters: How Your Mouth Ages Your Body and What You Can Do About It. It is based in part on the work of Dr. Brian Palmer, Dr. John Mew, Dr. Michael Mew, and Dr. William Hang.
Once again, it is simple answers that address root causes of complex health issues. Learn better, do better, be better!
Appreciation to Dr. William Hang for my orthodontics – worth it to fly to California! Also to Reza Movahed, DMD in St. Louis for offering to make his excellent oral surgery services available.
Content on this website, in Primal Dentistry: Less is More and Mouth Matters is not considered medical or dental advice. Please see a physician before making any medical or lifestyle changes and a dentist if you need help with oral conditions.
© Carol Vander Stoep 2018 All rights Reserved