Ideal Oral Facial Development: Crowded and crooked teeth may be the result of improper tongue placement and can pose many healthy concerns, says Dr. Lisa M. Butler.

Nearly two-thirds of the U.S. population has some degree of malocclusion (crowded/crooked teeth). Some of the common causes of dental malocclusion include the birth process/cranial trauma, incorrect position of the cranial structures, frenum (oral muscle) attachments, enlarged adenoids/tonsils, finger/thumb sucking, mouth breathing and tongue position/posture. The key factor in these conditions is that the tongue is not resting on the roof of the mouth.

The face will not develop properly if the structures that make up the face are unable to perform their intended function or have been damaged. When the tongue is not resting in the roof of the mouth, the jaws are impeded from growing forward. Mouth breathing lowers the tongue position to facilitate the flow of air into the expanding lungs. More often than not, the child will also have a reverse swallow habit and a characteristic forward shoulder/head tilt. The person will alter the way they hold their head in order to compensate and increase the amount of oxygen they receive.

The biggest health concern is a lack of oxygen to body tissues, which can be life-altering. Many children that suffer from upper airway obstruction can be misdiagnosed with attention deficit disorder and hyperactivity. The child may also experience snoring and/or clenching and grinding their teeth. Snoring can be a sign of sleep apnea, a condition in which the body is not receiving enough oxygen that can lead to heart and circulatory problems later in life.

In addition to decreased oxygenation of the body, facial development can be negatively affected in the form of underdeveloped/narrow jaws, flattened cheeks, dark circles/tired eyes, receding chin, sloping forehead, gummy smile and crowded teeth. These traits are described as “long face”, or too much vertical facial growth. Ideally, learning correct breathing and swallowing before the age of 8 years old can have the biggest impact on facial development. However, the lower jaw can develop well into the late teen years and teenagers can still receive benefits.

Myofunctional therapy (exercises) and oral appliances can be used to help correct habits and encourage proper tongue resting and swallowing positions. A dental professional can evaluate frenum attachments and guide the patient into an appliance that will help develop the jaws to their proper potential. Traditional orthodontic braces may not address the underlying cause, even though the teeth are initially straight. A retainer is often advised for the remainder of the patient’s life, as the teeth will shift back if the underlying condition that caused the crowding is not corrected.

Some alternatives to traditional orthodontics include orthotropics, myobrace, Crozat and/or ALF appliances. In conjunction with myofunctional therapy, these appliances can provide optimal oral facial development and overall health.

Lisa M. Butler, DMD, is the owner of Integrative Dental Associates, in Phoenix. For more information, call 602-956-4807 or visit IntegrativeDental.com.