By Yvonne Vannoort, The Dentist
As a dentist seeing many children, I am aware I have the opportunity to assess not only the health of children’s teeth but also their degree of facial development. My aim is to help children achieve a well balanced face with a functional bite and symmetry of the facial bones which in turn promotes a healthy body.
Facial growth is mostly complete by age 12. Factors inﬂuencing favorable facial growth are good nutrition, normally functioning facial muscles and tongue, and breathing well.
The way muscles in the mouth and face function, especially the tongue, is crucial for good facial development. The tongue needs to rest in the roof the mouth as this stimulates the parasympathetic nervous system, helping the body to relax.
In infancy, the tongue functions diﬀerently when a baby is breastfed compared to bottle fed and these patterns of function become lifetime habits.
Breastfeeding elevates the tongue to the roof of the mouth; the negative pressure induced by this action draws milk out of the breast and the baby swallows.
Bottle feeding is passive; the milk requires little pressure to reach into the mouth, the muscles work diﬀerently and less intensely. The tongue does not need to exert pressure in the roof of the mouth.
Pacifiers change the position of the tongue in the mouth and also the way the tongue functions. Tongue function patterns determine how the palate grows which in turn develops the nasal passages. Breathing well through the nose is critical to a well developed face.
Children may develop the habit of mouth breathing because of:
- A tongue tie that tethers the tongue to the ﬂoor of the mouth
- Allergies resulting in a blocked nose
- Sensitivities to foods that result in blocked airways.
- Enlarged adenoids and tonsils
- A deviated septum of the nose
- Sleeping in an overheated room or with too much clothing
If you suspect your child is mouth breathing, these are signs to look for:
Watch them during the day; their lips should be together other than when they are talking or smiling. The lips should also be together when they eat and swallow as the tongue normally elevates to the roof of the mouth during a correct swallow.
This tongue movement during a swallow, which occurs some 2000 times a day, is important in expanding the upper jaw to the proper size. A strong muscle, the pressure that the tongue exerts on the bones of the palate is the body’s way of developing correctly.
During the night, check your child’s mouth is closed while he or she is sleeping. Children who mouth breathe will often drool on the pillow and have a restless sleep. They may wake with a blocked nose and be irritable or hyperactive during the day because they haven’t slept well.
Consider your child’s digestive system and bladder function. Children who mouth breathe may be constipated as digestion is not as eﬀective as it is when they nasal breathe.
Because they lose carbon dioxide from their system when they mouth breathe, children may also bed wet. Carbon dioxide is a muscle relaxant and without it, smooth muscles, such as the bladder, contract and then cause the bladder to empty.
As the face matures, the eﬀect of mouth breathing on its development can be a longer face than usual, a retruded lower jaw and small chin. The cheekbones may be ﬂatter and less pronounced because the middle of the face is less well developed.
The dental arch is the shape formed by all the upper or lower teeth. Teeth are often crowded and a narrow dental arch forms which results in a narrow smile. A ‘gummy smile’ is often seen if the upper jaw grows lower in relation to the skull than usual and more gum is usually noticeable above the teeth.
Children may develop dark rims under their eyes – called venous pooling – as the blood under the eyes drains less efficiently when the middle part of the face is not so well developed.
When we identify the basic need to breathe through the nose, provide good nutrition and check for correct muscle function, we can direct facial growth and promote overall health.
There are options to help achieve optimal facial development depending upon the age and needs of a child. A consultation with one our dentists, who have studied orthodontics, is a great way to explore your child’s facial development.