Craniofacial development: 7 things parents need to know
Tongue ties
Tongue tie (aka ankyloglossia) is a condition that a person is born with. Everyone has a lingual frenum; a piece of tissue that attaches the underside of your tongue to the floor of the mouth. A tongue tie is when that tissue is too short, tight, or thick to allow for proper tongue position, movement and function. Tongue ties do not resolve on their own. People who have ties that are not treated early in childhood will develop compensations in order to chew and swallow, and they will likely have issues with growth and development because the tongue cannot rest in the roof of the mouth, which brings us to #2. (For more detailed information on ankyloglossia, read our 3-part blog series on tongue ties).
Proper oral rest posture
Mouth closed (lips sealed), with the tongue lightly suctioned on the palate; this is how your mouth should be when at rest. When the tongue rests in the palate it acts as a natural palatal expander; putting force on the bone and teeth to grow the palate both in width and depth. For someone with a tongue tie, their tongue cannot fully reach their palate and will usually rest low in their mouth. This low tongue posture leads to a palate that is narrow, high/vaulted, and they will have teeth crowding due to the lack of space. Proper tongue posture is essential for growth and development of the face. Because the roof of the mouth is also the floor of the sinus, improper growth of the palate means less space in the sinuses/nasal cavity, which brings us to the topic of breathing.
Nasal breathing
For someone with proper tongue posture, nasal breathing comes naturally because you can’t breathe through your mouth when your tongue is suctioned in the palate! Nasal breathing is important for many reasons, the most basic being that your sinuses warm, humidify, and filter the air. Mouth breathing can be a vicious cycle; when the tongue is low, mouth breathing happens, the body then senses too much air entering the body and will create congestion in the nose to try and slow down breathing, which leads to more mouth breathing. Mouth breathing can also lead to more inflammation of the tonsils and adenoids, further blocking airway passages. Mouth breathing means that there is an open mouth resting posture, which leads to a lower jaw that grows down and back instead or forward and out. Mouth breathers can end up with many problems besides poor growth and development including: more frequent infections, digestive issues, headaches, sleep problems, poor focus and concentration, behavioral issues, anxiety and depression. Dr. Bill Hang states it best “Getting a child to be a 100% nasal breather at the earliest possible age is critical to a child's overall health and ultimately their longevity.”
Sleep
If you can’t breathe, you can’t sleep. We discussed nasal breathing first because mouth breathing during the day can often lead to disordered breathing at night, but there are other reasons for poor sleep such as nasal or airway blockages, obstructive sleep apnea, or poor sleep hygiene. No matter the cause, if a child isn’t getting restorative sleep, they are at risk for poor physical development, learning problems, behavioral issues, weight gain and frequent illness.
Diet
We all know how important our diet is to our health. If you eat a diet lacking in nutrients your body can’t function optimally. For children it is even more important because they are growing. Nutrients are essential, they form our cells and give us energy, but one component of our diets is often overlooked - the chewing. Chewing is an important part in the development of the face. We need to use our muscles and bones in order for them to become strong and grow to support us. Our modern diets are often lacking in raw or whole foods that require a lot of force to break down. Think about the most common foods that children eat; most of them are processed (like chicken nuggets, bread, and pasta) overcooked, mashed or pureed (yogurt, smoothies, jarred baby food), or designed to breakdown easily with little force (chips, crackers, puffs, melts) they take little to no chewing in order to swallow them. We need to prioritize giving our children real, whole foods, that are not overly processed, and that have as few ingredients as possible. They are healthier in terms of nutrition, and they require chewing which will stimulate proper growth of the jaws. When it comes to growing our jaws: if we don’t use them, we lose them.
Habits
While chewing is great, sucking on objects besides food (pacifiers, thumbs, lips, clothes etc.) can be detrimental if it continues past the first couple years of life. Non-nutritive sucking (such as a thumb or pacifier) in infancy is normal and can be very calming, but if a baby needs this type of soothing we want to evaluate for a possible tongue tie (children who are tongue tied often have difficulty with self-soothing, so they may need to use their thumb or pacifier more in order to calm down, digest, and sleep). Beyond infancy, there are issues with these habits, the first is that if the thumb (or other object) is in the palate, the tongue can’t be - this goes back to the tongue acting as a natural palatal expander. If the tongue can’t do its job, growth will be affected. As a hygienist, I have seen cases where a child who sucks their thumb almost continuously had a palate that was perfectly shaped around the shape of their thumb! The second issue is that the sucking and swallowing pattern when the thumb is in the mouth is different than the mature swallowing pattern we want to develop. Many of these children need therapy to correct an immature, reverse, or tongue thrust swallowing pattern.
Early is better
Did you know that the majority of jaw growth happens before age 11? At age 5, the upper jaw is 85% of its eventual adult size! This is why it is important to catch issues early on and set our children up for success from infancy. Our myofunctional therapy plans are designed for children 5 years or older due to the comprehension, coordination, and cooperation needed for structured therapy. If you are the parent of a young child who has a tongue tie, myofunctional, airway or sleep issues, don’t lose hope - we offer our “Early Start Program” just for you! There are so many things we can do both as parents and as airway focused practitioners to ensure that children are able to grow, develop and THRIVE!
If you have questions about your child’s particular situation and think myofunctional therapy might help, schedule a consultation today to get started!
For more information on growth and development I recommend reading “Jaws: The Story of a Hidden Epidemic”.
For parents looking for guidance on raising happy, healthy kids, I recommend the book “Brave Parent”.