Long-Term Impacts of Oral Dysfunction
When thinking about growth and development from the newborn phase through toddlerhood and beyond; energy, time, and resources are primarily devoted to developmental milestones. However, though less widely discussed in parenting circles, facial and oral development is an area that is quickly becoming an important focus point. The growth and function of the jaw and structures of the mouth play a significant part in airway development, sleep, and so much more! If you or your child has a suspected tongue tie, difficulty feeding (bottle or breast), has difficulty holding a pacifier, sleeps or hangs out throughout the day with the mouth open, mouth breathes, struggles with chronic ear infections, snores, etc., this blog is for you!
How Can Tongue Position Impact Facial Growth and Development?
Facial and oral development is a dynamic process that begins in utero and continues throughout childhood and adolescence. As baby develops in the womb, their tongue begins to achieve the ability to suction up to the roof of their mouth. The act of the tongue lightly suctioning to the roof of the mouth is the body’s natural palate expander. Pretty cool, huh? The tongue should naturally splay across the roof of the mouth at rest and that pressure allows for the palate to flatten out and expand outward. Now, the roof of the mouth is the floor of the nose, so as the palate comes down, there’s more room for the septum, sinuses, and wider nasal cavities. If the tongue isn’t reaching the roof of the mouth, the palate can then become high and arched and begin to take up real estate within these aforementioned areas as well as impact their development. Why does this matter to a chiropractor?
Impaired breathing and poor sleep quality can create a heightened nervous system
Compensatory breathing (using the muscles of the neck and shoulders to try to get more air) can contribute to neck, shoulder, and jaw tension
Suboptimal jaw development can lead to TMJ, neck tension, tension headaches, etc.
A decreased ability to clear the middle ear (occurs with proper swallowing) can contribute to ear infections
How Can Tongue Position Impact Breathing and Airway?
The nostrils contain tiny hairs and other fun mechanisms designed to filter out bacteria and other harmful bits we breathe in through our nose which is why it’s perfectly designed as the primary method of breathing. When we’re mouth breathing and the nostrils are taken out of the filtration equation, the tonsils and adenoids get hit with the influx of unfiltered air. Guess who’s primary job isn’t to filter the air we suck in through our mouths? You betcha, tonsils and adenoids. Those poor little guys can become irritated, swollen, and cranky when they’re asked to take on a job they weren’t designed to do full time. Now, we have an anatomically smaller than ideal airway, and the structures within that airway are inflamed and taking up even more space, making it even more difficult to get air in and out. While surgery might be important in address the airway concern, it is also advantageous to explore any additional contributions to WHY they became enlarged in the first place. To really drive home the point that tongue positioning matters… try to suction your tongue to the roof of your mouth and mouth breath… it’s REALLY difficult. The tongue being elevated to the roof of the mouth ensures nasal breathing. However, if the tongue is drooping to the floor of the mouth… it’s open season for mouth breathing. Why does this matter to a chiropractor?
Mouth breathing can contribute to poor sleep quality resulting in fatigue, headaches, and SO much more
Breathing and oxygenation of is incredibly important for healing and optimal performance (not even discussing sports here, simply just showing up as a human in your best form)
How Can Tongue Position Contribute to Frequent Ear Infections?
Ear infections are common amongst infants and toddlers and many attribute this to the smaller size and horizontal positioning of the tubes making drainage a bit more challenging. While this is true, the tongue pressing against the roof of the mouth when swallowing (when there is full range and mobility of the tongue) actually helps to clear the middle ear. Lack of proper tongue function can in turn, contribute to frequent/reoccurring ear infections. If there is already a less than optimal clearance of the ear due to eustachian tube positioning and we can’t help clear them as easily with proper swallowing, we then have both a structural and functional disadvantage to helping those little ears drain in the most ideal way.
Why does this matter to a chiropractor? As a pediatric chiropractor, parents frequently bring their kiddos in for chronic ear infections. While there can be many causes, we are always looking at structure and function as the first touch point. Chiros (with additional knowledge in this area) can provide gentle bodywork to the surrounding fascial systems and utilize cranial work/intraoral work to help improve function of the structures of the mouth, jaw, and tongue. Dr. Dani works alongside other providers to ensure that the tiniest of patients have the care team necessary to provide an individualized care plan for their concern. The goal is to conservatively correct function before looking into more invasive procedures to address structure - though this is sometimes needed.
Eustachian Tubes in Adults vs. Kids
Eustachian tubes in kids are smaller and more horizontal, while adult tubes are larger and more vertically set
Pressure along the roof of the mouth (the floor of the nose) from the tongue helps to clear the middle ear
How Can Tongue Position Impact Facial Features and Orthodontics?
As we discussed previously, the tongue pressing to the roof of the mouth creates a nice wide palate. A nice wide palate allows for a nice wide jaw. A wide jaw allows for more space for teeth and decreases dental crowding. As your toddler starts sprouting their cute little baby teeth, you should notice that their mouth resembles a white picket fence. There should be a tooth, then a space, then another tooth, followed by… you guess it, another space. Those little baby teeth are just that, little baby versions of what’s to come. If they have a perfect, packed baby toothed smile, they likely won’t have enough space as those bigger adult teeth come in. This can lead to crowding of the teeth which can then require expansion, braces, etc..
Additionally, the nice wide palate naturally allows for a wider, healthier facial structure, a more sculpted jaw, and more defined features. If the palate is high and narrow, we tend to see longer faces because the face/palate grew more vertically rather than horizontally.
Why does this matter to a chiro? Dr. Dani is all about prevention when possible! If we can work on optimizing structure by getting your little one to the right providers early, it lessens the likelihood of more intensive interventions later on. At minimum, we’re lessening compensation patterns that we’ll have to work harder on correcting down the line such as neck, jaw, and shoulder tension - which impacts the entire body.
How Can Tongue Position Impact Sleep?
If the tongue doesn’t rest at the roof of the mouth during the day, it likely doesn’t suction up to it’s proper resting place on it’s own at night. So where does it go? Well, if it’s not tensioned up to the roof of the mouth and out of the airway space, it can find it’s home flopping into areas that can impede the ability to breathe optimally. This can contribute to sleep disordered breathing such as sleep apnea, snoring, and more. Why does this matter to a chiropractor? Breathing and sleep are key components to optimal health, wellbeing, and longevity. If we aren’t sleeping well or breathing well, it is likely going to impact your quality of life and how you feel in your body.
How Can Sleep Impact My Child’s Behavior?
While we all know sleep is important for recovery, growth, and overall development, did you know that mouth breathing at night can increase the likelihood and frequency of bed wetting (or for adults - needing to get up to use the restroom at night), nightmares/night terrors, and sleep disordered breathing? Sleep disordered breathing has now even been linked to higher likelihood of anxiety and ADHD symptoms. While this may sound a little wild at first, if we aren’t optimally oxygenating our system and the brain isn’t able to get the rest and recovery it needs - it makes total sense that it would be firing a bit differently than if it were given the opportunity to “reset and recover" at night.
How Can Oral Tension Contribute to Jaw, Neck, Shoulder, and even Midback Pain?
Everything in the body is connected by fascia and tension in one area of the body can have a systemic effect. Think about twisting a shirt at the shoulder… it doesn’t just twist up at the point of your fingers, it pulls on the entire shirt and impacts it globally. A restriction within the structures of the mouth, such as a tongue tie, commonly gifts tension to surrounding structures such as the jaw, neck, shoulder, and mid back. Since you can’t “grow out of a tongue tie,” this can lead to chronic tension and discomfort in these areas. If a true tongue tie is present and a release procedure is planned, bodywork and at-home strengthening/stability exercise recommendations should always be incorporated prior to and following any release. Tension within the body can also contribute to oral dysfunction so it’s important to address this prior to any oral tie release as well! Compensations from oral dysfunction commonly include TMJ issues, headaches, neck pain, mid back pain, and can even contribute to range of motion concerns. This was a major driving force in Dr. Dani’s decision to have an adult tongue tie release. Read about it here.
How Can Parents Support Their Child’s Facial and Oral Development?
If you’ve noticed some of the concerns listed above, suspect a tongue tie, or have had a tongue tie procedure performed for your infant, working with someone trained in oral motor skills to help teach your little one strength and coordination of the tongue through at-home exercise is incredibly important. As a Denver based Pediatric Chiropractor, Dr. Dani is frequently referring to other providers with additional training in oral motor skills such as:
IBCLCs (lactation)
Speech Language Pathologists
Occupational Therapists
Myofunctional Therapists for ages 4yo+ - check out the blog by Kimmie Herrera with Smile and Airway Health - What Happens When Oral Posture and Function are Missed in Infancy
While Dr. Dani contributes gentle infant bodywork to address tension contributing to dysfunction, one of the previously listed providers is concurrently working on achieving ideal function of the structures of the mouth and jaw through at-home exercises.
Airway Focused Dentists as well as Airway Focused Orthodontists are another great option for addressing concerns listed above as they can help identify and correct the anatomy contributing to dysfunction.
Why Would You See a Chiropractor For Oral Dysfunction?
It may seem a little left field for a Denver based newborn bodyworker to be rambling on about oral dysfunction, breathing patterns, and tongue ties rather than the “typical” chiropractic concerns most parents think of. However, there’s a major overlap with oral dysfunction and the feeding dysfunction Dr. Dani sees in infants as well as chronic body tension concerns she sees in adults. We breathe, chew, and swallow on a rather frequent basis and if we’re compensating… it’s going to show up in the rest of the body. Most commonly, it shows up as chronic neck/midback tension, TMJ concerns, and even pelvic floor concerns. Dr. Dani utilizes a combination of manual therapies, Craniosacral Fascial Technique, Chiropractic, Dry Needling (when appropriate), intra-oral work (manual therapy inside the mouth to reduce tension in the muscles and fascia), and cranial techniques to help improve function of the entire body (especially areas involved in feeding) to decrease tension that contributing to dysfunction. These therapies help to create a more symmetrical and mobile starting point for exercises provided by a therapist specializing in oral motor skills. Gentle body work can improve quality of life by allowing babies and adults to move more freely and functionally. When you move better, you feel better!
Hi there!
My name is Dr. Dani and I’m an in-home chiropractor for busy women and infants within the Denver Metro area. I work with women of all ages and stages, but truly shine with the pregnancy, postpartum, and pediatric populations. I strive for quality care through extended appointment times, diverse treatment modalities, personalized home-care recommendations, and education so families can feel both empowered and cared for!
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