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Orofacial Disorders: The Tongue and Development of the Face

Happy Monday Tribe!

It’s almost September, I can’t believe it!  Today we will be talking a little bit about developmental stages in the face and the tongue, and some disorders that arise from these issues.

The reason that I treat children, and talk about it quite often, is that in my profession, working with the cranial system, that is THE BIGGEST time frame we have to impact changes in the brain.

Of course, you can still make changes as an adult, but the reason for children is that most of the development in the face happens during childhood.

The BIGGEST brain growth happens from age 0-2 years old. 
By Age 2- A mature swallow is well established
By age 3- Adult like swallow has developed
By age 6- 80% of upper and lower jaw growth is complete
By age 7-12 – 90% of the upper and lower jaw growth is complete.

——

Whenever I’m examining a child, the motion of their head, nervous system, I will always examine the relationship of their palate, and make sure I refer as needed to get the maximum results because of this time line.

This is an example of a high palate that can arise from either birth trauma, thumb sucking, tongue tie, and other orofacial disorders.

A high, narrow palate leads to sinus issues, since the roof of the mouth is also the floor of the nasal cavity.
* I’ve had many individuals come to me after having sinus surgery, and some feel no different.  This is because the root of the problem lies in the palate being the cause of the problem because it is the FLOOR of the sinus, not the actual sinus itself.

Guaranteed anyone with sleep apnea like disorder or just oxygen depletion has a high narrow palate.  It’s a given.  And most really really improve with the proper care, not needing uncomfortable CPAP machines.  I’ve done many case studies and spoke about my care, combined with dentists and other individuals.

Many have no idea of their birth trauma, past head traumas, or improperly done orthodontics that have placed them in this pattern.

You HAVE to have craniopathy care to normalize this function of the system, but it is a TEAM effort to get this palate looking this way.
(more on this in a minute).

Another reason for orofacial disorders is something called improper oral rest posture. 

I bet most of you had no idea there’s a proper way to hold your lips and your tongue in your mouth?!  Am I right??!

Well, I was with you about a year ago until I started doing myofunctional therapy, tongue tie work and fixing my narrow palate. 

In reality, there is a proper healthy resting posture and it is SUPER IMPORTANT!

In order to accomplish this:
-Your lips need to be slightly touching
-A freeway space of 2-3mm needs to be in place
-Tip of tongue resting on incisive papilla
-Lateral borders of tongue touching lingual of maxillary molars
-Dorsum of tongue touching palate
-Nasal breathing

Most individuals I see in my practice have what is called a low tongue resting posture.  In reality, the tongue should be up on top of your mouth all the time.  That is what gently expands the upper palate as you grow!  This is why the tongue must always be evaluated when getting orthodontics!

So what is an unhealthy resting posture?!
-Open lip posture
-teeth clenched or abnormally far apart
-mouth breathing
-tongue resting low and forward
-lips straining upon closure
-bunched mentalis muscle

The jaw and the tongue can also drop down too much in people who have

  • enlarged tonsils
  • enlarged adenoids
  • chronic nasal allergies
  • thumb sucking habits
  • prolonged sippy cup usage/ pacifier
Why sippy cup?  Well when you use a sippy cup, it pushes the tongue down continually.  Same with a pacifier.  The tongue needs to lift up! It can lead to tongue thrust, improper swallowing, hinders speech development, so you can actually start cup drinking at age 1!

Here are some visual identifiers in children when they have sucking habits:
-high, narrow palate
-thumb indentation in the mouth
-calluses on their fingers
-infections around the nail bed

Tongue Thrusting is one that we see pretty often in children with cranial problems. 

In tongue thrusting, the tongue protrudes from the front of the side, there is an open bite, possible lisp, incorrect swallow, tongue rests low and forward and possible airway obstruction.

Tongue thrusting is just a part of a bigger issue.  The improper posture of the tongue, lips and jaw.  This is why many dental appliances just don’t work for these conditions.  You have to address the nervous system and brain and then train the tongue and the lips for the correct posture.

This low tongue position causes that upper palate to continually narrow because you need that tongue lifting up!!

Another cause-  you probably guessed it.  TONGUE TIE. 
This is why a tongue tie evaluation from a professional is really important.

Most utilize it just for feeding issues in infants, but in reality it can affect the entire function of the palate.  Some ties do not need to be removed, and can be helped with just body work from myself, others need removal.  It affects the neck, airway and palate in adults dramatically.

This is the big point here:
A orofacial disorder in a child can result in an adult with obstructive sleep apnea.

I see it all day every day.

Here are some possible sign of a tongue-tie in toddlers:
– Delay in speech
-Gagging a lot of different foods
-unable to handle certain food textures
(also these can be helped and changed dramatically wiht cranial work and cranial nerves)

So, what are your options?!!

1. Come in for evaluation!!  Bring children as early as possible to evaluate their cranial system and tongue.  Just getting a tongue tie revision isn’t just what’s needed.  Trust me.  I get referrals every week from lactation consultants where babies have had their tongue tie removed but still can’t utilize their tongue!  You can to connect it with the brain!

2. Myofunctional therapy.  HUGE, huge to be instructed on that oral rest posture

3. Tongue tie revision.  If you have a tongue tie, you must do the cranial and myofunctional therapy first.  It works so much better this way.  You need to know how to use your tongue and lips first before just removing something.

4. Dentist.  If their is a very narrow palate, then dental co-management is often necessary.  Gentle expansion can happen to widen the palate and prevent these patterns and sinus and sleep apnea issues later in life.

5.  ENT.  Sometimes nasal surgery is needed, but only after all other methods had been addressed.  Often what I see is nasal surgery isn’t needed, but it really depends on the case.

I hope this was helpful!

Have a wonderful week!