The Effect of Airway on Facial Growth

Springfield, MO | Dr. Randi Green DMD, LVIF

Getting straight answers about your health and dental health can be complicated. The human body is a complex organism made up of many overlapping systems. When one of those systems has a glitch, pain and abnormalities can affect other bodily systems and make life more of a challenge. 

Unobstructed nasal breathing is the number-one key to a person’s quality of life. Human beings are naturally nasal breathers.

In fact, Hippocrates observed in the 5th century BC that breathing is the balancing force in maintaining mental and physical health.

"Mouth breathing usually begins in response to an airway obstruction such as allergies, an illness, enlarged tonsils and adenoids, or a deviated septum."

Mouth breathing can also become a habit that remains once the obstruction is eliminated. Normal facial development is reliant upon proper nasal breathing.

Watch Dr. Anne-Maree Cole's video about Facial Growth and Development and Working in Harmony with Nature - Dr. Randi Green studies and trains under physiologic dentist, Dr. Anne-Maree Cole at the Las Vegas Institute.

The Prevention of Sleep Apnea in children and adults. The answer may surprise you.

Our bodies working in harmony with nature. Physiologic dentistry looks to the root cause of malocclusion.

If you have time watch this one too. It's almost one hour long, but we think what Dr. Cole says is too important to not share with our guests and patients.

Nine Common Signs of a Mouth Breather

  • Snoring

  • Sleep apnea

  • Lack of concentration

  • Allergies

  • Sinus problems

  • Chronic sickness

  • Swollen tonsils and adenoids

  • “Allergic Shiners”- dark circles under the eyes

  • Long face

Why is Nasal Breathing Better?

Breathing oxygen through the nose is one of the most beneficial things you can do for the health of your body and your longevity.

Breathing through the mouth puts more strain the body while delivering less oxygen and this occurs in two ways—over breathing and lack of nitric oxide production in the sinuses.

Mouth breathing also contributes to improper tongue position in the mouth, which affects growth and development of the face and jaws.

Do you breathe through your nose or mouth?

So, what is mouth breathing? Take a moment and notice how you and your family are breathing right now.

Is it through your nose or your mouth? Many people think they are nasal breathers but instead breath through their mouths.

Observe those around you—those you see with an open mouth are mouth breathers. Some even hide their mouth breathing with habits such as gum chewing, nail biting or chewing on pens. Proper nasal breathing should be very passive and done with little to no effort.

Fixing improper breathing can begin at any age. Of course, if these issues are caught early (think infant or toddler years), facial growth and development can get back into a rhythm of healthy growth.

How Does Mouth Breathing Affect Development


Our human evolutionary design allows us to adapt to any stimulus and is a great survival mechanism. These adaptations can often compromise proper form and function elsewhere in our body.

In the case of mouth breathing, low tongue posture leads to a narrow palate as the tongue is not there to counteract the inward pressure of the cheek muscles. If the tongue rests on top of the bottom teeth, they may not grow as tall as they should, or even tip inward.

Take a look in your mouth—if your bottom front teeth are taller than your bottom back teeth, you may be a mouth breather.

Tipped in lower teeth or lower teeth that don’t grow tall enough because of a maladaptive tongue position can lead to a retruded jaw and possible TMJ trouble as well.

Others keep their tongue down low in the mouth within the bottom teeth. The bottom jaw usually develops ok in these instances, but the narrow upper jaw that results can lead to an underbite or a “bulldog” bite.

Midface deficiency features form due to improper breathing patterns. This deficiency makes a face look flatter around the cheekbones, nose, chin, and thin upper lips.

Other signs of midface deficiency are a prominent nose, “weak” chin, crowded teeth, deep overbite, underbite, and a thin upper lip.

"Individuals with any form of malocclusion will have longer faces, often much longer."

More concerning, are the broader issues associated with midface deficiency and mouth breathing. They include signs and symptoms such as dental malocclusions (crooked teeth and misaligned bite), bruxism (teeth grinding), attention deficit, poor sleep patterns, sleep apnea, daytime fatigue, TMD, and TMJ pain symptoms, as well as headaches. 

The Airway and TMJ are linked. Watch this video that shows how mouth breathing can affect your body and well being.

Other things that can adversely affect facial growth include tongue tie, thumb and finger sucking, lip biting, chewing on objects like pens/pencils or ice. 

As do most maladaptations, the effects of mouth breathing don’t stop in the face and jaws. The effects can trickle down the rest of the body affecting posture. These postural effects can cause skeletal changes over time like rotations of the vertebrae, loss of curvature in the neck, forward head posture, tilted pelvis, and tight calf muscles to name a few.

Sleep apnea and snoring is also a concern for those children who are mouth breathers. Snoring is never normal in a child and children who snore should always have an airway evaluation, and an evaluation to assess for proper growth and development. A physiologic dentist and the ENTs with which they often work can complete these evaluations.

Parents, do you find yourself asking these questions?

    Why is my child restless during sleep?
    Why does my child suffer from bedwetting?
    Why can't my child stay asleep all night?
    Why does my child snore?
    Why does my child sleep with his or her mouth open?
    Why does my child hold their head in front of the shoulders?
    Why does my child get frequent ear infections?
    Why does my child have asthma?
    Why does my child have allergies?
    Why does my child have frequent sore throats?
    Why does my child have bad breath?
    Why does my child have cavities so often?
    Why does my child have crooked teeth?
    Why does my child grind his or her teeth?

If you find yourself wondering any of the above questions, your child may be developing poor oral habits that can lead to facial abnormalities and asymmetries. Dr. Green can help create healthy, beautiful and stable results without surgery or extracting teeth. 

With early treatment and guidance, more esthetic facial growth can lead to ideal redial development, better dental health, and better health for your child.

 A tale of identical twins. The twin on the left had four bicuspids extracted and the twin on the right did not. Both went through treatment and the difference is clear with treatment provided more fullness and esthetic beauty.

A tale of identical twins. The twin on the left had four bicuspids extracted and the twin on the right did not. Both went through treatment and the difference is clear with treatment provided more fullness and esthetic beauty.

Twins who are genetically identical still show more contrast in the shape of their jaws than any other part of their skeleton (Kraus 1959) showing that much of the variation is due to non-genetic environmental factors such as open mouth postures, unusual swallowing habits, and tooth extraction that can distort the growth of the jaws. Orthodontists in the past have found it difficult to explain why modern children have so much malocclusion but the following new hypothesis appears to fit the known facts better than those put forward previously:

"Environmental factors disrupt resting oral posture, increasing vertical skeletal growth and creating a dental malocclusion, the occlusal characteristics of which are determined by inherited muscle patterns, primarily of the tongue.” (Mew 2004)."

Habitual mouth breathing can lead to long face syndrome "long face" or elongated facial features during a child's development.


Sisters, Kelly, seven years old and Samantha, eight-and-a-half years old displayed habitual mouth breathing and were developing associated facial growth patterns. Both were taught to breath through their noses and swallow correctly. One sister followed this advice and the older sibling was more complacent and did not keep her mouth closed while breathing. Can you spot the difference? (Mew)

Take Action with a Facial Growth Evaluation

Traditional Orthodontics vs. Facial Development Orthodontics

Traditional orthodontists wait until growth is complete or nearly complete to start treatment meaning that treatment usually starts in pre-teen years usually with braces.

This approach can make treatment more of a challenge and take more time. In contrast, facial development orthodontics and myofunctional therapy utilizes active growth to re-establish normal facial growth patterns as early as age four.

Dr. Green’s ability to develop the jaw and midface elevates “straight teeth orthodontics” to a new level by focusing on breathing, swallowing, and posture problems, as well as producing esthetic faces, beautiful smiles, healthy temporomandibular joints, and long-term stability.

3-Dimensional Advanced imaging has created an opportunity for better evaluation and treatment of you and your child's health. It is the map that helps identify underlying structural and physiological imbalances of your head and upper neck.

Facial development orthodontics at Springfield Smile Doctor creates long-term stability and for kids can often minimize or even eliminate the need for traditional braces. Treatment times with facial growth appliances for children can range from 6-12 months.

If you are thinking “this is great for my kids, but what about me? I for sure had some of those issues when I was a kid”, growth guidance is also an option for older kids and adults. The timelines and protocols are slightly different. 

Before and After Photos of Anterior Growth Guidance Appliance (AGGA) Treatment for Springfield Facial Development Orthodontic Patients

Read about Amanda's journey with TMJ + AGGA with Dr. Randi Green and the smile team!

Dr. Randi Green screens all adult and children guests for breathing disorders including (OSA) obstructive sleep apnea and (UARS) upper airway resistance syndrome.

Dr. Green practices physiologic dentistry in Springfield and believes in treating the mouth-body connection. She integrates these essential screenings in her new patient visit for a complete whole health dental experience.

This whole health approach allows her to recognize, diagnose, and treat children before facial growth suffers due to poor oral habits such as mouth breathing. She and the smile team have advanced training and knowledge about the complex topic of facial growth and development. 


Do you want to know if facial development orthodontics is right for you or your child? Send us a quick note.

Name *
Phone *