The Effect of Airway on Facial Development

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.

Proper nasal breathing is so vital for children's facial growth and development. We want to avoid mouth breathing to set kids up for success and potentially prevent a lifetime of problems. We provide early conservative intervention that works with kids' natural growth patterns to create smiles beyond teeth.

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

Maxillary Development for Children

Our young patient’s posture has greatly improved quickly. Dr. Green is correcting her underbite with non-surgical treatment after traditional mechanical orthodontic expansion did not provide the necessary maxillary expansion and development.

*Note: We do not coach patients into any specific posture. The patient below presented with oral posture issues, which can affect overall bodily posture (left). On her own, by helping her with nasal breathing and finding her optimal biting position, her overall body posture changed within months (right).


Are you looking for answers to these important 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 wonder about any of these crucial questions, your child may develop 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.

Early treatment with physiologic orthodontics and myofunctional therapy can lead to more aesthetic facial development, better dental health, and better health and quality of life for you and your child.

Talk With Dr. Randi Green, The Smile Doctor

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

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.

Finding Their Own Way: Bilateral Ectopic Premolar Teeth that Spontaneously Repositioned during a Course of Jaw Development Orthodontic Therapy: A Case Report and Literature Review

Anne Maree Cole and Laurence J Walsh


Can Improper Tongue Posture Affect Facial Development?

Q: Where is my tongue supposed to rest? A: In the palate.

If not addressed with early intervention, improper tongue position can lead to many dental and health issues.

Dr. Green screens and treats children and adults seeking treatment due to incorrect tongue posture.

Springfield, MO dentist Dr. Green works with local myofunctional therapists, including her in-house team of trained dental hygienists, so that her patients can see their best outcomes with non-surgical therapy.

These dental, mouth, airway, and tongue experts work together to investigate poor tongue positions further and provide essential therapy.

Dr. Green, your dental expert, will sometimes act like your quarterback, advising treatment with specialists and experts.

She will help run the right plays and help determine the best course of action in an individualized treatment plan.

Incorrect tongue posture is something that Dr. Green screens for during her initial exam.

A resting tongue in the bottom of the mouth can put pressure against lower teeth, gradually pushing teeth and your jaw forward into a pathologic, sometimes painful position.

Also, other clues from poor tongue posture can lead to crowded teeth and bite issues. These forces from the tongue can change the facial appearance and strain the neck and back.

Poor tongue posture can also lead to developing forward head posture and make it difficult to swallow food.

Improper tongue position can cause gaps and spaces, malocclusion, and problems during facial growth and development.

These signs and symptoms can lead to more severe TMJ pain issues later in life if left untreated.

Those TMJ issues include chronic headaches, snoring and sleep apnea, inability to breathe nasally, and more related mouth-body symptoms.

Below is a video showing the tongue during an MRI scan to show how it functions during speech.

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

Why is Nasal Breathing Better?

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

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 breathe 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.

Myofunctional therapy is a highly effective form of physical therapy exercises used to help improve breathing, bites, and oral facial posture. A weak tongue can contribute to airway collapse, especially during sleep. Where is your tongue? If it's not in the roof of your mouth, you might benefit from myofunctional therapy with the smile team.

How Does Mouth Breathing Affect Childhood 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, teeth 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 that don’t grow tall enough because of a maladaptive tongue position can lead to a retruded jaw and possible TMJ trouble.

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 can lead to an underbite or a “bulldog” bite.

Tongue and Lip Tie Assessment

We can perform a tethered oral tissue evaluation to determine if tongue- or lip-tie may be present. See more information about tongue and lip release for infants and older children.

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

More concerning are the broader issues associated with nose breathing vs. mouth breathing.

Mouth breathing signs and symptoms can have an effect on 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 development include tongue ties, thumb and finger sucking, lip biting, and 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 to the rest of the body, affecting posture.

These postural effects can cause skeletal changes over time like vertebrae rotations, neck curvature loss, forward head posture, a tilted pelvis, and tight calf muscles.

Sleep apnea and snoring are 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 evaluation to assess for proper growth and development.

A physiologic dentist and the ENTs with which they often work can complete these evaluations.

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.

Nose Breathing vs Mouth Breathing Face Shape
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 changes in the shape of the face 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 breathe 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 comprehensive evaluation

Traditional Orthodontics vs. Physiologic Orthodontics

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

This approach can make treatment more of a challenge and take more time.

In contrast, physiologic orthodontics and myofunctional therapy utilize active growth to re-establish normal facial growth patterns earlier.

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 and producing esthetic faces, beautiful smiles, and healthy smiles temporomandibular joints, and long-term stability.

3-Dimensional Advanced imaging has created an opportunity for better evaluation and treatment of your child's health.

This detailed map helps identify underlying structural and physiological imbalances of your head and upper neck.

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”, maxillary development is also an option for older kids and adults. The timelines and protocols are slightly different but the results could be life-changing.

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

Dr. Green practices physiologic-based dentistry in Springfield, MO, and believes in treating the mouth-body connection.

She integrates these essential screenings into her new patient visit for a comprehensive dental experience.

This whole-health dental approach allows her to recognize, diagnose, and treat children before facial development suffers due to poor oral habits such as mouth breathing.

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