Facial Growth & Development

How Do Breathing and Oral Function Relate to Facial Development?

The tongue, lips, jaw and surrounding orofacial muscles all play an important role in oral function and the developing craniofacial system.

At rest, an ideal tongue posture involves the tongue resting comfortably against the palate, with the lips gently together and breathing occurring through the nose when nasal breathing is possible. In a growing child, persistent mouth breathing and altered oral muscle patterns may be associated with changes in craniofacial development.

Research has associated chronic mouth breathing with patterns such as increased facial height, a narrower upper jaw, altered dental position and changes in jaw posture. However, facial growth is complex and is influenced by many factors, including genetics, airway anatomy, breathing patterns, oral habits and overall development.

Sleep-disordered breathing can also affect a child's daytime functioning. Children do not always present with obvious daytime sleepiness; some may instead experience changes in attention, behaviour, mood or activity level.

What About Tongue-Tie?

A tongue-tie, or restricted lingual frenulum, does not automatically cause altered facial growth. Rather, a restriction may limit tongue mobility and make certain functional patterns more difficult to achieve.

The relationship between tongue mobility, tongue posture, breathing and craniofacial development is complex. An assessment looks at function rather than simply the appearance of the frenulum.

At Back To Your Roots, we assess oral rest posture, tongue mobility, breathing and other orofacial functional patterns to help establish healthy habits and support efficient function as children grow and develop.

The Causes of Facial Deficiency

When we begin breathing through our mouth, our nasal passage and upper jaw begins to narrow and proper growth is stunted because the tongue doesn’t sit in the palate to act as a natural expander. When the upper jaw changes in shape, the lower jaw grows to compensate and to keep the airway open. This creates a “long” facial profile, a less prominent chin and a smaller mouth overall. This leads to extensive crowding, a smaller airway and a less desirable facial appearance.

The term “adenoid face” has been used to describe the facial characteristics of children with severely enlarged adenoids. The adenoids are located in the throat and are similar to the tonsils. When the adenoids are enlarged, they force children to breathe with an open mouth. This open mouth posture can change their facial appearance. The typical features of an adenoid face include:

  • Long, narrow shape

  • Flattened features

  • Narrow and vaulted palate

  • Elevated nostrils

  • Short upper ip

  • Gummy smile

  • Lower jaw

  • Sleepy and/or droopy eyes

Nose Breather

Nose Breather

Mouth Breather

Mouth Breather

Factors That Can Influence Facial Growth

Facial growth and development are influenced by many factors, including genetics, skeletal structure, airway anatomy, breathing patterns, oral habits and the way the orofacial muscles function.

Persistent mouth breathing and an open-mouth resting posture have been associated with changes in craniofacial development in growing children. When nasal breathing is difficult, the tongue may rest lower in the mouth and the lips may remain apart. Over time, altered oral posture and muscle function may be associated with changes in the development of the upper jaw, dental position and facial proportions.

A narrow upper jaw or altered jaw relationship can also be associated with dental crowding and changes in the available space for the tongue and upper airway. These relationships are complex and vary from child to child.

What Is an "Adenoid Face"?

The term "adenoid face" has historically been used to describe certain facial characteristics observed in some children with chronic nasal obstruction and enlarged adenoids.

When enlarged adenoids make nasal breathing difficult, a child may develop a persistent open-mouth posture. Chronic nasal obstruction and altered breathing patterns may be associated with changes in facial growth and oral posture.

Characteristics historically associated with adenoid facies may include:

  • Increased facial height or a long, narrow facial appearance

  • Narrow or high-arched palate

  • Open-mouth resting posture

  • Altered jaw position

  • Less prominent chin

  • Changes in lip posture

  • A tired or "sleepy" facial appearance

These features are not diagnostic of enlarged adenoids or sleep-disordered breathing on their own. If a child has persistent mouth breathing, nasal obstruction, snoring or other sleep concerns, appropriate medical assessment is important.

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