Myofunctional Therapy and Facial Development in Young Children
Why function influences growth
The bones of the face do not grow in isolation. They develop in response to the soft tissues and functions surrounding them, including breathing, swallowing, chewing and resting tongue posture. This principle has underpinned orthodontic thinking for decades. Where those functions are disrupted during the growth years, the pattern of facial development can be affected alongside them.
What we see in mouth-breathing children
Children who habitually breathe through the mouth often present with a recognisable pattern. Pooled analysis of cephalometric studies has reported that the maxilla and mandible tend to rotate backwards and downwards, the occlusal plane becomes steeper, the upper front teeth tip forwards, and the pharyngeal airway is frequently narrower.
An important caveat applies. These findings come from observational studies, so they demonstrate association rather than proving that mouth breathing causes the changes. Genetics, allergy, enlarged adenoids and tonsils, and oral habits all contribute.
Where myofunctional therapy fits
Myofunctional therapy is a programme of daily exercises retraining the lips, tongue and facial muscles, with the aim of establishing nasal breathing, competent lip seal and correct tongue rest position. In children, it is used to address the modifiable functional habits rather than the skeleton directly.
A systematic review of children with sleep-disordered breathing found improvements in craniofacial function or form in most participants, with greater effect where therapy continued longer and compliance was good. However, most included studies carried a moderate or serious risk of bias, so these findings should be read as promising rather than settled.
Our approach
Assessment comes first. Nasal obstruction, adenotonsillar enlargement and suspected sleep-disordered breathing need medical or ENT review, and myofunctional therapy works best alongside that care rather than instead of it. We work with families and, where appropriate, with orthodontic colleagues.
Contact the practice to arrange a children's airway and growth assessment.
References
Camacho, M., Certal, V., Abdullatif, J., Zaghi, S., Ruoff, C. M., Capasso, R., & Kushida, C. A. (2015). Myofunctional therapy to treat obstructive sleep apnea: A systematic review and meta-analysis. Sleep, 38(5), 669–675. https://doi.org/10.5665/sleep.4652
Liu, Y., Zhou, J.-R., Xie, S.-Q., Yang, X., & Chen, J.-L. (2023). The effects of orofacial myofunctional therapy on children with OSAHS's craniomaxillofacial growth: A systematic review. Children, 10(4), Article 670. https://doi.org/10.3390/children10040670
Moss, M. L., & Salentijn, L. (1969). The primary role of functional matrices in facial growth. American Journal of Orthodontics, 55(6), 566–577. https://doi.org/10.1016/0002-9416(69)90034-7
Zhao, Z., Zheng, L., Huang, X., Li, C., Liu, J., & Hu, Y. (2021). Effects of mouth breathing on facial skeletal development in children: A systematic review and meta-analysis. BMC Oral Health, 21, Article 108. https://doi.org/10.1186/s12903-021-01458-7
