Braces have never been and never will be unavoidable. They are not some genetic guarantee you receive upon birth. They are merely the result of oral habits developed from birth; particularly those dealing with the tongue.
After years of braces and the last straw in lost retainers, there’s a reason why your teeth shifted. I hope you’re sitting… because the culprit is not your lost retainer it’s your tongue!
The tongue is now and will continue to reign as the MVP in oral and facial development. Never to be dethroned by any orthodontist or supplier of braces.
It’s a lot to take in. Similarly to discovering that you lived with Santa and the Tooth Fairy you’re whole childhood (i.e. they weren’t real). How is it that the tongue is so powerful that it has this profound impact on the size of the mouth, the shape of the face and the structure of your teeth?
What kind of barn is your mouth?
Imagine a simple drawing of a house without a roof. It has a simple 3-line open rectangle shape. Two lines that meet at a point would complete the roof and create a pointed top, thus creating an almost pentagonal shape. Now imagine a simple drawing of a barn with a nice rounding that completes the roof. Ideally, we want our palates to develop into a barn shape with the nice arched round roof. Our dental arches should form with a U shape.
The tongue is the foundation for that development. The tongue should naturally sit up along the palate when we are optimally nasal breathing. The constant pressure of the tongue on the arch facilitates growth around the tongue into that perfect U shape.
Our tongue in that sense is the blueprint for palatal development and should fit in the palate without overlapping the teeth.
When the tongue is low in the mouth, we lose the foundation, and like the open rectangle house, without that round support the palate forms a narrow and almost pointed “roof” shape. It would create an A shape, narrow arch with a high palatal vault. This narrows the available space for the teeth and causes dental crowding and often malocclusion.
The mandible (lower arch) follows the growth of the maxilla (upper arch). So the growth, or lack thereof, in the palate will be matched, in most cases, by the mandible. Those with underbites, or a wider mandible that contains the maxilla (either in part or fully), often have a tongue that is lying low. The pressure from the tongue on the mandible, along with prolonged spacing between the teeth, cause the mandible to extend and restricts the growth of the maxilla further.
Crowding is not new
A narrow arch does not develop overnight. A high palate (roof of the mouth) and tight primary dentition (baby teeth) can predict the formation of a narrow arch and crowding of permanent teeth.
Typically a pediatric dentist may inform you that your child will need braces in the future. However, an orthodontist that is not trained in early intervention orthodontics will most likely not treat this until the child has developed around 12 permanent teeth. Treatment usually involves a palate expander that forcibly pushes the palate open, ideally, to the width it should have grown.
Retention is maintained by a retainer. When teeth “shift back” to some form of malocclusion it is often because the tongue has not maintained that palatal width with the pressure we discussed earlier. Our teeth are in constant motion and with a lack of stability from the tongue, they will gravitate to their position of origin. Granted, if expansion was done, the teeth do not shift back to origination. But they will move out of the alignment established with braces.
TMJ pain that’s hard to swallow
A low tongue posture is often accompanied by a “reverse swallow.” This improper swallow occurs when the tongue thrusts forward either against the teeth or between them to swallow. Every thrust forward causes the mandible to shift backward and compress the temporomandibular joint (TMJ) in an unnatural way. Multiple cases of this pressure will compound and affects the longevity and stability of the TMJ. Thus feelings of pain, clicking, and popping occur and cause frustration.
The reverse swallow also creates a long narrow face with a mandible that is recessed or retruded. In profile, this would appear as a lower lip that is not aligned with the upper lip. Even in people whose teeth appear straight, this form of a malocclusion does require braces as well. Over time the way the teeth occlude, or bite together, would cause undue harm to the jaw and discomfort during chewing.
What to do
Establishing proper tongue posture with good habits, early intervention, or myofunctional therapy leads to proper oral development in young children. However, it is never too late to attain proper tongue posture to improve wellness. A wide palate means a wide nasal floor with open passages and greater airway space. Ultimately reducing and/or eliminating the potential for sleep apnea, chronic infections, anxiety, asthma and more.