Simply because you recently learned of myofunctional therapy, does not mean it is new. The first mention of myofunctional therapy and the impact of proper functional of the facial and tongue muscles on oral development happened in 1918! Myofunctional therapy origins go all the way back to the father of orthodontics, Dr. Edward Angle. His student Dr. Alfred Rogers was interested in getting to the root of what was causing the various manifestations of malocclusion.
His studies lead him to orofacial muscle function and pressure. The way you use those muscles of your face and oral cavity matter and make a lasting impact on the trajectory of tooth position and oral development. Since his publications and initial studies, the field has grown far beyond dentistry. To the point where many different specialists, from nurses to physical therapists are providing treatment.
Recently I was asked by a colleague, who is newer to the field, if the impact of genetics on oral development was to be disregarded. Absolutely not! Whether or not your child will need braces is not in the hands of genetics alone. The more research that has been done on growth and development, the greater we see the concept of epigenetics. More commonly referred to as the balance of nature and nurture.
This concept can be defined as “a group of acquired or inherited and potentially transgenerational dynamic molecular mechanisms that are affected by the environment and act directly upon the genome and genetic machinery throughout life to regulate gene expression.” These environmental influences can vary from habits, observed behavior, diet, climate, trauma, or any number of external influences on your predisposed genetic expression.
My biological brother who sucked his thumb until preschool and wound up needing braces. I had a pacifier habit that I did not quit until I was around 3 or 4, but never needed braces and developed ideal occlusion and tongue function. We share the same genetic predisposition, and similar external influences but still developed differently. Why?
I attribute it to my habits post pacifier. In the days of Bubblicious, HubbaBubba and BubbleYum, I was obsessed. The more sugar the better! I loved to absorb the flavor, which anyone who has had those or any similar brands are aware was short in duration. I discovered a trick to increase the flavor output, chew the gum lightly, use your tongue to develop it into a box shape, and press my tongue against the box to leisurely enjoy the distribution of sugary goodness into my mouth.
For years, I indulged in this quiet joy. Essentially developing my own version of a myofunctional therapy program. Engaging my tongue in proper rest position, strengthening all the muscles that innervate the tongue by forming various shapes, establishing a strong lip seal as I held onto my precious pink treat, and redeveloping my swallow. All unknowingly. How could a 5 year old possibly determine this would help develop the best jaw development? I didn’t know then, but my habit was the best thing that happened to me, as I dreaded the dentist ever telling me I needed braces. There certainly was no Invisalign in the 90s.
My brother had his own habits, but none that involved the oral cavity as much as my obsession with everything bubblegum. The influences of our oral habits took our development into different directions. Surprisingly, I still have never had a cavity, despite the sugar rush that was constant for several years. Yet my brother has had orthodontic treatment, cavities, and gum disease, similarly to our parents.
This is clearly a singular instance of this non-therapeutic approach to myofunctional therapy impacting clinical outcomes. However, this does lead into a greater conversation about the impact of habits, functions, and early intervention on such in the developing child. Could we reach a point where myofunctional therapy replaces orthodontics in some instances? The research will be needed to support this idea. But what does remain true is that genetics is not now, and may never be the only causative factor to consider in the potential need for braces.