What are orofacial habits?
At The Breathing Clinic we are passionate about educating parents about the effect of orofacial habits so that parents can take proactive steps to address these habits before they affect their child’s orofacial development.
The term “orofacial” refers to the mouth and face and “orofacial habits” refers to those habits that involve the mouth or face. Most parents are not aware that oral habits like mouth breathing and non-nutritive sucking habits (e.g. thumb sucking, finger sucking, dummy sucking and tongue sucking) affect tongue posture inside the mouth. More specifically, these habits can cause a “low tongue resting posture”, which means the tongue sits low in the mouth rather than assuming its natural resting position against the roof of the mouth behind the top teeth. A low tongue resting posture can have a profound effect on the growth and development of a child’s oral cavity, nasal cavity and upper airway if this habit continues over a prolonged period of time. For example:
- When the tongue sits low in the mouth it cannot exert its natural outward pressure to counteract the inward pressure of the muscles of the face. Over time, the inward pressure of the facial muscles causes the upper jaw to become narrow and V-shaped (rather than being wide and U-shaped). This has the effect of reducing the space available for the teeth to properly and fully erupt leading to crowded, crooked, misaligned teeth.
- Mouth breathing and non-nutritive sucking habits can also lead to retraction of the lower jaw, which means the lower jaw sits back from its natural resting position. This means the base of the tongue (which attaches to the lower jaw) also sits back in the throat more than it should. This can predispose children to snoring and sleep apnoea, especially in a supine position i.e. when resting on the back. A retracted lower jaw may also create problems for the temporomandibular joint, which joins the upper and lower jaws near the ear. This can lead to impingement of the Eustachian tubes, which extend from the oral cavity to the inner ears causing hearing problems.
- When the upper jaw becomes narrow and V-shaped (rather than being wide and U-shaped), this can cause the roof of the mouth (palatal arch) to become high and narrow. The roof of the mouth also forms the base of the nasal cavity, and when the roof of the mouth becomes high and narrow this can affect the size and shape of the nasal cavity, which can lead to problems with sinus drainage and airflow, making nasal breathing more difficult and causing or reinforcing mouth breathing.
- These changes can also lead to poor lip seal, and may compromise the proper, natural movement of the tongue leading to difficulty eating, chewing and swallowing food or liquid. Speech and articulation can also be affected by poor control of the shape and movement of the tongue.
Tongue-tie and tongue thrust
Another important orofacial consideration is tongue-tie - technically known as “ankyloglossia”.
"Structural tongue-tie" is where the tissue under the tongue (called the lingual frenum or frenulum) is too tight or too short, thereby restricting movement of the tongue. In newborn babies tongue-tie can make breast-feeding difficult because the baby cannot latch onto the breast properly. This can cause sore nipples and some mums may abandon breast-feeding because of this. If an infant continues breast-feeding but has poor weight gain, this may be an indicator of tongue-tie. Other signs of tongue-tie in newborns include excessive drooling, constipation, vomiting, reflux and difficulty settling. Tongue-tie can be easily checked, so it is a good idea to discuss this with your Paediatrician.
"Functional tongue-tie" can occur if the muscles of the tongue are weak. Weak tongue muscles can occur in certain medical conditions and can also occur as a result of a low tongue resting posture, for example, in association with mouth breathing.
As children grow, if tongue-tie is not addressed it can affect chewing and swallowing patterns, as well as speech. Tongue-tie can lead to a "tongue thrust", which means the tongue thrusts forward instead of pressing against the roof of the mouth when chewing and swallowing. If the tongue is unable to peform normal movements, this can lead to messy eating and/or picky, selective food choices, with children preferring foods that are soft and easy to eat.
Programmes @ The Breathing Clinic
At The Breathing Clinic & Wellness Centre we offer a range of programmes to help children restore healthy breathing patterns and discontinue sucking habits such as prolonged thumb or finger sucking, prolonged dummy sucking and prolonged lip, cheek or tongue sucking.