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Optimal Airway Development and Myofunctional Therapy

Orofacial postures matter. The pictures on the right of these sisters have different breathing patterns and tongue positions, which vastly influenced their oro-facial development, thus attractiveness and it follows, their health. The sister on the left generally breathes through her mouth. Her sister (right) predominantly nasal breathes. Tongue positions are also different at rest. Note muscle tension differences, the facial angles and proportions.

The fact that Jenny became much more attractive over time is obvious in this image. Use the following links and videos to figure out why and how Jenny’s face changed so significantly in just a few years and what health benefits she derived.

Watch this incredible story of how sleep apnea, snoring and other sleep issues can affect a child.

Facial Meltdown

Attractive people enjoy advantages. Of course! They are not just perceived as more intelligent, they often are – partly because they receive more attention. They often receive superior economic and career opportunities – reasons enough to strive for maximizing one‘s genetic ”beauty“ potential. And of course attractive people own social advantages. But did you know each person has the power to control many of the keys that define beauty? 

Would you be surprised to know prominent, well-defined cheekbones, a square jawline, hollowed cheeks, and balanced facial features also indicate health? In fact, a beautifully developed face pays enormous health dividends. 

To help your child avoid snoring/apnea, ADHD, or a real, not just perceived, ten point IQ drop, read on. Early wrinkles, early erectile dysfunction, diabetes, exhausted adrenals, crooked teeth, and other health problems may also be in the cards. Start early – facial development is ninety percent complete by age twelve. To read more visit the Facial Meltdown blog.

Why Do We Have Crooked Teeth?

Learn How Awareness and Myofunctional Therapy Can Help Prevent or Solve General Health Concerns While Optimizing Appearance

Self-Check for Myofunctional Therapy Needs


Mouth VS Nasal Breathing

Why Myofunctional Therapy? 

Facial and airway development depend on correct oral posture from birth! Have you ever wondered why most children eventually need wisdom teeth extractions, have crowded teeth, or why growing numbers of children have ear infections, ADHD, asthma, jaw joint discomfort, you name it? These and at least thirty other health issues are actually symptoms of incorrect oral posture. They are generally late stage signs of incorrect breathing and under-developing airways. Yes, genetics plays a role in how facial bones grow, but less than most realize. In most cases, orthodontic therapy treats one symptom of a facial/ airway collapse that occurred slowly during development. It generally ignores the root cause of crowding – incorrect oral posture.

Straight teeth can be the goal of orthodontic care, but they should never be the point because crowded teeth are your last indication your child’s face is not developing as it should. Not always obvious, a collapsed airway is first and leads to a broad range of health problems most people would never imagine are related. If you do not correct oral posture, orthodontic therapy takes longer when it is successful and relapses ninety-four percent of the time without lifetime retention. And even with permanent retention, uncorrected muscles patterns can and do change tooth relationships and facial bone. In fact, ignoring oral posture and accepting traditional (retractive) orthodontic treatment dramatically adds to underlying health problems and often makes a person less attractive. Again, the need for orthodontics is a late stage sign that children have not achieved correct oral posture and optimal facial/airway development.

The fun daily muscle memory Myofunctional Therapy activities offered in this series help children develop optimal facial growth. More importantly, they develop optimal airways! Who wants to struggle with sleep apnea, breathing and respiratory allergies for a lifetime? Wouldn’t you rather your child more easily shine in activities like sports and music? While I strongly encourage working with a therapist for guidance and individualization, this set of videos can be extremely useful for extra help or review. Know that myofunctional therapy can also significantly help adults struggling with airway. Mastering these correct postures help prevent further airway loss and can in fact, increase airway size. Learn more here!


What to Expect From Myofunctional Therapy

A few suggestions to follow during practice sessions and what to expect from them. Better jaw joint (TMJ joint) stability, more balanced facial features, improved facial muscle tone and improved table manners are just a few positive outcomes you might not already expect. Incorrect oral postures start when a child is young!

Myofunctional Therapy Companion Lessons

Immerse yourself in a sample therapy program that enlarges airways while establishing more balanced muscle function in the head and neck. It is always best to work one-on-one with a therapist. This is available solely for you to get an idea of what therapy is about and why it is so critical for a large swath of the population, young or not!

Intensive Phase 1- Lesson 1- Pre-Therapy (Weeks 1, 2)

Almost everyone can benefit in some way by doing these simple jaw stabilization exercises! I do them daily while driving. The beauty of the lessons throughout this series is that each person benefits a little differently but on an “as needed” basis. Keep in mind that I targeted children in these videos, but adults often need them equally. They may no longer be able to shape facial growth, but they can still improve their airways – and keep them from further collapse! Adults and teens whose skeletal bones are no longer as plastic, but who habituate muscle patterns taught by myofunctional therapists, can move many people with moderate apnea into the “mild” category. In my book, Primal Dentistry, I explain airway situations parents should notice and address as infants become young children as well as what to do once a person has timed out of the development window. As always, it makes more sense to prevent snoring, choking and sleep apnea while children are young and can self-activate proper facial/airway growing patterns with a little help. This video series is an extension of that desire to help everyone understand this better and to succeed. Most facial growth and development occurs during two childhood growth peaks. The first occurs during the change from baby teeth to adult teeth between 5-10 years old, the best ages to accomplish correct oral postures. The second growth peak occurs between 10-15 years of age. Sixty percent of facial growth occurs by age eight, ninety percent by age 12. Take advantage of this early bone plasticity! NOTE: All props used during these exercises are inexpensive and easily available–or there are easy substitutes. For instance, you likely don’t have orthodontic rubber bands available, but you can use small bits of food to substitute: a half a raisin, a small part of a sliced carrot, etc. You can also find some of what you need at a dollar store or a crafts store. Use charts to monitor your progress, linked below.

NOTE: Use these linked charts (which footnote the muscles used in each exercise) or these to keep track of your progress through the following lessons.

Intensive Phase 1- Lesson 2 (Weeks 3, 4)

What if you took back the power to help your young children shape their own faces – and futures – with three simple, but critical oral postures? Don’t ignore these for yourself, since faces remodel, albeit more slowly, throughout a lifetime. Forward growth necessary for more tongue space and a larger airway occur through about age twelve. Lower jaw growth is roughly 60% complete by age eight. After a child has fully developed, myofunctional therapy can no longer help with the forward growth so necessary for a great airway. It simply helps avoid additional negative bone remodeling and it remodels soft tissue to help accommodate space for the tongue. In Brazil, it is common to use myofunctional techniques in lieu of facelift procedures, though that use trivializes its importance. Nonetheless, which is best – to pull the skin up and back or to tone and reshape the underlying facial muscles? NOTE: If you take a break from these muscle memory skills, even for a short vacation, it is important to start again from the beginning, since the skills build on each other and it is easy to relapse in the early phases.

Intensive Phase 1- Lesson 3 (Weeks 5, 6

Moving along. . . When I assess new clients in the dental office, I almost always know who has incorrect oral posture, even before I lay eyes on them. They are the ones who check off the health history boxes that indicate they gag easily (even with oral x-rays) and hate rubber dams (used to isolate teeth for better tooth repair). They are also picky eaters, especially about textures. REMINDER: If you take a break from these muscle memory skills, even for a short vacation, it is important to start again from the beginning, since the skills build on each other and it is easy to relapse in the early phases.

Intensive Phase 1- Lesson 4 (Weeks 7, 8)

Lessons 7 and 8 are combined in this segment. Lesson 8 starts at 9 minutes, 10 seconds. You are finally going to begin habituating the positive muscle memory postures you’ve developed during daytime into your sleeping time. This is a huge step! Another “Primal Dentistry” excerpt, this time regarding the nitric oxide produced when nasal breathes: ” NITRIC Oxide (NO) and reduced cramps. NO is a potent health component. This is not the NITROUS Oxide gas used in dental offices to reduce anxiety. The benefits of nasal breathing begin within hours of birth when nitric oxide gas, produced in the nasal sinuses when one nasal breathes, is first detected in blood. NO then suffuses nasal passages and the connected eustachian tubes. Here it inhibits microbial growth before being inhaled into the lungs where it improves oxygen absorption. High blood oxygen in combination with adequate CO2 levels means better oxygen delivery to muscles and other tissues. Increased blood flow also improves oxygen delivery to muscles and NO strongly dilates blood vessels. (Did you know increasing NO production is the basis for Viagra?) Exercise builds up lactic acid in muscles, which translates to muscle cramping from inadequate oxygenation. Yet another benefit is that nitric oxide regulates lactic acid build-up. Performance efficiency. Nasal breathing increases circulation, blood oxygen, carbon dioxide/pH levels, lung volume and heart efficiency and decreases water loss by more than 40%, helping to maintain hydration.

NOTE: It would have been optimal for my model to have had a tongue tether (tie) release prior to being this far into therapy.

Intensive Phase 1- Lesson 5 (weeks 9, 10)

Building on the correct swallow! Quite an accomplishment getting this far! NOTE: Many of my older hygiene clients with sleep apnea and a strong “reverse swallow” were rocking their front teeth loose with their tongues with every swallow! It wasn’t until the later stages of my clinical career that I put together tooth clenching (and resultant bone loss around teeth) with sleep apnea and a reverse swallow, also known as a “tongue thrust”. Before you move forward, check your progress with Proficiency Check 1!

Proficiency Check 1 (Post Lesson 5)

It is important to make sure you can do all these things before you move forward to Lesson 6 (weeks 11 and 12).

Intensive Phase 2- Lesson 6 (Weeks 11, 12)

Now you’ve aced your Proficiency Check 1, it’s time to progress! More advanced swallowing! Excerpt from “Primal Dentistry: Less is More”: “The more advanced sport coaches teach their athletes to always nasal breathe. It vastly improves performance since they’re not blowing off massive amounts of carbon dioxide through gaping mouths. Remember, CO2 helps release oxygen from red blood cells to all tissues including muscles. A fourteen-year-old young man in my practice listened to me talk to his dad about this subject and switched to nasal breathing during track practice. At first he had to slow his pace while his brain and body readjusted, but within three months he had shaved a minute off his mile. That’s crazy good! And I absolutely use Breathe Right Strips when I exercise, not having developed the nasal passages I should have when young! Know top athletes wear custom oral devices made to maximize their airways in the throat area by adjusting the lower jaw position, discussed in the next chapter. Human Growth Hormone. One sports/sleep coach took it even farther and correctly said, “If every athlete slept with a closed mouth, we would have greatly improved recovery and overall performance.” That’s because nasal breathing at night is critical for sports recovery. Nighttime is when we make human growth hormone, essential for muscle repair and development. You release natural human growth hormone into your blood supply during deep REM-stage sleep. To reach this sleep stage you must sleep uninterrupted for 20-30 minutes. Breathing through your mouth during sleep generally causes sleep arousals that impede your transition into, and reduce the time you spend in, REM-stage sleep. Nose breathing delvers calm, deep, restorative sleep and is a natural, drug-free way to replenish human growth hormone nightly…”

Intensive Phase 2: Lesson 7 and 8 (weeks 13,14 and then 15,16)

Lessons 7 and 8 are combined in this segment. Lesson 8 starts at 9 minutes, 10 seconds. You are finally going to begin habituating the positive muscle memory postures you’ve developed during daytime into your sleeping time. This is a huge step! After these two lessons, you will do the Proficiency check 2. You’ve made fantastic progress!

Proficiency Check 2. (Post Lesson 8)

It is important to make sure you can do all these things before you move forward to the next Phase.

Intensive Phase 3- Turning Activities into Habits. (Weeks 17, 18)

Converting activities into Habits! Weeks 17 and 18 plus year-long follow through necessary for nerve/muscle connections to become habits or to complete muscle memory. Learning to eat typical foods correctly using these new skills. Unrelated to this video, but another “Primal Dentistry” excerpt you’ll find relevant: Your tongue must rest on the floor of your mouth in order to breathe through your mouth but this is unhealthy. It should lock onto your palate front-to-back. When it does: “1. It naturally expands facial width by stimulating stem cells along the palatal midline. A triple benefit results: a wide airway plus more room for your teeth and tongue. Teeth erupt in a wide pattern around the tongue instead of crowding together. 2. Your tongue is “toned,” thus compact and less likely to choke off the airway. 3. When your tongue undulates gently against the roof of your mouth during a proper swallow, eustachian tubes twist and their internal pressure changes. These constant pressure changes clear them and aerate the middle ear. Children who swallow correctly suffer less middle ear infections! 4. During a correct swallow, pressures build on a chain of bones that milks the pituitary gland of its important growth, thyroid, sex and blood pressure regulating hormones. Why skip these free, critical hormones? Along that line, a more expansive face opens up many other pathways from the head to the rest of the body as described in the last section. 5. Together with a lip seal, if your tongue is properly suctioned to the roof of your mouth, it will naturally suspend your lower jaw in space like a suspension bridge, relieving the need to clench even while sleeping. Many dentists build splints for their clenching customers to protect the teeth and their supporting structures. However if oral posture is correct and facial development is not too far from optimal, the tongue functions as a natural splint. You should know these “Clenching prevention” splints are passé. Clenching at night almost universally means a person struggles to breathe at night. An uncalibrated splint that doesn’t account for a collapsing airway at night likely worsens breathing problems. The client will more than likely never know it. I will relay my shocking personal experience with that in the next chapter…”


-Tricks for making pill-swallowing easier.

-Isometric exercises to help with forward head posture, helping you balance head and neck muscles.

-How to check if you are holding on to enough carbon dioxide for optimal health or if you need to learn some Buteyko breathing exercises to enable better CO2 retention.

My Mouth Matters! Growing Up! Breaking the Habit! [Thumb Sucking Cessation]

Mouth and teeth respond to thumb sucking by molding around the thumb. Thumb or finger sucking also teaches children oral postures that lead to crowded teeth, squashed airways and “freeway space” for the tongue. Facial changes can also squeeze the eyeball orbit. Poor sleep and even apnea are just part of the web of downstream health problems your child may face if he/she does not learn correct oral posture while young.

Myofunctional therapy helps maximize health by correcting thumb or finger sucking habits, incorrect tongue resting posture, tongue thrust swallowing patterns, open mouth rest posture and mouth breathing. It helps guide teeth into a more desirable relationship during a child’s early development (especially before the age of 12) and enhances appearance and posture.

Before your child can maximize his/her health and beauty with myofunctional therapy, you must eliminate tongue-ties and non-nutritive sucking patterns such as thumb sucking. This video along with the prepared following program will help you help your child be successful!

Charts to use: Put a sticker on each day you did not suck your thumb: My Thumb Chart_AM_PM.pdf

Charts to use with video weeks one and two: Myofunctional­ Therapy Breaking My Habit

Additonal Materials

What to Do After A Frenum Release Week 1

A “tongue-tie” refers to the string-like tissue on the midline of the underside of the tongue. It is vestigial embryonic tissue that can lock the tongue down, keeping it from proper positioning and function. It is critical to evaluate the need for releasing a tight frenum prior to beginning Myofunctional Therapy. All newborns in Brazil are required to have a tongue tie evaluation, whereas here in the U.S. we barely recognize them. Brazil has 31 PhD programs in myofunctional therapy where it has gained both popular and institutional awareness whereas the U.S. has no formal programs within educational institutions. Know that a tight frenum can cause nursing difficulties and speech impediments. Frenum releases also release shoulder girdle muscles, easing tensions there. Select your frenum release provider carefully. I strongly suggest you consult with a myofunctional therapist about timing and with whom you should work. NOTE: Releasing the frenum can be uncomfortable. I strongly suggest applying an ozonated olive oil to the area because these oils seriously relieve discomfort while being the best disinfectant you have available to you. Make sure the oil is warmed enough to be completely fluid and be gentle. The big caveat here is that ozonated oils help areas heal quickly and you don’t necessarily want that in this case. HOWEVER if you choose to use ozonated oils, it is even more vital to be diligent with these post-release exercises because they do speed healing.

What to Do After A Frenum Release Week 2

Content on this website, in Primal Dentistry: Less is More and Mouth Matters is not considered medical or dental advice. Please see a physician before making any medical or lifestyle changes and a dentist if you need help with oral conditions.

 © Carol Vander Stoep2018 All rights Reserved