Facial Growth and Development

     As parents, we absolutely want what is best for our children in every way.  We are well aware of the specific milestones that our children should reach during the first eighteen months of life.   But there are several important growth and development factors that must be evaluated during the first decade of each child’s life.  It may surprise you that your child’s dentist should be the guardian of normal facial growth for your child, not just taking care of your child’s teeth.  The goal of your child’s dentist should be to monitor and guide the growth and development of young child’s face and teeth.       

     Many parents are unaware that 60% of their child’s facial development is completed by age 6, and that 90% is completed by age 12.  This means that the earlier your child sees a dentist that understands this, the better the opportunity to detect and correct developmental problems that are present.

     Facial growth involves the individual growth of each bone in the face.  Several things can cause an unequal growth of these bones and this imbalance may affect a child’s health and appearance. A normal balanced face is the result of more than just bone growth.  It is the balance of normally functioning muscles and teeth, proper nutrition, and the ability to breathe through the nose properly.  Studies show that when the proper balances are altered, changes in health and appearance occur.

     The most common abnormalities in facial growth and development are caused by a compromised airway--the inability to breathe properly through the nose.  These children breath through their mouth which sets up a chain of events which will severely impact not only the health of the child throughout his life, but also will impact the facial features.  The most common cause of this altered mouth breathing is enlarged adenoids and tonsils.

     The effects of a compromised airway on the growth of a child are revealed in many ways. The tongue positions itself between the lower teeth to allow a child to breathe through the mouth, changing the growth of the lower jaw so that it grows more vertically and makes the child’s face look longer. At the same time, the upper jaw and midface (the nasal bones, cheek bones, and bones supporting the tissue of the face) fail to develop outward because the tongue is not on the roof of the mouth 12-15 times per minute (the rate of breathing).  This would have pushed the roof of the mouth wider, counteracting the inward pressure from the cheek muscles.  The result of mouth breathing is a deficiency of growth of the upper jaw and midface which, added to the long facial growth from the lower jaw, directly impacts the facial balance and beauty of the child and later the adult.

     Children are born with small adenoids and tonsils.  They reach their maximum size between the ages of 3-6, and reduce in size during the teen years.  But they can become infected and block a child’s nasal passages resulting in nasal congestion, mouth breathing, and increased snoring.  In severe cases where the adenoids and tonsils block the nasal passages completely, they can cause sleep disturbances such as sleep apnea where breathing is stopped altogether.  A child may be tired all the time as a result of interrupted sleep related to the nasal blockage.  This may also result in a mis-diagnosis of ADHD when it is really sleep apnea.  But, of course, enlarged adenoids and tonsils are not only the cause of mouth breathing in children.  Other causes must be investigated by your physician.

     The ideal treatment for chronically enlarged, obstructing adenoids and tonsils is to have them surgically remove by a qualified surgeon.  The child’s dentist, working closely with an ENT (Ear, Nose, and Throat) Specialist, can help to eliminate these things which are causing abnormal facial growth.  In the cases where negative facial growth changes are already significant and facial harmony is already disrupted, the dentist may intervene and use various appliances to modify the abnormal growth pattern and restore the balance to growth.  Taking your child to the dentist as early as possible, yes even before age 3, is very important.

     It is important to bear in mind that no matter what your child’s rate of development and growth, a loving and supportive environment are crucial to his or her happiness and self-esteem.  If you have a concern about your child’s ability to breathe or rate of growth or development of the face or teeth, call our office for a free consultation to discuss the concern and see if anything can be done.