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How Palatal Expansion with Myofunctional Therapy Improves Facial and Jaw Development

Updated: Aug 2, 2021

The 3 biggest factors that impact facial and jaw development include:

  1. Proper tongue posture and functionality (swallowing & speech)

  2. Lip sealed with teeth lightly touching

  3. Upper Airway (Respiration, nasal breathing)

When any of these factors are interrupted during development, I commonly see in my office patients with narrow vaulted palates, a lower jaw that is too small, one or both jaws recessed, or an upper jaw that is too small (underbite). I wanted to emphasize in this article narrow and vaulted hard palates. The hard palate is the floor of the nasal cavity and when a palate is narrow and vaulted it can impact breathing from the nasal cavity. The tongue shapes the hard palate when it is at the roof of the mouth. When the tongue is low lying near the bottom teeth and thrust forward due to airway issues, tongue tie restrictions, allergies, etc, the hard palate develops narrow and vaulted.

The size of the hard palate is important to house the tongue once it is functioning in its proper position. If the palate remains narrow and vaulted after a tongue-tie release, the tongue may not have enough room to remain at the roof of the mouth naturally. So a palatal expander may be necessary to provide the tongue with sufficient space to house the tongue at the roof of the mouth.

A palatal expander works by applying a force to the maxillary bones (hard palate) strong enough to separate the bones at the suture, widen the entire upper jaw and expand the palate. Expansion should NEVER exceed 5 mm and should remain under 5 mm of growth. Palatal expansion works best in early adolescent years before the maturation of the mid-palatal suture; however, palatal expanders have been placed on adults or non-developmental years. Although some orthodontists are skeptical about using an expander for adult patients, studies are showing that the appropriate candidate can benefit from a palatal expander. A cemented palatal expansion appliance with a bite plane is used successfully in adults, augmented with lateral maxillary osteotomy in the older age ranges (Alpern & Yurusko, July 1987).

See our client Annie who is 60 years old who had a palatal expander and Myofunctional Therapy:

With expander and Myofunctional Therapy, you can see the difference in her cheekbones and lips as well as her posture. While it can be done for cosmetic reasons, this procedure is usually done to address airway-related disorders such as obstructive sleep apnea or difficulty nasal breathing. An indicator of obstructive sleep apnea or difficulty nasal breathing is the forward head posture. In our patient after expansion and Myofunctional Therapy to repattern her muscles, you can see more of a jawline and her posture has changed.

Myofunctional Therapy is more than just placing your tongue at the roof of the mouth, it is also ensuring that the tongue has the proper structure to be housed at the roof of the mouth in addition to the functionality of the tongue and throat muscles for airway, breathing, swallowing, and speech. These muscle patterns impact the development of face and mouth muscles. Having a full assessment of the oral motor muscles and structure is essential for an appropriate treatment plan and successful long-term outcomes.

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