Where do dental deformations come from?

For a long time, practitioners attributed dental deformations to genetic factors. Mechanical treatments which consisted in applying force on the tooth with braces, aligners, etc, and tooth extractions were thought to be the only legitimate solutions to reestablish tooth alignment. Many scientific studies over the last 20 years have demonstrated that most dental deformations are caused by… an imbalance in the functions of the mouth and face, also known as orofacial functions. There are many major causes of these functional imbalances: continued sucking on a pacifier or thumb, soft food that is detrimental to chewing, etc.

In 2002, the French National Authority for Health (called the ANAES at the time) issued the following recommendations for our profession:

“An initial checkup should take place before the age of 6 years, during which several anomalies, including functional anomalies, should trigger interceptive treatment.”


Atypical swallowing: guilty

We swallow our saliva more than 2,000 times a day, unconsciously. Before the age of 3 and the arrival of our first molars, the tongue takes up all the room in our mouth. To swallow, young children only have the sucking program developed in utero, in their mother’s tummy, and which they reproduce when breastfeeding. It is the swallowing method observed when children suck their thumbs or are nursing, characterized by the formation of an airtight seal around the lips that lets the tongue push up against the labial mucosa. This is primary swallowing.

Starting at age 4 and the arrival of the first molars and chewing, a new swallowing program must be developed and will remain throughout life: secondary swallowing.

This change of program happens naturally in 60% of 4-year-olds. Source – De la Dysfonction à la Dysmorphose en Orthodontie Pédiatrique – Dr Fellus, 2015.

But primary swallowing persists in 40% of 4-year-old children. We speak of atypical swallowing, which is characterized by a contraction of the cheek and chin muscles and the interposition of the tongue between the dental arches. Atypical swallowing results directly in a dental bone deformation, but can lead to many additional complications.

The snowball effect

Along with directly visible dental deformities, atypical swallowing can lead to speech and language disorders that often come in the form of language delays or lisping, along with mouth breathing that leads to recurrent infectious diseases and chronic diseases over time.

What practitioners call “wrong tongue posture” is the interposition of the tongue between the dental arches when swallowing and a low tongue position at rest. On the other hand, good lingual posture involves raising the rear section of the tongue when swallowing and a position in contact with the palate at rest.

Therefore it is not surprising that poor tongue posture can cause speech and language disorders.

But the health issues are much more important: a low position of the tongue usually leads to total or partial mouth breathing.

Nasal breathing is physiological and therefore healthy because it filters air (and pollution) before it gets to the lungs. It is the first line of defense against allergens, bacteria, viruses and particles. That is not the case with mouth breathing, which is pathological and can lead to infectious diseases and chronic diseases over the long term. There are many symptoms in children: colds, sore throats, recurrent ear infections, sleep disorders, circles under the eyes, fatigue at school, difficulties concentrating, behavioral problems, etc.

Luckily, automatic reeducation of swallowing has a domino effect and rehabilitates related functions.

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