Working in a dental surgery we have lost count of the number of times concerned parents have brought their child to see a dentist with worries about the placement of their child’s teeth, often to be told that it is too early to intervene and that they must wait until all the permanent teeth are through before conventional orthodontic intervention.

Modern research has now shown that the need for conventional braces can be reduced and even eliminated by preventative measures that tackle the cause of crowding and crooked teeth from as early as 3 years old, when signs of poor oral confirmation first become evident.

Conventional orthodontic treatment can only begin once all permanent teeth are through (usually around 12 years of age) and rely on the use of a brace to align the teeth by forcing them into a certain position, often with the need for extraction of healthy teeth to allow the treatment to commence.

It was previously thought that genetics alone was the deciding risk factor in whether a child would need future orthodontic treatment later in life however, research has shown that other factors can cause crooked teeth; such as mouth breathing, tongue thrusting, reverse swallowing, and thumb sucking. These factors are known as incorrect myofunctional habits and as a result the tongue does not sit in the correct resting position in the mouth leading to poor jaw development as over time the forces of the tongue, cheeks and lips effect the positioning of the teeth and the growth of the jaw.

It is commonly thought that crowding is caused by teeth that were simply too big for the mouth or too many teeth for the jaw, however, when the underlying incorrect myofunction is addressed at an early age the jaw is able to grow to its full genetic potential, meaning that the mouth in adulthood is plenty large enough to comfortably accommodate all the teeth.

Incorrect myofunctions not only impact on the appearance of the teeth but often accompany serious health concerns if not corrected. Malocclusion (misalignment of teeth) can lead to problems with biting and chewing, increase the likelihood of trauma to the soft tissues in the mouth from biting and lead to TMJ (jaw) issues due to incorrect biomechanics of the jaw.

As well as positioning of the teeth and growth of the jaw the medical profession now recognises Mouth Breathing as abnormal with it being the biggest contributing factor to Sleep Disordered Breathing (SDB) problems, which include developmental and behavioural problems, snoring, gasping, obstructive sleep apnoea (OSA) and disrupted sleep. If OSA is left untreated it can lead to serious and significant health problems in later life.

The Myobrace was invented in Australia over 20 years ago and is growing in popularity and is now used in over 100 countries worldwide. The aim of the Myobrace is to correct the underlying causes of crooked teeth whilst the skeleton is still developing to optimise facial development so that there is plenty of space for the adult dentition without crowding. Treatment is most successful in children aged 3-15 years old and is achieved by the wearing of a series of intraoral appliances that are worn to sleep and also for a period of 1-2 hours during the day. The aim of the appliance is to correct the positioning of the tongue and lips, and encourages nose breathing and correct swallowing. It works by applying light forces to expand the arch and align the teeth and jaw. In addition to the appliance the patient is given a series of breathing, swallowing, tongue, cheek and lip exercises to strengthen and retrain the facial muscles in order to give the patient the best possible chance of reaching their genetic growth potential and maximising the success of the treatment.

Treatment time ranges greatly depending on the type and severity of the myofunction, ranging from as little as 3 months up to 24 months.

The treatment usually consists of four stages;

  • Habit Correction- Teaching the patient to correct bad oral habits
  • Arch Development- Additional arch development may be required to widen the upper jaw.
  • Dental Alignment- The use of a dental appliance to align the teeth into their natural position.
  • Retention- preventing relapse with a retainer, often preventing the need for permanent retention.

When compared to the use of conventional orthodontic methods such as fixed braces there are some obvious advantages of the Myobrace. Prior to orthodontic treatment the removal of healthy functioning teeth is often required and long term this leads to absorption of the alveolar bone in the jaw surrounding that tooth which can lead to a sunken face appearance and contribute to the appearance of early ageing. As well as this the root of the tooth is damaged in almost 100% of cases using fixed orthodontic appliances due to the sustained force on the teeth. Alongside this the enamel can be damaged by the process of cementing the brackets to the teeth. Relapse is also likely in 90% of causes without permanent retention due to the cause of the crowding not being resolved.

If your child has a dummy or is a thumb sucker this can lead to an open bite and protruding front teeth which will require orthodontic correction. However, some forms of myofunction are less apparent and you may even be unaware of them until they get picked up at a dental check-up.

Things to look out for can include open mouth breathing, the lips should meet together and the mouth fully closed when your child is not speaking or eating, and excessive movement of the lower lip when swallowing can indicate incorrect swallowing. In many cases your dentist will be able to identify and abnormalities at your child’s routine dental appointment.

For more information regarding the Myobrace treatment or any other concerns, please arrange an appointment with Dr Isik: Dr Kara Isik – Kingswood Parks Dental (