Crooked Teeth


There are two main causes of crooked teeth: GENETICS and OROFACIAL MYODYSFUNCTIONS. We cannot change genetics, but we can improve and correct orofacial myodysfunctions.

Orofacial means the mouth and face, and myo means muscles. Hence, orofacial myodysfunctions means the muscles of the mouth and face are not functioning correctly.

The main muscles of the orofacial complex form the tongue, the lips and the cheeks. The tongue is located inside the mouth, whereas the lips and the cheeks are located outside the mouth, on the face. The jaw bones are located in between the tongue, and the lips and cheeks. For the jaw bones to grow and widen optimally, the tongue needs to function against the palate, pushing the upper jaw from the inside out. The lips and cheeks, on the other hand, need to not be exerting forces inward, as these forces would push against the jaws from the outside in, constricting the growth instead.

The jaws are the houses for the teeth. When the jaws are narrowed, the houses are too small to fit all the adult teeth in, resulting in teeth that are crowded and crooked. Additionally, narrowed jaws also lead to imbalanced bite that can be damaging, including deep overbite, reversed bite and even crossbite.

There is no one definite cause, as there are a number of factors that may influence the development of orofacial myodysfunctions, including (but not limited to):

  • Tethered oral tissues (tongue ties, lip ties, cheek ties)
  • Weak muscle tone
  • Mouth breathing habit (possibly due to upper airway obstructions, such as enlarged tonsils and/or adenoids)
  • Poor parafunctional habits (such as thumb-sucking, dummy-sucking, and finger-sucking)
  • Poor nutrition and soft diet (processed and sugary foods can be pro-inflammatory to the human body)
  • Poor posture (such as text neck syndrome due to over-usage of mobile phones)

Often a few of the above are in play, consequently needing to have all of them addressed by a number of health care providers simultaneously.

If left untreated, with time there are increasing risks of needing extractions of some adult teeth due to space issues, full braces to then straighten the teeth, and even surgical intervention of the jaw bones to improve their dimensions and relationship. There are also more serious health risks that can develop as the child gets older, and even in much later years in life. These may be jaw joint disease (Temporomandibular Joint – TMJ – Dysfunctions), sleep disorders (such as sleep apnoea), speech impediment, and even dental caries (cavities in teeth) and periodontal (gum) disease.

By correcting orofacial myodysfunctions, the jaws are given the opportunity to grow and widen naturally to their maximum unique potential for the individual. This opportunity, however, is only open over a certain window, which is when the child is still growing. As a rule of thumb, the less baby teeth a child has, the further that window is closing. Hence, have your child assessed by the time he/she is 5 years old, before it’s too late. Depending on the severity of the problem, this orofacial myofunctional pre-orthodontic therapy is usually indicated between 7 to 9 years of age.

The therapy usually involves a number of daily exercises and using myofunctional appliances (tools) that act like gym equipment for the muscles of the mouth and face. These tools are removable, easy to insert, remove and clean, and are much more comfortable than fixed braces. In most cases, braces can even be avoided completely, especially if the patient is very compliant in following the routine of practicing the exercises and using the myofunctional tools daily.

Tethered oral tissues, such as tongue ties, lip ties and/or cheek ties, may need to be released to allow effective re-training of these orofacial muscles.

To achieve optimal functional health, we believe in:

  1. Tongue up against the roof of the mouth
  2. Lips always closed, except during eating and talking
  3. Breathe through the nose
  4. Swallow properly