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    Abnormal bite- and jaw development

    Bite abnormalities arise in between 60% to 75% of the population and affect both children and adults, of these 30% have an abnormality which should be remedied. [2] Untreated bite abnormalities can affect oral health and bite and jaw function. It is important to notice early, those children that often have normally open mouths or breathe through their mouths. This is a signal that the balance between the various muscle groups in the face and oral cavity have been disturbed, which in time can lead to abnormalities both in the mouth’s functions, and in bite- and jaw development.

     

    Difficulties in closing the lips, and a frequently open mouth, can cause drooling, dry mouth, increased risk of caries, risk of infection and common bite abnormalities such as open bite, protruding teeth, overbite and narrowed palate roof. All these abnormalities affect to some degree the ability to chew, process food in the mouth and to swallow, and can also affect the ability to form sounds. In addition to this, there are psycho-social factors to take account of - with all the awkwardness that an abnormal appearance can cause in everyday life. [1]

     

    IQoro® is a new and unique neuromuscular treatment method that requires just 30 seconds’ exercise, three times per day. Here we will show in overview how training with IQoro® strengthens and improves the balance between different muscle groups in the face and oral cavity during the early growth period from approximately one and a half years old. In addition, abnormalities can be prevented from occurring, and already established abnormalities minimised or eliminated. Early intervention during the growth period increases the possibility of optimising bite- and jaw development and the conditions to optimise the mouth’s functions.

     

    Underlying causes

    From the moment that the first milk teeth break through at a few months’ age, it takes approximately 14 years before we have 28 permanent teeth. During this period the jaw and the face are also growing. When this growth period has ended, developments continue but only very small changes in the bite’s formation. For some however, the bite does not develop normally: the relationship between the upper and lower jaw develops differently than what we would associate with being normal. This can be because the teeth that break through do so in the wrong way, that there is a shortage of space, or that the jaws are too small in relationship to the breadth of the teeth. It could also be due to an under- or overbite. [1]

     

    The development of the teeth and the jaws are mostly steered by genetic factors. During the growth period, from 6 to 8 months old to 12 to 14 years of age, other external factors can be causes of a sub-optimal bite- and jaw development. External factors can be long-term sucking of the thumb, or fingers, dummies, the bottom lip or feeding bottle, and can cause bite abnormalities if the bad habit is not broken in time. Other causes can be external trauma e.g. accidents in sports activities, in the playground or in traffic, etc.

     

    During the growth period, a disturbance in the balance relationship between various muscle groups in the face and oral cavity can cause the following abnormalities [6]:

     

    • Open mouth - can be caused by oversized tonsils or adenoids that obstruct the breathing pathways. Another cause can be chewing muscles which are too weak.
    • Open bite - in order to be able to swallow with this abnormality, the tongue positions itself in the opening between the front teeth of the upper and lower jaw in order to make a seal at the front of the mouth and in this way create a low pressure in the oral cavity. This is a precondition for being able to swallow effectively. Generally speaking, this is also the reason why an open bite cannot be eliminated without intervention.
    • Short top lip - this is compensated for by raising the lower lip, which results in tensing of muscles in the floor of the mouth and in the chin, and in developing an incorrect swallowing technique.
    • Weak top lip - causes protruding upper front teeth.
    • Weak bottom lip – causes protruding lower front teeth.
    • Slack, weak tongue - spreads in width and can push out the lower front teeth.
    • Chin muscle stronger in relation to the tongue - pushes in the lower front teeth to lean inwards.
    • Cheeks are stronger in relationship to the tongue – leading to a higher palate arch.
    • Tongue is stronger in relationship to the cheeks – causing a broad and shallow palate arch.

       

     

    Orthodontic treatment – initiated after the growth period

    During the growth period the focus should be on actions to break the bad habits such as thumb sucking, as early as possible.

    If a jaw or bite abnormality has become established in the permanent bite by then, orthodontic intervention is required. This treatment begins when the growth period has ended and when all 28 permanent teeth are present, usually between 12 to 14 years old. Appearance begins to be of greater importance at this age, and the individual is thought to be able to decide himself for or against such treatment.

     

    To correct abnormalities, treatment with a removable brace can be performed by a general dentist, or a permanent brace can be fitted by a specialist in orthodontics. Certain, more complicated, bite- and jaw abnormalities can require a combination of both surgical and orthodontic treatments. [1]

     

    In many countries, the general child and youth dental health care system provides needs-based orthodontic treatment free of charge. Such treatment in adults can be provided, but the individual patient usually bears the cost.

     

     

    Treatment with IQoro® - initiated during the growth period

    IQoro® is a new and unique neuromuscular treatment method that requires just 30 seconds’ exercise, three times per day. From around one and a half years old, training with IQoro® can be used as a preventative treatment, it optimises the balance relationship between various muscle groups in the face and oral cavity. This works because training with IQoro® stimulates the upward-going efferent nerves and in this way reaches the control system in the brain to be able to activate all the skleletal striated muscles in the face, oral cavity and pharynx [5]. This can help to prevent abnormalities developing, or reduce or eliminate those that have developed during the growth period.

    Treatment with IQoro® can be initiated with the aim of preventative action when open mouth or mouth breathing is observed in a child. If enlarged tonsils or adenoids in the nose are the reason for mouth breathing - for which a surgical operation can be required - it is still of value to train with IQoro® in the post-operative phase to improve and strengthen musculature in the face, oral cavity and pharynx.

    IQoro® acts on, and regenerates, the entire swallowing process. It stimulates the sensory nerves in the mouth, and by doing this reaches the brain’s control system for the swallowing process, which is closely linked to the control systems for other bodily functions [7], including breathing, the ability to form sounds (speech), facial expression [5], postural control [4], stomach and intestine functions, and more. This explains why exercising with IQoro® can have a positive effect on so many different functions. [5]

    Adults with bite- and jaw abnormalities, where surgical operation is required, can also be helped by IQoro® in the post operative phase to regain optimal muscle function in the face, oral cavity and pharynx.

    Abnormal bite- and jaw development
    Abnormal bite- and jaw development

     


    Text by:

    Dr. Mary Hägg, Doctor of Medicine, Post-doctoral researcher at Uppsala University specialising in orofacial medicine, Head of Department at the Speech and Swallowing Faculty: Ear, Nose and Throat Clinic at Hudiksvall Hospital, Sweden. Registered Dentist. In cooperation with MYoroface.

    October 2016. (Translation from the original Swedish text by T.W.Morris, MYoroface).


    Sources:

    1. SBU, (2005), Bettavvikelser och tandreglering i ett hälsoperspektiv – en systematisk litteraturöversikt.
      http://www.sbu.se/contentassets/17090202cd864117a22698e16581e177/fulltext_tandreglering.pdf
      (English translation, “Bite deformities and orthodontic intervention from a health perspective – a systematic review of existing studies”)
       
    2. Malmö Högskola, Ortodonti, Forskning. Hämtad: 2016-10-18 https://www.mah.se/fakulteter-och-omraden/Odontologiska-fakulteten/Avdelning-och-kansli/Ortodonti/Forskning/

      (English translation, “Research”)
       

    3. Zhu Y, Li J, Tang Y, Wang X, Xue X, Sun H, Nie P, Qu X, Zhu M. Dental arch dimensional changes after adenoidectomy or tonsillectomy in children with airway obstruction: A meta-analysis and systematic review under PRISMA guidelines. Medicine (Baltimore). 2016 Sep;95(39):e4976. doi: 10.1097/MD.0000000000004976
       
    4. Hägg M., Tibbling L. Effect of IQoro® training on impaired postural control and oropharyngeal motor function in patients with dysphagia after stroke. Acta Otolaryngol 2016; 136 (7):742-748. DOI:10.3109/00016489.2016.1145797 http://dx.doi.org/10.3109/00016489.2016.1145797
       
    5. IQoro® - List of scientific articles
       
    6. Castillo Morales RC, Brondo JJ, Haberstock B. In: Die orofaziale Regulationstherapie, 1st ed. München: Richard Pflaum Verlag GmbH & Co. KG München, Bad Kissingen, Baden-Baden, Berlin, Düsseldorf, Heidelberg, 1991, pp 21-188.
       
    7. Ekberg O, (2011), Röntgendiagnostiska avdelningen, Universitetssjukhuset MAS, Malmö, Normal sväljning inklusive anatomi och fysiologi, (pdf). Hämtad 2015-12-05, kl 15.00,
      (English translation: "Normal swallowing including anatomy and physiology")

     

     

        

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