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The Need for Integrative Ortho: Warning Signs

Open Mouth Posture

open-mouth-postureWatch video

The lips only need to be apart even slightly for this habit to have an effect of the growing jaws and teeth. Check you child when they are asleep and when they are concentrating on some quiet activity, like TV, computer or reading.

Long Face and Recessive Chin

long-face-recessive-chin Looking from the side, if the lower portion of the face seems tall and the chin is set back from the rest of the face, chances are that poor facial growth is already taken hold. Don't wait another minute before seeking an evaluation.

Circles Under the Eyes


The dark circles are from the pooling of blood and is a sign of poor circulation and breathing. Mouthbreathing and over-breathing are often the culprits. It is part of the syndrome called "Adenoid Face".

Lack of Spaces Between Baby Teeth or Crowding of New Teeth

no-space-between-teeth-crowding Parents are often surprised when "perfect" baby teeth are followed by crooked adult teeth. If there are not sufficient gaps between baby teeth, then the new, much larger, permanent teeth won't have room to erupt. They'll have no choice but to come in crowded.

Frequent Stuffy Noses, Colds, Allergies or Asthma

frequent-stuffy-nose-allergies-asthma Each of these symptoms may have a reason of its own, but the mouth breathing they cause also makes each of them worse and longer lasting. And since the open mouth posture helps create crooked teeth, some part of this cycle must be stopped ASAP.

Chapped Lips



More moisture is lost through the lips than through any other part of the face or body. When the lips lose moisture, the skin covering them can become tight and start to split.

Open mouth posture encourages evaporation because the air is constantly passing over the lips. When lips are chapped all year long, suspect open mouth posture.


Swollen Tonsils and Adenoids

swollen-tonsils-adenoids We used to think this was only a problem if there were multiple infections. Now we know that if the tonsils interrupt nasal breathing, poor facial growth can begin at an early age. First we try to shrink the tonsils, but clearing the airway is very important no matter how you do it.


Tongue Tie


If the tongue is bound to the bottom of the mouth so that it cannot easily rest on the roof of the mouth there will be narrowing of the upper jaw. Have your child curl the tongue up and back to see the attachment.


Snoring or Loud Breathing During Sleep

snoring-loud-breathing-sleep We used to think snoring was only a problem for the bed partner. Now we know it is the first stage of Sleep Disordered Breathing and can lead to more serious breathing problems. In infants, snoring can be paired with behavior and attention problems by 1st grade (Bonuck, 2012). Snoring is not to be considered "normal".  

Forward head posture

forward-head-posture Children hold their heads forward so they can breath better. But this habit puts strain on the neck and jaw muscles and dramatically affects the shape of the face.

Tongue Thrusting

tongue-thrusting The tongue is a powerful muscle for its size and can reak havoc on the teeth if it is pushing on them all the time. Watch for the tongue sticking out during swallowing, speaking or at rest.

Facial Muscles Moving on Swallowing


 facial-muscles-move-swallowingWatch video You will see the lips purse, the skin on the chin wrinkle up, and, sometimes, the head bob forward. These tell tale signs means there is a tongue thrust underneath.


Pacifiers, Sippy Cups, Thumbs (and other things that don't belong)


Oral habits that change the resting posture of the tongue are sure to lead to crooked teeth and affect proper breathing as well.

Restless Sleep, Nightmares, Bedwetting

restless-nightmares-bed-wetting  One reason for these symptoms is poor breathing and poor oxygen exchange. This can be caused by the same open mouth posture that leads to crooked teeth.

Daytime Sleepiness


Poor sleep can lead to poor performance in school and sports. Look for excessive or regular daytime sleepiness, or for hyperactivity that may be erroneously labeled as attention deficit. Sloppy, noisy eating, and drooling. These can be signs of a myofunctional disorder of the tongue and are usually associated with poor tongue posture and crooked teeth.

Noisy Easting and Drooling


noisy-eating-drooling These can be signs of a myofunctional disorder of the tongue and are usually associated with poor tongue posture and crooked teeth.


And, of course, Crowded, Crooked Teeth (how could I forget?)

crowded-teeth-crooked This is the one symptom that everybody knows to see an orthodontist about. But it is only one of the things we have to be aware of. The question that a myofunctional orthodontist will always ask is, "Why did the teeth get like this?"


orthodontist-clifton-nj-new-jerseyWe thank our patients for the trust they have put in our orthodontics practice the past 30 years (60 years if you include my Dad and Elaine).
I hope this website earns their trust again.

Barry Raphael, DMD

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