One, Two, Three


Harrison 123_586412090 800The Toddler age from birth to three presents many challenges for parents, healthcare professionals, and the kids themselves. Poor prenatal health of the mother, premature births and failed nursing adaptation begin a cascade of issues that compromise timely and orderly development of the face.  Unprepared and untrained parents need counseling and support for the difficult and all-consuming mission of raising children.

The baby product market is a confusing array of pacifiers, teethers, sippy cups, and designer nipples for bottle feeding.  Do you really think the manufactures care “a lick” about what encourages good oral development? Is soothing the baby more important than the risk of cavities, cross bites and open bites that will result at age 7? Could something be done to prevent your child from 2 years of braces when they are 12?  Well “Yes” and “No”, “Maybe” and “Sometimes”, “It Depends”.

Orthodontist are very interested in early facial development as I would think Pedodontist, Pediatricians and Pediatric ENT physicians are as well, but as a rule that needs to be broken, orthodontist do not see children until they are 6 or 7 manifesting the accumulative insults they have had to accommodate to from those early years.

So, what are the signs and wonders the new parents should be aware of?  Nothing can compete with excellent prenatal health, full term natural delivery and natural nursing. That’s a big 1,2,3, seldom achieved. The earliest signs of future problems are mouth breathing and tongue tie. Children should sleep with mouth closed throughout the night and the tongue should be checked for a binding frenum keeping the tongue bound to the lower jaw and limiting its range of motion. Low tongue posture will certainly cause the upper arch to narrow into cross bite because the tongue is not postured correctly. Speech and swallowing will also be adversely affected as time will demonstrate. Another hurdle toddlers must jump is another 1,2,3. Tonsils, adenoids, and ear infections are airway restrictions that can impede and alter facial development. Sleep and dietary habits are crucial and critical for physical and mental health. General behavior and mental abilities are indicators of future expectations again pointing to the requirements of sleep stages.

Young children that have sleep disordered breathing and sleep apnea should be addressed first with a pediatric sleep study to determine the appropriate treatment but not all physicians are aware of how much orthodontic intervention can contribute to success. The most important training these children can receive is being taught how to breath correctly – mouth breathing must stop or success is limited.  The focus begins with widening the upper arch to a normal size for that individual so that the tongue can occupy its correct position.  Breathing improves because the nasal airway volume is increased. Adding a mandibular advancing appliance when the lower jaw is deficient in length aids in its development as well as opening the airway space behind the tongue  But, above all else, unless breathing is nasal, many problems cannot be resolved.

Don’t let one, two, three strikes risk your child’s health and well being. Age two – three is the ideal time to evaluate facial development.


John B. Harrison DDS,MSc

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