Oral & Facial Under‑development

Treatment & Airway Health Solutions

Understanding Oral Facial Underdevelopment: When Modern Life Affects Ancient Growth Patterns

In recent decades, healthcare providers have noticed a concerning trend: children and adults are developing smaller jaws, narrower airways, and more crowded teeth than previous generations. This condition, known as oral facial underdevelopment, affects far more than just appearance—it impacts breathing, sleep quality, and overall health throughout life.

At Rebis, our multidisciplinary team understands that oral facial underdevelopment isn't just a cosmetic concern or simple orthodontic problem. This condition represents a fundamental change in how human faces develop in our modern world, with consequences that affect breathing, sleep, and health throughout life. Our airway-focused approach addresses both the symptoms and root causes of underdevelopment to support optimal health and function.

What Is Oral Facial Underdevelopment?

Oral facial underdevelopment refers to the inadequate growth and development of the facial bones, jaws, and associated structures that house the airway. This condition results in smaller nasal passages, narrower dental arches, less space for the tongue, and restricted airways that can significantly impact breathing and sleep quality.

Unlike genetic conditions that affect facial development, oral facial underdevelopment is largely influenced by environmental factors in our modern world. Changes in feeding practices, food textures, breathing patterns, and lifestyle factors have altered the normal developmental signals that guide facial growth during childhood.

Key Features:

  • Narrow dental arches and high-arched palates

  • Crowded teeth and small, retruded jaws

  • Narrow nasal passages and restricted airways

  • Long, narrow facial appearance

The Feeding Factors

Breastfeeding vs. Bottle Feeding

Breastfeeding requires different muscle actions and tongue movements than bottle feeding. During breastfeeding, the infant's tongue performs a complex rolling motion against the roof of the mouth that helps expand the palate and create adequate space for proper development. Bottle feeding allows milk to flow more passively, reducing the muscular work that guides normal facial development.

Soft Food Diets

Modern processed foods require much less chewing force than traditional diets. This reduction in chewing exercise during childhood means the jaw muscles don't develop their full strength, and the mechanical forces that normally guide jaw growth are diminished.

Early Weaning and Food Textures

Children who are weaned early from breastfeeding or who primarily consume soft, processed foods miss critical opportunities for the oral motor development that supports proper facial growth.

Modern Causes:

How Our World Changed Facial Development

Understanding oral facial underdevelopment requires looking at how human development has changed over the past century. Anthropologists studying skulls from different time periods have documented dramatic changes in facial structure, with modern humans showing significantly smaller jaws and narrower airways than their ancestors.


Breathing Pattern Problems

Chronic mouth breathing

Often caused by allergies, enlarged adenoids, or nasal congestion

Poor tongue posture

When mouth breathing, the tongue rests low instead of against the palate, reducing the primary expansion force for the upper jaw

Altered growth patterns

Mouth breathing promotes long, narrow facial development rather than broad, forward growth

Health Consequences

Airway and Sleep Impact

  • Restricted airway space: Smaller jaws and retruded tongue position reduce airflow capacity

  • Sleep-disordered breathing: Increased risk of snoring and sleep apnea

  • Poor sleep quality: Increased breathing effort, frequent micro-awakenings, and reduced deep sleep

  • Daytime symptoms: Fatigue, concentration problems, and mood issues

Dental and Orthodontic Problems

  • Severe tooth crowding and impacted teeth

  • Bite problems leading to TMJ dysfunction and headaches

  • Increased treatment complexity requiring extractions or surgery

  • Higher risk of decay and gum disease due to crowding

Facial and Functional Effects

  • Long, narrow facial appearance with receded jaw profile

  • Reduced lip support and compromised smile aesthetics

  • TMJ dysfunction with pain and limited jaw movement

The Rebis Approach: Comprehensive Airway-Focused Treatment

  • 3D Airway Analysis

    • Cone-beam CT imaging for detailed craniofacial evaluation

    • Measurement of actual airway dimensions and restriction points

    • Assessment of jaw position relative to airway space

    Functional Assessment

    • Breathing pattern analysis (nasal vs. mouth breathing)

    • Sleep quality evaluation and sleep-disordered breathing screening

    • Oral function assessment including tongue posture and swallowing patterns

  • Palatal Expansion Techniques

    • Rapid palatal expansion: For younger children to dramatically increase upper jaw width and nasal cavity space

    • Slow palatal expansion: Gradual expansion working with natural growth patterns

    • Surgically assisted expansion: For adults with fused palatal sutures

    Mandibular Development

    • Functional appliances to encourage forward jaw positioning during growth

    • Fixed appliances for gradual lower jaw advancement

    • Integration with myofunctional therapy for optimal muscle support

  • Tongue Posture Training

    • Proper resting tongue position against the palate

    • Correcting dysfunctional swallowing patterns

    • Coordinating tongue posture with nasal breathing

    Facial Muscle Coordination

    • Lip competence training to reduce mouth breathing

    • Proper chewing pattern development

    • Speech integration to support optimal oral function

  • Expansion-Based Treatment

    • Arch development to accommodate all teeth while increasing airway space

    • Forward jaw development to maximize airway dimensions

    • Vertical dimension optimization for better facial proportions

    Advanced Techniques

    • Self-ligating brackets for physiologic tooth movement

    • Custom aligner therapy with arch expansion capability

    • Temporary anchorage devices for complex movements

  • Orthognathic Surgery

    • Maxillary advancement to increase nasal and upper airway space

    • Mandibular advancement for tongue space and posterior airway opening

    • Bi-maxillary surgery for optimal positioning

    Adjunctive Procedures

    • Genioplasty for chin advancement and airway support

    • Nasal surgery for obstruction correction

    • Soft tissue procedures for enlarged tonsils/adenoids

  • Nutritional Optimization

    • Growth-supporting nutrients (Vitamin D, K2, magnesium, protein, omega-3s)

    • Anti-inflammatory nutrition approach

    • Elimination of trigger foods causing inflammation

    Underlying Health Factor Management

    • Allergy treatment and environmental modification

    • Postural and breathing training

    • Sleep hygiene and circadian rhythm optimization

Treatment Benefits

The Rebis airway-focused approach addresses both symptoms and root causes to achieve:

  • Improved breathing: Enhanced nasal breathing capacity and reduced mouth breathing

  • Better sleep quality: Reduced sleep-disordered breathing and more restorative sleep

  • Optimal dental alignment: Straight teeth with adequate space and proper bite function

  • Enhanced facial aesthetics: Improved facial proportions and profile

  • Long-term health benefits: Reduced risk of sleep apnea, TMJ dysfunction, and associated health problems

Who Benefits

  • Children requiring early growth guidance intervention

  • Adults with airway restriction and sleep-disordered breathing

  • Patients with CPAP intolerance seeking alternatives

  • Anyone whose facial structure restricts optimal breathing and sleep quality

Our multidisciplinary approach recognizes that optimal facial development supports not just attractive smiles and straight teeth, but healthy breathing and quality sleep throughout life.


Frequently Asked Questions: Oral & Facial Under-development

  • Oral facial underdevelopment is inadequate growth of facial bones, jaws, and airway structures, resulting in smaller nasal passages, narrower dental arches, and restricted breathing. Unlike genetic conditions, this is primarily caused by modern factors like bottle feeding, soft food diets, and chronic mouth breathing.

  • Key signs include chronic mouth breathing, snoring, restless sleep, behavioral problems, difficulty concentrating, frequent infections, crowded teeth, and long, narrow facial appearance.

  • Traditional orthodontics often extracts teeth or retracts them to create space. Our airway-focused approach prioritizes breathing function by expanding jaws and advancing them forward to maximize airway space while achieving excellent dental alignment.

  • Earlier intervention is more effective. We can begin growth guidance as early as age 6-8, with optimal results during peak growth periods (ages 8-14). However, adults can still benefit significantly, though treatment may require surgical approaches.

  • Children's growth-guidance treatment typically takes 1-3 years. Adult treatment may take 2-4 years, with surgical cases requiring additional time for healing and coordination.

  • Myofunctional therapy retrains tongue, lip, and facial muscles to function properly. It's crucial because poor muscle function often contributed to underdevelopment and can cause relapse. It teaches proper tongue posture, swallowing patterns, and nasal breathing.

  • Many patients experience improved nasal breathing, reduced snoring, better sleep quality, enhanced facial aesthetics, and resolution of TMJ symptoms. Children often see dramatic improvements in behavior, concentration, and overall health.

  • While many patients experience significant improvement or resolution of sleep-disordered breathing, we can't guarantee a "cure." Our goal is to optimize airway anatomy and function. Some patients may still need CPAP but often at reduced levels.

  • Coverage varies by plan and specific treatments. Some aspects like 3D imaging for airway evaluation can often be billed through medical insurance. We work with patients to maximize benefits and offer financing options.

  • Some patients can eventually discontinue CPAP after successful treatment, while others use it as a bridge during treatment or need reduced pressure settings. This depends on your individual case and treatment response.

  • Yes. Our integrative approach involves collaboration with ENT specialists, allergists, sleep physicians, and other providers to address all contributing factors. We believe in seamless, coordinated care for optimal outcomes.