ANI Nanny Network Blog

Your Face Really Can Freeze That Way…. guest post by Sarah Hornsby

P1000907 - CopyFor years I rolled my eyes when my grandmother said, “If you keep making that face it will freeze that way” after she caught me crossing my eyes, crinkling my nose, or saw me sticking out my tongue. My sister and I would giggle at the thought of a man with his face frozen in a puckered grimace that he made as a child, or some poor girl trying to speak with a tongue that was permanently protruded as the result of a silly face she once made.

While my grandmother’s theory of faces becoming “frozen” was laughable in my childhood years, I have recently come to the conclusion that at least part of this old wives tale may be accurate.

In my career as a myofunctional therapist, I work with children, and my focus is essentially on their faces. It is my job to help them learn to use the muscles of their mouth and face “correctly” in order to improve an array of troubles centering on speech, dental health, orthodontic treatment and facial growth and development.

Most of the children I see have experienced breathing problems. They have learned to breathe through their mouth, rather than their nose from an early age. This is usually caused by conditions such as enlarged tonsils, chronic nasal congestion, allergies, or even food sensitivities. The only option for these suffering children to get enough oxygen into their bodies is to breathe through the mouth.

What is interesting to me, and is my job to notice, is that once the physical condition is corrected (tonsils removed, medications given, foods eliminated or diet altered etc.) the child’s mouth often, if not always, remains open.

This is where the “frozen face” idea comes into play. If a child has the ability to breathe through their nose, why would they continue to keep their mouth open?

The answer is a simple matter of habit and muscle memory.

These children have essentially developed muscle patterning habits around an inability to breathe through their nose. Basic human functions, such as forming words, chewing and swallowing food, drinking liquids, and even swallowing their own saliva, are compromised by the inability to use their nose. These children are growing and developing around the fact that they cannot breathe properly. This simple habit will stay with them if it is not corrected, making certain facial features permanent or “frozen” into their adult years.

To understand this better, think of a baby fruit tree sapling. Its branches are so flexible and malleable that its growth can be guided into positions that are most convenient for harvesting fruit. Once the tree is older, its branches have matured sturdily into the position the farmer has chosen. The branches are now solid and unable to be manipulated.

It is important to realize that growth is a very powerful force. The growth of the bones and structures of a child’s face can be likened to the growth of the tree sapling. A child with an open mouth will grow into an adult with flatter facial features, less prominent cheekbones, a longer face, droopier eyes, a narrower palate, a smaller lower jaw, and numerous other physical attributes that go hand-in-hand with having an open mouth.

These physical changes occur over time, but the fact is, the facial features are altered. While their faces are not literally FROZEN in a mouth-open position, it is certainly a habit that is reflected in the facial features of adults who have these symptoms as children. I work with these adults too, and they all admit to wishing their parents had known how to prevent these problems when they were young.

Doctors have actually identified symptoms that coincide with an open-mouth habit. The term “Adenoid Face” was coined after a study showed that children who did not have their enlarged adenoids removed, had longer, flatter, and droopier looking faces.

Physical changes in appearance are one thing, but what’s happening on the inside is equally as important. When the mouth is open, the tongue does not rest in its proper position, which is on the palate. This may sound insignificant, but the tongue acts as a natural retainer, or expander, to guide the growth of the upper jaw. When it’s not there, the development of the palate is narrower, and the teeth come in more crooked, or do not have enough space. This makes braces a challenge for both the child and their orthodontist. This is actually the main reason that children end up in my office.

While dental issues and speech troubles are easy to identify and relate to, there are a number of symptoms that are subtler, yet still physically detrimental.

These children have been shown to get sick more often, have a more difficult time focusing in school, are more likely to have undiagnosed childhood sleep apnea, and live an overall lower quality of life because of their struggle to breathe. They often have a high incidence of digestive issues and stomach aches as well, which can be directly related to an inefficient swallowing pattern. They gulp down large amounts of air each time they eat, drink, and swallow, causing an array of digestive issues. Most of my patients report regular stomach aches, gas, and even acid reflux. These symptoms literally disappear once they learn to swallow effectively.

So, as a parent, what does this mean?

When parents contact me to set up an evaluation, the first thing I ask them to do is start watching their child’s mouth. Below are some thoughts to consider with your own child:

  • Is his or her mouth open very often? Even if it’s just a few millimeters, and the lips are barely parted, it still counts. Begin to observe your children while they are distracted – watching TV, listening to a story, staring out the car window, or concentrating on something. These are the times you are most likely to notice an open mouth.
  • Are they nasal or mouth breathing? Can you hear the difference?
  • Are you able to tell if they are congested? Ask them to take 10 breaths through their nose and see if this is a challenge.
  • If you know that they have allergies or food sensitivities, do you know if these are causing nasal congestion or enlarged tonsils?

Many parents are shocked, and feel quite guilty, that they have never noticed the constant open mouth or other symptoms I point out in their child. This is quite common, so parents, don’t be too hard on yourselves!

Now you know what to watch for and why it matters. You have a new tool in your parenting repertoire, and now you know how to use it.

My therapy program is a partnership with the parent and child. It consists of a series of exercises to help children learn to re-program habits, while strengthening the oral and facial muscles. It is a simple, yet incredibly effective and life changing treatment. I am excited to be part of a field where I can help make a difference in young lives, and bring clarity to parents.

I have included a link to a Myofunctional Screening Form that can help you determine if your child has any of the oral, breathing, or dental issues that I look for in my patients. If you believe that these concerns are something your child is dealing with, please contact me for help and answers to your questions.

So just remember, your face really CAN freeze that way, but it’s preventable!

Author’s Bio:

Sarah Hornsby was educated at Eastern Washington University where she received a bachelor’s degree in dental hygiene. She has undergone an incredible career shift to become a myofunctional therapist, writer, speaker, teacher, mentor, and advocate for the field of myofunctional sciences. Her practice is based in Seattle, Washington but Sarah has provided care to patients from around the world. Her treatment techniques involve changing habits and teaching exercises focused on breathing, tongue placement, chewing, and swallowing. Sarah’s goal is to not only treat patients, but to educate parents, healthcare providers, and the general public about the tongue, airway, and facial musculature, and how these parts of the human body connect to general health and well-being.

References:
  1. Care of nasal airway to prevent orthodontic problems in children” J Indian Med association 2007 Nov; 105 (11):640,642)
  2. Harari D, Redlich M, Miri S, Hamud T, Gross M.. The effect of mouth breathing versus nasal breathing on dentofacial and craniofacial development in orthodontic patients. Laryngoscope.2010 Oct;120(10);():2089-93
  3. Okuro RT, Morcillo AM, Sakano E, Schivinski CI, Ribeiro MÂ, Ribeiro JD. Exercise capacity, respiratory mechanics and posture in mouth breathers. Braz J Otorhinolaryngol.2011;(Sep-Oct;77(5):656-62
  4. Okuro RT, Morcillo AM, Ribeiro MÂ, Sakano E, Conti PB, Ribeiro JD. Mouth breathing and forward head posture: effects on respiratory biomechanics and exercise capacity in children. J Bras Pneumol.2011;(Jul- Aug;37(4)):471-9
  5. Conti PB, Sakano E, Ribeiro MA, Schivinski CI, Ribeiro JD.. Assessment of the body posture of mouth-breathing children and adolescents. Journal Pediatrics (Rio J).2011;(Jul-Aug;87(4)):471-9
  6. Jefferson Y: Mouth breathing: adverse effects on facial growth, health, academics and behaviour. General dentist.2010 Jan- Feb; 58 (1): 18-25
  7. Meridith HV: Growth in head width during the first twelve years of life. Pediatrics 12:411-429, 1953
  8. Carl Schreiner, MD. Nasal Airway Obstruction In Children and Secondary Dental Deformities. UTMB, Dept. of Otolaryngology, Grand Rounds Presentation.1996
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