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My six-year-old has always had a gorgeous wide grin and massive face. Due to sleep apnea, behavioral issues, and lisp, we started him on Vivos Healthy Start oral appliance about 3 months ago. It's supposed to be a habit corrector, removable, worn overnight and 2 hours daytime. Well, in 3 months now he has developed anterior open bite! Also, his bite looks narrower to me, slightly. Please see before and after pictures and tell me, is this ruining his teeth? Dentist kept reassuring us it was fine, and they're not concerned, but nothing they said explained or put me at ease. They claim his tongue thrust has done this and the appliance will correct it. It's hard to compare because he got 2 new teeth in and one new molar, but I keep looking at the pictures and thinking, for 6 years his smile has looked PERFECT, and suddenly in 3 months, it has completely opened up due to tongue thrust that has been there all along? What am I missing? Could it be that losing those bottom 2 teeth caused him to put more pressure on the top teeth to swallow, causing it to open up more? Are his teeth aligning differently due to maxilla movement? Is the bulk of the mouthpiece adding more force to his tongue thrust while he sleeps because he can no longer keep a good lip seal? He doesn't come down at night anymore saying he can't sleep, so that is good. I'm not sure how to feel. I'm scared about messing him up. We paid a lot for this, and I just hope it's helping not hurting. His sister is also in treatment, 9yo, and her progress is looking good. Please see attached pictures of him and advice appreciated!
Yep, I think you're right. That looks like he's experiencing some level of recession. If your kid really did have solid facial development when he was younger then I don't think he should require these sorts of devices. I am very doubtful that him losing some baby teeth would cause this sort of problem.
You are talking about this sort of thing, right? It's almost certainly compromising his ability to keep his teeth closer together and thus it is hindering his ability to keep his tongue suctioned to the roof of his mouth which is why he is experiencing a narrower palate. Teeth/lips apart -> oral suction fails and the tongue falls down off of the palate-> natural swallowing can no longer impart forces from the tongue into the roof of mouth -> palate starts to cave in and become more narrow over time due to opposing forces like gravity. Try keeping your teeth apart and you will quickly see how much harder proper tongue posture is. That is what such a device is doing to your son.
I am not a professional but I would recommend ditching the device and instead start feeding your son tougher, chewier foods to build up his jaw and tongue strength so he can use them properly. We aren't meant to have bits of plastic clasped around our teeth when we sleep.
Make sure he practices good posture throughout the day and when he sleeps. Don't let him keep his head forward or slouch etc. I'm not entirely sure when kids are meant to start doing adult swallows (i.e tongue swallows) but I think he is definitely old enough. I would suggest gently scolding him when he engages in bad postural habits and reward him when he tries to fix and improve them. This sort of incentivization is great for speeding up progress.
If he is mouthbreathing at all while he is asleep I would suggest buying some mouth tape to keep his lips closed. The need for this should lessen as his jaw and tongue both strengthen
Yes, very similar to that picture, only it doesn't have specific spots for each tooth like that, not customized. I put it in once to see how it felt, and it really did seem to jam open the teeth. I thought it was odd, but I figured with how popular they are and the amount of success stories that they must need that to set things right. I didn't try to swallow wearing it. I will try that and see. Now that I'm seeing his bite go awry, I'm really worried. The kids used to mostly sleep with lips sealed, and now the mouthpiece is so bulky, they can't close their lips around it while sleeping. I mentioned that to the dentist, and they said not to worry, eventually the lip muscles will build up and close around it during sleep. I'm going to call and ask them again tomorrow because I don't feel like they were able to answer my questions in a way that put my mind at ease. I just wanted input from others to help me feel like my worries aren't unfounded, or to correct me if I'm misinterpreting things.
The thing about these devices is that for people with really substantial craniofacial deformities, it will often times align the teeth in a way that perhaps looks more aesthetically pleasing but completely compromises the foundations of the face. It is a case of treating a particular symptom and not the underlying cause; this is what braces do, for instance. They will give you perfectly aligned teeth but they won't do anything for your recessed maxilla or narrow, vaulted palate.
The fact that your sons teeth got worse instead of seeming to appear better raised my suspicions that he was never in need of such a oral appliance in the first place.
"The kids used to mostly sleep with lips sealed, and now the mouthpiece is so bulky, they can't close their lips around it while sleeping. I mentioned that to the dentist, and they said not to worry, eventually the lip muscles will build up and close around it during sleep"
This is why many classically trained orthodontists should be dismissed as dinosaurs. This device is enabling your children to mouth breath. Mouth breathing causes literally hundreds of problems https://myfaceology.com/mouth-breathing/. You can expect his behavioral issues and sleep apnea to be exacerbated by mouth breathing. Having the lips apart means they won't be in contact with the teeth and keeping them aligned which will be a major problem if he continues to mouth breath after ditching his appliance; it isn't a coincidence that people who leave their mouth open almost always have crooked teeth.
It really pissed me off when you mentioned that they said it would be okay because his lips would grow around to fill the gap.
Can you guess which girls lips have deformed via hypertrophy to accommodate a slack jawed, open mouthed posture and which girls lips are lightly touching together with zero effort?
Well, that's just it - they are saying the right things... Mouth breathing is harmful, sleep depends on proper development to open the airway, etc. Their goals are good and aligned with my goals. They wanted to encourage forward growth with him, said his width was good but midface "sunken" and this habit corrector was to retrain the tongue to be on the roof of mouth and encourage proper swallow and forward growth of his maxilla. Yes, I want that. They want that. They say this will do that. They have treated other kids and resolved mouth breathing, snoring, apnea, bedwetting. The kids really have been sleeping 99% better since starting on them. So maybe it's not the perfect choice (to do it again, I'd have gone with the ALF), but it is helping in that regard. It's hard to know what to do because I don't want to go back to sleeping problems. I can see with his cheesy smile that he does have forward tongue thrust. This is not really correcting it. If I ask what more can be done, I'm sure they will probably refer me to their myofascial therapist for more $$$ and say stick with it. After this phase 1, they move to a phase 2 custom piece that is harder and they said they will chew on it to stimulate growth. Right now I have them chewing falim gum while using electronics about 1-2hrs a day, and they said that was great for them.
I forgot to mention - his mouthpiece also began cracking apart along the ridges on both sides. They said they had never seen it wear like that, and they replaced it. He admitted to moving it around while in his mouth, which we told him not to do, and we stressed again how important it is not to talk while wearing it either. I'm wondering if improper wearing of the appliance might be partially to blame, too, because I'm not staring at him the whole 2 hours that he is wearing it, obviously. I am going to observe him tomorrow and just make double sure that he is wearing it right. I looked back at the pictures I took to document, and I'm so glad I took pictures!!! He actually lost those teeth BETWEEN the consultation and the start of the appliance, so they were already starting to grow in when he started wearing it. There was definitely NO open bite at all before he started with the appliance. It's so hard to know for sure whether it's the appliance or him because he's 6. He does silly things sometimes, and he might be just playing with it or wearing it wrong or who knows what. I am going to diligently evaluate his wear tomorrow and maybe call the dentist again with my concerns if I determine that he is doing it right. I also want to make sure they are measuring IM width because I'd love to have that for comparison to know we're not narrowing the palate.
At first glance, this appliance looks useless and possibly a hindrance to your kid's growth.
Fortunately at 6 years old, he's young enough to correct his apnea and tongue thrust with just exercises. If you're not sure that you're familiar enough with Mewing to teach him the exercises yourself, bring to a myofunctional therapist to work directly with him. If you look up "myofunctional therapy" or "orofacial myology" with your town/state/area's name, you'll probably find a few therapists. If there none in your area, some of them do video chat therapy.
I’m so terribly sorry this happened. Myobrace lengthens the face... 2.5 mm average for a 10-year old. I’m only a mom, but can explain what’s happening. Unfortunately, many people don’t get it. Then we can talk about some options I am aware of! 🙂
MYOBRACE is a JOKE!! I literally called them to get info and the woman 👩 on the phone literally yelled at me!? I said I am looking to see if they will respond to customer issues by creating a better product and she said take it or leave it... it is what it is. Then she literally yelled at me that I researched for 6 months saying that waiting was the worst thing I could do! Just because I was researching, didn’t mean I wasn’t doing anything, I said. My concerns are exactly as this here!!!! I wish I recorded the call, because I said it is an offense to practice medicine without a license. Then she said she had a Myofunctional therapy certification and knows stuff. Then I said, then why are you telling me that Myobrace DOESN’T lengthen the face when your own website has research that shows it does? She said...well, I don’t know what you’re referring to. You should call them, record the call and Sue!
UPDATE: I talked to my son about what was going on with his teeth, and he admitted that he was moving the mouthpiece around in his mouth while wearing it. He's 6, so I get it. We talked about not doing that and trying to keep his tongue on the spot, push swallow, etc. both with the mouthpiece in and without. About a week later, I asked to see his teeth, and the open bite is clearly closing. I wish this forum didn't freeze every time I try to upload a picture. I asked what he was doing differently, and he said he wasn't moving it around in his mouth anymore. We have also been chewing falim gum consistently.
I would like the see the studies you're talking about (lengthening the face). It says Healthy Start on their website, but the appliance case says Vivos.
I appreciate you all taking the time to help and validate my concerns. It has been a really busy few weeks, so we have just been continuing using it and evaluating for now. It really has been helping their sleep issues, which was indicating for me that it's helpful. Am I wrong on that?
I'm going to try to attach an image of what the actual appliance looks like.
UPDATE: I talked to my son about what was going on with his teeth, and he admitted that he was moving the mouthpiece around in his mouth while wearing it. He's 6, so I get it. We talked about not doing that and trying to keep his tongue on the spot, push swallow, etc. both with the mouthpiece in and without. About a week later, I asked to see his teeth, and the open bite is clearly closing. I wish this forum didn't freeze every time I try to upload a picture. I asked what he was doing differently, and he said he wasn't moving it around in his mouth anymore. We have also been chewing falim gum consistently.
I would like the see the studies you're talking about (lengthening the face). It says Healthy Start on their website, but the appliance case says Vivos.
I appreciate you all taking the time to help and validate my concerns. It has been a really busy few weeks, so we have just been continuing using it and evaluating for now. It really has been helping their sleep issues, which was indicating for me that it's helpful. Am I wrong on that?
I'm going to try to attach an image of what the actual appliance looks like.
Cool. Good to get sorted out. I would be cautious of using gum!!! Dr. Mew did a 180 on this for a reason. He talked about jaw issues. Used to recommend this for kids, but no longer does.
I had not heard that chewing gum could affect vision! I will have to look into that. I thought it was good stimulation. Obviously they're not chewing it all day long, only an hour or so typically.
Sorry, I corrected that. Chewing hard things can negatively affect vision. Nobody will say this. This is just mama experience. Dr. Mike Mew used to recommend an hour a day. Truthfully, I wouldn't. Far less than this can shorten the face. The airway is not just behind the jaws.. but above the palate.
I was going to say that a bonded RPE can close an anterior open bite better than banded. That's because it's basically a rear splint. The issue with the width of the teeth may be from the teeth floating more forward. That's where they go... they float forward. If you want to move them back, there are ways to do that...
As you have found, kids faces are super, duper malleable and quite adjustable.
Thank you. Sorry, I tried to find my messages, but I'm new to the forum. You are welcome to message, and hopefully it will email me a notification where I can click through.
I cannot find the video where he 180'ed on chewing gum for kids. He definitely did following his own daughter doing that. He said about jaws... I don't have the reference. Sorry! Also... I sure wish he'd clean up his old videos where he used to recommend it.
The way to connect to anyone is "Personal Messages" > "New Message". I was thinking about your son this morning and wondered something...
If he was new to the device or not? So, basically, what I am pretty sure happened is this... (if newer to treatment)...
The jaw couldn't quite close properly so it was like a door jam on the bottom, inside corner of the ramus... then with growth his anterior portion adjusts. It would make the face approximately the distance longer of the device... a mm or two. (A nickel's width is 1.95mm). Anyway, it possibly could make the face longer with that where growth is extrapolated out.. but.. the body does some interesting things.
You are a good mom. This is hard stuff... and very nerve-wracking. I just wanted to say that. 🙂
BEFORE/AFTER (about 3 months with wearing mouthpiece)
and NOW
You can definitely see that it's closing again. Those side teeth could not touch before, no matter how much he tried. This progress is just from him not moving the mouthpiece around in his mouth anymore for the past 2 weeks. Just crazy how malleable little jaws are at 6 years old! Working on that tongue thrust still. If anyone has resources for YouTube videos or any exercises that would help, I am all ears!
Sorry, I corrected that. Chewing hard things can negatively affect vision. Nobody will say this. This is just mama experience. Dr. Mike Mew used to recommend an hour a day. Truthfully, I wouldn't. Far less than this can shorten the face. The airway is not just behind the jaws.. but above the palate.
I was going to say that a bonded RPE can close an anterior open bite better than banded. That's because it's basically a rear splint. The issue with the width of the teeth may be from the teeth floating more forward. That's where they go... they float forward. If you want to move them back, there are ways to do that...
As you have found, kids faces are super, duper malleable and quite adjustable.
I don't usually agree with darkindigo, but this is a fact: chewing will shorten the face. Be very careful, short faces are not ideal, especially as the shortening happens mostly in the dental area (teeth getting pushed inside the gums, so lower jaw becomes smaller).
BEFORE/AFTER (about 3 months with wearing mouthpiece)
and NOW
You can definitely see that it's closing again. Those side teeth could not touch before, no matter how much he tried. This progress is just from him not moving the mouthpiece around in his mouth anymore for the past 2 weeks. Just crazy how malleable little jaws are at 6 years old! Working on that tongue thrust still. If anyone has resources for YouTube videos or any exercises that would help, I am all ears!
You don't have the ability to go to an actual orthodontist? I've seen many orthodontist websites showing they do give exercises for children which do show great results.
There is one where a small piece of ice is pushed by the tongue upwards, repeated a few times. This is done at different areas on forward upper palate, middle upper palate, etc...
Obviously there is also the exercise where you just explain to a child how to properly swallow and then make him do it, simply mouth closed swallow against palate not against teeth.
This is an old post. Thankfully, his open bite did close after his bad habits were corrected. He has many grown up teeth now, and seeing his baby smile makes me sad!!! I miss it! His teeth are looking better, though. He's 8 now. He has been wearing the appliance overnight still, minimal daytime wear. Not the best angle, but posting an updated photo (best I can find at 5am). Lmk if anyone sees anything concerning. I'm still learning here!
Attaching some pictures of his actual face (not just the teeth) from different angles and expressions, order from older to most recent over the past year ish. He's a handsome boy! I open to hearing opinions on how the face structure looks and any concerns or red flags.
Hi! It is unlikely that you will be able to give qualified recommendations on the forum but judging by what you have. If you're worried, you'd better go to an orthodontist and show him your son's teeth. It is better to do this as early as possible because it is quite difficult to correct the situation if the teeth start to grow incorrectly. I can recommend an excellent orthodontist in Albany if you live somewhere nearby. I corrected my daughter's bite at this orthodontist and was very pleased with his services.
Any device can unexpectedly affect a child's teeth, so it is always necessary to consult with specialists. Although, sometimes, even they cannot foresee any consequences. A similar thing happened to my daughter. She wore braces for several years to straighten her teeth and bite. As a result, when she took off her braces, she had a hole between her front teeth, which greatly annoyed her. I had to wear braces again. Children are difficult to raise, so it's not so easy becoming a foster parent in oregon. We managed to achieve my daughter's desired result, but we had to pay extra for a second pair of braces.
