I started practicing correct tongue posture at the beginning of my orthodontic treatment a few years ago, and since the removal of my braces I've been working to correct a slight tongue-thrust after completing myofunctional therapy. One of my goals is correction of facial asymmetry, but it seems that my face is more asymmetrical now than it was a few months ago.
I've known that the right side of my face (specifically my eye and cheekbone) has always been 2-3mm lower than the left, and more recently I've come to suspect that the tight platysma and sternocleidomastoid muscles on the right side of my neck (and whole body for that matter) are partly responsible. I've begun regular stretching of my neck and home-traction sessions using a suspended towel, and it seems that I've made some progress with general palate expansion and opening of my nasal cavity (i.e., easier nose-breathing). However looking in the mirror it appears that the right side of my face is expanding outward but not shifting upward. That is, there is more distance from my nose to the outer edge of my cheekbone on the right than on the left, in addition to the cheekbone being lower on the right.
Would these changes be ultimately self-correcting, or are there further steps I should be taking to encourage the upward shift of my right maxilla? With my tongue I can detect an asymmetrical curve to the roof of my mouth, and often I focus my mewing/tongue pressure on the right side - which may be helpful or detrimental, I'm not sure.
My MFT is a physical therapist by trade who doesn't believe palate expansion is possible for adults. Also there are no dentists or orthodontists in my state (much less in my area) familiar with orthotropics or this new way of thinking. Thus having impressions or regular x-rays done to track progress may well be impossible. Any feedback on whether I should be concerned about this worsened asymmetry and what to do about it would be appreciated.
To my current understanding, the side that is more outward and lower has more clockwise rotation (clockwise on a profile that is pointing to the right). CCW rotation is what leads to the appearance of a more compact face, and contray to what many think, this rotation should not necessarily create forward movement. I have been battling with similar issue, and I suspect I am close to figuring it out. I just wrote more about this in another thread: /community/community/case-discussions/progress-of-progress-two-year-skull-change/paged/2/#post-19750
In your case, this would mean that you need to learn to activate the lateral pteryoids on your right side by jutting the mandible forward in a certain way. You may notice that such jutting balances out the tongue posture in an anatomically pleasing way.
Thanks...I think I understand what you mean by CW and CCW rotation; I just haven't thought of it in these terms. As for pushing my mandible forward "in a certain way", I suppose you mean forward and slightly to the right? Your explanation makes sense but my concern is over-activating my masseters, as their over-development was a hindrance to bite correction in the beginning and may lead to pulling my jaw backward and un-correcting my bite (i.e., so that my molars make contact first as they did before braces). Or does activating the pterygoids in turn cause the masseter to relax?
The masseters are responsible for closing the jaw, the pterygoids are kind of opposite to the masseters: they open the jaw and bring it forward... or to the sides, if activated individually. So you should be able to avoid activating the masseters.
That's what I had hoped...So if the pterygoids are "pushing" rather than "pulling" muscles (as most seem to be), I would think I need to push my mandible to the left rather than the right - ? I've tried both directions and it's hard to tell so far which motion activates the right pterygoid.
I think that's correct, the left pterygoid is responsible for shifting the mandible to the right and vice versa. You can palpate the pterygoids by putting a finger on the cheek below the zygos near to the molars. Ultimately you would of course want a somewhat even activation of both.
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