Hi all,
I've been looking for evidences about the effectivity of orthotropics and orofacial myofunctional therapy without much success. Indeed, what I find is that, according to Tessitore-Crespo [1], the type of occlusion and the breathing pattern don't correlate with the tongue rest position. Actually, what they claim is that, independently of breathing pattern and occlusion type, the predominant tongue resting position is the one with the apex lowered and the dorsum raised (which is similar to Moyers' proposal, but not identical, I think)
Looking further into the literature, it seems that the term "tongue resting position" was introduced by Cookson [2], which also supported no correlation at all (there are publications dating older, 1949, referring to it as "normal tongue position" [8]).
The current covenant about the correct tongue position (the first anterior third touching the incisive papilla) seems to come from Altmann [3]. However Moyers [4] defined it differently, the apex touching the incisive papilla, the upper incisors or the lower incisors and the dorsum touching the hard palate. In both cases, the method to reach such claims was not given.
There is some research supporting the relation between the tongue rest position and the overall mandibular growth and occlusion type. For instance, [5] claims that the position of the apex of the tongue correlates with mandibular deformations. There are also other references listed in [1] and [6]. However one should notice that it's difficult to access the tongue position of the cohorts even by using radiography (for instance, some reports don't use contrasts and others don't even use radiography)
For an overview of the current bibliography about tongue posture check chapter 3 of [1] and chapter 2 of [6].
Regarding orofacial myofunctional therapy, [7] claims that the current research is insufficient to decide whether orofacial myofunctional therapy in addition to orthodontics leads to a better result instead of only orthodontics.
So, in summary, no one knows for sure the optimal tongue resting position.
[1] http://repositorio.unicamp.br/handle/REPOSIP/313726
[2]COOKSON, A .M.Tongue resting position. A method for its measurement and correlation to skeletal and occlusal patterns. Pract Dent Rec.v.18, n.3, p:115-20, Nov .1967.
[3] ALTMANN, E.B.C. Deglutição Atípica. In: Fisioterapia, Fonoaudiologia e Terapia Ocupacional em Pediatria, São Paulo, Sarvier, 1990, p.117.
[4] MOYERS, E.R. Diagnóstico.In: Ortodontia, 3. ed, Rio de Janeiro, editora Guanabara Koogan, p.172-173, 1991.
[5] GRABER , T.M.; RAKOSI, T.; PETROVICK, A.G.. Análise Funcional. In: GRABER, T.M.; Graber , T.M.; RAKOSI, T.; PETROVICK, A.G.. , Ortopedia dentofacial com Aparelhos Funcionais. 2.ed. Rio de janeiro: Guanabara Koogan S.A., 1999, p.139-143
[6] http://tede.metodista.br/jspui/handle/tede/1243 (freely available at http://livros01.livrosgratis.com.br/cp028343.pdf)
[7] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4296637/
[8]WRIGHT, C. R. et al. A study of the tongue and its relation to denture stability. J Am DentalAssoc,v.39,p.269,1949.
it may not be scientifically proven buts its pretty obivioulsy has a big affect on breathing, my step dad had average tongue posture then he broke his jaw and had to drink meals for months, now his tongue almost just sticks out of his mouth, now hes always breathing heavy out of his mouth he has terrible forward head posture now
where your tongue is postiioned affects your posture massively and your posture affects breathing
Regarding orofacial myofunctional therapy, [7] claims that the current research is insufficient to decide whether orofacial myofunctional therapy in addition to orthodontics leads to a better result instead of only orthodontics.
Well they are not wrong. There is a severe lack of good research regarding occlusal & craniofacial development. While the academia is struggling to determine whose dogma is the superior one, people who already know what works for them will continue on making improvements. In the light of what individuals in this community (and others) are achieving, saying that no one knows what the optimal tongue resting position is is not fair. Do not mistake ignorance of the academia with ignorance of the people. The academia is so heavily invested in their dogma that they will resist every paradigm shift to their last breath. This is not necessarily a bad thing, but it means that you may never be able to help yourself unless you are willing to swim against the current.
There is plenty of literature available that heavily implies that tongue posture is correlated to with occlusion and mouth/nose-breathing, to the point where any reasonable person would come to the very same conclusions we've come to, given the available information.
You're 100% right that you won't find many studies that correlate tongue posture *specifically* and in particular to these conditions, but the implications of mouthbreathing (poor oral/tongue posture) vs nasal breathing (more than likely proper oral/tongue posture) are readily apparent. Also, consider how difficult it is to study the a single, multi-variate and almost unquantifiable, ongoing habit's (tongue posture) effect on occlusion and craniofacial growth (in morphologically diverse individuals presenting different degrees of severity, no less) in a statistical analysis and then ask yourself why the research on that specific subject is limited and the jury (academia) is out on an actual conclusion.
We can reasonably derive all of the information we need to ascertain proper tongue posture from existing data/literature, and even just by looking at the face of an individual with well-developed jaws and drawing assumptions from there. Mouthbreathing has a clear link to transverse maxillary deficiency, a high palatal vault, maxillary retrusion, and other indicators of craniofacial dystrophy. It's likewise already well-established scientifically that wide palates, forward growth of the maxilla -- and if we're getting technical -- desirable cephalometric indicators are all more prevalent in individuals who nose-breath and hence, more than likely have proper oral posture. As to what "proper" oral posture is, have you seen any of these well-developed individuals with hypertrophied buccinators and moon-faces? No. We can reasonably then assume that they have a proper, adult swallowing pattern which at the very least requires the engagement of the posterior tongue on the soft-palate, regular engagement of which implies habituality and the ability to continue to practice this habit unconsciously, even in sleep. Likewise, do you see any of these individuals with a protruding hyoid/drooping submental region at rest? Also no, because the posterior tongue is glued to the soft palate. Where does the anterior tongue rest then? Most likely, as far forward as possible in order to pull the rest of the tongue out of the lower airway so that they can BREATHE. There's likewise been plenty of dentofacial orthopedic FEM's conducted showing that an applied force on the anterior maxilla/palate has a positive effect in terms of counter-clockwise rotation of the maxillary complex, i.e forward and upward growth and desirable aesthetic outcomes.
There's plenty more evidence in support of what we believe to be proper oral posture and force application by the tongue, but I don't want to continue writing this novel, nor do I want to spoonfeed.
Regarding orofacial myofunctional therapy, [7] claims that the current research is insufficient to decide whether orofacial myofunctional therapy in addition to orthodontics leads to a better result instead of only orthodontics.
Well they are not wrong. There is a severe lack of good research regarding occlusal & craniofacial development. While the academia is struggling to determine whose dogma is the superior one, people who already know what works for them will continue on making improvements. In the light of what individuals in this community (and others) are achieving, saying that no one knows what the optimal tongue resting position is is not fair. Do not mistake ignorance of the academia with ignorance of the people. The academia is so heavily invested in their dogma that they will resist every paradigm shift to their last breath. This is not necessarily a bad thing, but it means that you may never be able to help yourself unless you are willing to swim against the current.
Unfortunately, this does not imply that the correct tongue resting posture can be precisely determined for each individual. It could be that for some people, for instance, only a higher dorsum and a lower apex would lead to aesthetical benefits as opposed to a plastered tongue on the palate. Also, in some people, the environmental causes may not be significant compared to the genetic inheritance whatsoever.
The reports that I see elsewhere by orthodontists are that orthotropics, in some individuals, may lead to a perfect result, while, in others, it may result in a catastrophic relapse. Most of the papers, if not all that I've seen published by the Mew's, seem to lack significant measurements and always assess only a small sample (usually few individual cases).
I think that orthotropists are underestimating the significance of the genetic inheritance. However I would certainly like to find out that my pessimistic suspicions are wrong or, at least, that, in my case, the environmental effects would be enough to engender significant changes.
On the other side, I'm well aware about the prejudice in researching alternative methods and I would certainly like to see conclusive results without any p-hacking and a good amount of data.
There is plenty of literature available that heavily implies that tongue posture is correlated to with occlusion and mouth/nose-breathing, to the point where any reasonable person would come to the very same conclusions we've come to, given the available information.
You're 100% right that you won't find many studies that correlate tongue posture *specifically* and in particular to these conditions, but the implications of mouthbreathing (poor oral/tongue posture) vs nasal breathing (more than likely proper oral/tongue posture) are readily apparent. Also, consider how difficult it is to study the a single, multi-variate and almost unquantifiable, ongoing habit's (tongue posture) effect on occlusion and craniofacial growth (in morphologically diverse individuals presenting different degrees of severity, no less) in a statistical analysis and then ask yourself why the research on that specific subject is limited and the jury (academia) is out on an actual conclusion.
We can reasonably derive all of the information we need to ascertain proper tongue posture from existing data/literature, and even just by looking at the face of an individual with well-developed jaws and drawing assumptions from there. Mouthbreathing has a clear link to transverse maxillary deficiency, a high palatal vault, maxillary retrusion, and other indicators of craniofacial dystrophy. It's likewise already well-established scientifically that wide palates, forward growth of the maxilla -- and if we're getting technical -- desirable cephalometric indicators are all more prevalent in individuals who nose-breath and hence, more than likely have proper oral posture. As to what "proper" oral posture is, have you seen any of these well-developed individuals with hypertrophied buccinators and moon-faces? No. We can reasonably then assume that they have a proper, adult swallowing pattern which at the very least requires the engagement of the posterior tongue on the soft-palate, regular engagement of which implies habituality and the ability to continue to practice this habit unconsciously, even in sleep. Likewise, do you see any of these individuals with a protruding hyoid/drooping submental region at rest? Also no, because the posterior tongue is glued to the soft palate. Where does the anterior tongue rest then? Most likely, as far forward as possible in order to pull the rest of the tongue out of the lower airway so that they can BREATHE. There's likewise been plenty of dentofacial orthopedic FEM's conducted showing that an applied force on the anterior maxilla/palate has a positive effect in terms of counter-clockwise rotation of the maxillary complex, i.e forward and upward growth and desirable aesthetic outcomes.
There's plenty more evidence in support of what we believe to be proper oral posture and force application by the tongue, but I don't want to continue writing this novel, nor do I want to spoonfeed.
Could you, please, cite the plenty of literature that you are referring to? I mentioned some old papers showing positive correlation, however the collection of the data was not very reliable in most of these studies.
@fgyamauti thanks for the contribution to the forum. Your initial post didn't quite ask anything. It just sort of makes a statement against the forum that seems inflammatory.
That's fine though. My approach to this has been to imagine myself at the time when braces first appeared. I'm 100% sure there was doubt and that all the first patients were essentially experiments and highly incredulous. Of course, as humans I can completely understand the "intuition" that we must be fixed externally instead of fixing ourselves from within. Both approaches work in my mind but only in combination.
Well, imagine being around at the time braces were created. Would you believe in them? Would you say "there's no research that braces will correct straight teeth permanently?" Sure, you probably would because...well there wouldn't be any. Maybe a few years after braces you'd say "well it's debatable whether or not their teeth have been straightened or not and look at that, they need retainers to maintain the results, their teeth aren't stable all the time" Then after a few decades they've become accepted as the de facto method of straightening teeth, even with their drawbacks that seem to be well understood by now. (longer faces, retruded jaws) And now we've pretty much accepted that braces work due to so much history and the biological processes that we've used to explain their effectiveness such as bone-remodeling but there has been no optimal use of braces defined that would align everyone's teeth just right.
Anyway, my point is that with the relatively small amount of effort by a small set of individuals, plus a concerted effort by the status quo to maintain the status quo (whether intentionally or through inertia), I can understand the lack of evidence you highlight.
I'm not a dedicated researcher myself so I do commend you for looking through the literature. I admit that I'm following my gut instinct, primarily based on personal experience and observation of others with similar issues. I AM an athlete to a degree. I enjoy staying in shape. If someone told me, now as an adult, that exercise and muscle tone doesn't affect posture I'd laugh in their face. If someone told me that a child that grows up with exercise will develop the same as if they didn't start exercising until their 20s...I'd laugh in their face. Of course the child that exercises will have extreme differences from their other counterpart that starts to exercise in their 20s. The hard part is proving it. You can't. The best you can do is twins and the Mews have done a few twins and shows the differences in treatment.
Well, so your statement still stands: "So, in summary, no one knows for sure the optimal tongue resting position."
I think your statement is true, given all I've said. I think it's true because this whole thing is experimental and we have human variation aside from genetics. I would be most curious of we could take well understood genetics, bone remodeling concepts, and a computer simulation to maybe guide this discovery into tongue posture and how it affects development from birth.
In closing, though there is a lack of substantial evidence, my inner athlete tells me that the degree to which've I've developed my throat muscles, tongue muscle, cheek muscles, etc will affect the way that my skull bones grow, which include my teeth and all the rest.
Excuse the typos.
I agree, I think its healthy to acknowledge that were basically grasping for any semblance of a solution to a very complex issue. Personally the reason I believe in mewing is because it seems to follow the philosophy of ockham's razor. It makes no sense for such a rapid change in human facial structure to take place without a strong environmental cause. Mewing so far has been the only theory that I've been able to notice in my daily life anecdotally.
Aside all that good posture and good tongue posture are inherently harmless and net positives even if vanity is the only reason I'm even trying