212 Linden Drive, Suite 150
Winchester, VA 22601
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Dentofacial Development

Drawing of boy sucking thumb and effects of thumb sucking on teeth

Why is my child’s dentofacial development important?

Parents are naturally concerned with the overall health and wellness of their growing children. Your child’s current and future health and wellness are directly linked to the growth and development of his or her face and mouth during the formative childhood years. It is therefore important to begin at an early age with regular evaluation of the skeletal and muscular structures that support the mouth and the airway.

How can I ensure that my child’s dentofacial development is proceeding normally?

At Winchester Dental, we work in conjunction with pediatricians and otolaryngologists (ENTs) to correct and ensure the proper craniofacial (dentofacial) development of our young patients. When this development proceeds properly, a child’s airway and temporomandibular jaw joints can develop normally.

What does orthopedic correction involve?

Dentofacial orthopedics involves gentle, gradual repositioning of the facial bones to maximize airway space and skeletal development. This process is minimally invasive and highly preventative, and our team has extensive training in this field. We evaluate children according to these criteria:

Airway Issues

If your child…

  • sleeps in an abnormal position, propped up with pillows or with her head off the bed…
  • breathes through his/her mouth instead of breathing nasally…
  • snores loudly and/or often…
  • stops breathing at night for 10-20 seconds at a time, and then chokes, gasps, or awakens…
  • sweats profusely during sleep…
  • sleeps restlessly…
  • wets the bed…
  • has difficulty awakening even though he or she has slept long enough…
  • suffers headaches during the day, especially in the morning…
  • becomes irritable, aggressive, or cranky…
  • falls asleep or daydreams at school or at home…
  • has school-related or other behavioral problems…
  • has ADHD (Attention Deficit and Hyperactivity Disorder)…

…these may be indications of dentofacial development issues.

Daytime Sleepiness/Irritability

Is your child unnaturally sleepy or irritable during the day? Compromised nighttime breathing may lead to poor sleep quality. This can, in turn, lead to daytime fatigue and irritability. When the underlying breathing issues remain uncorrected, children may develop learning difficulties, hyperactivity, inhibited growth, and even ADHD.

Dental Arches

Is there sufficient space for the tongue? Are the arches developing the prescribed wide horseshoe shape, or a compromised narrow V shape?

Dental Crowding

Is the palate too narrow? When this is the case, permanent teeth are frequently blocked due to insufficient eruption space. An overcrowding condition will result and may affect a child’s appearance, chewing ability, and/or speech clarity.


Does the child suffer frequent earaches? These may occur when an underdeveloped upper arch traps the developing lower arch, causing it to impinge on the ear canals.

Facial Profile

Is the child’s lower jaw recessed? This may indicate improper orthopedic development.


Does the child suffer frequent headaches or neck aches? These may occur when compromised facial bone development causes strain on facial muscles.

Mouth Breathing

Does the child breathe habitually and noticeably through his/her mouth? This indicates an airway issue and improper orthopedic development.

Oral Habits

What are the child’s oral habits? Thumb-sucking or finger-sucking, or long-term use of a pacifier or baby bottle, can affect the shape of your child’s jaw bones and the position of his/her teeth.


Does the child snore? Snoring is generally associated with mouth breathing, and may indicate reduced oxygen intake during sleep. It sometimes results in increased blood pressure and is sometimes associated with sleep apnea, a dangerous condition during which a sleeping individual repeatedly stops breathing momentarily.


Does the child suffer symptoms such as headaches, aching neck, ringing in the ears, and sinus problems? These symptoms may indicate TMD (temporomandibular joint disorder). The temporomandibular joints are found just in front of the ears, connecting the jaw bone to the skull. Within a TMD, a malocclusion (bad bite) and its resulting muscle strain may eventually lead to a musculoskeletal dysfunction of the head and neck. Left untreated, TMD can affect the entire muscular and skeletal system.

What can orthopedic correction do for my child?

Once we have evaluated your child, we will advise you on a course of treatment specifically designed to promote his or her proper and optimized growth. We may recommend that your child wear a customized functional appliance that will widen the upper dental arches and control his or her musculature while it correctly positions the lower arch. This will help improve the child’s nasal breathing by widening the nasal turbinates, and will correct existing vertical overclosure or narrow facial development. It will also create ample tongue space, permitting proper tongue positioning. The appliance may also work to reposition the teeth in order to maintain the orthopedic corrections.

What are the benefits of early evaluation and treatment?

When we evaluate and treat a child early enough in his or her dentofacial development, the benefits are many and may include:

  • An improved facial profile
  • Elimination of snoring
  • Fewer earaches and headaches
  • Healthy, comfortable jaw joints with effective, painless chewing
  • Improved cardiovascular health
  • Improved confidence and self-esteem
  • Lifelong airway improvements
  • Restoration of restful nighttime sleep and daytime attentiveness
  • Reduced speech impediments