Rock, Paper, Scissors is a game most kids still play. Just like scissors beats paper, the orthodontic version of that game finds muscle beating bones and wires every time.
This was known over 100 years ago, ignored for most of my career, and is only now finally coming to light again.
Poor rest oral posture, often seen as “mouth breathing,” was recognized in the 1800s as a causative factor of unfavorable facial growth.
Orthodontists in the early 1900s published articles on the dental and facial effects of poor oral posture and advocated correcting it to help children grow more favorably. Mental retardation was even noted as an outcome of poor growth linked to poor posture.
By the time I was a child in the 1950s, orthodontics was becoming mainstream and not just for wealthy children in big cities. Kids were getting braces and all were given retainers to wear forever to hold the movements the orthodontist had created.
I was treated in 1958–59 and faithfully wore my retainers until I decided they weren’t helping. My teeth shifted slightly afterward. Among my friends, it was common knowledge that teeth would move if you stopped wearing retainers. Kids then were no more faithful with retainers than they are now.
My orthodontist told me I had a “tongue thrust,” which was wrongfully associated with anterior open bite. No remedy was suggested. My entire treatment was mechanical—removing teeth and using wires to align the rest.
When I began my training in 1972, I was taught the same approach and told to instruct patients to wear retainers full time for a year and then at night for life. Thanksgiving breaks often brought patients back from college saying, “My retainers don’t fit.” Since retainers do not change shape, you can guess what the real issue was. Muscle balance wins every time.
Myofunctional therapy was mentioned briefly in my residency but only negatively. Dan Garliner was cited as a proponent of myo, but we were told his work was “charlatanism.”
We were taught that what we did as orthodontists mattered more. Myo was dismissed entirely.
By 1981, I had serious doubts about everything I had been taught. I began a CE journey that continues to this day.
I learned how poor rest oral posture impacts facial growth, airway size, health, and even longevity. I met myofunctional therapists like Joy Moeller and Barbara Greene who were changing lives. I began referring patients daily for myofunctional treatment. I lectured to myofunctional therapy organizations.
I even came to believe myofunctional therapists are more important to overall health than I am.
The truth is simple: muscles win and wires lose.
Instead of tens of thousands of orthodontists, we need hundreds of thousands of myofunctional therapists to help children become nasal breathers and thrive.
