Myobrace® & Healthy Start™ For All Ages

We find that many patients have already developed a malocclusion by 3 years old and can tremendously benefit from an early interceptive orthodontic treatment using myofunctional oral appliances, like Myobrace® and Healthy Start™. We know the child will not need to wear retainers for life because their expansion will not collapse if it is completed before the age of 7. Therefore, we strive to get children into interceptive treatment while their jaws are still developing — ideally before the age of 6. Though the American Association of Orthodontists® generally recommends starting orthodontics at the age of 7, Dr. Roca feels the sooner we get a head start in correcting any oral habits that are creating the child’s malocclusion, the better the chance we can avoid future orthodontic treatment.

Myobrace and Healthy Start therapies are based on correcting the poor oral habits and patterns that are associated with poor jaw development and incorrect positioning of teeth. In this video below, orthodontist Dr. Barry Raphael offers a summary of the rationale for this approach.

In addition, it used to be quite common for treatment with braces or Invisalign to be delayed until all the permanent teeth are present, usually around the age of 11 to 14 years. At this time, 90% of jaw growth has been completed, and the window to intervene with poor habits to change a child’s trajectory of growth has been missed. On some occasions, other offices may recommend extractions of teeth to alleviate crowding and allow alignment of teeth. However, at Arlington Smile Center, we would never extract teeth to relieve crowding. Instead, we would make more room toward the front of the mouth. Patients who are retracted as children are normally suffering from severe apnea as adults, and we often end up reversing the retracted cases and making room for new teeth.

Growing evidence links poor jaw development (narrow palates and recessed lower jaws) to poorer airways and the development of snoring and obstructive sleep apnea. Based on the increased health risks associated with these problems, it can be a very rational option to optimize jaw development much earlier in life.

Myobrace and Healthy Start are worn for one to two hours every day, as well as overnight during sleep. The appliance teaches the child to breathe through the nose, rest the tongue in the correct position, swallow correctly, and keep their lips together. Since Dr. Roca is a certified oral myologist, she incorporates oral myology into each Myobrace and Healthy Start visit.

Children are born with the potential to develop jaws that can accommodate all 32 teeth. The exception would be those children born with a congenital syndrome or genetic disorder. We now know that the way the tongue rests and moves has a powerful influence on the development of the upper jaw. This is affected by a child’s oral habits and muscle functions, and whether they have a correct or incorrect breathing pathway. This will, in turn, affect how their genes and jaw development are expressed.

An example of correcting a crossbite early: A patient of ours started at 5 years-old. She always had her mouth open, always slept horribly and never fully rested. She developed a crossbite from her open mouth posture and her incorrect swallow and tongue tie.

Start stage I Myobrace. 12/3/2018

Only one month later. With stage I Myobrace worn 1 hour a day and all night, her cross bite is almost corrected. 1/27/19

Nine months of Myobrace. First two permanent teeth erupting into the correct position and crossbite. 10/24/19

This is one of our 7-year-old Myobrace patients. We did not use an expander.

1) Day one of Myobrace. Her two central lower adult teeth have erupted crooked and, as you can see, there is not room for the other adult teeth that need to grow in once the baby teeth fall out.

1) Day one of starting Myobrace. She had a very deep bite, and we could not see her lower teeth. The midline is off center with her nose, and there was no room for permanent teeth to erupt because the space was too narrow.

2) One month after starting Myobrace. Notice how her midline is centered, her deep bite is gone and there is now room for some lower anterior teeth to erupt straight.

3) After four months of Myobrace. Even more room for permanent teeth.

4) After seven months of Myobrace, she has plenty of room for new erupting teeth.

5) One year after starting Myobrace.

The Myobrace was worn only one hour a day and all night, allowing her to avoid the need for braces completely so far. There is no need for an expander. What’s amazing is that it was all natural! We are teaching the patient the proper tongue posture and the proper lip seal and swallow. She is on her way to a life of healthy teeth that will not suffer and no orthodontic relapse.

This is another one of our 7-year-old Myobrace patients.

The start of Myobrace, age 7.

After three months of Myobrace stage I and three months of Myobrace stage II.

A total of eight months in Myobrace, no expander at all.

These are the results on our 8-year-old patient after just three months of stage I Myobrace.

Before

Three months later.

Before

Three months later.

Early Treatment is critical. Nine out of 10 kids have sleep-disordered breathing!

One problem we have found is that some people undergoing orthodontic treatment have not been concurrently addressing the accompanying myofunctional and postural patterns. The end result is a bite that may be “straight and aligned” but the rest of the body is not. The bite and the body “mismatched” creating stress and strain with a life time of neck and body pain.

It is important that you recognize that the way our teeth touch  and create specific chewing patterns that induce muscle hyperactivity in the orofacial region, of the plantar flexors of the foot and of the cervical muscles. These same muscles indirectly and directly regulate breathing patterns and compensation necessary for unilateral postural dominance.  If we see asymmetry in the face that we can’t easily release with treatment or we see difficulty getting the diaphragm fully engaged, we will need to refer you out to collaborate with other postural, respiratory or physical therapists that understand the connection between mouth and body. Remember, form follows function.

The body’s is designed with a natural asymmetry of the internal organs. This asymmetry is intended to compensate for bilateral symmetrical activities such as walking, but the result is that each person will adapt to their posture in response to this asymmetry. Some will slouch forward, others become hyper-erect and others may favor one side over the other. Problems only occur when a person cannot leave this pattern of posture and become “locked” into whichever posture they initially preferred. This “locked” body position leads to a loss of many references for healthy function.

Through coaching and specifically targeted exercises patients can gradually begin using muscles they have not previously used in postural support, and over time posture issues can be corrected until the patient no longer needs to use these targeted exercises.

Depending on how strong the unhealthy postural pattern is engrained and how committed the patient is to the home program prescribed, Integrative Postural Therapy can be absolutely life-changing.  Please see the videos’ reference to a physical therapy specific program on breathing and posture that we regularly work with during your treatment for the best results.