It Starts at Birth
A few years ago, I was looking at one of the parenting magazines and noticed an ad from my colleagues at the American Association of Orthodontics. It was an image of a pregnant woman with the phrase, ‘It’s never too early to think about your child’s orthodontics’ directly above it. I remember rolling my eyes and thinking, ‘Oh, come on. You’re really stretching it now. Orthodontics? For an infant?’ I had no idea that in the very near future, after years of practice, observations, and teachings, how true that statement would be for me, and how it would come to represent my philosophy of practice as an orthodontist and pediatric dentist. Of course, I don’t think the ad was referring to the holistic treatments I practice and teach, but it did awaken in me an understanding of the importance of early intervention for children, even infants. In this article, I will only concentrate on the frenulum and pacifiers. I will talk about other factors such as airways, nutrition, emotions, musculoskeletal problems, as well as myofunctional problems and their relationship with jaw development.
Starting Early
In utero, we know that a mother’s nutrition, physical activities, stress levels, and where the baby sits can significantly affect the growth of the cranium, jaw, and every other bone in the body. There are many ways that orthodontists/dentists can educate expectant and new mothers to ensure the skeletal and dental formations for their children are strong and optimal. Simple prevention and early treatment can help parents avoid serious problems for their children later on.
I remember during ultrasounds for both of my pregnancies, I would be sure to check my baby’s facial development. I commented to my husband after seeing one of my daughter’s ultrasound images, “Oh no! Her mandible is pushed back.” My concern startled the OBGYN. She laughed for a minute or two and after composing herself assured me not to worry because, “mommy could fix that as soon as she comes out.” What she didn’t realize was the effort I went to, including osteopathy and chiropractic treatments, as well as working early with a midwife, to prevent cranial and mandible (jaw) issues in my baby.
Tiny Causes, Big Problems
A couple of weeks after I gave birth to a beautiful, healthy baby girl, I started noticing some problems. She was having trouble breastfeeding properly, difficulty with her bowel movements, and feeling some pain when she would turn her neck in a certain way. Others might not have thought much of these subtle symptoms, but my training in osteopathy and pediatric issues allowed me to pick up on them. After consultations with several different specialists from osteopaths, pediatricians, lactation consultants, and many others, I said to my husband, “I think it’s her frenulum. We need to do a frenectomy. I’ve only been the mommy up to this point, but now I think I need to have my doctor hat on. This is my area of medical specialty, after all. I really believe these symptoms are all related, and it will change with a frenectomy.”
Immediate Improvement
So, after enough doctor visits and second guessing myself, I finally broke down and called my assistant, asking her to come to my home and assist me with a frenectomy for my daughter. At just four weeks old, it is a very simple procedure, and with osteopathic palpating I can feel the body and know just how much it needs to be released.
My daughter cried for maybe 2-3 seconds and then…her whole face opened up. She started breastfeeding and for the first time, it didn’t feel like electrical shocks were surging through my entire body. In a matter of days, her bowel movements became regulated to 1-2 times per day. Before the frenectomy, she was having a bowel movement every 4-5 days, and I was told it was normal!
Her vertebrae started stabilizing after osteopathic treatments. In addition, her mandible was released and came forward significantly as it was previously held back by the upper jaw, which was held back by the frenulum. As the physical changes continued to come, what my husband and I noticed even more was the dramatic change in her energy level.
In the midst of rejoicing all of these wonderful improvements in our daughter, we had to ask ourselves, “What if we hadn’t known about this simple solution that’s the cause of so many bigger problems for children later in life? What would her life have been like?” Because she would have had to work so hard just to be fed at the breast, maybe she would have grown up with the subconscious belief that life is hard. Perhaps she would have believed that even meeting her simplest need was too much of a struggle, or that she could never find a way to be satiated by life.
It is my belief that there are simple healthcare choices we can make for our children that will positively affect their consciousness and ultimately how they receive life in general as adults.
There’s a scientific theory called the Law of Sensitive Dependence on Initial Conditions. It basically means that it’s always the action that requires the least amount of effort that carries the most power to change the outcome; like how moving a pawn on the chessboard can suddenly change the entire outcome of the game. A frenectomy was a simple choice that made a profound change for my daughter and now, life is a game she can win.
What is frenulum?
Connecting the upper and lower lips to the gums and beneath the tongue is a thin band of tissue known as a frenulum (frenula for plural). Its function is to anchor the jaw in place and provide stability. If any of these bands is too tight, it can restrict the mobility of a baby’s mouth, lips, and tongue, and even inhibit the proper growth of the jaws. The first clue that a baby may be dealing with a rigid frenulum is its inability to breastfeed correctly or at all. If he doesn’t have full mobility of his mouth and tongue because of this restriction, he will not be able to latch onto the breast properly. The vast majority of doctors think nothing of this telltale sign and instead, suggest formula and bottle-feeding as the answer.
Missed Opportunities
Since the cranium, including the jaw, is a single unit, the muscular tension caused by a tight frenulum affects all the other bones that come into contact with it. This includes the neck vertebrae, which can become misaligned because of the irregular way the muscle is being pulled. In addition, if the tongue is not resting in the proper place inside the mouth because of frenulum tension, the mechanics of suckling can’t be properly performed. Incorrect or partial attachment to the breast means the baby cannot get adequate nourishment. Signs of insufficient attachment include getting too tired after feeding for just a short time or making clicking sounds while feeding. If the baby isn’t properly attached to the breast and receiving the correct amount of breast milk, the body doesn’t receive the signal that a meal is coming. Ultimately, peristalsis in the abdominal muscles doesn’t happen properly and the baby eventually experiences constipation.
Latching onto the breast isn’t just important for feeding; it provides other essential benefits for mother and child, too. Not only does breast milk fortify the immune system like no other food, but the sucking motion itself acts as a pump to move cerebrospinal fluid through the baby’s system, bathing and fortifying the chakras (physical energy centers) and establishing a sense of safety and wellbeing in its subconscious. As long as a mother continues to breastfeed, oxytocin, the “love hormone” that establishes the bonding and need for protection between mother and child, continues to be produced, as well.
If you choose not to breastfeed, don’t produce enough milk, or cannot for some other reason, there are other ways to support your child to achieve the above results and signs you can look for to identify a rigid frenulum. Some additional indicators are lips that aren’t pliable and pull away from the gums easily. Babies who cannot protrude their tongue often have tight frenula. Later, speech impediments can be a clue, too.
Problems with Older Children
If any of the frenula are too tight, particularly below the tongue and behind the upper lip, the jaw growth continues to be held back and the misalignment creates musculoskeletal strain for the entire body. The result could be a mouth that doesn’t have room for all the teeth that are coming in, gummy smile, restricted airways due to the jaw not being able to move forward properly, speech problems, improper swallowing, or a combination of all of these issues. As the teeth overlap because of crowding, parents naturally rush to get braces for their children. Because most orthodontists do not see children at birth, they never consider the frenulum to be the cause of disturbances in cranial rhythm, or any of these other problems that don’t seem connected at first glance. Sadly, after the cause of these problems goes undetected for years, an orthodontist will only address the issue if the child has a gap between the upper teeth. In this case, the doctor will surgically remove the frenulum with a laser, usually right before or after braces are removed. By this time, the child is 12-15 years old and the malformations of the jaw and cranium (skull) are on their way to becoming permanent.
Catching it earlier is always better, especially with regard to breastfeeding options, but a child’s oral growth plate continues to move and change through about age 12. Still, the sooner the correction can be made, the better.
Thumb or Pacifier?
After speaking with many osteopathic doctors, holistic OBGYNs, and midwives, I am of the belief that infants are aware of their own cranial issues and suck their thumbs to adjust their craniums on their own while in utero, and especially after birth. It’s a self-healing and intuitive way of treating the body. Of course, after only a couple of months, it also becomes a way to sooth and calm themselves. The only problem with sucking the thumb is that it’s too narrow. As it spends more and more time in the mouth, it narrows the upper palate, the sinuses, and airway passages. This forces the upper jaw and teeth forward, creating “buck” teeth, cross bites, TMJ, and recurrent sinus infections.
When my son was born, as soon as the thumb made its way to his mouth, I took it out and replaced it with a pacifier. Choosing the right pacifier is very important. The pacifiers given by hospitals, usually called “soothing pacifiers” are only good for the first couple of weeks after birth and in the event there is any nipple confusion. After that point, they do the most damage by significantly narrowing the palate and creating an open bite. The best pacifiers have one flat side and one bulbous side. I personally prefer the Nuk brand silicone pacifiers. I also like the non-latex and BPA-free models, too. It’s also important to change the size of the pacifier as the child grows and based on the current age. Regardless of the type of pacifier you’re using, I recommend stopping usage by age 2 ½. At that time, the child should be equipped with other ways to soothe itself during bedtime. If you’re having trouble making this transition with your child, ask for help from your pediatric dentist, myofunctional therapist, or healthcare provider.
