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Natural Awakenings SW PA, Greater Pittsburgh

Health in a Smile: A Holistic Solution to Impaired Mouth Syndrome in Children

Dec 30, 2022 09:30AM ● By Brooke Goode
Two children with impaired mouth syndrome

Rick/AdobeStock.com

One of the first things we notice when we meet someone is their smile, so it is easy to understand why children with crowded teeth might be self-conscious when they encounter new people. But the condition is not just a cosmetic concern. “Teeth crowding are surface markers of structural chaos below,” says Felix Liao, DDS, author of Your Child’s Best Face: How to Nurture Top Health & Natural Glow. Dental crowding results from a deficiency in jaw growth, which can contribute to a partially stunted face, narrower airway, poor sleep and consequent learning and behavior problems. 

According to a recent medical research review, its prevalence among children and adolescents is up to 84 percent. Fortunately, parents can take steps to nurture healthy dental/facial development in their children so that there is enough room for all 32 teeth to line up straight and for the tongue to operate between the two jaws without occupying the airway.

Crowded teeth are the tip of an iceberg called Impaired Mouth Syndrome (IMS), a term coined by Liao in 2017 for a wide-ranging set of medical, dental and mood problems in children, from sleep and growth disturbance to respiratory infections and poor focus. According to a 2013 study by the Stanford Sleep Center, “Pediatric obstructive sleep apnea in non-obese children is a disorder of oral facial growth.”

IMS is an all-too-common condition that often goes undiagnosed, untreated or incorrectly treated. The result is a child that falls short of their full genetic potential and an adult that suffers recurring pain and fatigue. An underdeveloped maxilla—the upper jaw that also forms part of the nose and eye socket—can lead to a litany of symptoms, including teeth grinding, a weak chin and jaw pain, and may also impact the appearance of the face, causing imbalanced features. By contrast, a well-developed facial structure will support better breathing, sleep and postural alignment, and benefit from high cheekbones and full lips.

“Rarely does managing symptoms result in a healthy child,” says Ben Miraglia, DDS, a board member of the American Academy of Physiological Medicine & Dentistry. IMS symptoms improve when the jaws are activated to grow to their full potential. This is now possible with a partnership between parents and a new breed of dentists known as Airway-centered Mouth Doctors (AMD) that receive specialized training on the syndrome and its treatment.

These specialists work in the realm of whole health, looking at the interconnectedness of the body rather than individual body parts in isolation. They collaborate with other doctors and therapists, including myofunctional therapists that devise exercises for the mouth muscles and encourage nasal breathing. AMDs also work with dietitians to devise a bone-building diet free of the toxins, pollutants and chemicals found in processed foods that can impair normal facial development.

AMDs approach the condition without drugs or surgery, often without having to use braces which can result in a deflated mid-face. By designing retainer-like oral appliances to be placed over the teeth, they spur the growth and alignment of the jaws to help widen the airway and support sleep.

Mouth structure and jaw alignment are foundational to whole-body health in children, and Liao’s vision for achieving thriving health in kids includes these recommended steps:

  • Early recognition by parents of IMS red flags in their child, including chapped lips, a weak chin, crooked teeth, dental cavities, disrupted sleep, slumped posture, fatigue, lethargy, hyperactivity and learning or behavior problems
  • Diagnosis of an impaired mouth by a trained AMD
  • Complying with AMD guidance, including the use of a professional oral expander appliance
  • Eating a non-inflammatory, bone-building diet
  • Following whole health team protocols to align the head, jaws and spine, and integrate mind, body and mouth

Growing the jaws is the groundbreaking solution to crowded teeth in children that parents have been hoping for. A plant will blossom more fully in sunshine than in shadow. The same can be said when it comes to a child’s smile and overall health.


Brooke Goode is the National Editor for KnoWEwell, the Regenerative Whole Health hub.

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