Myofunctional Appliances in Jersey

Myofunctional appliances, facial growth and profile orthodontics

Where we stand

There has been a great deal of recent interest — much of it driven by social media — in appliances that claim to reshape the face, widen the airway and change the profile. You may have come across terms such as myofunctional therapy, orthotropics, airway orthodontics, Myobrace, or simply mewing. Some of these ideas have a long clinical history; others are newer, more contested, and not yet supported by the level of evidence we would expect before adopting a treatment as routine care.

We think it’s important to be open about where these approaches sit, because parents and patients deserve a clear, specialist-led answer rather than a marketing pitch.

What we actually do at Jersey Orthodontic Centre

Guiding the growth of the jaws and the airway is not a fashion or a trend for us — it is a core part of specialist orthodontic training and one of the jobs a specialist orthodontist is uniquely qualified to do. We have been treating growing patients with growth-modification appliances for over 30yrs and we continue to do so where the diagnosis is right for the child in front of us and where the evidence supports it.

What has changed dramatically is how we can do it. The bulky acrylic expanders and removable mono bloc functional appliances that defined this kind of treatment in the 1960s, 70s and 80s have largely been superseded by modern alternatives. Even the trusted Clark Twin Block has more aesthetic competition these days from modern appliances that are precise, can simultaneously move teeth as well as reposition jaws, and are customised and discreet alternatives. For example, recent developments that have aided us in this regard include:

• Aligners for children. Clear aligner systems, designed specifically for the mixed dentition, allow us to create space in the dental arches, manage early crowding, intercept crossbites and influence growth using removable, transparent appliances rather than fixed acrylic plates. This makes them easier to wear and therefore more likely to be worn. In appropriately selected cases the experience for the child — and the aesthetic experience for the parent watching them grow up — is transformed.
• Digital intra-oral scanning. Modern scanning technology has replaced the impressions that many children remember — and dread — from a generation ago and offer us the ability to create precisely fitted braces as well as acting as baselines for simulated smile designs used to create aligners.
• Remote monitoring through Dental Monitoring we keep a much closer eye on patient progress and compliance as the software reports weekly on the dental changes and aligner/functional appliance fit between in-person visits. 

Used together, these tools let us offer the intent behind growth modification — creating space, balancing the bite, guiding the face — with the precision and finish a specialist practice can stand behind.

What the British Orthodontic Society says

In November 2024, following a recent General Dental Council fitness-to-practice case, the British Orthodontic Society issued a public statement on the kinds of claims now circulating online about orthodontic treatment. We endorse it fully. The BOS advised patients to proceed with caution and seek a second opinion if they are told that an orthodontic treatment will:

• cause a child’s cheekbones to rise or jaws to change significantly in position;
• cure or cause jaw joint problems;
• improve speech;
• improve breathing disorders;
• improve a child’s intelligence.

The Society’s position is that there is no scientific evidence to suggest patients can change the shape of their face, or improve their intelligence, by chewing or by holding the teeth and tongue in a closed position. See the BOS website link for further information and also the blog page of the globally respected orthodontic academic, Professor Kevin O’Brien. 

https://bos.org.uk/news/claims-about-orthodontics/

https://kevinobrienorthoblog.com/british-orthodontic-society-comments-on-claims-being-made-about-orthodontic-treatment/

What the published evidence actually shows

Independent academic orthodontists who have reviewed the evidence on myofunctional appliances and orthotropic-style treatment over many years — most prominently the aforementioned Professor Kevin O’Brien, Emeritus Professor of Orthodontics at the University of Manchester — have reached a consistent and measured conclusion: the published trials are sparse and the effects are small.

A well-selected functional appliance, aligner system, or fixed appliance can predictably achieve a 6–8 mm overjet reduction in a co-operative growing patient — often in a shorter time frame. By comparison, the evidence base for myofunctional appliances as a stand-alone treatment is, frankly, modest.

That does not make the underlying ideas worthless. Nasal breathing, lip competence, tongue posture and a healthy airway genuinely matter, and we screen for all of them as part of every assessment. We are also realistic that genetics, the environment and oral function all contribute to the way a face and bite develop. What we do not do is promise parents that an off-the-shelf silicone trainer worn for an hour a day will reliably reshape their child’s face, transform their airway, or reliably eliminate the need for braces. The evidence simply is not there.

What this means for you as a parent

If you have read about myofunctional appliances, mewing, palatal expanders or “growing the face forward” and you are wondering what is right for your child, the most useful thing we can offer is a thorough specialist assessment, an honest discussion of what the evidence does and does not support, and — if treatment is indicated — access to the most precise and discreet appliances currently available, fitted by a clinician who has spent his career in this field.

We would rather talk you out of treatment your child does not need than into treatment they do not.