Breathe, Sleep, Grow

What is Proper Tongue Posture?

Proper tongue posture means the entire tongue rests gently against the roof of the mouth (the palate)
when you're not talking or eating.

It should be:
· Lips closed
· Tongue sealed to the palate, especially the middle and back
· Breathing through the nose

How Tongue Posture Affects the Airway & Breathing

1. Supports Nasal Breathing
   · A tongue that rests on the palate naturally encourages nasal breathing by helping keep the
   mouth closed.
   · Nasal breathing is healthier than mouth breathing—it warms, filters, and humidifies air, and
   supports nitric oxide production (which helps oxygen delivery).
2. Shapes the Upper Jaw and Palate
   · The tongue is a natural "expander" of the upper jaw.
   · When it rests on the palate, it stimulates proper growth of the upper jaw (maxilla) outward and
   forward.
   · A well-developed maxilla = wider airway space behind the nose and throat.
3. Prevents Narrow, High Palates
   · Without tongue pressure, the palate may grow high and narrow, which restricts the nasal
   airway and contributes to mouth breathing.
   · Narrow palates are often linked with crowded teeth and underdeveloped midfaces.
4. Improves Tongue Position During Sleep
   · A low tongue posture (resting in the bottom of the mouth) falls backward during sleep, which
   can block the throat and restrict airflow, increasing the risk of snoring or obstructive sleep
   apnea.
   · A well-positioned tongue stays forward and up, keeping the airway more open.

Long-Term Benefits of Good Tongue Posture

· Better oxygen flow during the day and night
· Improved facial development (especially jawline and cheekbones)
· Reduced risk of sleep-disordered breathing
· Healthier bite alignment and less need for major orthodontic or surgical correction later

Tongue Tie

Tongue Tie = Poor Tongue Posture

When the tongue can’t move freely, it often:

• Sits low in the mouth

• Can’t reach the roof of the mouth

• Can’t function properly during swallowing, speaking, or at rest

What Can Help?

Tongue Tie Evaluation:

A trained provider (myofunctional therapist) can assess if your child has a functionally restrictive tongue tie.

Release (Frenectomy or Frenuloplasty): If needed, a gentle procedure can free the tongue, allowing for better posture and movement.

Myofunctional Therapy: Exercises to help retrain the tongue and oral muscles—often combined with orthodontics like maxillary expansion for full benefit.

Orthodontic Support: Maxillary expansion can improve space in the palate so the tongue has room to rest where it belongs.

Note: Poor tongue posture is not always due to a tongue tie. Poor tongue posture can be simply poor tongue tone, strength, and stretch. A myofunctional therapist would start working with tongue exercises to first see if the tongue can be positioned properly in the roof of the mouth. If myofunctional therapy alone does not help, a tongue tie release may be needed. It is VERY important to take these steps in a certain order to prevent the tongue from tying back down, sometimes even more severe than the initial tongue tie. 

When Bigger Isn’t Better: Enlarged Tonsils & Adenoids and Their Impact on Airway Health

What Are Tonsils and Adenoids?

• Tonsils are two lymph nodes located at the back of the throat.

• Adenoids are a patch of lymphatic tissue located higher up, behind the nose, where you can’t see them.

They help fight infections—but in many kids, they become chronically enlarged, especially due to allergies, frequent illnesses, and even due to a narrow palate and mouth breathing. 

How Do Enlarged Tonsils & Adenoids Affect Breathing?

Airway Obstruction

• Large tonsils can block the back of the throat, and enlarged adenoids can block the nasal passages, making it harder to breathe—especially during sleep.

Mouth Breathing

• If the nose is blocked by adenoids, kids may breathe through the mouth by default, which:

• Dries the mouth and airway

• Contributes to poor tongue posture

• Interferes with facial and jaw development (narrow, high vaulted palate)

Interrupted Sleep & Sleep Apnea

• Blocked airways can cause:

• Snoring

• Pauses in breathing (apnea)

• Restless sleep

• Nighttime awakenings

This disrupts deep, restorative sleep and may lead to:

Daytime fatigue
Trouble focusing in school
Hyperactivity or behavioral issues
Delayed growth (since growth hormone is released during deep sleep)

What Comes Next?

Sleep Study: In some cases, a simple sleep study (polysomnography) can help confirm sleep apnea or breathing issues.

Surgical Removal (Tonsillectomy & Adenoidectomy): If the tissues are significantly blocking the airway, surgical removal may be recommended—often with dramatic improvements in sleep, breathing, and behavior.

Orthodontic Collaboration: Orthodontic treatments like maxillary expansion can help improve nasal airflow and reduce the impact of enlarged adenoids.

What Can Be Done?

ENT Evaluation: An ear, nose & throat specialist can assess the size of your child’s tonsils and adenoids, especially if sleep-disordered breathing is suspected.

Sleep Study: In some cases, a simple sleep study (polysomnography) can help confirm sleep apnea or breathing issues.

Surgical Removal (Tonsillectomy & Adenoidectomy): If the tissues are significantly blocking the airway, surgical removal may be recommended—often with dramatic improvements in sleep, breathing, and behavior.

Orthodontic Collaboration: Orthodontic treatments like maxillary expansion can help improve nasal airflow and reduce the impact of enlarged adenoids.

How Orthodontics Can Help

The Role of Maxillary Expansion

Maxillary (palatal) expansion is a gentle orthodontic technique that widens the upper jaw. It can:

• Increase nasal airway volume

• Improve breathing through the nose

• Reduce mouth breathing and snoring

• Support proper tongue posture by creating more space in the palate (with the help of myofunctional therapy)

• Help align teeth and jaws for a more functional bite

• Help reduce size of adenoids or prevent enlargement again after removal

Note: Expansion at the ages of 5-8 can significantly improve the nasal airway. Expansion in the later ages have less of an effect on the nasal airway volume and sometimes more invasive procedures have to be done for optimal results. 

Give Your Child the Gift of Breath and Rest

Early Orthodontic Evaluation is Key

The American Association of Orthodontists recommends that children get their first orthodontic check-up by age 7. Why? Because early signs of airway or jaw development issues can be identified and treated more easily at an early age. 

Let’s work together to help your child breathe better, sleep deeper, and grow healthier.

Credit: Children’s Airway First Foundation