Hi my wonderful TMJoiners! I'm Priya Mistry the TMJ doc and today I'll be talking about forward
head posture, mouth breathing, and TMJ Disorders. There is a correlation between all three of
those even though they seem like they may not be related. Do you breathe through your nose or your
mouth or both? Do you have forward head posture? Do you have TMJ issues? If so, watch this video
until the end as well as Part 2. So this is Part 1 of 2 and next week I'll be releasing Part 2/2 of
this video. The reason I broke it into two parts is because there is a lot to go over,
so these videos are very "information heavy" so be sure to watch both parts to fully understand the
correlation between forward head posture, mouth breathing, and TMJ issues. Before getting right
into it, be sure to check out my website and my social media accounts which I've linked below.
There's tons of information, tips on TMJ pain relief. There's just a lot of information in
all of those resources so be sure to take a look at them. Be sure to Subscribe to this
channel if you're looking for information on TMJD for yourself or for a loved one.
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information is pushed out into the interwebs so we can hopefully work together to help more people.
For those of you who don't know me, I'm a general dentist with a practice in Vancouver,
Washington where we are dedicated to taking care of patients with TMJ disorders.
So let's get right into it. First, I want to go over a few things to sort of lay the foundation
for this video because like I mentioned before, it's pretty involved. So the two things I want to
go over before getting into the "meat" of this, is that 1) Form Follows Function 2) I want to
review Correct Tongue Posture at rest. So "Form Follows Function" - what does that even mean?
This means that the form or shape of our bones is highly influenced by the function of our muscles.
So an easier way to say this is that between muscles and bone, muscles will always win.
And this can be kind of hard to understand because bone is harder than muscle, but keep in mind that
muscle can exert forces and those forces can add up over time and can actually shape
or mold bone. An organ that has a lot of strong muscles that can exert a lot of forces
is actually the tongue. So having correct tongue posture will actually affect the
development of the bones in our face. So that leads us right into correct tongue posture.
What is correct tongue posture? Correct tongue posture at rest means that any time you're not
speaking or chewing, your tongue - the tip, middle, and back - should be up against the
roof of your mouth with a light suction. So evaluate your tongue posture right now
as I'm speaking to you. Is your tongue up against the roof of the mouth as I described? Or is it
low, hanging out near the floor of your mouth? If you don't have correct tongue posture right now,
don't panic and don't try to correct it. Trying to correct it on your
own can actually strain the muscles that surround and support the tongue
and it can actually lead to pain, particularly if you have TMJD issues to begin with.
The best way to attain proper tongue posture now if you don't have it is through Myofunctional
Therapy. Myofunctional Therapy is a physical therapy for the muscles that surround and support
the tongue. For more information on this, please watch my video "What is Myofunctional Therapy"
which I've linked above and below. So why is correct tongue posture even important? Well,
correct tongue posture affects orofacial development - the development of the mouth
and the face - and it enhances nasal breathing - breathing through the nose instead of the mouth.
So let's examine these one by one, starting with orofacial development.
If the tongue is in the correct position from birth onwards - yes, birth onwards - that means
it's exerting pressure onto the roof of the mouth. This pressure overtime helps form the shape of the
roof of the mouth, with the ideal shape being wide and flat. If the roof of the mouth is wide,
it can accommodate all of our teeth. If the roof of the mouth is flat, it does NOT put
pressure on the nasal septum which can prevent it from deviating. All of this can sound very
confusing if you're hearing it for the first time so I'm going to explain it another way as well.
The roof of the mouth is the floor of the nose. So I'll say that again and try to visualize
it - the roof of the mouth is the floor of the nose. If the roof of the mouth is narrow and
arched instead of being wide and flat, it will exert an upward force onto the nasal septum,
which can then cause it to deviate. This makes breathing through the nose more difficult.
So correct tongue posture affects the development of the roof of the mouth.
It also affects development of the jaw bone. So if the tongue is in the correct position - up
against the roof of the mouth with a nice suction - that upper arch (your dental arch up here) will
develop wide and flat and what we find is that the jawbone (the mandible, here) will sort of
follow. It will also develop wide and flat. This jaw bone will follow whatever is happening up top.
If the tongue is on the floor of the mouth - which is not ideal - what ends up happening is that the
tongue exerts pressure downwards, which results in more vertical growth in the lower portion of
the face. So essentially, a longer face. To sum it up, instead of the face growing forward and wide,
it grows long and narrow for those who have incorrect or low tongue posture. This orofacial
development pattern has a negative impact on the nasopharyngeal airway. So in English,
that means that this long and narrow development can lead to a narrow airway. This narrow airway
can then potentially result in sleep disordered breathing - sleep apnea or upper airway resistance
syndrome (UARS). For more information on all of this (because I know this video is
jam-packed with information), please watch my video "Tongue Tie, Airway, and TMJ Disorders".
Let's take a break from all this heavy information that I'm throwing at you guys and just take a look
at some images here. I have two CBCT images here - Cone Beam Computed Tomography - it's basically
3D imaging of this general area. So when you look at these images, any black that you see
is air spaces, white is bone and teeth, and gray is soft tissue. This gray mass here is the tongue.
So in the first image you can see that the tongue is high up against the roof of the mouth. In the
second image, you can see that the tongue is low and you can actually see the black space
between the tongue and the roof of the mouth. You can also see the corresponding airways.
Often times when the tongue posture is low, it also posterior - it is too far back - and that
is obstructing the airway. The CBCT imaging I do at my office for every single patient
allows me to really see every single patient's tongue posture at rest and this can come in
very valuable for treating the TMJD or having a discussion after we're done with the TMJD work
on whether the patient wants to pursue that incorrect tongue posture if that's the case.
Additionally, we see that correct tongue posture is associated with nasal breathing - breathing
through the nose - and that low tongue posture is associated with mouth breathing - breathing
primarily through the mouth, which is not ideal. So I'm going to cover this again in a few minutes,
but I just wanted to set that up for you guys so you have that thought in your heads.
As a quick side note, I do want to address how low tongue posture develops and there's
usually two main factors. 1 is a tongue tie and 2 is allergies or any sort of nasal obstruction
that make it really difficult or impossible to breathe through the nose. For more information
on tongue ties, watch my video "What is a Tongue Tie?" and it will go over that in depth.
Allergies or nasal blockages make it difficult or impossible to breathe through your nose
so you have to then breathe through your mouth. To breathe through your mouth,
the tongue has to then be in a low position. Think about it. You literally cannot breathe through
your mouth and have your tongue against the roof of your mouth. Try this with me if you can.
Put your tongue - the tip, middle, and back - up against the roof of your mouth.
Then plug your nose and try to breathe through your mouth. You can't. Let's try it!
It's impossible - you can't. So if your nose is blocked and you're breathing through your mouth,
your tongue has to be low by the floor of the mouth. So what's ideal? Breathing through the nose
or breathing through the mouth? Well, we want to breathe through the nose as much as we can - 100%
of the time day and night if possible. And the reason for this is that the nose has a really
cool system that filters, humidifies, and heats or cools the air depending on the ambient temperature
before it's sent to the lungs. When all of this is done, the lungs can then receive that air
more efficiently and more effectively and then distribute it through the rest of our bodies.
If we're breathing through the mouth, this whole system - filtration system,
humidifying, etc - is skipped and the lungs do not receive the air as effectively.
Essentially, we have to breathe great mouthfuls of air to get the same oxygen as we do
when breathing less quantity and more easily through our noses. So mouth breathing is actually
much more exhausting and much more taxing on the body than nasal breathing because we have to take
big gulps of air to get the same oxygenation as we do with breathing a less quantity through our
noses. For more information on this, please watch my video "Nasal Breathing vs. Mouth Breathing".
So now let's connect the two - nasal breathing and tongue posture. If you have
correct tongue posture - again, with your tongue up against the roof of your mouth - you're likely
breathing through your nose which is ideal. If you have low tongue posture, you're likely
breathing through your mouth which is not ideal. This is an easy concept once you think about it.
As I mentioned previously, you literally cannot breathe through your mouth AND have correct tongue
posture. So again, take a moment to evaluate yourself. Can you breathe through your nose?
If you're not sure or if you're pretty sure that you can't, it might be a good idea to be evaluated
by an ENT - an Ears, Nose, and Throat doctor also known as an Otalaryngologist. What a word, huh?
I'd also highly recommend reading the book "Breath" by James Nestor to fully understand the
benefits of breathing through your nose instead of your mouth. I've even changed the way that I
breathe after reading that book, and I'm primarily a nasal breather as it is. Many of my patients
have read this book as well and it's really helped them on their TMJ journey. I've linked this book
in the description box below, and if you have some spare time for reading, be sure to check it out.
So that's really it for this video. In Part 2, which will be released next week,
I'll be bringing it all together. So again, the title of these videos are "Mouth Breathing,
Forward Head Posture, and TMJD" and you're probably thinking "wow,
all she's done is talk forever about correct tongue posture and mouth breathing.. where
is she going with this?" but Part 2 will really bring it all together so be sure to stay tuned.
Again, I'm Dr. Mistry and I hope you found this video helpful. If so, please feel free to like,
Subscribe, and share with your family and friends. For TMJD relief from the comfort of your own home,
please download my free PDF guide called "3 Steps to TMJD Relief".
You'll find that on my office website which is linked below.
As, always questions and comments are always welcome. Let me know if you breathe through
your nose or through your mouth or if this video offered any information that you didn't
know before. And remember my friends, you can never have TMI about TMJ! Thank you!