STUDIES & RESEARCH
For my fellow research moms who want to read it for themselves… Here are my favorite studies, articles, and videos on all things infant oral ties, frenectomy, mouth breathing, facial and airway development.
The Chapters
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If you have favorite studies or research you think should be included, send the link here!
Facial & Airway Development
Deshkar M, Thosar NR, Kabra SP, Yeluri R, Rathi NV.
The Influence of the Tongue on the Development of Dental Malocclusion.
Cureus. 2024 May 29;16(5):e61281. doi: 10.7759/cureus.61281. PMID: 38947580; PMCID: PMC11211712.
Conclusions: “The position of the tongue is very important for maintaining good dental alignment and occlusal harmony from early childhood into adulthood. Over time, maladaptive tongue postures like tongue thrusting or macroglossia can cause malocclusion by altering the delicate balance of forces inside the oral cavity. For harmonic dental occlusion, the tongue position must be maintained in a balanced manner while at rest and when swallowing. To get the best possible treatment results for patients with malocclusion, clinicians should think about evaluating and treating tongue position. Furthermore, dealing with complex cases of malocclusion associated with tongue-related disorders requires coordinated efforts between orthodontists, speech therapists, and other healthcare specialists.”
https://pmc.ncbi.nlm.nih.gov/articles/PMC11211712/?utm_source=chatgpt.com#abstract1
Harari D, Redlich M, Miri S, Hamud T, Gross M.
The effect of mouth breathing versus nasal breathing on dentofacial and craniofacial development in orthodontic patients.
Laryngoscope. 2010 Oct;120(10):2089-93. doi: 10.1002/lary.20991. PMID: 20824738.
Conclusions: “Naso-respiratory obstruction with mouth breathing during critical growth periods in children has a higher tendency for clockwise rotation of the growing mandible, with a disproportionate increase in anterior lower vertical face height and decreased posterior facial height.”
Mouth Breathing vs. Nasal Breathing Effects
Case Studies on Pediatric Sleep and Breathing
by Dr. Soroush Zaghi
A. J. Yoon, S. Zaghi, S. Ha et al.
How tongue mobility changes face and jaw development
20 September 2019, PREPRINT (Version 1) available at Research Square
“While this study is one of the largest of its kind overall, there were few volunteers with severely restricted tongue mobility or with abnormally aligned teeth, which may limit some of the findings. Nevertheless, the results do suggest the tongue plays an important role in development of the mouth and face, and if the tongue cannot move freely enough, people risk developing high-arched palates, a narrow upper jaw, and longer soft palates.”
James S. Oh a, Soroush Zaghi b c, Nora Ghodousi b, Cynthia Peterson b, Daniela Silva a, Gilles J. Lavigne d, Audrey J. Yoon a
Determinants of probable sleep bruxism in a pediatric mixed dentition population: a multivariate analysis of mouth vs. nasal breathing, tongue mobility, and tonsil size
Sleep Medicine, Volume 77, 2021, Pages 7-13, ISSN 1389-9457,
Conclusion: “In our study, probable sleep bruxism was found to be significantly associated with impaired nasal breathing, habitual mouth breathing, restricted tongue mobility, and/or tonsillar hypertrophy. Restricted tongue mobility was found to be an independent risk factor for bruxism among individuals with normal nasal breathing. This study further shows that tonsillar hypertrophy, restricted tongue mobility, and nasal obstruction may have a synergistic association on the presentation of PSB.”
https://www.sciencedirect.com/science/article/abs/pii/S1389945720304998
Soroush Zaghi, Cynthia Peterson, Shayan Shamtoob, Brigitte Fung, Daniel Kwok-keung Ng, Triin Jagomagi, Nicole Archambault, Bridget O’Connor, Kathy Winslow, Zahra Peeran, Miche’ Lano, Janine Murdock, Sanda Valcu-Pinkerton, Lenore Morrissey.
Assessment of Nasal Breathing Using Lip Taping: A Simple and Effective Screening Tool.
International Journal of Otorhinolaryngology. Vol. 6, No. 1, 2020, pp. 10-15. doi: 10.11648/j.ijo.20200601.13 Received: January 15, 2020; Accepted: February 12, 2020; Published: February 24, 2020
Conclusion: “Proper breathing, specifically exclusive nasal breathing, is essential to the health and development of children. Children who are unable to breathe well through the nose compensate by breathing more through the mouth. This not only negatively impacts their current health but may also lead to detrimental issues in adulthood. Early detection of improper breathing is therefore vital.”
Primarti RS, Fatma A, Jayanti CNR, Musnamirwan IA, Setiawan AS.
Mouth Breathing and Its Impact on Sleep Breathing Disorders in Children: A Cross-Sectional Study in Bandung, Indonesia.
Clin Cosmet Investig Dent. 2025 Sep 1;17:435-444. doi: 10.2147/CCIDE.S536188. PMID: 40919295; PMCID: PMC12412591.
Conclusion: “Mouth breathing in school-aged children is significantly associated with a higher risk of developing sleep-disordered breathing. These findings highlight the importance of early screening and timely intervention to prevent adverse health outcomes linked to SDB.”
Zhao Z, Zheng L, Huang X, Li C, Liu J, Hu Y.
Effects of mouth breathing on facial skeletal development in children: a systematic review and meta-analysis.
BMC Oral Health. 2021 Mar 10;21(1):108. doi: 10.1186/s12903-021-01458-7. PMID: 33691678; PMCID: PMC7944632.
Conclusions: “The results showed that the mandible and maxilla rotated backward and downward, and the occlusal plane was steep. In addition, mouth breathing presented a tendency of labial inclination of the upper anterior teeth. Airway stenosis was common in mouth-breathing children.”
Lin L, Zhao T, Qin D, Hua F, He H.
The impact of mouth breathing on dentofacial development: A concise review.
Front Public Health. 2022 Sep 8;10:929165. doi: 10.3389/fpubh.2022.929165. PMID: 36159237; PMCID: PMC9498581.
“Mouth breathing is one of the most common deleterious oral habits in children. It often results from upper airway obstruction, making the air enter completely or partially through oral cavity. In addition to nasal obstruction caused by various kinds of nasal diseases, the pathological hypertrophy of adenoids and/or tonsils is often the main etiologic factor of mouth breathing in children. Uncorrected mouth breathing can result in abnormal dental and maxillofacial development and affect the health of dentofacial system. Mouth breathers may present various types of growth patterns and malocclusion, depending on the exact etiology of mouth breathing. Furthermore, breathing through the oral cavity can negatively affect oral health, increasing the risk of caries and periodontal diseases.”
Tongue-Ties, Oral Tie Release & Breastfeeding
Cordray H, Raol N, Mahendran GN, Tey CS, Nemeth J, Sutcliffe A, Ingram J, Sharp WG.
Quantitative impact of frenotomy on breastfeeding: a systematic review and meta-analysis.
Pediatr Res. 2024 Jan;95(1):34-42. doi: 10.1038/s41390-023-02784-y. Epub 2023 Aug 22. PMID: 37608056.
Impact: “This systematic review and meta-analysis showed that breastfeeding self-efficacy, maternal pain, infant latch, and infant gastroesophageal reflux significantly improve after frenotomy in mother-infant dyads with breastfeeding difficulties and ankyloglossia. Providers should offer frenotomy to improve breastfeeding outcomes in symptomatic mother-infant dyads who face challenges associated with ankyloglossia.”
Ghaheri BA, Lincoln D, Mai TNT, Mace JC.
Objective Improvement After Frenotomy for Posterior Tongue-Tie: A Prospective Randomized Trial.
Otolaryngol Head Neck Surg. 2022 May;166(5):976-984. doi: 10.1177/01945998211039784. Epub 2021 Sep 7. PMID: 34491142.
Conclusions: “When measured 10 days after frenotomy for PTT, infants improve feeding parameters using an objective bottle-feeding system. Similar improvements are seen with patient-reported outcomes when PTT is released. Posterior tongue-tie is a valid clinical concern, and surgical release can improve infant and maternal symptoms.”
Ghaheri BA, Cole M, Fausel SC, Chuop M, Mace JC.
Breastfeeding improvement following tongue-tie and lip-tie release: A prospective cohort study.
Laryngoscope. 2017 May;127(5):1217-1223. doi: 10.1002/lary.26306. Epub 2016 Sep 19. PMID: 27641715; PMCID: PMC5516187.
Conclusions: “Surgical release of tongue-tie/lip-tie results in significant improvement in breastfeeding outcomes. Improvements occur early (1 week postoperatively) and continue to improve through 1 month postoperatively. Improvements were demonstrated in both infants with classic anterior tongue-tie and less obvious posterior tongue-tie. This study identifies a previously under-recognized patient population that may benefit from surgical intervention if abnormal breastfeeding symptoms exist.”
Cordray H, Mahendran GN, Tey CS, Nemeth J, Sutcliffe A, Ingram J, Raol N.
Severity and prevalence of ankyloglossia-associated breastfeeding symptoms: A systematic review and meta-analysis.
Acta Paediatr. 2023 Mar;112(3):347-357. doi: 10.1111/apa.16609. Epub 2022 Dec 9. PMID: 36437565.
Conclusion: “Ankyloglossia is adversely associated with breastfeeding success and maternal well-being.”
Paul Hong, Denise Lago, Judi Seargeant, Lauren Pellman, Anthony E. Magit, Seth M. Pransky. (September 2010).
Defining ankyloglossia: A case series of anterior and posterior tongue ties
International Journal of Pediatric Otorhinolaryngology, Volume 74, Issue 9, 2010, Pages 1003-1006, ISSN 0165-5876,
Conclusion: Anterior ankyloglossia is much more common and readily managed when compared to posterior ankyloglossia. Posterior ankyloglossia is a poorly recognized condition that may contribute to breastfeeding difficulties. The diagnosis is difficult due to the subtle clinical findings but relevant health care providers should be aware of this condition. Frenotomy is a simple, safe, and effective intervention for ankyloglossia which improves breastfeeding.
https://www.sciencedirect.com/science/article/abs/pii/S0165587610002569