The most important thing is for parents to be aware that the growth of the face can go wrong and that this can be avoided if early action is taken. If your child's face does not look quite like the other children’s, be concerned. Watch for flattening of the cheeks or an unusual shape around the mouth because these will almost certainly get worse.
Hanging the mouth open. This is probably the most important single factor. As you can read on other parts of this site, open mouth postures will cause the face to grow down to an extent that a child may have difficulty in closing their lips at all. Once this has happened, it can be very difficult to correct other than by surgery. Try to persuade your child to keep their mouth closed. From a young age.
Adverse Growth. The downward (vertical) growth of the face tends to set the jaw back and restrict the size of the throat. In order to breathe more easily, the head is tilted back. Try dropping your jaw an inch and you will see why this is. To restore the balance of the spine the neck is tilted forward. This unbalances the whole vertebral column and osteopaths, physiotherapists and chiropractors find this is a common cause of headaches, neck aches, and long term back trouble.
Horizontally growing face and a vertically growing face.
Note how head is tilted back to enable them to breath
Sucking Habits If your child's face does not look quite like the other Childerns' do seek advice. Strange sucking habits, or swallowing with the tongue showing, can also distort the teeth and jaws, and may precipitate a speech impediment. Remember that the only thing that guides the teeth into position are the lips, the cheeks, the tongue and the other teeth and any faults in these will be reflected by irregularity of the teeth, followed later by facial disfigurement.
Spaces. At the age of five there should be spaces between the front teeth. Their permanent successors which should arrive about the age of six, are a lot larger, and if there is no space they will crowd. It is easier to prevent crowding by creating space than to correct it afterwards.
Crowding. If the lower front teeth are crowded at six years of age take advice and do not accept a ‘wait and see approach’. At the very least your child needs to improve their mouth posture.
Unattractive Eyes. If the top jaw grows down, the eyes look prominent and the outer corner of the eyelids will sag making them look tired with too much white-of-eye showing. The lower eyelid will develop a ridge rather than slope smoothly into the cheek.
Weak Chin. Look at your child sideways and see if you like the position of the chin. It is likely to be set back if their mouth is open a lot and they will have a double chin.
Prominent Chin. Children who fidget or are overactive, may suffer from too much growth of the lower jaw, even more so if they stick their jaw forward and work it from side to side. Excessive jaw growth can be very difficult to correct when they are older. The old wives tale says "if you make faces and the wind changes it will stick like it".
Excessive Gum. You will notice that good looking people do not show a lot of gum when they smile. The more gum that shows the less attractive the face. If a young child shows a lot of gum their face is growing downwards.
Speech. The tongue should be in the palate for most sounds and if it protrudes sideways or forwards between the teeth, they are likely to become displaced. A lisp usually indicates that the tongue is between the teeth. The lips should come into contact between most syllables. Ask your child to count up to five and see how far apart their lips are after the 'five'. If it is more that 3mm there is a mild problem if more than 7mm a severe problem.
Eating Habits. Many children avoid hard foods, this will allow their muscles to become weak and can be a principal cause of vertical growth. Bad habits often develop when the child is first weaned. Babies suck with their tongue and do not naturally swallow until they are about fifteen months old. If they are weaned by spoon feeding before that, they are likely to develop a tongue-between-tooth swallow. A mother can recognize this because she has to scrape the baby-food from around the mouth with a spoon and reinsert it. Try to encourage babies to chew hard things and not give them slops until they have learnt to swallow naturally but remember that too much persuasion can have the reverse affect.
Where should the teeth be? To measure the correct position of the upper front teeth simply put a pencil mark on the forwardmost point of the nose, and measure from there to the edge of the upper front teeth. Ideally it should be 28mm at the age of five and increase one mm each year until puberty, when it should be 36mm for a girl and 38mm for a boy. Average children in industrial countries are 3 or 4mm more than this. If it is more than five millimetres over this there will be some irregularity of the teeth and disfigurement of the face, and if more than eight millimetres the child is certain to grow up with a less than ideal face.