- Work on lip competence. Strengthen the lip muscles for proper closed mouth resting posture.

- Play the games to practice suction hold and build strength in the middle and back of the tongue

- Explain that entire tongue should “live” on the roof of the mouth, and not on the floor. 

Try GOPex, a program designed by Dr. Sandra Kahn and Dr. Simon Wong to help develop healthy habits for facial growth, airway health, and jaw. 

Include grandparents, teachers, other adults to help achieve the goal: lips closed, tongue on the roof, thorough chewing, straight posture. If they understand the goal, they are more likely to stay vigilant and involved. Agree on a fun code word.

Ideally, people should be chewing over three hours per day. To encourage more time spent chewing at meals, focus on both the texture of the food and intentional eating with lips closed. Clear your fridge of soft food. Introduce age-appropriate, hard, and fibrous foods that require effort to break. Give a whole apple instead of pre-cut slices.

Chewing gum is a helpful tool for good cranio-facial growth as it provides the resistance training, but it should not be a substitute for slow eating a range of tough, real foods.

Outdoor physical activities - lots of movement and balance training - are essential for cranio-facial development because the body operates as a single, connected chain.  The tongue is not an isolated muscle; it is connected to the hyoid bone and the deep front line of muscles that runs all the way down to the feet. The muscles in one’s core and neck give the stability for the muscles of the jaw and tongue to function correctly.

Overall low tonicity in the body leads to a slumped, forward-leaning head which physically pulls the jaw down and back, making harder for the tongue to reach the roof of the mouth. Outdoor play like climbing, crawling, walking on the curb of a road or uneven ground send signals to the brain to level the head. This helps automatically triggers the tongue to move into its proper resting spot on the palate to help stabilize the skull. 

The tongue is structurally linked to the rest of the body through the Deep Front Line (DFL) of the fascia, connecting the tongue and jaw, the throat and neck, the diaphragm, the pelvic floor, the inner thighs and the feet.

Reach out to a therapist knowledgeable about cranio-facial development, one that focuses on how a child’s mouth functions, not just how their teeth look. They should have a broad approach, looking at the connection between breathing, sleep, and physical growth. They should ask about: (1) sleep quality (shallow breathing, snoring, restless sleep), (2) feeding history (early, bottle-feeding), (3) self soothing (pacifiers, thumb sucking) or any history of picky eating that might be related to muscle weakness. They should check how the child swallows, sits, talks and whether they naturally breathe through their nose or mouth.

Go to an orthodontist before you child is 8 years old. Find a provider who emphasizes re-training habits (tongue posture and swallowing) rather than just moving teeth. To identify an orthodontist knowledgeable about cranio-facial development, you should look for one who practices “airway-focused” or interceptive orthodontics — one who focuses on guiding jaw growth and creating space for the airway and tongue, rather than just straightening teeth.

See more in our Parents Guide.