Mewing Research

This systematic review and meta-analysis evaluated orofacial myofunctional therapy (OMT) as a treatment for obstructive sleep apnea (OSA). OMT incorporates exercises to optimize tongue placement and increase oropharyngeal muscle tone - principles closely aligned with mewing.

Seven RCTs involving 310 patients were included from 1,244 abstracts screened, following PRISMA guidelines for studies published before March 2023.

Adults showed a statistically significant AHI reduction of -10.2 points (95% CI: -15.6 to -4.8, p < 0.05) compared to controls. Secondary outcomes also improved significantly: Epworth Sleepiness Scale dropped by 5.66 points, Pittsburgh Sleep Quality Index improved by 3.00 points, and minimum oxygen saturation increased by 2.71 points.

The single pediatric RCT showed poor compliance (<50%) and no meaningful improvements in AHI, oxygen saturation, or snoring frequency in children.

This systematic review examined the effects of orofacial myofunctional therapy (OMT) on craniomaxillofacial growth in children with obstructive sleep apnea hypopnea syndrome (OSAHS). OMT is a neuromuscular re-education method considered an auxiliary treatment for OSAHS and orthodontic care.

Following PRISMA guidelines, researchers screened 1,776 articles, reviewed 146 full texts, and included 9 studies in the qualitative analysis, covering 693 children total. Bias assessment found 3 studies at severe risk and 5 at moderate risk.

Improvement in craniofacial function or morphology was observed in most of the 693 children across included studies. Therapeutic benefits increased with intervention duration and improved patient compliance, supporting the principle that sustained oral posture correction can influence facial development in children.

This systematic review and meta-analysis evaluated evidence on early orthodontic intervention combined with orofacial muscle training for correcting myofunctional and myoskeletal problems in children with developing dentition.

From 265 initial search results across MEDLINE, Cochrane, and LILACS databases, 15 studies qualified - 8 RCTs and 7 controlled clinical trials. These measured skeletal and dentoalveolar changes via cephalometric analysis, mouth posture, lip closure, tongue resting position, tongue pressure, and swallowing patterns.

Quantitative synthesis was only possible for 2 of the included RCTs. No evidence supported bonded lingual spurs over banded fixed appliances for anterior open bite correction (SMD: -0.03; 95% CI: -0.81 to 0.74; P = 0.94). While early orthodontic and myofunctional treatment appears promising, the quality of existing evidence was deemed questionable.

This paper presents the "airway centric" approach to orthodontics, which prioritizes nasal breathing and tongue posture in treatment planning.

Core Principles:

Key Arguments:

• Breathing mode shapes facial development
• Extraction orthodontics may worsen airway
• Expansion often preferable to extraction
• Tongue posture fundamental to stability

Facial Development Factors:

Treatment Implications:

• Screen for mouth breathing
• Address tongue posture before/during treatment
• Consider myofunctional therapy
• Avoid treatments that reduce airway

Relevance to Mewing:

Supports the core mewing principles: - Tongue posture matters - Nasal breathing essential - Function drives form - Proper oral posture for stability

Controversy:

• Not all orthodontists agree
• Traditional vs. functional debate ongoing
• More research needed
• Represents paradigm shift in thinking

Limitations:

• Opinion/perspective piece
• Not a controlled trial
• Represents one viewpoint in ongoing debate

This systematic review examined the evidence for skeletal maxillary expansion in adults.

Review Question:

Can adults achieve true skeletal palatal expansion (vs. just dental tipping)?

Key Findings:

The Problem with Non-Surgical Methods:

• Adult sutures resist opening
• Force goes to teeth, not bone
• Teeth tip outward instead
• Risk of root resorption
• Unstable results

SARPE (Surgically Assisted Rapid Palatal Expansion):

• Surgical weakening of suture
• Followed by expansion device
• True skeletal expansion achieved
• More predictable in adults

Force Requirements:

Implications for Manual Techniques:

This review confirms: - Adult expansion needs significant force - Surgical or bone-borne approaches needed - Manual pressure (thumb pulling) is inadequate - No evidence for DIY methods

Clinical Relevance:

Adults seeking palatal expansion should pursue: 1. Professional orthodontic evaluation 2. CBCT imaging to assess suture 3. SARPE or MSE if indicated 4. NOT DIY manual techniques

This histomorphometric study examined age-related changes in the midpalatal suture to understand why palatal expansion becomes more difficult with age.

Study Design:

• Cadaver specimens across age ranges
• Histological examination of midpalatal suture
• Measured suture interdigitation and ossification
• Correlated changes with age

Key Findings:

Ossification Pattern:

• Posterior region fuses first
• Middle section follows
• Anterior region fuses last
• High individual variation

Implications:

Relevance to Thumb Pulling:

This study explains why DIY manual techniques are unlikely to work in adults: - Sutures are largely fused after ~25 - Significant force needed to expand fused suture - Manual thumb pressure cannot match required forces - Professional devices apply measured, sustained force

Clinical Significance:

Supports the need for surgical assistance (SARPE) or bone-borne devices (MSE) for adult palatal expansion, rather than tooth-borne or manual approaches.

This landmark study experimentally tested whether mouth breathing affects facial development by inducing obligate oral breathing in young rhesus monkeys.

Study Design:

• Young rhesus monkeys (growing animals)
• Nasal obstruction induced via silicone nose plugs
• Forced obligate mouth breathing
• Compared to control animals (nasal breathing)
• Monitored over growth period

Key Findings:

Observed Changes:

• "Long face syndrome" development
• Lowered tongue posture
• Altered muscle function
• Narrower maxilla
• Increased facial height

Mechanism:

When nasal breathing is blocked: 1. Tongue drops to allow oral breathing 2. Loss of tongue pressure on palate 3. Cheek pressure unopposed 4. Face grows downward and narrower 5. "Adenoid facies" pattern develops

Relevance to Mewing:

This study provides foundational evidence that: - Breathing mode affects facial development - Tongue position (influenced by breathing) shapes the palate - Changes occur during growth periods

Limitations:

• Animal study (primates, not humans)
• Extreme intervention (complete obstruction)
• May not directly translate to human outcomes
• Studied growing animals, not adults

Clinical Significance:

Supports the principle that oral posture and breathing mode influence craniofacial development, though the study used extreme interventions in growing animals.