What if crooked teeth are not the problem, but evidence of a larger problem involving growth, breathing, and oral function?
In this episode of Airway Answers: Expanding Your Breath of Knowledge, Nicole Goldfarb speaks with Dr. Barry Raphael about the complicated relationship between the tongue and traditional orthodontic treatment.
They explore:
✨ How tongue posture, swallowing, mouth breathing, and other soft-tissue patterns may influence dental and facial development
✨ Why straightening the teeth does not necessarily correct the dysfunction that contributed to the malocclusion
✨ The difference between creating a beautiful bite and supporting whole-body health
✨ How physics and the “particle principle” help explain the forces that guide teeth and facial growth
✨ Why the tongue needs adequate space before it can function properly
✨ How orthodontists and myofunctional therapists may view the tongue differently
✨ Why identifying a tongue-tie does not automatically mean it should be released
✨ How genetics, environment, breathing, and behavior interact during development
✨ What a case involving identical twins reveals about the potential influence of function and environment
Dr. Raphael also presents his “Airway Timeline,” which traces how environmental stressors and compensatory habits may contribute to soft-tissue dysfunction, altered craniofacial growth, restricted breathing spaces, sleep-disordered breathing, and eventually obstructive sleep apnea.
This framework encourages clinicians to look beyond crooked teeth and consider three essential areas: structure, function, and behavior. Addressing only one may leave important contributors to the patient’s condition unresolved.
The conversation is also a reminder that treatment should be based on function, not appearance alone. A visible tongue-tie, narrow palate, or imperfect bite does not tell the entire story. Careful evaluation should consider nasal breathing, sleep quality, oral rest posture, swallowing, available tongue space, and the patient’s individual symptoms.
Dr. Barry Raphael has practiced orthodontics since 1983. After shifting his clinical focus toward airway health and soft-tissue dysfunction, he established the Raphael Center for Integrative Orthodontics in Clifton, New Jersey. His multidisciplinary team includes professionals in myofunctional therapy, craniosacral therapy, functional medicine, nutrition, and health coaching.
Nicole Goldfarb is a speech-language pathologist, Certified Orofacial Myologist, international speaker, and owner of the San Diego Center for Speech Therapy & Myofunctional Therapy. She has a special interest in sleep-disordered breathing, restricted oral tissues, and myofunctional disorders.
If you’re an orthodontist, dentist, myofunctional therapist, speech-language pathologist, or parent interested in how breathing and oral function shape development, this episode will challenge you to look beyond the teeth.
🎧 Explore this fascinating conversation and reconsider the tongue’s role in orthodontics, airway health, and facial growth.
Twin case images featured in the presentation are credited to Dr. Chris Farrell of Myofunctional Research Co.
#AirwayAnswers #BeautyOfBreathing #IntegrativeOrthodontics #AirwayOrthodontics #MyofunctionalTherapy #TonguePosture #TongueTie #Malocclusion #FacialGrowth #MouthBreathing #PediatricAirway #SleepDisorderedBreathing #AirwayHealth #AirwayCircle
Support the show
ABOUT OUR HOST:
Renata Nehme RDH, BSDH, COM®, OMS™ has been a Registered Dental Hygienist since 2010. In 2016, when she was introduced to the world of "Myofunctional Therapy" she immediately knew that was her calling, especially when she learned that it encapsulated many of her passions- breastfeeding, the import of early childhood development, and airway health.
In 2021 Renata founded Airway Circle with the intention of creating a collaborative and multidisciplinary group of like-minded health professionals who share the same passion for learning and giving in the dental health and airway space.
Myo Moves - Become a Patient: www.myo-moves.com
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