Psychodynamics of Facial Form in Young Children
Ernest A. Rider, DDS

Psychologists have dealt with physical appearance as a component of social acceptance and have attempted to address the importance of being relatively attractive or unattractive. As a result, some very interesting research data has accumulated.

According to child development experts, peer relationships make important contributions to the emotional growth and development of children. Studies show children pick their friends according to how they look. In addition, children develop their own self- image based on how they feel they look and on peer acceptance of their appearance.

Further studies show teachers' expectations of their students performance is closely related to how a child looks. Good-looking children were found to achieve higher grades, were better adjusted and had higher self-esteem than their less attractive classmates.

In one study attractive people were found to be more confident, socially outgoing and adventurous. Furthermore, these fortunate individuals were more responsive and sexually warm than their less attractive counterparts. Unfortunately how a person looks seems to be one of the most important ways we measure an individual's worth. According to the study, attractive people acquire better jobs, experience more successful marriages and live happier, more fulfilled lives than less attractive people. Bizarre as it may seem, even jurors are influenced by a person's appearance.

Historically, the study of facial esthetics has been claimed by sculptors, painters and philosophers. Beauty was viewed subjectively and determined primarily by the perception of beauty by the viewer. Now new technology has made it possible to surgically intervene and change facial proportions. This has resulted in the creation of objective parameters for evaluation of facial esthetics. Norms for size, shape and interrelation- ships of facial proportions have been determined. This has made it possible to determine the degree to which an individual differs from the ideal and dictates the type of intervention necessary to produce more pleasing facial features.

Now that ideal facial dimensions have been determined for all ages, video-imaging technology has made it possible to allow critical assessment of facial proportions. The effects of orthopedic and/or surgical intervention can be visualized now and treatment planned accordingly.

Studies have shown that the face is the most important form of personal identification and self-presentation particularly when one compares the time and investment a person spends on facial care with care of other parts of the body.

The multi-billion dollar cosmetic industry is a witness to the fact that people care how they look. In the field of dentistry, the proliferation of whitening agents, bonding materials, veneers and caps are a reaction to widespread public appeal. Skilled orthodontic treatment and jaw surgery can visually enhance teeth and facial beauty. Plastic surgeons have the ability to surgically alter normal features that are perceived as unaesthetic to make the person feel more attractive. Sometimes, in spite of successful surgery, the person will still not feel attractive, being dominated by the perceived stigmata of unattractiveness from childhood.

The relationship between the development of the face and naso-respiratory function has been demonstrated by worldwide research. Respiration and mastication are bio- logically inseparable. Fulltime nasal breathing is important to normal jaw development.

The nose controls the sense of smell; it humidifies and regulates nasal airflow and also filters, sterilizes inhaled air and is the "pump" that fills the lungs with air. Since the nose and the mouth are closely related, what affects the nasal cavity will also affect the upper and lower jaws, the tongue and all associated structures including head posture. Normal breathing is conducive to normal growth of the upper and lower jaws and the correct development of the bite. Abnormal breathing habits (mouth breathing and snoring) not only affect the normal development of the jaws and teeth, but affect the total well being of the individual.

Crisis care in medicine is the most costly and least effective form of treatment for any ailment. This has focused health care providers on the importance of prevention as an effective cure. Diet and exercise are important elements in the prevention of heart disease. Regular visits to the dentist, proper brushing and flossing prevent cavities and gum disease. Unfortunately, in orthodontics it is still common practice to allow detrimental growth to proceed until a child is almost mature before starting treatment. This need not be!

Parents can appreciate that the greatest increments of growth occur early in a child's life. In the first 6 months weight doubles and in three years height doubles. These growth increments are never duplicated again in such time spans. At birth 30% of facial growth is completed, by age one 50%, by age four 60%, age eight 80% and by age twelve 90%. Obviously, harmonizing facial growth at a very early age enables the face and jaws to grow more normally during these critical growing years and enhances the child's self- image. Waiting until 80% or 90% of growth is complete reduces the chances of long-term success.

The best time to treat a child's facial skeletal problem is as early as the child will tolerate treatment, usually by age 3 or 4. Breathing problems should be addressed earlier. Untreated, these facial problems deteriorate and often the child will need jaw surgery to resolve the problem. A skilled orthodontist can detect a child's facial development problem early and advise parents as to the proper treatment. Many parents delay too long before consulting an orthodontist, believing that "braces" go on after the permanent teeth have developed. Many children need an orthodontist's help long before they need braces.

Special orthopedic treatment devices, other than braces, can be used to modify and guide the growth of the face and jaws into normal patterns and correct certain types of deformities before surgery becomes necessary. Again, early diagnosis and treatment can prevent major problems and diminish or completely eliminate any long-term psycho- logical impact these deformities may have on the child.

This helps the child to start school with a good self-image; it creates a healthy environment for the development of the temporomandibular joint, for the eruption of permanent teeth and for the development of good speech, chewing, swallowing, and breathing habits. Most of all, it makes school days happy days.

Footnote:
Dr. Rider is a Board Certified Orthodontist specializing in facial deformities in children and adults.