La beauté se respire par le nez | Johan Nouwen | TEDxNouméa

Translator: Matt Leedham Reviewer: Claire Ghyselen When my daughter was eight years old, she always had a blocked nose. She would breathe through her mouth. She also used to suck her thumb which made her teeth push forward.

She was cute but she did have quite an unusual look. Her face got longer but didn't get wider. It was so long that, when she smiled, you could see her gums.

At night, she snored. I started to get really worried. I knew that there was a problem.

Being a doctor, I went back to my notes and I did research to find out what was wrong, and then I found out. So, we unblocked her nose. As she wasn't able to stop sucking her thumb, an orthodontist put a device between her teeth to make her stop.

That worked really well. She did speech therapy to learn to position her tongue correctly. She slept with a plastic retainer in her mouth.

Believe it or not, but in six months, her face became perfectly balanced. Her teeth became vertical, her face opened up. Now, she is gorgeous.

It didn't take much at all but this little change was enough to completely revolutionise her growth. I am speaking to you this evening so that none of you here miss out. If we analyse the skull of a newborn and compare it to an adult's, the size of the cranium, in other words, where the brain is, at the point of birth, has reached almost three quarters of its total size.

It's because the brain has developed hugely during pregnancy and so the skull has done likewise. However, at birth, the lower part of the face is completely squashed. In the mother's womb, the baby's skull does not serve any purpose.

The baby does not feed itself, or breathe, so its face does not develop. But at birth, there is a great shock. The child must feed by itself, breathe itself, and communicate.

Its face, therefore, must develop. Okay, so how does that happen? Well, the different bones of the skull are connected by what we call sutures.

When the sutures are put under pressure, the bones stretch out. That's how the skull develops, in response to stimulation. An essential stimulation in the face's development - which was lacking with my daughter - is the position of the tongue.

The tongue is located in the mouth. Above that is the palate, which is formed by the fusion of the two maxillary bones. The maxilla are important because they determine the position of the jaw, the opening of the nose, the shape of the cheekbones and the eyes.

The tongue is larger than the palate. So, if the tongue slides against the palate, it puts pressure on the sutures which widens the two maxilla bones. The tongue opens the maxillae.

If the maxillae open, the palate, which is triangular at birth, spreads out, becomes horizontal. That makes space for the teeth which will develop. The 20 milk teeth, then the 32 permanent teeth.

If the maxilla opens, the nose opens. That allows the child to breathe increasingly large amounts as they grow. The cheekbones spread out, which gives the face a nice shape and, it pushes the eyes upwards which allows the eyelids to stretch out and slim down.

If the tongue rubs against the palette, the mouth closes. You're all trying it now! (Laughter) It's very important that the mouth is closed because that allows the teeth to grow properly.

They are pushed forward by the tongue but held back by the lips. So they grow straight. And they aren't too long because their growth is stopped by the teeth which come from the other side.

Because opposite, they face resistance, these teeth lock in tightly in the bone. It's great. (Laughter) And if the mouth is closed, the teeth and the gums are protected and washed by the saliva.

Everything goes well, everything goes marvellously well. The growth is harmonious. But watch out: this balance is fragile.

What happens if, like my daughter, the child grows with a blocked nose? They could have an allergy, a deformity, enlarged tonsils or adenoids. If the child grows with a blocked nose, they breathe through the mouth.

So the mouth opens, the tongue drops to give a passageway of air and it no longer sticks to the palate, and so the tongue no longer causes the opening of the jaw. That is where the problems begin. Another example: under the tongue a small string connects the tongue to the bottom of the mouth.

We call this the frenulum, it's easy to see. What happens if this frenulum is too tight? The tongue is forced downwards, it is no longer stuck to the palate and no longer causes the opening of the jaw.

That can be catastrophic. If the jaw doesn't open, it remains triangular and narrow. When the teeth come, they don't have space they grow on top of one another, we say that they overlap.

This man is 40 years old. His maxilla, his upper jawbone, has not developed at all. It's very narrow, so there is no space for the teeth.

And rather than making space, he had eight teeth removed. Do you realise, eight teeth is a quarter of his whole set. After all that, the remaining teeth are crowded anyway, they overlap.

To begin with, this man's problem was that he grew up with a blocked nose. That's all. He consulted doctors and dentists.

Not a single one thought to make him breathe through his nose. If the jaw doesn't open the nose, the nasal cavities don't open either. The pathway which brings air to the lungs does not develop.

So it's a vicious cycle: the less a child breathes through the nose the more difficult it becomes to breathe through the nose. Likewise for sleeping, because sleeping requires breathing. Especially as, when you sleep, your muscles relax meaning that the airways contract.

If there is also a blockage inside, it's very difficult to breathe. So, the child develops sleep problems. They snore, sleep open-mouthed.

They have a very disturbed sleep. They spend the night trying to find a comfortable position so that they can breathe easily but they don't find it. So they have nightmares and sleep terrors.

They wet the bed. Look, this is the typical position of a child with enlarged tonsils. The poor child has to sleep on their back, head tilted back, mouth wide open to try to make as much space as possible.

The child who grows with a blocked nose condemns the adult to never being able to breathe through the nose. Never, because their nose hasn't developed. The adult also develops sleep disorders.

These adults experience more car accidents, they are more often diabetic, obese, and hypertensive. Some need machines to help them sleep. It's really serious.

The cheekbones don't open either. The eyes don't slim down but become rounded. That gives the child a sad, tired look.

As the tongue rests on the mandible, the lower jawbone, the jaw lengthens. In addition, the maxilla doesn't open, that causes the face to stretch out. When the child smiles, you see their gums.

It's Ronaldinho's smile. (Laughter) It's unexpected. (Laughter) If the nose is blocked, the mouth is open and so the teeth cannot grow properly.

They are pushed forward by the tongue but they are not held back by the lips. Typically, a child who develops a blocked nose has teeth which push forward, like a rabbit. It's not funny.

The comparison doesn't end there. As these teeth don't meet other teeth from the other side, they are long. They don't stop growing and so they stick out.

Because opposite, there is no resistance, they are poorly aligned. Teeth which are long, which push forward, which are not well aligned, which are not protected by the lips, are fragile and they break. Especially when children run, jump and fall over.

If these teeth last childhood, there will be problems in adulthood. Being poorly aligned, they become loose very easily. When the mouth is always open, it is dry, there is less saliva.

Now, saliva protects. Less saliva means more cavities, and more gum disease. A foul breath.

All of that because of enlarged tonsils, a blocked nose or a tongue tie. Still, it's not too difficult to sort out. At the same time, we all know children like that.

Children who snore, always with their mouths open. They look exhausted, their teeth push forward or overlap each another, have "gummy" smiles. Or worse, children who wear braces and yet still have their mouth open.

This girl is 10 years old. She comes to see me because she can't breathe through her nose. She has a problem with pronunciation: she has a lisp.

For the last two years, she has received orthodontic treatment. It is unbearable. With a tongue tie like that, how can you expect the tongue to work properly?

Obviously she has a blocked nose, it is not developed. Of course she snores. Okay, she has nice teeth, but there is so little space that the braces have pushed the teeth outwards to the extreme.

Normally, the teeth are in the middle of the bone not on the sides where they don't stick. If we had cut just the frenulum, nothing special, it takes 10 seconds, it doesn't require any specific skill. It is risk free.

If we had cut the frenulum, this little one could have suckled her mother. You cannot suck with a blocked tongue. She would have slept, breathed, she would have spoken properly.

As it is, people mock her every time she speaks. She wouldn't have done dozens and dozens of speech therapy sessions to learn how to speak well, to speak better. You can't speak well with a blocked tongue.

It's like learning to drive with the handbrake on, it's ridiculous. She wouldn't have done two years of orthodontics. It hurts and it's also expensive.

If we had looked for the frenulum at birth, when consulting paediatricians or general practitioners, or on school trips, or during these numerous speech therapy sessions, or, even more obviously, before starting orthodontics, If we had cut it or had it removed, her growth would have been completely different. The frenulum serves no purpose, it's an embryonic vestige like the appendix. It's rather surreal that a problem which is so easy to fix is ignored to such an extent by nurses.

So, when you see a child who, by all accounts, has problems with the growth of their face, you must treat them. If it's not your child, you must explain to the parents why it must be treated. Treating it means first of all restoring nasal respiration.

The doctor must make the child breathe. They will treat allergies, deformities, remove tonsils and adenoids if they are too enlarged, cut the frenulum if necessary. Then, you must teach the child to position their tongue correctly against the palate, while doing a serious speech therapy re-education.

When all of that is done, orthodontic treatment can be done to accelerate the normalisation of the face's development. It is useless before. So, it is not normal to have a child who always has their mouth open because they have a blocked nose.

Nor is it normal to have a child who snores in other words, a child with respiratory problems when they sleep. It might seem trivial or benign, but it isn't. It's a public health problem.

You must treat this child to optimise the development of their face. Now, at least, you, all of you, know it. Thank you.