At Yakima Smiles, Dr. Pete Nathe offers an innovative and exciting new type of orthodontics called Facial Development Orthdoontics® or Physiologic Orthodontics that not only creates a beautiful smile with perfectly aligned teeth but also solves the problem of adverse growth and development of the face and jaws. This new approach allows for a more ideal and stable orthodontic result as well as an aesthetically pleasing face and profile. The ultimate goal is a broad, beautiful smile AND the lifelong health benefits of a healthy airway and TMJ. We invite you to contact our office at (509) 965-7909 to learn more about the benefits of Facial Development Orthodontics® in Yakima, Washington, and schedule your appointment with our experienced and specially trained dentist.

What is Facial Development Orthodontics®?

The field of dentistry and orthodontics is always advancing and Facial Development Orthodontics® is the latest advancement. In conventional orthodontics, problems like underbites, overbites and crossbites are very difficult to correct and often relapse long term because the underlying factors that caused them are not typically addressed. Sometimes jaw surgery is recommended for underdeveloped jaws, but there is a limit as to how much the surgeon can stretch the tissue. Again, long term retention is difficult because the causative factors are not addressed. Facial Development Orthodontics® offers a non-surgical option to adverse face and jaw growth. Dr. Nathe has extensive training in this new orthodontic field. Facial Development Orthodontics® uses an anterior growth guidance appliance to develop faces and jaws to their full genetic potential.

How is Facial Development Orthodontics® different from traditional orthodontics?

The goal of traditional orthodontics is to straighten the teeth and create a nice smile, but it neglects jaw and face development and position. Retraction, where the teeth are moved backwards in the mouth, has been the accepted method of treatment with traditional orthodontics. Patients with underdeveloped jaws usually experience dental crowding and “don’t have enough room” for all their teeth. Sometimes, removal of the four permanent bicuspids is recommended followed by retractive orthodontics which makes the jaw even SMALLER. This leads to compromised facial aesthetics, temporomandibular joint disorder and obstructive sleep apnea, in addition to a dramatic loss of facial aesthetics.

What causes adverse face and jaw growth and orthodontic misalignment?

The “Big Three” in face and jaw development include:

  • Consistent nasal breathing
  • Lip Seal
  • Proper Tongue Posture

When any of the “Big Four” are interrupted during development, we commonly see patients with an upper jaw that is too small (underdeveloped), a lower jaw that is too small (underdeveloped) and one or both jaws recessed.


Effects of incorrect tongue position due to mouth breathing or poor oral position


The orthopedic and orthodontic effects of mouth breathing, poor lip seal and adverse tongue posture

Mouth breathing, open mouth posture, tongue positioning habits and tongue tie are known to have a very destructive influence on a child’s developing face. Without the scaffolding effect of the tongue resting on the palate, the upper jaw deforms in three dimensions and changes the shape of the mid-face and lower half of the face causing:

  • High narrow palate/narrow maxillary arch
  • Mid-face deficiency
  • Flattened face
  • Sloping forehead
  • Elongated lower face
  • Narrow face
  • Thin lips
  • Recessed chin/retracted lower jaw
  • Sunken cheeks
  • Small jaws without room for all the permanent teeth
  • TMJ pain and dysfunction
  • Obstructive Sleep Apnea
  • Headaches/shoulder & neck pain/poor posture
  • Dental crowding and malocclusion


The SOLUTION: Facial Development Orthodontics® with anterior growth guidance

Innovative, cutting-edge technology combines facial growth analysis and development with non-retraction orthodontics to achieve straight teeth and a beautiful broad smile, more ideal facial proportions and profile and healthy joints and airway. Treatment, following re-establishment of nasal breathing, consists of an orthopedic growth phase to achieve aesthetic facial dimensions and profile and an orthodontic phase to straighten teeth and preserve newly created space without retraction orthodontics. Sounds complex and high tech? It is! But, Dr. Pete Nathe of Yakima Smiles has had extensive education and training in Facial Development Orthodontics® and the results are nothing short of amazing!

Phase 1: Evaluate and re-establish nasal breathing, if necessary

Oral position (lips together, tongue on palate) is largely responsible for the normal growth and development of the face and jaws. The tongue is a powerful muscle and should rest against the upper palate (roof of mouth) and cause the upper jaw to broaden and grow forward in the healthy and aesthetically appealing manner. When this does not happen, because of mouth breathing (or a tongue tie) and open mouth posture, the midface does not grow properly and the lower jaw is typically trapped behind a deficient midface. Dr. Nathe can assess this with the a Bolton Analysis and Cosmetic Line reading followed by complete records, photos and computerized analysis.

Not only does mouth breathing and poor oral rest cause changes in facial growth, they also impact long- term health because the jaws, palate and airways develop abnormally and can lead to:

  • TMJ issues
  • Obstructive Sleep Apnea
  • Headaches/shoulder & neck pain/poor posture
  • Dental crowding

The most common causes of mouth-breathing, poor oral rest and constricted face and jaw development include:

  • Enlarged tonsils and adenoids
  • Allergies
  • Frequents viral infections
  • Chronic open mouth posture
  • Tonge tie
  • Myofunctional (tongue) habits
  • Genetics – only 10%

Possible steps to re-establish nasal breathing and proper oral posture may include:

  • Gentle lip taping or Myo Munchee to confirm or train (if no obstruction) consistent nasal breathing
  • ENT evaluation and treatment
  • Allergist evaluation and treatment
  • Myofunctional therapy
  • Tongue tie release

Phase 2: The Anterior Growth Guidance Appliance (AGGA)

The Anterior Growth Guidance Appliance “AGGA” is an exciting new orthopedic and orthodontic technology that actually stimulates the production of new bone and models and reshapes existing bone to develop a more aesthetic face, as well as healthier airways and jaw joints. It is the foundation of Facial Development Orthodontics®!

At Yakima Smiles, we utilize either a fixed AGGA or a removable AGGA, depending on the age of the patient and the stage (primary, transitional or adult) of the dentition.

The removable AGGA (for children with primary and transitional dentition) puts light pressure on the nerve that runs right through the palate. This activates growth centers in the upper jaw to produce bone and stimulates remodeling and development of the entire nasomaxillary complex, including the mid-face and upper jaw. We can help children with adverse growth patterns by developing their face and jaws to their full genetic potential (size, position and shape). In some instances, a removable AGGA can even eliminate the need for future orthodontics or enhance the aesthetic results and health benefits of orthodontics by creating a broad palate with plenty of space for the teeth to evenly erupt in perfect alignment.

The fixed AGGA (for adults) stimulates remodeling and bone development behind the canines as the jaw and face grow in each dimension. The AGGA broadens the upper jaw, which allows the lower jaw to track forward. It addresses the devastating effects of mouth-breathing on facial development, airway patency and jaw joint health.

Benefits of the AGGA:

  • Upper jaw forward development allows the trapped lower jaw to move forward
  • Develops face and jaws towards their true genetic potential
  • Creates space for proper bite and teeth alignment
  • Corrects underbites, overbites and crossbites without surgery

A comfortable custom oral appliance is fabricated that stimulates bone production in each dimension. The mid-face and upper jaw develop forward, allowing for a beautiful, broad smile, and a healthy airway and jaw joints. A broad arch is critical for facial beauty, a perfect smile, and a healthy airway and TMJ.

What does an AGGA look like?

fixed anterior growth appliance
removable anterior growth appliance


Phase 3: Controlled arch orthodontics – NO retraction!

Innovative, modern orthodontics to preserve the newly created space and achieve straight teeth, a beautiful profile and faces developed to their genetic potential, a healthy airway and uncompromised jaw joints. It takes a dentist with a commitment to training and dedication to clinical excellence but it CAN be done!
  • Dr. Pete Nathe and his Yakima Smiles team are happy to provide a complimentary Bolton Analysis of your child’s face and jaw development.

There is a lot more to orthodontics than just straight teeth!!!

Contact our office today at (509) 965-7909 to make an appointment with our experienced dentist and learn more about how Facial Development Orthodontics® in Yakima, Washington, can benefit you!

Hat Lady

What are Dr. Pete Nathe’s qualifications?

While Facial Development Orthodontics® produces a result that is nothing short of amazing – it is a technical and complex process. Dr. Pete Nathe of Yakima Smiles has completed the entire orthodontic continuum at the renowned Las Vegas Institute for Advanced Dental Studies with the following series of advanced clinical courses:

  • Physiologic Orthodontics
  • Full Face Orthodontics
  • Controlled Arch Orthodontics
  • Advanced Jaw Development Orthodontics
  • Facial Beauty Institute Advanced Diagnostics

Training and Experience Matter!


Facial Development Orthodontics® could be a great solution if:

  • You have an overbite
  • You have an underbite
  • You have a crossbite
  • You have been told you need corrective jaw surgery
  • You have been told you need teeth extracted as part of orthodontic treatment
  • You suffer from TMJ symptoms
  • You suffer from obstructive sleep apnea
  • You have mid-face deficiency or long face syndrome
  • You have a very narrow face and recessed chin
  • Your bite is misaligned
  • You are a mouth breather

If this sounds like you or your child then call Yakima Smiles @ 509-965-7909 today for more information or to schedule an appointment! Facial Development Orthodontics® could change your life.