Face-Focused Orthodontics and Dentofacial orthopedics for Children and Adults


Innovative, cutting-edge technology combines facial growth analysis and development with non-retraction orthodontics to achieve straight teeth and ALSO a beautiful broad smile, proper facial proportions and profile and healthy joints and airway. Treatment, following reestablishment 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 face- focused orthodontics and the results are nothing short of amazing.


Phase 1: Evaluate and reestablish 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 and open mouth posture, the midface does not grow properly and the lower face narrows and elongates (which Dr. Nathe can access with the Bolton Analysis) causing:

  • mid-face deficiency
  • elongated or flattened face
  • narrow face
  • nose seeming larger than it is
  • thin lips
  • sunken cheeks
  • retracted lower jaw and recessed chin
  • sloping forehead
  • high, narrow palate

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
  • Myofunctional (tongue) habits
  • Genetics
  • Retraction orthodontics

Possible steps to reestablish nasal breathing and proper oral posture may include:

  • Gentle lip taping to confirm or train (if no obstruction) consistent nasal breathing
  • ENT evaluation and treatment
  • Allergist evaluation and treatment
  • Myofunctional therapy in our office (included in fee)
  • Tongue tie release in our office (included in fee)


Phase 2: The Growth Appliance (6-12 months)


The Growth Guidance Appliance is an exciting new orthopedic technology that actually stimulates the production of bone and models and shapes existing bone. It corrects facial growth abnormalities associated with mouth-breathing, genetics, previous retraction orthodontics, poor oral rest and tongue position by:

  • Widening the upper palate
  • Cause the upper jaw to grow forward
  • Creates space and allows teeth to move to proper position

Mouth breathing, open mouth posture and tongue positioning habits are known to have a very destructive influence on facial development. Without the scaffolding effect of the tongue resting on the palate, the maxilla deforms in three dimensions and changes the shape of the maxilla and lower half of the face causing:

  • mid-face deficiency
  • elongated face
  • narrow face
  • larger appearing nose
  • thin lips
  • retracted lower jaw and chin
  • sloping forehead
  • increased chance of Temporal Mandibular Disorder (TMD or TMJ)
  • increased chance of clenching or grinding your teeth
  • increased chance of headaches
  • increased chance shoulder and neck pain
  • increased chance of back problems
  • increased chance of Obstructive Sleep Apnea

A comfortable custom oral appliance is fabricated that stimulates the palate to produce more bone and grow in each dimension. The entire midface and upper jaw broaden and grow forward allowing for a beautiful smile and pleasing profile, a healthy airway, pain-free jaw joints and overall well-being.

Phase 3: Controlled Arch Orthodontics – NO Retraction! (18 – 24 months)


Innovative, modern orthodontics to preserve the newly created space and achieve straight teeth, a beautiful profile and properly developed face, 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 face-focused orthodontics in Yakima, Washington, can benefit you!