Osteopathic Approach to the Oral Cavity

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Dr. Sylvia Orozco Silberman DO, MS
August 21, 2023 / 6 mins read

“Anatomy is a living wholeness of function and should be seen as a mystery of form, not static academic structure.”

— James S. Jealous DO


The tongue is an incredible muscle that plays a critical role in several functions that are vital for survival, such as the influence on airway anatomy and the swallowing function for the intake of nutrients.

I invite you to notice the location of your tongue. Is it at the roof of your mouth? Is it hanging relaxed and down? Is your mouth open so you can breathe? Do you have bite marks on the inner lining of your cheeks? Can you swallow while having your cheeks held apart?

The tongue should rest at the roof of the mouth at all times. The lips should be sealed, with a relaxed face. The chewing of whole unprocessed hard foods stimulates mandibular growth, aka your jaw.

Imagine how essential the function of the tongue is. We swallow about 400 to 600 times a day. The tongue’s function is vital for survival as babies breastfeed for nutrients. Its resting position impacts the palate shape and craniofacial development, which in turn influences airway capacity.

The function of the tongue determines the form of the palate. While swallowing, the tongue motion pushes on the palate, like a glacier coming down a valley and spreading the mountains apart. If the tongue rests at the bottom of the mouth, the individual develops a high palate. This limits the airway capacity in the nasal cavity, making it more likely that the person is a mouth-breather.

Therefore, form follows function. The form of the palate follows the function of the tongue. The cranial facial development of an individual follows suit. A dentist, with this appreciation, can tell you about the oral cavity just by looking at a patient’s facial bone structures.


Chewing is important! We are meant to chew on hard, whole foods and meats in order to stimulate the mandible to grow. One can appreciate the changes in mandibular growth from early humans to now. As we started cooking and softening our foods, our mandibles became smaller and smaller. This lack of stimulation to enhance the growth of the jaw results in the whole body shifting to a new center of gravity. The body compensates and brings the head forward, flattening the cervical spine and upper back. So, the function of chewing determines the form of the mandible, which affects the curvature of the neck and back.

The oral cavity plays a role in nasal breathing (airway), swallowing, chewing, and talking. These activities take place all the time, throughout the day. So, imagine if the function of swallowing or chewing is compromised. It would affect our airway passages, and our posture, as well.


We have 29 bones in the head. Most of the sutures in the head are not fused – which, in fact, serves a purpose to allow for motion. In allopathic medical school, and in dental school, there is no acknowledgment for the study of the motion exhibited by the bones in the head.

Our lymphatic system (called “glymphatics” in the brain) propels through and around the brain. Its purpose is to transport immune cells to the brain. The system also cleans up large molecules, such as toxins, in the brain. The capacity for motion between the individual cranial bones—into a coordinated whole cranial motion of flexion and extension around the joint where the sphenoid bone and occipital bone come together—allows for the fluid to flow efficiently and cleanse the brain.

Improper tongue function and lack of chewing affect craniofacial development. In addition, other events in our lives determine the form and function of the cranium. Birth injuries that don’t allow for the cranium to mold on the way out—such as a baby’s position, pitocin use, vacuum use, or C-section—can affect the joint. All these events can also compress the cranial nerve that goes directly to the tongue.

Additionally, traditional orthodontic care does not encompass the oral cavity’s effect on the whole body, including the ultimate goal of bringing the tongue into its proper function and placement at the roof of the mouth.

We live in a compromised environment with poor soil, poor food quality, too much screen time, and a heavy toxic load. So, where are we left?

Let’s optimize the body’s clean-up system to cleanse the brain. Create room at the roof of the mouth to house the tongue. Get the tongue to work appropriately at rest and during a swallow. Let’s get the mandible activated during chewing. Let’s unwind the patterns in the body created by birth injuries, orthodontic care, rapid palate expansion, trauma, concussions, and so forth.

The ALF (Advanced Lightwire Functional) appliance is a biocompatible wire that is placed in the upper palate and lower jaw and was created by an osteopathically-minded dentist, Darick Nordstrom, DDS. His intention was to create a device that would work in synergy with the rest of the body’s physiological functions. The ALF appliance works with the body in a non-forceful way. It acts as a 24/7 cranial osteopathic device, amplifying the body’s cranial motion so that the whole body can unwind and heal itself.

It is positioned using a team approach between a cranial osteopathic physician, a functional dentist, and a myofunctional therapist, and used in conjunction with osteopathic manipulative treatment, and a myofunctional therapist working with breathing and tongue function. The appliance can provide an incredible transformation for children and adults.

For more information on resources:

Book: The Alf Approach, by Dr. Tasha Turzo, DO (https://www.drtashaturzo.com/alf-
Article: https://www.tandfonline.com/doi/full/10.1080/08869634.2019.1570638