Horizontal Growth- Where are We Growing?

One of the most interesting observations from research in to identical twins is the difference in growth of the maxilla, the upper jaw. This section of the face varies from growing purely horizontally to purely vertically. The difference to how the face looks and their health is remarkable.

Tara Lynn, possibly one of the best example of facial growth that I’ve seen. Great body posture and great cheek bones. Is looking good and being healthy a coincidence or are they different sides of the same coin. We tell people they are looking healthy when they are looking good


Vincent Schiavelli, his upper jaw has grown downwards nearly vertically and to an extreme amount. In maintaining a paten airway he chose to rest with his tongue between his teeth so that his mandible is placed directly under his maxilla. The falling maxilla has left his nose looking much bigger, is this true or is it his cheek bones that have fallen down?


Clint Eastwood. Good muscle tone, strong jawed but his tongue is down a little, so although he generally rests with his lips together his maxilla is down a little. So he does not have a small button nose but a stronger raise one, especially at the bridge


Richard Kiel. Excellent muscle tone but lips apart and tongue down most of the time so his maxilla has dropped, pushing his tongue down into his airway. He responded by holding his mandible forwards that gave space for his tongue. It’s difficult to analyse someone’s maxilla when they are smiling but his nose certainly looks larger and there is lost tissue under his eyes.


Kate Moss. A great example of someone who’s face grew well. Hollow cheeks from swallowing correctly. With good muscle tone, tongue on the roof of her mouth and good body posture her maxilla has gown near horizontally forward. A big question is whether a pout the same as a lip apart posture? It seems that it is different since Kate leaves her lips together at rest, which is most of the time. Pouts have sexual connotations and their use in modelling shots many not represent normal lip posture.


Margret Thatcher. Her maxilla has dropped down really quite far leaving her with diminished cheekbones a large nose and bags under her eyes. Her mandible has hinged down and is slightly set back from the maxilla as she moves her tongue forward between her teeth hanging her jaw down. This helps to maintain her airway but she also need to hold her head forwards and rotated up. Notice that he neck is curved and (under her hat) that her forehead is sloping, she is not a Neanderthal throw back, her head is rotated in compensation to her face melting down.



The direction of growth of your maxilla is hugely influential on how your face will develop and yourgeneral health. Horizontal growing faces are healthy, look good and are easy to treat where as vertical growing faces are less healthy, don’t look as good and are very difficult to treat. It was once a great goal of orthodontics to change the pattern of facial growth.

Although some cases clearly changed from horizontal to vertical, it proved impossible to do the reverse, converting a vertical pattern to a horizontal one. This seemed to confirm the assumption that growth patterns were genetic, thus supporting the mechanical approach to correction and allowing the cases that grew more vertically to be labelled as unfavourable growth patterns, absolving any blame. It also proved impossible to predict the pattern of growth. Prediction has long been considered a hall mark for the credibility of a science but despite research suggestion that this was possible, when the good and great were sent information on treated cases where the growth direction was already known they gained no better than random scores for their ability in growth prediction.


Example of unfavourable facial growth associated with orthodontic therapy, in particular retractive orthodontics. The child declined to be identified but the effect is apparent from the tracing


The aim of any system that complies with the objectives of orthotropic theory is to convert vertical growth to horizontal growth, so that difficult cases become easy to treat and moderate cases will unusually align their own teeth (as the other 5,400 species of mammals did without braces)- in pure orthotropics treatments no fixed braces are used.

  • By changing this boy from a vertical to a horizontal growth pattern his teeth have aligned without braces and there has been a marked improvement in his facial appearance.


  • The final illustration is a comparison of the jaw positions of an indigenous modern human compared to the average of modern humans that were considered to have good facial growth, and no malocclusion (crooked teeth) the genetic differences are small. The change is dramatic and clearly illustrates the vertical pattern of growth that is occurring.