How a Long Face Can Impact Health

About one in five Americans has long face syndrome, known clinically as “facial hyper divergence.” In patients with this condition, the lower part of the face that includes the jaw and chin is longer than normal, which makes the face appear long and narrow. Hyper divergence can develop in early childhood and persist through adulthood.

Many people with this facial structure aren’t aware that they have it, though they often have dark or droopy skin under the eyes and their gums tend to be visible when they smile.

Troubling symptoms

When long face syndrome goes untreated, trouble can occur if the jaw and chin separate from the rest of the face. When this happens, some people develop difficulties eating and talking. Others experience severe medical and dental problems, including:

• Snoring
• Sleep apnea
• Chronic fatigue
• Jaw misalignment
• Crowded teeth
• Worn down or broken teeth.

No one knows exactly what causes long-face syndrome, though researchers believe a combination of factors—from chronic nasal obstruction, nasal allergies and breathing through the mouth to weak chewing muscles and genetics—may contribute.

Long face syndrome usually is diagnosed when a patient complains to a dentist or primary care doctor about one of the above issues. The condition typically is uncovered in adults as part of a diagnosis of sleep apnea or a dental problem, and is suspected in children who breathe through the mouth or have a noticeably misaligned jaw. A primary care doctor or dentist will diagnose long face syndrome by performing a facial examination and taking an X-ray to measure the facial proportions.

A variety of treatments

Facial hyper divergence is easier to treat in younger children because their faces are still developing. Surgically removing the adenoids (tissue behind the nose) to clear breathing passages might be enough to help younger children, while older children and adolescents might benefit from adenoid removal plus braces to correct previous damage and prevent future malformations.

For adults, treatment can be challenging because their faces are fully developed. Adenoidectomy can improve breathing but will not correct jaw misalignment, so an adult would then need to wear braces for 12 to 18 months. After that, oral surgery still might be required.