Your palate is the roof of your mouth. It separates your mouth from the cavities of your nose. Development of your palate starts in utero around the sixth week of development and continues to develop through early childhood.

A narrow palate is two standard deviations narrower than average. Two standard deviations below average means that your palate is narrower than the palates of 98 percent of people.

Structural mouth abnormalities present at birth and habits like aggressive thumb sucking can contribute to improper development of the palate. If left untreated in childhood, a narrow palate becomes more difficult to treat as a teenager or adult.

A narrow palate puts you at risk of developing conditions like obstructive sleep apnea, impacted teeth, and speech concerns. Treatment with palate expanders or surgical intervention may be able to relieve these symptoms.

In this article, we examine symptoms of a narrow palate, potential causes, and treatment options.

A narrow palate can lead to breathing issues and teeth misalignment. Here’s a look at how symptoms may appear at different life stages.

In babies

Babies with a narrow palate may have difficulty nursing or feeding from a bottle. Improper suction from a narrow palate can potentially lead to air bubbles when nursing that leads to excessive gas. Other potential symptoms in babies, include difficulty:

  • nose breathing
  • latching when nursing
  • sleeping
  • breathing at night
  • clearing nasal fluids

In children

A narrow palate can cause breathing issues in children that lead to a habit of mouth breathing or obstructive sleep apnea. It can also lead to dental concerns like:

  • crowded teeth
  • crossbites
  • impacted teeth
  • increased risk of poor oral health

Your child may also develop speech variances, especially with sounds that involve contact of the tongue against the palate.

In adults

Adults may have many of the same symptoms as children. Once the mouth is fully developed, treatment becomes more difficult and usually requires surgery.

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High-arched narrow palate – with abnormal tooth shape (C). Copyright : © 2018 Medicina Oral S.L.

A tongue-tie is when you’re born with an overly short frenulum, which is the band of tissue that connects the bottom of your tongue to your mouth. A 2017 research review showed that about 4 to 16 percent of newborn children are born with a tongue-tie, and it’s more common in boys.

Tongue-ties restrict movement of your tongue and can potentially disrupt proper development of your mouth.

Normally, your tongue exerts gentle pressure on the roof of your mouth that aids in the natural widening of your palate through childhood. In a person with a tongue-tie, the tongue may not touch the roof of their mouth. A small 2014 study showed that a lack of contact between the tongue and palate can disrupt bone formation and position of the teeth.

Treating a tongue-tie in infants may help prevent improper development of the mouth as an adult. The most common treatment is a relatively simple procedure called a frenotomy.

Along with a tongue-tie, several other factors can contribute to the development of a narrow palate.

Genetics and developmental issues for a fetus

A 2016 study with mice showed that abnormalities affecting the head and face account for about 1 in 3 developmental issues for a fetus, and the majority involve the palate or upper lip. Any condition that disrupts development of the palate in utero can lead to a narrow palate.

A number of genetic conditions can also lead to improper palate development. Ramon syndrome, pyknodysostosis, and Marfan syndrome are three of many potential genetic causes.

Thumb sucking and pacifiers

Aggressive thumb sucking and pacifier use causes pressure in the mouth that can disrupt palate development and teeth alignment.

Most of the time, children stop thumb sucking between the ages of 2 to 4. Children who don’t stop sucking their thumbs by this age may be at an increased risk of improper mouth development.

Facial injury

A facial injury while the palate is still developing can disrupt proper bone growth. The University of Iowa says that injuries to the palate in children are relatively common. Most of the time, injuries heal without needing specific medical treatment.

A narrow palate is often accompanied by dental concerns like:

  • crowded teeth
  • crossbites
  • impacted teeth

It can also cause breathing issues due to obstruction of the nasal cavity. For some people, this obstruction may lead to a habit of mouth breathing. Obstructive sleep apnea is also common in people with a narrow palate due to narrowed airways.

Some people may also experience speech variances due to changes in the way the tongue touches the palate when speaking.

In general, a narrow palate becomes harder to treat as you get older. In infants and young children, a type of orthodontic device called a palate expander may be sufficient to reshape the mouth. Adults often need surgery.


A frenotomy, in which the frenulum is snipped with surgical scissors, may be used to treat tongue-ties in infants to prevent future concerns with mouth development.

Palate expanders

Palate expanders are devices that exert pressure on your mouth to widen your palate. A small 2017 study showed that they’re most commonly used in children and teenagers under 15 years old before the palate finishes developing.

Along with widening your jaw, they may be used to correct improper alignment of your teeth. Some types of palate expanders are attached to your mouth while others are removable.

Jaw widening surgery

Once the mouth stops developing, fixing a narrow palate becomes more difficult. Jaw widening surgery is often the best treatment option for teenagers and adults.

Surgery involves making a cut in the bone of your upper jaw and repositioning it with an expansion device. The bone will fuse after weeks to months of healing. You’ll have a gap in the front of your teeth which can be corrected with orthodontics.

Distraction osteogenesis for maxillary expansion (DOME)

DOME is a particular jaw widening procedure developed at Stanford University to help symptoms of obstructive sleep apnea caused by a high-arched, narrow palate. A small 2017 study showed that previously developed surgical techniques for treating a narrow palate primarily focused on fixing dental concerns.

A small 2019 study found that DOME is effective at reducing sleep apnea symptoms and improves subjective measures of nasal breathing.

A narrow palate often leads to dental concerns like crowded or impacted teeth. It can also lead to speech problems and trouble breathing. Genetics, abnormal mouth development, having a tongue-tie, and aggressive thumb sucking as a child can all play a role in the development of a narrow palate.

A narrow palate is easiest to treat in infants and young children before the mouth stops developing. In adults, a narrow palate is usually treated with surgery.