BREATH IS LIFE.
There are those of you out there that think breathing through your mouth is perfectly normal. You have done it all your life and know no other way. The problem is that humans are meant to be nasal breathers and if you are not breathing through your nose, there are serious health implications. If your child is a mouth breather, there are things you can do early on to help them grow and develop properly. They are now, finally teaching dental students to screen for these things, since as a dentist we are in a great position to do so. At Parker River Dental we are expanding our scope of practice to help recognize these issues and seek proper treatment.
It all begins with breathing. You need to breathe well, to sleep well, to function well. If you don’t breathe through your nose 90% of the time, you have disordered breathing. If you mouth breathe just 30% of the time you have severe disordered breathing. I am going to say that again. IF YOU MOUTH BREATHE MORE THAN 10% OF THE TIME IT IS PATHOLOGIC.
Breathing through the nose filters the air and reduces exposure to toxic substances. It adds humidity and warms inhaled air. You get an increase in oxygen uptake and circulation. It slows down breathing and improves lung volume and helps your diaphragm work properly. Nasal breathing lowers your risk of allergies and reduces risk of coughing. Breathing through your nose aids your immune system. It also lowers your risk of snoring and sleep apnea and supports the proper formation of the teeth, mouth, and face.
James Nester in his book Breath, describes what happens when breathing through your mouth. His studies showed that there was and increase in blood pressure, an increase in pulse rate, a decrease in heart rate variability due to your body being in a state of stress, an increase in insulin resistance, a decline in mental clarity, and difficulty eating.
There are many people who can breathe through their nose during the day, but mouth breathe at night. Since we sleep 30% of the time, this still makes for a pathologic situation. Sleep is a non-negotiable aspect of health. We cannot get our restorative sleep and body healing if we are in fight or flight sympathetic mode due to struggling with our airway. According to Dr. Soroush Zaghi from the Breathe Institute, the consequence of untreated pediatric sleep disordered breathing are:
1. Difficulty with emotional regulation
2. Twice the likelihood of becoming a bully
3. Being moody, inattentive, and destructive
4. Increased risk of cognitive dysfunction and poor academic performance
5. ADHD
6. Bedwetting
7. Delayed growth due to decreased growth hormone
8. Obesity due to increase in insulin resistance and daytime fatigue leading to lack of activity
9. Increased risk of Cardiovascular issues
As parents we want our children to be happy, healthy and succeed in life. Having these struggles are huge obstacles for any child. As a dentist there are some red flags I look for to see if a child is struggling with sleep disordered breathing. Some of these can be seen by you as their parent as well.
1. Are they breathing through their mouth?
2. Do they show signs of strain in the muscles of their chin?
3. Do they have enlarged tonsils?
4. Are they tongue-tied?
5. Do they have worn teeth?
6. Do they have a narrow palate?
Having just one of these symptoms can indicate that your child is having airway difficulties.
As I indicated before, getting you or your child to breathe through the nose is the first step. Nasal congestion can be caused by a physical problem but can be the result of nasal allergies, food sensitivities, cold temperatures, dry nasal passages, sinus inflammation, cigarette smoke, or environmental air pollution. Once these things are addressed, if there are still signs of difficulty breathing, we can explore further. You don’t need a sleep study to tell if your child is struggling, in fact they are not usually accurate with children. All you need to do is video record them sleeping. You will be able to tell by the breathing, itself, the snoring, or the restlessness and acrobatics the child does while sleeping and that can be some valuable information to share with the ENT.
Tongue posture is an important thing to consider for children and adults. Your tongue should be forming a suction on the roof of your mouth so it is touching your palate, front and back. Try this and open your mouth. Can you breathe through your mouth with your tongue in that position? No, you can’t. Your tongue is like a switch for nasal and mouth breathing. The switch is up and you breathe through your nose, the switch is down and you may be breathing through your mouth. If you are unable to bring your tongue up, it may be due to poor muscle tone and myofascial therapy can help, or it may be due to a restriction, or tongue-tie, where the muscle attachment under your tongue doesn’t allow for proper mobility of the tongue. This can also be helped with therapy or may need a combination of therapy and a simple surgical procedure called a frenectomy. If it is ever recommended that you have the surgery without the therapy as part of it, I would find a different practitioner to perform it. It will be much more successful in healing properly without scar tissue.
Tongue posture is very important for a growing child. Nasal breathing and having the tongue on the palate allows for the proper formation of the palate, which is the floor of the nose, the maxilla, or upper jaw, which is the floor of the orbits, and the mandible, or lower jaw. Children who don’t have proper tongue posture have narrow palates, receded lower jaws, crowded teeth, a narrow face, and bags under the eyes. They may even develop compensations such as slumped shoulders and forward head posture to help keep their airways open. These are the kids that need orthodontics and palate expanders which helps with some of their problems, but if you don’t address the cause they may still have upper airway resistance and/or sleep apnea.
I chose to write about this topic today to raise awareness of this very serious issue. In the book Airway Management, A Solution for Our Health Crisis by Dr. Steven Olmos, he discusses how the medical community is discovering more and more links between poor airway management and many health problems such as diabetes, cardiovascular disease, and blood pressure. He notes that sleep breathing disorders are often not diagnosed or treated, even though they can be life threatening. Sleep apnea is responsible for more sickness and death than any other sleep disorder and he claims that only about 20% of the people that have it are being treated. According to Dr Zaghi, children who breathe through the mouth will eventually become adults with sleep apnea if it goes untreated. I wish I knew this when my children were young. One of my sons definitely had a lot of these struggles and I am happy that I at least had the forethought to get him the palatal expansion he needed at a young age, but we are going to continue our treatment to hopefully keep him form developing sleep apnea. I hope to be able to help other children and their parents catch these problems that are so prevalent, at a young age and help them to develop healthy airways with less intervention.
-Written By: Dr. Robin Davies, DMD, CHC