September 23, 2019
by Dezarae Aldridge-Earl, RDH
You check on your 5 year old before heading to bed and can hear her snoring, yet again. You wonder if it’s just her allergies? You think to yourself, will it ever pass? You remember the conversation you had with your doctor at the last appointment when you were reassured that the enlarged tonsils were fine and told “she will grow out of them.” There also seemed to be little concern for the nightly snoring that continues night after night.
As you close the door behind you, you get that chill that radiates down your spine every time you hear that sound. The sound of teeth grinding on teeth. Man, you can’t stand that sound, like nails on a chalkboard. The dentist mentioned the wear on her front teeth at the last cleaning, but didn’t seem too concerned. They too were hopeful that she will simply “grow out of it.”
….Fast forward 10 years without any interventions and you may not recognize that cute little girl that you once knew years ago. You may see crowded teeth when she smiles, and teeth that don’t completely close in the front, a place where the tongue often wants to rest. She may have had some difficulty with speech when she was younger and even possibly still does. You may notice your daughter has developed a daily habit of breathing through her mouth. It’s not because she chose to do so. She started this years ago out of necessity for a need of oxygen to survive. The ENT told you that the tonsils were fine and there was not a need to remove them because there wasn’t enough of a history of either ear infections or strep throat to complete the procedure. However, your daughters developing body and airway never agreed. The large tissue masses that took up more than 50% of her airway, restricted her nasal breathing, and ultimately changed the craniofacial development of her growing face and jaws.
Did you know, our jaws grow while we are sleeping and when we do not have a lip seal and proper oral resting posture, our mandible hangs open, down and forward. The tongue then hangs low in the mouth and does not hold the space for the growing maxilla. This allows the palate to develop into a vaulted, high narrow palate, where there is not enough room to house the tongue, a place where it belongs. The tongue can also fall back into the airway, blocking and restricting air flow. If breathing this way continued long enough in a growing face, ultimately the individual will develop a narrow, elongated face. By the age of 12, the majority of facial growth and development is completed.
You may also find that your daughter has never slept well. You may hear her at night while she either grinds her teeth or snores. She may have sleep disordered breathing. Both teeth grinding and snoring is NOT normal and should not occur in either children or adults. Both grinding and snoring are symptoms of a bigger problem, likely an airway issue. Let me say loud and clear, NO CHILD SHOULD EVER SNORE! If you hear this, or have a client that identifies that their child snores at night, I would strongly advise them to have an airway assessment completed by a skilled healthcare provider. Dental providers are the perfect fit to offer this valuable screening and can easily be completed during a routine recare appointment.
When an individual is either teeth grinding or snoring during sleep, they trigger the sympathetic nervous system state, with a reduction in parasympathetic tone (fight or flight). Some studies suggest that children with habitual snoring could be associated with possible increases in cardiovascular risk in adulthood. Snoring triggers stress hormones and ultimately limits a child’s ability to acquire the required amount of deep sleep that is needed for growth and repair in a growing individual. Sadly, many children have been misdiagnosed with ADHD and placed on unnecessary medications, when all they really need is simply a good night’s sleep.
As parents and healthcare providers, we need to be the voice for growing children and adults. We can work together to collectively provide whole and overall health and wellness in dentistry. Together we can improve the lives of so many more individuals and potentially prevent conditions like cardiovascular disease and OSA in many individuals. It’s time to step up and standardize a higher level of care for all. I would strongly encourage any dental provider that is currently not including an airway assessment as part of their regular practice to begin today. By doing so, you just may change and save a life for the better. You never know who may be suffering in silence.
Educating your team in airway health and orofacial myofunctional therapy (OMT) is a great place to start to add in the missing pieces of the puzzle and begin to connect more of the dots. Some great resources include following Dr. Steven Lin, author of the Dental Diet. Reading the books Jaws: The story of the Hidden Epidemic and GASP, Airway Health. Attending a course on myofunctional therapy. There are many great clinicians offering courses through Canada and the US on this topic. Having a better understanding for identifying and referring clients that have a tongue tie for a release and OMT.
We generally see our clients more often than a general MD does and have the power to change the lives of so many we see. Together let’s literally change the face of dentistry and make a difference in our communities while growing healthy faces and healthy bodies.
About the Author
Dezarae Aldridge-Earl, RDH and Airway Health Advocate. CEO & Independent Dental Hygiene practice owner of, ‘Dental Hygiene with Dezarae’.
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