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Is Your Child Breathing Well at Night?

Why is a dentist asking you that question? There are several reasons a dentist could be the first one to notice if your child has an airway problem. Despite the distinct separation between medicine and dentistry with things like education and insurance, they are totally intertwined. The mouth is an important part of your body. Problems in the mouth affect the entire body, and systemic health problems affect the mouth.

There is a particularly noteworthy correlation between the mouth (teeth and jaws) and the airway. Many people are aware of the connection between sleep apnea and the mouth; most are not aware that this connection is true for both adults and children.

What is Pediatric Sleep Apnea?

Pediatric sleep apnea is a condition in which a child stops breathing for any length of time during sleep. As with adults, it can be accompanied by snoring, gasping, and choking sounds. It can also be silent.

Children who stop breathing at night do not get quality sleep, which is essential for growth and development. Sleep is also integral in the healing process, so children with sleep apnea tend to be ill more often than other children.

In addition to sleep apnea, children can also suffer from other types of sleep-disordered breathing, in which breathing does not stop but is restricted enough to reduce oxygen levels and quality of sleep.

How Can a Dentist Tell If My Child has an Airway Problem?

There are certain signs of pediatric sleep-disordered breathing that appear in the mouth. During your child’s dental evaluation or professional teeth cleaning, Dr. Ann, Dr. Lauren, or one of our hygienists may note some of these signs and ask you more about your child’s sleep patterns.

The following list includes things we, as dentists, look for as red flags for airway problems.

  • Teeth grinding – It is not normal for children to grind their teeth. If they do, you should suspect a breathing problem. In children, teeth grinding is a protective reflex that is the body’s attempt to open the airway and get more oxygen to the brain.
  • Narrow jaw structure – The shape of the jaws is an important factor in the size of the airway. A narrow upper and/or lower jaw often indicates a narrow or constricted airway.
  • Large overbite – In children whose lower jaws are much smaller than the upper jaws, large overbites develop. In addition to the size of the jaws, the relationship of the upper and lower jaws to each other influences the airway significantly. A large overbite often indicates that the lower jaw is putting pressure on the airway, causing restricted breathing.
  • Mouth breathing – Children who consistently breathe through their mouths, especially at night, have a higher risk for plaque buildup, gingivitis, and cavities. High levels of plaque buildup in certain areas of the mouth are distinctive of mouth breathing. Dr. Ann, Dr. Lauren, Phyllis, and Nancy recognize these signs as evidence of mouth breathing and will ask questions about your child’s sleep habits to find out if the mouth breathing is a result of an airway problem.
  • Tongue position – How the tongue is situated affects the position of the teeth, which ultimately impacts the development of the upper jaw. When the tongue does not rest up against the roof of the mouth, the upper jaw can develop into a narrow, high arch. As we discussed above, a narrow jaw predisposes a child to a constricted airway and sleep-disordered breathing.
  • Acid erosion of teeth – Many patients with sleep apnea also suffer from acid reflux. This is because the attempt to breathe when the airway is blocked creates a negative pressure in the chest cavity, pulling stomach acid up into the esophagus and mouth. This acid erodes tooth enamel, leaving a very distinctive appearance.

How Is a Pediatric Airway Problem Diagnosed?

You, as the parent, are an important part of the diagnosis process. Detailed information about your child’s sleep habits and patterns are integral in diagnosing an airway problem. Simply sharing your observations about how your child sleeps can provide us with vital pieces of the airway puzzle.

Often a sleep test is required to determine the severity of a sleep-disordered breathing problem. This test gives precise details about oxygenation levels, sleep stages, and disturbances in sleep.

Another tool we have at Designer Smiles for evaluating the airway is our three-dimensional imaging system, the Prexion CBCT scanner. With a 3D image, we can measure the volume of the child’s airway, the size of the upper and lower jaws, and the size of soft tissue structures like tonsils and adenoids. This 3D imaging is a valuable tool in assessing anyone’s risk for airway problems.

What Is the Treatment for Pediatric Airway Problems?

Because the causes of pediatric sleep-disordered breathing are multi-factorial, there are several different lines of treatment. It is essential to determine the cause of airway constriction before the correct treatment can be performed. This often takes a multidisciplinary approach, meaning more than one doctor is involved. Dr. Ann and Dr. Lauren may be the first to notice an issue, and they will help you coordinate with the proper specialists to obtain the right diagnosis and treatment for your child.

One of the most common causes of sleep apnea in children is enlarged tonsils and adenoids. In these cases, an ear, nose, and throat (ENT) specialist will remove them surgically, creating an open airway and improved breathing.

A concern with the growth of the upper jaws is often addressed with interceptive orthodontics. We often use an appliance called a maxillary expander to stimulate proper growth of the upper jaw, which also opens the airway. Not only does it help align the teeth into the proper position; it also moves and shapes the bones of the hard palate.

Concerned Your Child May Have an Airway Problem?

Call today to schedule a consultation with Dr. Ann and Dr. Lauren. They will assess your child’s risk and help you get started in the diagnosis and treatment process.

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