Airway Dentist Boise
What is Airway Dentistry?
What is the field of Airway Dentistry?
Do I have signs of Sleep-Disordered Breathing or Sleep Apnea?
- Feeling tired even after getting eight hours of sleep
- Grogginess during the day
- Headaches upon waking up
- Sore throat in the morning
- Being unable to focus
- Waking up in the night while gasping for air
- Not dreaming or unable to remember dreams
What Can I Expect From Airway Dentistry?
Even if you don’t go to the dentist specifically because of airway dentistry, symptoms may be noticed during a general dentistry exam. At Centennial Dental, we strive to practice comprehensive dentistry. Our team will look for the oral signs of sleep-disordered breathing at every dental exam you have, just to keep on top of things. If you bring up symptoms or our team finds them, we’ll assess the patterns of your breathing. Usually, sleep-disordered breathing is caused by the relaxation of the muscles in the throat. With sleep apnea, breathing is completely stopped by these muscles. However, there are conditions like Upper Airway Resistance Syndrome (UARS) that don’t stop breathing, but can significantly disrupt sleep, causing sleep fragmentation. Both conditions affect Rapid Eye Movement (REM) sleep. This is one of the most important parts of the sleep cycle. REM sleep is used for your brain to rejuvenate itself from the day. If this is disrupted nightly, it can lead to serious issues with your alertness during the day.
Airway Dentistry at Centennial Dental
Pediatric Airway Dentistry
Sleep Disordered Breathing
The central issue for many children suffering from the effects of Sleep Disordered Breathing (SDB) or Obstructive Sleep Apnea (OSA) is a compromised airway. When a child’s airway is narrow, underdeveloped or obstructed in any way, the child will struggle to receive enough oxygen during the night, wake-up or change position to breathe, causing fragmented and interrupted sleep.
Snoring and apnea decrease oxygen supply to the body and brain, interrupt sleep and prevent the child from obtaining the vitally important stages of deep and REM sleep. Sleep Disordered Breathing, that can range from Snoring to Obstructive Sleep Apnea, is a vicious cycle and leads to symptoms such as:
- Swollen tonsils and adenoids
- Frequent ear and upper respiratory infections
- Bed wetting
- More severe allergies, asthma
- Digestive issues
- Disrupted sleep patterns
- Delayed growth
- ADD/ADHD like behavior
- Cognitive and learning issues
- Poor memory and ability to focus
- Aggression and socialization issues
Dr. Koeltl is a proponent of catching airway issues early in children, so that the issues can be addressed and corrected with airway focused orthodontic treatment. Proper orthodontic treatment can open up and develop the airway of a growing child by expanding the upper palate, bringing the upper and lower jaws forward and allowing the airway to widen. Airway focused orthodontic treatment offers a CURE for children suffering from SDB or OSA or PREVENTS it in children who might be at risk.
It is vital to not only address the underlying causes of both SDB and dental malocclusion but to also ensure that the causative issues do not reoccur. By incorporating myofunctional therapy with orthodontic care, we can help your child eliminate damaging habits like mouth breathing, improper swallowing and tongue thrusting. We have some superb myofunctional therapists in the Treasure Valley that we can refer you to.
By evaluating and screening your child for Lip-Ties or Tongue-Ties (tight maxillary and lingual frenum attachments) and offering procedures when appropriate, we can treat the anatomical barriers to good airway growth and health.
In summary, proper oxygenation through correct breathing, a healthy airway and a full night’s sleep in turn lead to an improved immune and hormonal system, better school and sports performance and an overall healthier and happier child.
Teeth & Airway Health
No Spacing OR Crowding Between Baby Teeth
Tooth Wear and Chipping
Over-Closed OR “Deep” Bite
An “Open” Bite
Around age 8, as the baby upper lateral incisors are shed, if the palate is constricted, there will be very little space or no for the permanent laterals to erupt. These teeth need at least 7 mm of room to come into the mouth properly. Unless the palate is expanded and room is made, the loss of space will not be regained. In addition to severe tooth crowding, a constricted palate is a sign of unhealthy air way development and improper jaw growth. Early treatment around age 7 or 8 is vital.
Extreme “Overjet” and “Overbite”
This type of “bite” and jaw position puts a child at extremely high risk for developing a constricted airway and Obstructive Sleep Apnea. Treatment to help guide the lower jaw forward should begin as young as possible knowing that the jaw basically stops growing around the time all the permanent teeth come in, usually around age 12. The earlier treatment for this condition begins, the more conservative and effective it can be. Waiting too long can result in unfavorable treatment options, including jaw surgery and if not addressed at all, will likely lead to OSA and poor health.
Flared Lateral Incisors
Frenums – “Tongue and Lip Ties”
The Nose is for Breathing, the Mouth is for Eating
- Normal and healthy breathing is done through the nose, NOT the mouth. Each nostril functions independently and synergistically to filter, warm, moisturize, dehumidify and smell the air. Only by the act of breathing through your nose is the air being properly prepared to enter the lungs.
- Babies are born obligatory nose breathers, but somewhere along the way nose breathing can change to mouth breathing, with dire consequences. Harmful effects of mouth breathing include drying out oral and pharyngeal tissues and not filtering the air entering our bodies from bacteria and irritants. This often leads to inflamed tonsils and adenoids, more frequent upper respiratory infections, dry cough, gingivitis and caries.
- Additionally, mouth breathing causes the jaws to grow incorrectly, the tongue to hang lower in the mouth, the upper palate to constrict and narrow, in turn causing a restricted nasal cavity space, as well as crooked teeth. This is an example of “form following function” – poor bone structure and muscle formation will occur from poor breathing function (mouth breathing.)
- Normal respiration follows a gentle wave pattern with 10 to 12 breaths per minute and is driven by the diaphragm. Mouth breathers take too many breaths, with rates from 12 to 20 breaths per minute or more and incorrectly use their chest muscles to breathe.
- Breathing delivers oxygen to the cells of the body and removes excess carbon dioxide. Carbon dioxide is produced as a byproduct of exercise and digestion of food, but, carbon dioxide is not just a “waste product:” having the right amount of carbon dioxide in your body is critical to health.
- Carbon dioxide plays a significant role in the release of oxygen from hemoglobin and how much oxygen your organs receive. It also triggers breathing, maintains blood pH and prevents smooth muscle spasms. All of these functions are reduced or impaired in mouth breathers.
- Surprisingly, oxygen is absorbed on the exhale, not on the inhale. The back pressure created in the lungs with the slower exhale of nose breathing allows more time for the lungs to transfer oxygen to the blood. This exchange requires carbon dioxide. Exhaling through the mouth allows too much carbon dioxide to leaver the body, resulting in less oxygen being absorbed in the body.
- An enzyme called nitric oxide is released in the nasal cavity ONLY WHEN NASAL BREATHING. Nitric Oxide is a vasodilator. It dilates blood vessels carrying oxygen increasing the efficiency of oxygen exchange in the body by 18 percent.
- There is no Nitric Oxide inhaled with mouth breathing, therefore less oxygen is absorbed.
- The reduced oxygen absorption leads to a cascade of poor sleep, poor stamina, low energy level and in kids can lead to ADHD symptoms. Children diagnosed with ADHD may in fact be mouth breathers who are simply sleep deprived.
- With proper nasal breathing, the tongue rests against the palate without touching the teeth and the lips are closed.
- In this position, the tongue provides passive pressure on that roof of the mouth that stimulates stem cells located in the palatal suture and within the periodontal ligaments around all the teeth, to direct normal palatal growth. The teeth erupt around the tongue which acts like a scaffold, producing a healthy arch form and straight teeth.
- The lateral pressures from the tongue also counter inward forces from the buccinator (cheek) muscles which can “collapse” the arch and constrict the palate.
- The low carbon dioxide levels associated with mouth breathing lead to over- breathing or hyperventilation (breathing too much, too deep and too fast) because the body is trying to keep the proper amount of carbon dioxide in the body for proper oxygen exchange and blood pH.
- With less oxygen being delivered to the brain, muscles and all the cells of the body, the body functions less than optimally.
- Sleep is often disturbed and of poor quality, leaving the mouth breather with fatigue, focus, behavior and cogitative issues during the day.
- As the mouth dries out, the pH of saliva drops, leading to increased caries.
- The lack of air filtration and humidification a result mouth breathing, irritates the tonsils and adenoids causing them to become inflamed and enlarged and increases the risk of upper respiratory tract infections.
- Lower levels of carbon dioxide cause smooth muscle spasms associated with gastric reflux, asthma and bed wetting.
- Smooth muscle is found throughout the body – in the respiratory system, digestive system and circulatory system, therefore mouth breathing can cause body-wide symptoms and problems.
- When properly breathing through the nose, the lips are closed and the tongue is correctly positioned, “resting” on the top palate behind, but not touching, the front upper teeth. You can usually find correct position of the tongue or “the spot” by saying the word “banana” or pronouncing the letter “N.”
- With mouth breathing, the tongue hangs in a down and low position, resting either in between the top and bottom teeth or behind the bottom teeth.
- When the tongue is in the proper position and resting on “the spot,” it acts as a scaffold or support for the shape and form of the upper palate and the teeth.
- When the tongue does not rest on “the spot,” the buccinator (cheek) muscles and orbicularis oris (lip muscles) are allowed to push “inward” unopposed, causing the upper arch to collapse.
- Children who mouth breathe have an underdeveloped, narrow maxilla with a high vaulted palate. They develop a retrognathic (pushed back) mandible and generally have a long face. This is known as “long face syndrome.”
- Some think the long face syndrome is actually dictated by genetics, rather than mouth breathing. Much anthropologic research has proven this false.
- Modern man is not genetically programed to grow this way, it’s our lifestyle, diet and unhealthy habits, like mouth breathing, that is causing these skeletal changes to occur in “modern man.”
- A study to demonstrate how mouth breathing alone could change jaw development and occlusion was conducted on monkeys by Dr. Egil Harvold and his team in the 1940’s.
- In the study, Dr. Harvold artificially switched the naturally nose-breathing monkeys to mouth breathing by surgically blocking their noses with silicone plugs.
- The monkeys were uncomfortable with the new mouth breathing, but eventually adapted to their new pattern of mouth breathing.
- However, where they originally had normal jaw shapes and normal teeth, after being forced to breathe through their mouths, they all developed changes to their jaws and developed malocclusions (crooked teeth).
- Breathing through the mouth creates changes in development of both the maxilla and mandible, and causes the airway to become constricted, predisposing the child sleep problems that result in poor health, growth and cognitive development and set children up for obstructive sleep apnea later in life.
- It may seem logical that mouth breathing occurs because the nose is congested, but that is not always the case.
- The brain of a mouth breather thinks TOO MUCH carbon dioxide is being lost too quickly from the body and makes adjustments in the body to stop the escape.
- One way the brain directs the body to try and “stop” the release of too much carbon dioxide is to stimulate the goblet cells in the nose to produce mucous to slow the breathing.
- This creates a vicious circle of mouth breathing, triggering mucous formation causing nasal passages to constrict and become blocked, leading to more mouth breathing. In fact, mouth breathing can cause nasal congestion leading to more mouth breathing.
- Determining if someone is a mouth breather is not always easy. Some people admit they always breathe through their mouth. Others believe they are nose breathers, but if you watch them, their mouth is open most of the time.
- Some may have their mouth closed while sitting still, but if they get up and walk across the room, their mouth is open.
- Kids often have a “cute” or “angelic” look with their lips parted making their lips look “full” and plump.
- You can usually observe or see the tongue resting behind the bottom teeth.
- Often kids who mouth breathe chew with their mouth open allowing them to breathe while they eat. They often tend to eat very fast or messily.
- An open mouth posture caused by chronic mouth breathing, leads to the lips becoming “weak” and unable to remain closed easily. This leads to drooling, both awake and asleep and can cause a rash around the mouth.
- Chapped lips are also common because mouth-breathers tend to lick their lips frequently. Nasal breathing allows for proper mouth lip seal is efficient at keeping saliva in and air out.
- Mouth breathing at night dries the tissues so the mouth, teeth, tissues and the throat are dry upon waking
- This further inflames the tonsils or adenoids.
- Always needing a glass or bottle of water at hand is a sign of mouth breathing
- If someone wakes with a dry mouth or in a puddle of “drool,” they are likely a mouth breather at night, which means they are also likely mouth breathing during the day.