Your child snores. What's the big deal? It's kinda cute, isn't it? While it may seem harmless, the problem is that snoring is almost always a sign that there's a problem with the airway during sleep. We're not talking about if this only happens when they are sick and have a stuffy nose. However, if more often than not, you hear sounds coming from your child while they're asleep, recognize that it's probably something that should get checked out by a healthcare professional. Snoring or other sounds made while sleeping are almost always a sign of Sleep Disordered Breathing.
Sleep Disordered Breathing (SDB) is an umbrella terms that includes conditions like obstructive sleep apnea, where an individual either partially or completely stops breathing multiple times throughout the night.
Sleep Disordered Breathing in children is extremely common. While your child is asleep, and their head and neck muscles are relaxed, their airway becomes compressed, and they are not getting enough air. The most common anatomical features contributing to this phenomenon are enlarged tonsils and/or adenoids, and a tongue that falls back and partially closes the airway due to insufficient tongue space, most often due to a narrow and high-arched palate, and/or a tongue-tie.
Why is this a problem? When the airway gets compressed, breathing becomes compromised, and the amount of oxygen that reaches your child’s brain is reduced. When sleep quality is impaired, children will struggle to reach their full potential and may display behavioral issues that are really rooted in poor sleep.
The motions of the jaw associated with teeth grinding may be your child's attempt to open their airway and breathe better. The most widely accepted belief is that grinding is a compensatory mechanism to open the airway. Children who grind their teeth almost always have other symptoms of sleep-disordered breathing as well. 9 out of 10 children have signs or symptoms of SDB, and many kids do not outgrow these issues if the underlying cause(s) are not corrected.
Healthy breathing is nasal breathing. Period. Mouth breathing should always be recognized as unhealthy and abnormal. It’s common, but it’s not normal. We have all experienced how uncomfortable it is to breathe through our mouth when we’ve been sick and have had a stuffy nose. Now imagine a child who always breathes like this. The amount of compromise is profound. Mouth breathing often shrinks the oral airway to about 1 mm, or about the diameter of a coffee straw. It’s impossible to get a good night’s rest when you can’t breathe right.
Keep in mind that children grow mostly at night, since growth hormone is released while they’re asleep. Facial growth, specifically growth of the lower jaw, is highly influenced by how our children breathe. Nasal breathing allows for downward and forward growth of the lower jaw, while mouth breathing fails to allow for sufficient forward growth. Without nasal breathing, you get very limited forward growth and almost exclusive downward growth, so you get a facial profile that is very long vertically, with a short length horizontally, which makes children appear almost as if they have a double chin, even if they have a healthy BMI. Their lower jaw is essentially under-developed. The same goes for the upper jaw. Mouth breathing can significantly alter the shape of the jaws and therefore the entire face. Small jaws inevitably lead to crowded, rotated, or crooked teeth, and mouth breathing tends to create a certain facial profile that has a very recognizable look. Feel free to do a Google search to look at images of the facial features of a mouth breather and a nasal breather. Keep in mind, the way we breathe as children affects how we look for the rest of our lives.
There are also behavioral manifestations of Sleep Disordered Breathing, which can include bedwetting, nightmares and/or night terrors, hyperactivity and attention deficit, allergy symptoms, frequent ear and throat infections, and many more.
The first step is to recognize that there is a problem that requires a solution. The solution that’s right for one child may not be right, or may not be enough for another, so it’s imperative to get down to the root cause(s) and be systematic in the approach for therapy. Sometimes it can be as simple as strengthening and redirecting the tongue to be in a different position at rest. This can be achieved with myofunctional therapy (myo = muscle), which can be accomplished with an appliance, and sometimes in conjunction with a certified myofunctional therapist. Other times, there may be other approaches that work best. Ultimately the solution has to be customized for your child, but finding the right solution requires working with someone who is trained and certified in recognizing airway problems and how to treat them.
I am committed to helping our children breathe better and thrive. My goal is to have a collaborative approach with each patient, parent, and any other healthcare providers who can contribute to help us achieve our goal: a happy, healthy, well-rested child who can reach their full potential. If your child snores or grinds their teeth, feel free to set up a consultation so we can discuss their symptoms and brainstorm possible solutions together. Schedule your visit with Dr. Bana Ball at Shady Grove Pediatric Dentistry in Rockville today!
In Health and Happiness,
Dr. Bana Ball
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