Questions & Answer About Your Teeth & Your Airway
What have my teeth got to do with my airway? Not very much, BUT, your airway can have a major impact on your teeth. Having a good, open upper airway and being able to breathe freely through your nose with your mouth closed provides the most efficient means of breathing and obtaining oxygen. It is also extremely important to the development of a well-formed oral environment, including the spacing and alignment of the teeth and jaw. Chronic mouth breathing can lead to several problems. What are the symptoms and causes of the restricted upper airway? Allergic patients often have puffiness and dark coloration beneath their eyes and may have a long, narrow face and turned-up nose. The main symptom is that the mouth is held open most of the time. Abnormal tongue function and position are usually a result of restricted airways. In children, you can often see the tongue postured between the teeth. Mouth-breathing patients often snore. An open mouth is the result of a restriction of the nasal or upper airway causing you to open your mouth to get sufficient airflow to your lungs. Restrictions can be caused by several things such as chronic allergies, deviated nasal septum, enlarged adenoids, tonsils, or enlargement of structures in your upper airway called turbinate. Why is mouth breathing a problem? Brief periods of mouth breathing such as having a cold or a transient allergy do not have a significant impact on your dental health. However, long-term (chronic) mouth breathing can have a major influence on the way that the dental arches develop and can affect the alignment of the teeth. This is most important in the early, developmental years of life and if untreated then, can carry on into adulthood. Several experts in the field define chronic mouth breathing as having lasted four months or more. If it’s developmental, why should I worry about it at my age? First, if you had the problem during your developmental years and it was not corrected at that time, it may be a major complicating factor in any significant dental work that you may need or consider as an adult. In addition, if you have had a chronic mouth breather, it may contribute to one or more medical conditions known as Sleep Disordered Breathing. Second, you need to understand so if you have young children or young loved ones you can watch for symptoms of chronic mouth breathing. What are the dental problems that mouth breathing causes? Constantly breathing through the mouth leads to a forward head posture and a forward tongue position. The tongue is a strong muscle that often causes the front teeth of a mouth breather to flare outward. In severe cases, a person’s front teeth do not come together when the back teeth are together- a condition dentists call an “open bite”. Further, because the tongue is not enclosed in its proper place between the dental arches, the muscle forces of the cheeks dominate and cause the roof of the mouth to form in a narrow “V” shape rather than a normal wide, flat shape. This in turn is often the cause of a lack of space for the teeth to be aligned properly. What can be done to correct the effect of mouth breathing? It is very important to first have medical treatment to eliminate the cause of the restricted airway. This could involve treatment for allergy, infection, or swollen turbinate or could require surgical removal of adenoids and/or tonsils. If the medical cause of the problem is not corrected before dental treatment, the chance of a relapse of the dental treatment can be high. Once the cause is treated, the dentist evaluates each case and decides which dental treatment will be most effective. Restricted upper airways can harm the growth and development of the face and jaw. Most of the growth in these structures occurs before puberty. For this reason, the earlier the condition is treated, the easier the correction is because of the elastic nature of the tissue. By the age of 18-20, born growth and development are largely completed and treatment becomes more difficult. How is the dental problem corrected ? Once any underlying medical problem has been treated, the dentist will most likely use orthodontic techniques to correct the bite. To correct the narrow “ V” shaped palate, palatal expansion may be necessary. There are different techniques to accomplish this. Immature patients’ surgically assisted expansion is used. The speed with which this is done will depend on things such as the age of the patient and the particular circumstances of each case. In effect, expanding the palate creates more space for the teeth, and other types of orthodontic treatment are then used for tooth alignment. Because the top of the mouth is also the bottom of the nose, palatal expansion frequently also improves nasal breathing to some degree. What about sleep-disordered breathing (SDB)? Patients with restricted upper airways often suffer from SDB. This is a term that would include such disorders as heavy snoring and obstructive sleep span. While dentists are often part of the medical team treating these disorders, these are primarily medical problems and may have a far-reaching impact on your health. They should be evaluated by the proper medical professional. It is mentioned here because dentists often see symptoms of restricted upper airway while doing routine dental exams and may bring them to your attention
The Hidden Dangers of Obstructive Sleep Apena & Snoring
What Is Sleep Apnea? Apnea means to stop breathing. Sleep apnea refers to a condition wherein you stop breathing during sleep. Most of us know someone who snores during sleep. You may also know someone who has commented that their partner has stopped breathing during sleep for seemingly long periods – long enough to be frightening. While snoring is often made the subject of jokes or teasing, it could be an indication of a serious health problem. The severity and danger associated with sleep apnea range from snoring that irritates your partner to life-threatening medical conditions. If apnea involves physical obstruction of the upper airway and/or heavy snoring, it is sometimes referred to as Sleep Disordered Breathing (SDB). In this pamphlet, we’ll focus on Obstructive Sleep Apnea (OSA) as it is the most common form of sleep apnea. What are the Signs and Symptoms of Sleep Apnea? The most common signs and symptoms include ; • Snoring • Waking up Tired • Dry Mouth/Throat • Difficulty Concentrating • Fatigue • Weight Gain • Sleepiness • Irritability If a young child habitually mouth-breathes or exhibits any of these indications. it is especially important to have them evaluated as these conditions have a significant negative impact on the development and form of oral-facial structure. It is also interesting to note that some studies have shown that sleep-disordered breathing is common among children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). How is Sleep Apnea Diagnosed? Because of the potentially serious aspects of sleep apnea, you should start with a medical examination and evaluation of your condition. Talk to your dentist who can refer you to a qualified physician with specialized training in the field of sleep medicine. Evaluation can range from an examination of your airway to an overnight sleep study called a Polysomnogram (PSG), followed by treatment that could be in tandem with your dentist. What Causes Obstructive Sleep Apnea? OSA describes an effort to breathe, but there is a physical obstruction of the airway causing apnea. It may be caused by a collapse of the soft tissue at the back of the mouth and in the throat, sometimes related to the inability to properly breathe through your nose. If the jaw is too small to accommodate the tongue, the tongue tends to fall back, further restricting your airway. This constriction impedes airflow. As you inhale and exhale. the tissue of the throat vibrates and causes the sound of snoring. The tissue gets flabbier over time. In more severe cases, when apnea occurs stop breathing for 10 seconds or more. When breathing stops, blood oxygen levels fall, forcing the heart to work harder, and causing blood pressure to rise. While this may disturb the sleep cycle, the person often does not fully wake up but feels tired in the morning. Some of the conditions associated with OSA include high blood pressure. obesity, heart disease, gastric reflux, depression, and diabetes. While OSA contributes to these conditions, they in turn worsen OSA, forming a vicious cycle. It is important to note that you don’t have to be overweight to have OSA. What are Some Options for Treating OSA? For many moderate cases of OSA, a custom-fitted oral appliance prepared by your dentist can offer effective treatment. In more serious cases. surgery to remove obstructions or to stiffen the flabby throat tissue may be recommended for treatment. Continuous Positive Airway Pressure (CPAP) is another choice for treatment. This means wearing a mask while sleeping that is connected to a small device that maintains positive air pressure, pushing air into your lungs. However. although painless and effective, some patients and their partners do not tolerate sleeping with the CPAP machine very well. What is the dentist’s Role in Treatment? Properly trained dentists can make custom-fitted oral appliances that are worn over the teeth at night to prevent the jaw from falling back during sleep, keeping the airway open. If you or someone you know exhibits any of the symptoms listed in this pamphlet, be sure to bring it to our attention. We can provide further information about this potentially serious condition. You could save a life!