Questions & Answer About Your Teeth & Your Airway

June 17, 2024

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 is 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 a number of things such as chronic allergies, deviated nasal septum, enlarged adenoids, tonsils or enlargement of structures in your upper airway called turbinate.

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 a number of problems.

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. A number of experts in the field define chronic mouth breathing as that 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, it is important for you 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 prior to 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 have a negative effect on 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 is 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


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