Sleep Disordered Breathing

We focus a lot on breastfeeding for a reason. It is the beginning of the development of a baby's dental arch and therefore airway size. That baby will soon grow into a child, and then an adult. Promoting optimal development from early doors is ideal when it is possible. Equally important is screening for a tongue tie or lip tie which will inhibit the bony growth of the maxilla and mandible as the full range of movement of the lips or tongue during feeding won’t be actioned and therefore less pressure will be placed on the palate to help form the dental arch and airway.

The big thing is to recognise that there are other pieces to airway development. The next step from breastfeeding would be the introduction of a harder food diet that needs to be chewed, open cup drinking to encourage swallowing and monitoring for mouth breathing. Intervening if needed with Oral Myofunctional therapy through the Myobrace system. Bringing the baby to the dentist from birth or earlier if a suspected tongue or lip tie will allow for both getting the child comfortable AND evaluating for dental and airway development.

We are passionate about sharing our patients' sleep breathing disorders to bring awareness to other families. As you know, we value sleep at our dental practice...our children and adult patients were “clocking the correct number of hours”, but what they didn’t realise was that they were not getting the quality of sleep they needed.

Does This Mean Our Patients Have Sleep Disordered Breathing?

When we identify the oral signs and symptoms as dental professionals it is our obligation to help and support families that we diagnose clinically. In children or adult patients we treat those who have Upper Airway Resistance Syndrome (UARS) or we work in conjunction with a sleep doctor at a sleep clinic for the more serious Obstructive Sleep Apnea (OSA) cases both of these both make up sleep-disordered breathing, we support both patients at our clinic through breathing habit correction, Oral Myofunctional therapy, maxilla morphogenesis and natural dental arch development to allow for better breathing and posture and reduction in symptoms.

Who/What Encompasses Risk To Sleep Disordered Breathing?

It’s more than you may think...

Is it sleep apnea? YES

Is it snoring? YES

Is it upper airway resistance? YES

Does it impact kids? YES

Does it impact adults? YES

Does it impact all shapes and sizes of human beings? YES

How Does Sleep Disordered Breathing Affect Our Health?

Sleep-disordered breathing is partial or complete cessation of breathing throughout the night. At the root of it, sleep-disordered breathing leads to a lack of oxygen to the brain and body. It could be longer events, or apneas, of ten seconds or more when a person stops breathing. It could be shorter pauses in breathing over and over that could lead to reduced oxygen or it could even be as “innocent” as snoring which also contributes to a smaller decreased oxygen saturation.

Snoring occurs when the flow of air from the mouth or nose to your lungs makes the tissues of the airway vibrate indicating airway collapsibility. The narrowed or blocked passage disturbs the airflow, which causes the soft palate and uvula to vibrate and knock against the back of the throat, causing snoring. Improvement of tongue posture and lip seal (Oral Myofunctional exercises) will help in preventing snoring and improve airway flow allowing better absorption of oxygen.

What Are The Signs and Symptoms of Child Sleep Disordered Breathing?

• Snoring

• Loud breathing when asleep

• Frequent nasal congestion

• Mouth breathing

• Bedwetting

• Night terrors

• Teeth grinding

• Restless sleeper

• Excessively sleepy

• Pause in breathing during sleep

• Behavioural issues

• Hyperactive or inattentive

• If your child experiences any of these signs or symptoms, please get them checked out at our clinic.

Babies are born obligate nose breathers, but somewhere along the way nose breathing can change to mouth breathing. Mouth breathing is a massive factor in sleep-disordered breathing during childhood. The habit of breathing through the mouth may be perpetuated even after nasal airway clearance. Both incorrect habits and nasal obstruction may cause facial muscle imbalance and craniofacial changes that lead to upper airway resistance syndrome (UARS) in adults. If we train our children patients in the correct breathing, lip seal, tongue position and swallow techniques (Oral Myofunctional exercises) we increase natural jaw expansion and allow for the teeth to come into a wider arch minimising/negating the need for orthodontic extractions. This can be compounded positively by the correct nutrition and chewing of fibrous foods.

What Are The Signs and Symptoms of Adult Sleep Disordered Breathing?

• Snoring

• Have loud breathing when asleep

• Frequent nasal congestion

• Mouth breathing

• Pause in breathing during sleep

• Frequent urination during the night

• Insomnia

• Night terrors

• Teeth clenching and grinding which shows as shortened teeth, cracked teeth, multiple lost teeth over the years even when oral hygiene is immaculate, fillings always need replacing

• Headaches first thing in the morning

• Temporal mandibular joint disorder (TMD) and its associated symptoms

• Restless sleeper

• Excessively sleepy during the day

• Neurological imbalances; anxiety, depression with mood swings

• Behavioural issues (commonly misdiagnosed as ADD/ADHD)

• Restless leg syndrome

What Do We Treat Sleep Disordered Breathing At Our Clinic?

Our unique evaluation at our biological consultation helps us and you understand if you are at high risk of sleep-disordered breathing, this includes posture photos, muscle testing, Cranio-facial development analysis and radiographic airway collapsibility evaluation.

The treatment will be completely unique for the individual, their age and symptoms, in children we usually use Oral Myofunctional therapy and Myobrace appliances to encourage natural jaw development through the correct nasal breathing, swallowing and lip seal. If the patient isn’t compliant with these exercises daily or we see them too late in their dental and airway development then we may have to encourage the growth of the jaw mechanically with expansion devices such as the 3D, ALF, RN Sagital appliance in conjunction with Myofunctional therapy with either a Myobrace or POD device.

In an adult patient, we don’t have the same growth phases to work with naturally this means the first phase of the treatment will usually be controlling the patient’s symptoms and reducing the pain (if they are experiencing any) by bringing the lower jaw downwards and forwards to decompress the temporal mandibular joint (TMJ), reduce occlusal interferences and open the oropharyngeal airway space this will relax and lengthen the supporting muscles to stop them from spasming. This is usually done with splint therapy. Once our patients are symptom-free we can then align the teeth into the new dental arch position using Oral Myofunctional therapy with the ALF or Homeoblock appliance, this will be training the patient to swallow, breathe, maintain correct posture of the cervical spine and strengthen the airway muscles correctly to prevent any relapse and reduce the airway collapsibility and at the same time encouraging natural jaw morphogenesis through these natural movements.

If we helped to diagnose obstructive sleep apnea we will work with your local sleep clinic and your sleep doctor to come up with the most tailored sleep and dental program for the condition.