Airway is key to life. Normal breathing is silent breathing through your nose. It is quiet and effortless. It allows our bodies to go into normal deep, restorative sleep, and to awake refreshed and ready to take on each new day. Snoring and sleep apnea are not normal breathing pattern and are not healthy. Normal breathing is vital for living a vibrant, happy life. Unfortunately, millions around the world simply can’t breathe normally – especially at night. Quality sleep breathing is essential for proper growth and development as well as overall systemic health. If airway health is compromised, the quantity and quality of deep sleep is affected. Deep sleep is where the brain detoxes and the body repairs tissues, builds bone & muscle and the immune system is strengthened.
When the jaw develops properly, the teeth have room to fall into place and create a nice smile with a healthy bite relationship. The jaw has the opportunity to develop well with proper breathing habits. A healthy airway starts with nasal breathing. This is accomplished with lips sealed and our tongues resting on the roof of our mouth. One of these habits could be compromised by a functional limitation due to anatomy. While catching these early is ideal, there are solutions available regardless of age to increase the quality of life through a better airway.
An orthodontist is a powerful player in the prevention of airway conditions. Orthodontists can intervene early in directing growth of the craniofacial complex thus preventing future conditions such as sleep apnea along with other co-morbidities. Additionally, an orthodontist that understands the causes of a tongue thrust swallow pattern can have this addressed through myofunctional therapy and a tongue tie release, if necessary. This can prevent relapse of orthodontic treatment while potentially improving other systemic issues that can accompany a reverse swallow. The orthodontist will prove to be a major player in the prevention of airway dysfunction AND correction of anatomy that contributes to airway dysfunction.
Dr. Ure is trained to look for signs of airway-related issues and can assess the airway and help to determine if there are deficiencies in growth or airflow. The dentist evaluates facial structures and symmetry, arch development, the soft tissues (including lips, tongue & throat), as well as the dentition. If discrepancies are noted, the dentist can help to guide a patient through the appropriate treatment. In children, growth can be influenced through early intervention. Adults have many options as well when it comes to improving the airway. The goal is for health and wellness through optimal breathing and sleep.
Some of the first signs show up in the teeth and these may appear years or even decades before being noticed. Signs such as teeth grinding, high blood pressure, and/or snoring, together with your medical history can point to the presence of obstructive sleep apnea (OSA) or upper airway resistance syndrome (UARS). If left undiagnosed, OSA and UARS have been directly connected to larger health concerns such as high blood pressure, cardiovascular disease, diabetes, stroke, dementia, depression, daytime fatigue, and more. If an airway-related issue is present, we can work collaboratively with your physician and provide referrals to our growing network of medical specialists. These specialists understand the importance of the dental-medical connection and can assist you with your diagnosis. Our practice is deeply committed to the health of our patients!
The Tongue
The tongue is an important factor in the formation of the nasal airway space. The position that it keeps in the mouth is highly important. The tongue should rest up at the palate with a light suction. Throughout childhood this rest position guides the formation of the palate ideally into a broad U-shape. If an individual has a tongue restriction (anterior or posterior tongue tie), or low tongue posture, this can compromise the formation of the nasal cavity. A low tongue posture from a functional limitation of the tongue or from mouth breathing or both, will result in a V-shaped, high palatal arch form. The resulting nasal cavity is constricted based on these anatomical limitations. Often, a deviated septum will accompany a V-shaped palate in an adult.
The Nose
The nose has many functions that contribute to the quality of oxygen that we breathe. It is the first line of defense against sickness by filtering allergens, bacteria and toxins. The nose also secretes nitric oxide which has a host of beneficial actions including increasing blood flow and lung volume. The nose is a complex organ specifically designed for processing the air we breathe by filtering allergens and bacteria while adjusting the air to the correct temperature and humidity for an efficient transfer to our lungs. Additionally, the super molecule nitric oxide (NO) is stimulated to be released by passing air. Nitric oxide functions in every organ of our body. Notably, NO has a role in the immune response as well as in dilating blood vessels to improve blood flow and decrease blood pressure. Nitric oxide also enhances memory and learning, influences secretion of hormones, acts as a signaling molecule, enables erectile function, regulates bladder function and more.
Tonsils and Adenoids
The tonsils and adenoids are part of the immune system and help protect the body from disease. Unfortunately, if they get too large, they can cause ear infections or worse, affect breathing and contribute to apnea. Swollen adenoids contribute to ear infections and mouth breathing. Mouth breathing can lead to enlarged tonsils. Swollen adenoids and tonsils compromise and constrict the airway space. This constriction can cause apnea (episodes of no breathing). When tonsils and adenoids are removed, it is still imperative to correct the conditions that led to the enlargement to prevent sleep disordered breathing recurrence later in life. This can be accomplished with myofunctional therapy and orthodontic treatment to facilitate proper arch growth.
Teeth and Arch
A clue to a compromised airway can easily be identified by a dentist. Narrowed and constricted arches and tooth crowding are often a sign that the nasal cavity is compromised as well as a sign of a low tongue rest position. The relevance of a narrow or constricted arch is limited space for the tongue in the mouth. With limited space, the tongue drops back into the airway compromising airflow and potentially leading to conditions related to sleep disordered breathing.
Lips
The lips serve in the articulation of sound and speech. They are the visible part of the mouth. The lips function in promoting nasal breathing if they are able to perform a lip seal without strain. In some individuals, the lip seal can be compromised due to an excessive and/or restrictive labial frenum. The frenum can restrict the upper lip as well as cause tooth separation between the two central teeth and/or can contribute to recession.
The Role of Saliva
Mouth breathing can lead to a dry mouth. It is important to maintain saliva to take advantage of its many functions. Aside from contributing to taste, chewing and swallowing, saliva fights germs in the mouth and prevents bad breath. It also has components that protect tooth enamel and prevent tooth decay and gum disease. There is a link between mouth breathing and periodontal disease. Gingivitis and periodontitis will not resolve if an individual habitually mouth breaths.
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