Airway and Sleep Issues

Airway and sleep issues can significantly affect a child’s growth and development. If your child displays any of the following issues associated with airway and oral function, or sleep, don’t ignore them. Please get a consult for your child. It is far better to catch these issues as little smoldering concerns before they are full-blown fires!

Open-Mouth Posture, Mouth Breathing, or Chewing with Mouth Open. This may be the most obvious sign that a child has an issue with breathing through the nose properly.

ADHD, Hyperactivity, or Moodiness. Sleep-disordered breathing can cause chronic fatigue, and the effects of long-term sleep issues like obstructive sleep apnea can lead to ADHD-like symptoms. Some sleep disorders are misdiagnosed as ADHD.

Dark Circles and Adenoid Facies. These are both visible signs of airway issues. Dark circles give a major clue that a child isn’t getting enough sleep or that sleep is of poor quality. Adenoid facies or “long face” can result from enlarged adenoids or tonsils blocking the nasal passages.

Chronic Ear Infections. Mouth breathing can cause inflammation around or in the ears, particularly if the adenoids are also enlarged. This can lead to chronic ear infections.

Chronic Sore/Scratchy Throat. Sleeping or breathing with the mouth open for long periods can irritate the delicate tissue in the throat.

Forward Head Posture. Chronic mouth breathing can also affect how we hold our head and ultimately our posture and gait. Hunched over shoulders or posturing forward is a big red flag for airway issues.

Bad Breath, Cavities, and Tonsil Stones. Chronic mouth-breathing dries out oral tissues and can drop the pH in our mouth, ultimately allowing pathogenic bacteria to thrive and leading to a slew of oral health issues.

Mouth breathing is not ideal for several reasons:

  • It can cause the mouth and jaws to develop improperly.
  • It prevents the amazing release of nitric oxide that nasal breathing provides.
  • It dries out the tissues in the mouth.
  • It bypasses all the positive effects of nasal breathing, such as humidifying and purifying the air we breathe and immune function.
  • It disrupts the oral microbiome, making it easier for cavity-causing bacteria to grow.

Airway Problems

When airway function is compromised, it can affect the proper development of a child’s teeth and jaws. Over time, an untreated airway issue can cause additional health issues and affect the development of facial features, eventually affecting how a child looks as an adult.

Muscle function, proper nutrition, breathing, and genetics influence a child’s facial development.

Normal breathing is breathing through the nose with lips sealed and the tongue at rest, “suctioned” to the roof of the mouth.

When a child cannot breathe normally through the nose, he or she will compensate for this by breathing through the mouth. Mouth breathing over an extended period of time can distort and shrink the airway. It may eventually lead to dental problems such as clenching and/or grinding the teeth, sensitivity, receding gums, periodontal disease, and tooth decay.

Proper breathing is essential for a child’s health and development.

Signs of Having an Airway Issue

If your child has an airway issue, he or she may display one or more of the following signs and symptoms:

  • Mouth breathing
  • Chapped lips
  • Dark circles/Venous pooling beneath the eyes
  • Posturing the head forward and/or tipping the forehead backward
  • Tethered Oral Tissues
  • Deviated septum
  • Tonsil and Adenoid problems
  • Chronic sinus infections
  • Loud grinding of teeth during sleep
  • Bedwetting
  • Ear infections
  • Allergies to food or the environment
  • Clenching/grinding teeth
  • Difficulty swallowing
  • Picky-eating

How to Detect a Possible Airway Issue in Your Child

Your child may have an airway issue if he or she

  • Has loud breathing when awake or asleep
  • Has chronic nasal congestion
  • Breathes mostly through the mouth
  • Chews with mouth open
  • Has pause or holds in breathing during sleep
  • Is a restless sleeper, wakes frequently
  • Is excessively sleepy during the day
  • Is hyperactive or inattentive (behavioral issues)

Dental-Related airway Issues

The following airway issues may be exacerbated by oral function and developmental issues:

  • Asthma and Allergies
  • Middle Ear Infections
  • Sleep Disorders, Namely Snoring and Sleep Apnea
  • Chronic Sinus Infections or Congestion
  • Inflamed or Enlarged Tonsils and/or Adenoids
  • Post-Nasal Drip
  • Chronic Coughing or Throat Clearing

Sleep Disordered Breathing

Sleep issues can signify sleep-disordered breathing (potentially even sleep apnea) and should not be ignored.

Sleep-disordered breathing could be a sign of more significant health concerns related to tonsils, adenoids, nasal patency, tongue-tie, improper tongue posture and/or swallow pattern, atypical jaw and facial growth, environmental or food allergies, or genetics. Please don’t ignore them!

Signs of Sleep Disordered Breathing

Signs of sleep ordered breathing include

  • Grinding teeth
  • Snoring
  • Noisy breathing
  • Twisted Bedsheets
  • Waking Up Frequently
  • Night Terrors
  • Mouth Breathing
  • Breath-Holding
  • Inability to Focus/Hyperactivity
  • Prolonged Bed-Wetting
  • Waking Up Exhausted

Why Mouth Breathing is Bad for Children

Mouth breathing is not ideal for children because it may lead to:

  • Allergies and Gut Issues
  • Oral Health Issues (e.g., gingivitis, dry mouth, cavities, crooked teeth)
  • Poor Quality Sleep
  • Behavioral and Learning Issues
  • Growth and Development Concerns

A child who mouth breathes takes in 20 percent less oxygen. As a result, this can negatively impact a child’s growth and development, as mouth breathing causes a narrowing of the airway resulting in lower oxygen levels in the blood. Consequently, this can lead to sleep issues such as sleep apnea.

Even a slightly opened mouth during the day is not ideal.

Nasal Breathing is Better

Nasal breathing, breathing through your nose with your lips closed, is critical to long-term systemic health.

The nose processes the air that you breathe before it enters your lungs. It filters, warms, humidifies, and purifies the air, and most importantly, releases nitric oxide to increase blood flow and decrease blood pressure, thereby helping to support a healthy cardiovascular system.

Tips and Advice to Improve Nasal Breathing

Doctor Staci offers the following tips and advice to improve nasal breathing.

Be sure to check with your pediatrician before making any changes.

Breastfeed as long as you are able (at least 12 months is best). If this isn't achievable, do not fret. There are other options. However, breastfeeding your child is ideal for jaw and airway development.

Consider Tongue and Lip-Tie Release Procedures for your child to restore normal movement and function. A tongue-tie (ankyloglossia) or a lip-tie is when the string of tissue (frenum or frenulum) under the tongue or above the upper front teeth is tight and restricts normal movement and proper function.

Tongue-tie and lip-tie issues can interfere with your baby getting a proper latch for breastfeeding or may lead to myofunctional, feeding, or speech problems in your older child. Consult with an International Board Certified Lactation Consultant (IBCLC) for any tongue and lip-tie issues in babies and an Oromyofunctional Therapist (OMT) in older children. An airway-focussed Pediatric Dentist can also help. IBCLCs, OMTs, and Dentists can help diagnose such issues, and they will refer you to a specialist (an ENT or specialized dentist) for treatment (tongue or lip-tie release procedures).

Break Pacifier and Thumb-Sucking Habits. These may be good self-soothing actions for young children, but they are also a way to disrupt palatal, jaw, and facial growth during early childhood if carried on for too long. This can result in poor airway health. Both prolonged pacifier use and thumb/finger sucking often cause a crossbite (the narrowing of the palate and nasal floor) and open bite (can lead to trouble with keeping lips closed), resulting in mouth breathing, tongue thrust, and improper tongue resting position and atypical swallowing patterns. This can lead to sleep-disordered breathing, including childhood obstructive sleep apnea (OSA). OSA in children is associated with symptoms that mimic ADHD and can increase risks of obesity, growth issues, allergies, and poor overall health. Try to eliminate pacifiers by age 6-7 months, or age one at the latest, and work with a Pediatric Dentist or OMT for prolonged thumb habits.

Change Up Food Textures and make sure your baby/toddler eats not only soft foods but plenty of fresh, whole, crunchy foods of all shapes and sizes. Crunchy, chewy foods like carrots, celery, meats, nuts, and seeds help facilitate proper jaw and dental development. Please follow choking hazard guidelines from your doctor on this.

Clean Up the Bedroom. Dust mites and pet dander are big culprits leading to nasal congestion. Having a quality air filter like an Air Doctor can help clean the air while your child sleeps. Try to discourage pets from being in the bedroom, dust and clean frequently, and keep the room free of too much clutter and stuffies, which can gather dust easily. Xylitol nasal spray, like Xlear, can help cleanse nasal passages before bed, too.

Consider Removing Tonsils and/or Adenoids if they are determined to be blocking the airway or prone to chronic infections. If your child is chronically snoring, grinding teeth, breath-holding, waking up a lot, bed wetting, hyper or emotional during the day, a trip to the ENT doctor may be helpful.

Manage Food Allergies to decrease inflammation and mucus production, leading to mouth-breathing. The biggest culprits are usually dairy and gluten. You may consider eliminating them from the diet for 4-6 weeks to see if symptoms improve. Work with your pediatrician or naturopath, an ENT, and/or an allergist.

Keep Up-to-Date on Airway and Sleep Issues with Doctor Staci

Unfortunately, parents are often told that grinding and snoring are normal and their child will “grow out of it,” but these seemingly innocent issues can be signs of more significant health concerns.

If you think your child has an airway or sleep issue causing dental and overall health issues, contact your dentist for a consultation. Conservative treatment methods are available to restore natural balance.

Follow Doctor Staci on Instagram or TikTok to keep up-to-date on tips and advice for airway and sleep issues.

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