Nothing is sweeter than a sleeping child. Sometimes, however, their snores become the thing of nightmares, indicating a serious yet treatable condition.
Many children today have upper-airway problems that can result in insufficient oxygen levels, thereby leading to developmental and behavioral problems. These problems include sleep apnea, capable of creating health risks in both children and adults; ADHD and daytime sleepiness that result in poor school performance; underdeveloped jaws with crowded teeth that cause a need for braces, and ultimately make patients more susceptible to periodontal disease and tooth loss late in life.
An estimated 10 percent of all kids snore, according to the National Sleep Foundation, but the reasons can vary. Snoring is caused by a blockage in the airflow through a child’s nose and throat that creates audible vibrations. Occasional snoring can be blamed on a stuffy nose from sinusitis or seasonal allergies, but blockage that regularly produces snores could be the result of several things.
Enlarged tonsils and adenoids are the most common cause of upper airway obstruction and snoring in children. On the other hand skeletal problems such as small upper or lower jaws not only present with crowded teeth but are other potential causes of snoring and ones that-until recently-have gone largely undiagnosed and untreated in young children. Another common factor associated with poor skeletal development leading to compromised airway and crowded teeth is an undiagnosed or untreated tongue tie.
These conditions of airway limitations are a bidirectional problem. What that means is the obstruction from tonsils and adenoids, or untreated tongue ties, create skeletal problems and the skeletal problems can cause airway obstruction. These skeletal and tooth eruption problems can be treated with orthopedic and orthodontic appliances as well as elective surgical procedures to eliminate tongue ties and enlarged adenoids or tonsils.
Many periodontal problems such as gum recession and, in some situations, even tooth loss commonly found in adults can be prevented with some types of orthodontic treatment during childhood. Preventive early treatment was not available in the past, which is why so many adult patients with history of orthodontic treatment and regular dental care are presenting today not only with shifting teeth but also with severe periodontal complications and breathing and sleeping disorders.
It is difficult to believe but a lot of dental problems are related to recurrent ear/nose/throat infections, or tight fibrous tongue tissue, which are all very common in growing children. Teeth, jaws and airway structures are not only in close proximity to each other but are developing and growing simultaneously and any disturbance in one of them will affect the others.
Children usually develop recurrent and chronic upper-airway diseases such as asthma, otitis media, allergic rhinitis and chronic sore throats before the age of 5, which is also before the permanent teeth are starting to erupt. Most of these problems present with congestion with can cause a transition from normal nasal breathing to mouth breathing. Scientific evidence today shows that chronic airway problems and chronic mouth breathing in children impair the growth of facial soft tissues, upper and lower jaws and teeth. Once these skeletal and dental complications take place, a vicious cycle develops with their structural impingement on airway function and a predisposition to dramatic medical conditions such as sleep apnea during childhood or later in life. These patients often present with underdeveloped upper and lower jaws, cross-bites, crowded teeth with fragile gums and insufficient bony support.
That is why when left untreated, these patients develop more severe oral health issues which require more complex treatments. The focus today is on preventive care.
Snoring is one of the first signs of potential airway obstruction. If the child does not appear ill and their pediatrician cannot diagnose a potential cause for the snoring, it could be due to a skeletal problem that needs to be evaluated. Frequent snoring is not normal in a child. They should be evaluated by and ENT, have a sleep study, and see a dentist trained in the evaluating jaw structure and airway impingement.
Bony facial structures should be evaluated at an early age. It is critical to identify and address jaw problems before eruption of the permanent teeth. Today some dentists utilize appliances such as expander to grow jaws, not only to create room for a full set of permanent teeth but also to improve breathing and sleep. Many times young patients can avoid surgeries and chronic asthma medications when proper evaluation and early intervention is utilized.
Early orthopedic/orthodontic treatment can offer aesthetic benefits as well. It can improve conditions such as a recessed jaw, under bite, bucked teeth, short face and narrow smile, all of which develop as a result of growth problems. Beauty comes from having the proportions which signify good health. There are limitations with age, but a child’s health can be enhanced by expanding bone and hence expanding the airway. The effect is dramatic while the bones are in the growth period of early childhood.
These early interventions are not only about cosmetics, but about setting the foundation for a healthy smile and a healthy life.
– By Dr. Robin Khan
If you want your child evaluated for snoring, contact our office today for a consultation.