The Link Between Airway and Dental Issues

By: Dr. Elizabeth Eggert

At Eggert Family Dentistry, we recognize the importance of a thorough dental evaluation. When you or your child come in for an exam, we don’t just attend to your teeth and gums. We make it our business to examine your muscles, jaw, and airway as well. We want to ensure that your tongue is functioning properly, that you have a broad upper arch, are able to breathe easily through your nose, and are swallowing correctly.

Why are we so thorough?

Many people don’t realize that they’re struggling with airway issues because the bulk of the symptoms manifest themselves while we’re asleep. Also, the body is so good at adapting, sometimes what someone knows as “their normal” is necessarily the most “healthy normal.” Luckily, Dr. Elizabeth and Dr. Jeff understand the connection between a variety of dental problems and how they may be linked to airway issues. For example, all of these dental problems that we check for during a regular dental examination can be linked to airway issues:

  • Bruxism
  • Functional tooth wear and fracture
  • TMD/myofascial pain
  • Malocclusion
  • Erosion
  • Periodontal disease
  • Caries
  • Abfractions (severe gum tissue recession)
  • Impacted teeth
  • Orthodontic or orthognathic relapse

The intersection of dental issues and airway: A couple examples

Nocturnal bruxism, or teeth grinding, is not uncommon in children and some doctors will tell parents it “normal.” We now understand that often tooth grinding, especially in children at night, often occurs because of a restricted airway. In fact, the connection between bruxism and sleep-disordered breathing (SDB) is so strong that bruxism is now acknowledged as a clinical marker for SDB and children with this disorder should consider a sleep screening.

Upper Airway Resistance Syndrome (UARS) is another type of sleep disordered breathing. Unlike sleep apnea, patients with UARS typically don’t completely stop breathing, however, the resistance of air through the airway causes multiple micro-arousals throughout the night. This often creates fatigue because the body is never able to reach the deeper and reparative stages of sleep. UARS also causes more stress hormones to be released into the body as a mechanism to help the body maintain and airway. These extra stress hormones often lead to an increase of inflammatory markers and can be linked to inflammatory diseases like hypertension, diabetes, TMD, cancer, among others.

Fortunately, a thorough dental examination can help detect a wide variety of dental problems that may be caused by or contributing to airway issues and/or sleep disordered breathing. Our dental exams go above and beyond simply looking for cavities and help you achieve and maintain optimal wellness.

Want to learn more?

If you’re interested in the connection between dental problems and airway issues, we highly recommend these books:

Sleep Interrupted by Steven Park, MD
No More Allergies, Asthma or Sinus Infections by Dr. Lori Jones
Close Your Mouth by Patrick McKeown
The Oxygen Advantage by Patrick McKeown

If you are concerned that dental issues are causing airway issues for you or your child, contact Eggert Family Dentistry or give us a call at 651.482.8412!

The Effects of Airway Issues in Children

By: Dr. Elizabeth Eggert

From a professional teeth cleaning to preventative screening for cavities and other looming dental issues, recare visits at Eggert Family Dentistry are an important part of your child’s healthcare routine. We also recognize that airway issues can mean severe health problems for your child. On this account, one of the important components of your child’s recare visit is our thorough screening for any abnormalities of the head or skull or anything unusual with the positioning of the jaw, palate, tongue, throat, tonsils or adenoids that could lead to mouth-breathing and contribute in any way to an airway issue.

It all begins with how we breathe

Air that enters the lungs through the mouth as opposed to the nose isn’t warmed or humidified in the nasal cavity. This makes a person more prone to infection. Additionally, blood gas studies cite a 20% drop in oxygen levels and a 20% rise in CO2 levels, increasing exhaustion, due to mouth breathing. Long-term oxygen deprivation can result in hypertension, malfunctioning lungs and enlargement of the right ventricle of the heart.

Whereas nasal-breathing is recognized as imperative to good health, mouth-breathing has many negative effects on the body. When air hits the back of the throat, it causes the airway to dry out and lose its elasticity. This makes the airway more susceptible to collapsing. In the instance of a partial airway obstruction, children may exhibit snoring tendencies. When the airway is fully obstructed, children suffer from the dangerous effects of sleep apnea.

Signs and symptoms of airway obstruction in children

  • Snoring
  • Heavy/loud breathing
  • Struggling to breathe at night
  • Daytime mouth-breathing
  • Dry mouth in the morning
  • Bedwetting
  • Daytime sleepiness
  • Underweight
  • Attention deficit problems (fidgety, easily distracted, interrupts frequently)

ADHD

Oftentimes, airway issues in children leads to behavioral problems. This occurs as a result of restricted oxygen to the brain, leading to fitful sleep, increased daytime irritability, distraction and hyperactivity. Unfortunately, many children who experience these behavior problems are medicated for ADHD with Adderall or Ritalin and the serious nature of airway issues go undetected. In a 2014 article in ADDitude, an online journal subtitled Inside the ADHD mind, NuSomnea claims that 50 percent of children diagnosed with ADHD show behavior improvement after being treated for obstructive sleep apnea and they suggest that up to 7 million children have been misdiagnosed with ADHD when in actuality they’re struggling with sleep issues, sometimes as severe as obstructive sleep apnea.

Another serious consequence of airway obstruction in children is growth deficiency. Children struggling with airway obstruction will experience restricted levels of oxygen to the brain, reducing the amount of growth hormone their body secretes. These children will be underweight and shorter in stature than their peers and may experience a plateau in their growth trajectory.

If your child is due for a recare visit or if you are concerned that your child may be predisposed to airway issues, contact us or schedule an appointment with Dr. Elizabeth or Dr. Jeff at 651.482.8412 today!

Sleep Apnea in Children – An Overview

By: Dr. Elizabeth Eggert

There is a growing awareness about the dangers of obstructive sleep apnea. However, what most people don’t know is that sleep apnea affects adults and children alike. Early intervention for children who struggle with sleep apnea can greatly improve their quality of life and protect them from serious complications and risk of death. Fortunately, knowledge is power. When equipped with knowledge about what pediatric sleep apnea is, signs to watch for that indicate a problem, and awareness of risk factors that can contribute to sleep apnea, you possess the tools you need to intervene if a child you love is at risk.

What is sleep apnea?

Just like the name sounds, obstructive sleep apnea is an airway blockage. During sleep, the most common cause for apnea is when muscles in the back of the throat relax, the tongue and surrounding tissues migrate back into the throat, and therefore obstruct the airway.

Symptoms of pediatric sleep apnea

The symptoms of pediatric sleep apnea are very different than sleep apnea symptoms in adults. Whereas adults suffer primarily from incessant snoring and chronic daytime fatigue, children’s symptoms vary greatly. Children may or may not snore and may actually appear hyperactive during the day. Oftentimes, kids who struggle with undiagnosed sleep apnea are misdiagnosed with ADHD. Other pediatric symptoms include but are not limited to:

  • Restless sleep
  • Snorting, coughing or choking in their sleep
  • Mouth-breathing
  • Bedwetting
  • Sleep terrors
  • Learning problems
  • Behavior problems
  • Persistent fatigue
  • Poor weight gain and growth

Risk factors that can contribute to pediatric sleep apnea

There are numerous conditions that predispose a child to sleep apnea. Some of these risk factors include:

  • Obesity
  • Down syndrome
  • Cerebral palsy
  • Family history of sleep apnea
  • Airway blockages from tonsils and adenoids
  • Low birth weight
  • Neuromuscular disease
  • Sickle cell disease
  • Craniofacial abnormalities

When to see a doctor

If your child is a mouth-breather and consistently wakes up feeling tired or exhibits ADHD symptoms during waking hours, it’s a good idea to bring him or her into the doctor for evaluation. You may want to consider an appointment with an ENT who looks at sleep OR a sleep doctor directly.

If you’re concerned that craniofacial abnormalities are causing sleep apnea for your child, call Eggert Family Dentistry. Dr. Elizabeth or Dr. Jeff can evaluate your child’s teeth, jaw, tongue, and airway and make recommendations. Depending on your child’s age, Dr. Elizabeth or Dr. Jeff can fit your child with an in-mouth appliance – similar to an orthodontic retainer – which helps to maintain an open airway all night long.

Complications of untreated sleep apnea in kids and adults

When left untreated, sleep apnea in children can result in failure to grow and thrive, poor brain development, heart problems, and even death. If left untreated into adulthood, sleep apnea can decrease a person’s lifespan by up to 10 years, cause an increase in blood pressure, an increase in the risk of heart attack, stroke, type 2 diabetes, cancer, and dementia.

Needless to say, sleep apnea is nothing to mess around with. Eggert Family Dentistry is proud to be sleep apnea savvy, serving our patients with the knowledge, skills and resources to effectively screen for and often treat sleep apnea in both children and adults. If you’re concerned that someone you love is suffering from sleep apnea, give us a call at 651.482.8412 or contact us to set up an evaluation.