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Exploring the Relationship Between Malocclussion, Childhood Breathing Disorders, and Sleep Disorders

As more of us are learning that we may suffer from breathing disorders that can lead to sleep apnea, research is showing us that there is a relationship between breathing disorders that can lead to sleep disorders and malocclusion, referred to as bite disorder.  We are learning that childhood breathing disorders can lead to malocclusion, which can further compromise breathing.  Long term breathing disorders can lead to increased rates for cardiovascular events such as stroke or heart attack, high or low blood pressure, depression and insomnia, tempermoandibular dysfunction (TMD) HDAD, Alzheimer’s, Obstructive sleep Apnea (OSA), and spinal issues associated with poor posture.

So, how does this happen?  When the airway of a developing child is compromised because of allergies, tonsils and adenoids, the child must breath through his mouth to get oxygen. The nasal passages become inflamed. The exchange of gases on and off the red blood cells is impeded due to the lack of Nitric Oxygen, or NO, which is continually produced by the epithelium of the nasal passages. The tongue stays on the floor of the mouth. The buccinator, or cheek muscles, in the absence of the balancing forces created by the tongue resting on the anterior two thirds of the palate, allow the collapse of the upper, or maxillary arch and prevent it from growing laterally. The result is a narrow, forward-growing maxilla, bilateral cross bites, and a high, arched palate. Often the nasal septum responds to the upward forces, causing a deviated septum, further compromising nasal breathing. The lower jaw, or mandible, which is influenced by the growth of the maxilla, grows down instead of down and forward. The result is an obtuse mandibular angle, a long lower third of the face, and often an anterior open bite. The airway can be further compromised on opening because the mandible opens down and back, instead of in a more downward direction.

As a parent, what can you look for to determine whether your child has a breathing disorder?  Does your infant have difficulty sucking or staying latched onto the nipple? Does he fuss and cry more than you expect when feeding? He may be having trouble getting air through his nose, so he sucks until he needs air, then unlatches and cries before reattaching. Do the nostrils appear small, inadequate, and unused?  Look at his tongue. Is it discolored from mouth breathing, or is there a tongue tie, limiting its ability to reach the palate? Does he have constant bad breath? Is he a messy eater with food all over his mouth? Are the lips continuously open when he plays or sleeps? Does he or she have dark circles under watery eyes? Is the lower third of the face growing too long? Does he have difficulty concentrating in school? Is he hyperactive? These can be some of the signs of a compromised airway.

What can you do?  Ask your pediatrician to evaluate if your child’s tongue is tied as well as whether your child’s tonsils obstruct the pharynx. They may say to wait until the tonsils and adenoids shrink, usually around the age of five.  If you receive such advice, consider getting an opinion from a physician familiar with sleep disorders. Consult a doctor who specializes in Ear, Nose and Throat (ENT) conditions.  You may also consult a pulmonologist, an expert in breathing disorders.  Possibly the best screening medical professional is a dentist with knowledge about breathing disorders, particularly sleep breathing disorders. Dentist trained to recognize breathing disorders and associated malocclusion can point you in the right direction to have your child evaluated.  There are procedures and techniques available to facilitate the normal growth and development of your child. 



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(703) 565-2503