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Treating Airway and Breathing Disorders

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Dentistry continues to grow and change each decade: In the 1970s, the primary focus was on dental occlusion and restorative dentistry. In the 1980s, the focus shifted to dental implants and the treatment of TMJ disorders (TMDs). In the 1990s, the new focus was on esthetics, cosmetics, and ceramic materials.

Since 2000, dentistry's focus has concentrated on digital technology and is now moving toward integrative dental medicine, which looks at a dental patient as a whole person. We concern ourselves with issues such as diabetes, systemic inflammation, cardiovascular health, gastric reflux, toxins, stress factors, drug interactions, and other issues related to the convergence of oral and overall health. Addressing airway and breathing disorders during childhood and throughout life will be the key focus of integrative dental medicine moving forward.

An understanding of the critical role of airway obstructions and disordered breathing significantly influences proper treatment planning in dentistry. Manifestations may include signs and symptoms such as dental malocclusions, bruxism, tongue-tie, attention deficit, poor sleep, sleep apnea, daytime fatigue, TMD, and morning headaches. Every patient treated, regardless of age, should be assessed for the presence of potential airway problems.

DeWitt C. Wilkerson, DMD

Inside Dentistry

Abstract
Patients can develop airway and breathing disorders at any stage of life. Issues such as allergic reactions, chronic congestion, malocclusions, mouth breathing, improper tongue position or tongue-tie, and other age-related and associated risk factors must be treated to correct the source of obstruction and reestablish proper naso-diaphragmatic breathing. Other conditions with similar symptoms, such as TMD, must be considered during treatment planning in order to avoid complications during therapy. Among older patients, treatment for airway and breathing disorders not only restores proper breathing function, but can also reverse some of the damage seen in brain scans. Because an open airway and proper breathing are foundational to oral and systemic health, every patient treated, regardless of age, should be screened for disordered breathing.

Risk Factors and Treatment for Children

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Breathing and airway issues are concerns at a very young age — even at birth.

Roger Price, PharmD, describes a common childhood scenario in which an allergic reaction to dairy products induces mouth breathing. "This mouth breathing results in a lack of filtration and cleansing of the air, allowing airborne bacteria to settle and flourish; an increase in the volume of dirty air over the lymphoid tissue; an increase in inflammation and congestion as a result of over breathing; a lack of release of NO from the sinuses, preventing bacterial control and vasodilation; and diminution of diaphragmatic breathing, which can lead to a reduced lymph flow to the tonsils and adenoids to remove the toxins," Price explains. "After eliminating the allergic triggers, restoring nasal breathing is a must."

Children can suffer from both obstructive and central sleep apnea. Approximately 10% of children snore and 2% to 4% of them have obstructive sleep apnea (OSA) (including babies, but especially those between 2- and 8-years-old). Up to 40% may experience subtle breathing disturbances, including those related to upper airway resistance syndrome (UARS) with sympathetic nervous system “flight or fight” response and blood cortisol stress hormone surges. Signs and symptoms of sleep apnea among children can include insulin resistance, cardiac modulation, mood swings, cognitive dysfunction/attention deficit, and behavioral changes such as hyperactivity and poor impulse control. In addition, these children are at an increased risk of future cardiovascular disease, especially those with childhood obesity.

When screening children for breathing and airway disturbances, integrative orthodontist, Barry Raphael, DMD, recommends that clinicians ask the following questions:

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  1. Does the child have any sleep issues such as restlessness, bedwetting, frequent awakening, or snoring?
  2. Is the nose chronically obstructed or congested in any way?
  3. Are the lips apart at rest?
  4. Does the tongue rest on the palate and stay there during swallowing?
  5. Are the chest and shoulders moving during breathing instead of the diaphragm?
  6. Is the child's respiratory rate greater than 16 breaths per minute?
  7. Is the child holding his or her head in front of the shoulders to keep the airway open?

To treat children’s sleep-disordered breathing, we must correct the sources of obstruction to reestablish naso-diaphragmatic breathing.

  1. Surgical removal of restrictive tongue frenum.
  2. Orthodontic expansion of the maxillary and mandibular dental arches
  3. Orofacial myofunctional therapy to train proper tongue position and swallowing.
  4. Training in proper naso-diaphragmatic breathing, including breathing exercises such as the Buteyko method.

An open airway and proper breathing are foundational to oral and systemic health. Screening all children for disordered breathing should be a top priority in every dental practice.

AIRWAY / BREATHING DISORDERS / TMD

Common manifestations of TMD include sore chewing muscles, clenching/bruxism, morning headaches, joint soreness, joint clicking/locking, restricted range of mandibular movement, dental malocclusions, cervical neck problems, poor sleep quality, and chronic fatigue. Some patients with both TMD and airway/breathing disorders may actually suffer negative effects from traditional TMD therapy.

CONSIDERATIONS FOR MIDDLE-AGED PATIENTS

For middle-aged men and women, poor sleep, frequent sleep arousals, daytime fatigue, foggy thinking, early memory loss, tired eyes, bruxism, and gastric reflux can indicate the presence of an airway or breathing disorder.

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Sleep apnea may result in low levels of GABA and high levels of glutamate that can essentially produce brain damage. This is indicated by signs of memory loss and foggy thinking and may appear to mimic the early signs of Alzheimer's disease. The good news is that effective therapy can often reverse the damage! After less than one year of continuous positive airway pressure (CPAP) therapy, reversals attributed to increased oxygenation have been seen in brain scans!

Millions of patients across the United States suffer from this reversible form of memory loss and brain damage, and dental professionals are perfectly positioned to screen and intervene!

When the body adapts to poor conditions, the whole body pays the price.

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Are you less productive?

Do you snore, grind your teeth, or wakeup tired?

Do you have poor quality sleep, daytime sleepiness and weight management problems?

Do you suffer from diabetes, high blood pressure, brain fog?

Do you have depression, acid reflux or dependence to caffeine, sugar or alcohol?

Do you have persistent head-neck-shoulder pain?

TREAT THE ROOT CAUSE with Craniofacial Epigenetic appliance. An orthopedic appliance for adults and children with airway improvement and increase oxygen to bodies organs and tissues (pneumopedic effects).

WHAT IS DNA APPLIANCE?

This is a removable appliance that works by widening the upper arch and nasal passages, allowing greater airflow to pass through. As a result, DNA appliance helps straighten your teeth, permanently correct sleep apnea and cure snoring. It also alleviates symptoms of TMJ disorders! This is designed to enhance development of the jaw and nasal structures virtually painlessly because it mimics how body and nature works through gentle pressure. It is a painless, discrete appliance designed for all ages.

Benefits:

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  • It improves teeth alignment naturally.
  • It treats sleep apnea and snoring.
  • It improves TMJ symptoms.

The fact is, sleep apnea is a serious condition which ultimately leads to hypertension, high blood pressure, stroke, heart failure, depression, fatigue and impotence. DNA Appliance is effective and painless.

WHO NEEDS THE DNA APPLIANCE?

The DNA is ideal for Adults and Kids who suffer from TMJ, Sleep Apnea, Small/Stuffy Nasal Passageways, Posture Problems, and Headaches.

DNA Appliance Therapy gently expands the upper jaw while keeping the bite balanced, so as to treat the bite and airway at the same time. As the upper jaw expands, the lower jaw enlarges and moves more forward into a more natural position. As the lower jaw moves forward, the tongue and soft tissue follow and have more room to exist, thus creating a larger and less obstructed upper airway.

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Small Mouth = No Space for Tongue, Poor Breathing, Poor Posture

THE DNA CAN CORRECT AND CURE SLEEP APNEA, TMJ, ORTHODONTIC, AND POSTURE PROBLEMS

It is comfortable, painless and is only worn in the evenings and while sleeping. While many comparable corrective therapies involve surgery, the DNA uses NO Surgery, Needles or Drugs. The appliance naturally corrects alignment of teeth, facial development, upper airway, and neuromuscular harmony.

NOT ALL DNA CASES ARE THE SAME

There is no cookie-cutter treatment. Though many patients may present with common symptoms, each case has unique problems requiring a specific treatment course and an extremely customized piece.

Read the latest research here.

Read archived research here.

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