Dear Parents out there, you don’t want to regret NOT knowing this!
In fact, I wonder how much money, time and specialist-run-around I might save parents just by teaching why this one sign could indicate your child has an underlying airway problem and how if spotted early could prevent serious dental complications (amongst other things)!
Frustrated parents telling me “if only I knew this before” or “why didn’t my GP tell me this!” has prompted me to publicly share with you what Doctors are only learning NOW about the hidden dangers of Mouth Breathing and the silent rise of Sleep Breathing Disorders in our kids.
By the way, I'm Dr Suzie. I'm a GP with a special interest in Allergy and ENT and for the last 3 years dedicated much of my time to helping parents navigate Sleep Breathing Disorders.
Now for the Simple Quick Check I ask parents to do.
Tonight take a look at how your child’s sleeping and see if they are breathing with their mouth open or closed - or even snoring!
If they do snore, I urge you to read why There is No Safe Levels of Snoring in kids here. Mouth breathing + High arched palates + Dental crowding of lower teeth are 3 so-simple-to-see YET too-often-missed clues that your child needs an airway check.
MOUTH BREATHING is the single most effective sign to indicate there is nasal obstruction. Firstly, Mouth Breathing is NOT normal NOR is it cute and YES it can indicate quite serious airway pathology. Humans are in fact obligate nasal breathers. Mouth breathing only involuntarily occurs when your nose is blocked.
To explain why children’s noses become blocked I use the analogy of a child’s nasal airway being like a small pipe. The pipe can get blocked at the front of the nose (I call this an anterior obstruction) or at the back of the nose (I call this a posterior obstruction).
The most common anterior obstruction I see is hay fever but obviously a severe deviated nasal septum is another. The most common posterior obstruction I see is an enlarged adenoid.
You can read my more detailed explanation of the consequences of nasal obstruction in 10 Things That Happen To Children When They Sleep With Their Mouth Open but the quick version is this.
One of the physiological consequences of a child with a blocked nose is Tongue Thrusting.
Tongue Thrusting refers to the tongue’s mal position. With nasal obstruction, children thrust their tongue forward resting it on their lower teeth. For normal palate development the tongue ordinarily should rest on the roof of the mouth assisting it to flatten as the palate grows and develops however without this pressure the palate becomes high arched and a narrow long face + narrow jaw + crowded teeth + receding chin can develop....and hence the expensive orthodontic bill for correction.
The good news is, we can screen and prevent this!
Firstly, Allergic Rhinitis is treatable. Commonly, Hay fever set off by allergens like pollens or dust mite can cause the tissue filters inside the nose called turbinates to swell resulting in a blocked nose. You can easily spot these runny-nosed-kids with their dark rings under their eyes (we call these ‘allergic shiners’) sneezing and vigorously rubbing their noses - we actually call this the ‘allergic salute’.
With epidemic levels of allergies amongst kids, Sleep Breathing Disorder is often a silent companion and dental crowding is sometimes the only visible complication.
Treating allergic rhinitis more aggressively is critical in preventing the orthodontic consequences not to mention shown in numerous studies to halt the cascade of other allergic diseases from developing, such as asthma.
As for posterior obstruction, the adenoid is typically the culprit. A remnant of lymph tissue a bit like a tonsil at the back of the nose that should gradually disappear by about 8 years of age but for some kids classically remains obstructing their nasal passageways and forcing them to breathe through their mouth.
Yet simple removal of an enlarged adenoid by a paediatric ENT is a fairly painless day operation which can seriously improve a children's breathing and can help correct resulting tongue thrusting preventing these modern day dental nightmares for parents.
In conclusion, if you're a parent just do this one simple thing for me - check if your child is Mouth Breathing.
Such a simple quick check - worth knowing, right?
PS. I am excited to say that finally GP's, Allergists, ENT, dentists, orthodontists and oromyofunctional therapists are NOW starting to work more collectively in this space to help tackle epidemic levels of Sleep Breathing Disorders and all it's complications. Yay!
PPS. If you are worried about a child, here is a good place to start.