Your child is your world, and she delights you every day. But recently you’ve been concerned – your kid is now a mouth breather, and she’s not even had a cold recently. And although she seems to sleep well – despite her loud snores – her bedding is always twisted and sweat-stained. As though she’s tried to kick her way out of it. Learning new things is becoming increasingly frustrating for her. And while she’s never had the best table manners at 3 years old, she’s become quite the noisy eater!
What’s going on?
Mouth breathing, snoring, and restless sleep are all connected, and are early warning signs that something is up with your child’s health. The good news is that we can intervene from the age of two and a half – and such early intervention can make a huge difference in their health and future.
What Are the Causes of Mouth Breathing in Toddlers and Preschoolers?
Mouth breathing in your child may be more noticeable when your child is asleep – or it may be a constant habit. Regardless, this form of breathing is bad news at night for developing brains. But what causes mouth breathing in the first place?
Ideally, your child’s jaws should be wide and U-shaped – but our jaws have become smaller, causing overcrowding for our teeth, crooked smiles, overbites or retruded bites, and slack-mouths. The resulting V-shaped jaws cause a high narrow palate and, more worryingly obstructed nasal passages.
Risk factors for airway issues and mouth breathing:
- Stopping breastfeeding before 3 months of age – obviously, it isn’t always convenient to breastfeed for this long, and there are instances when babies and toddlers self-wean. But even one feed a day can have a positive effect on your child’s development, as it promotes breathing through the nose and gives your child’s mouth and tongue muscles a workout. The resultant pressure on your child’s palate triggers bone growth of the jaw, ensuring the development of a wider jaw – and a more open airway.
Alternatively, use a slow-flow, orthodontic teat when bottle feeding. Research your choice of bottles carefully, but the flow cannot be too fast – if it squirts out of the teat when you turn the bottle upside down, your infant isn’t going to get the workout they need through sucking. Your baby must take the entirety of the teat into their mouth, not just the tip. Consider moving to drinking from a cup after the first birthday.
- Tongue-tie – a tight frenulum initially means that your baby is unable to latch on and breastfeed properly, but long-term can cause problems with eating, swallowing, and occasionally speech. Tongue-tie can prevent proper orofacial development, and potentially lead to a partially blocked airway at night.
- Thumb-sucking and reliance on pacifiers – though it can be an excellent way for children to self-soothe, the pressure on the palate forces your child’s jaw to stay narrow. Positive ways to stop thumb-sucking include:
- Introducing a children’s book about thumb sucking so your child can decide they want to quit.
- Make a reward chart.
- Encourage your child to wear socks over their hands at night to avoid sleep-sucking.
- Soft modern diet – when you go to the grocery store and look at the baby food you’re faced with jars and pouches of mush. Feeding young children soft cereals and mushed up food doesn’t help with their jaw development and therefore affects the openness of their airway. Baby-led weaning (BLW) and giving your child raw veggies they can crunch helps give their jaw a workout. When feeding a toddler, focus on giving them a variety of textures.
- Enlarged tonsils – swollen tonsils can partially block your child’s airway, causing breathing issues at night.
- Allergies – if your child has undiagnosed allergies, they may be struggling to breathe through their nose, resulting in mouth breathing.
Remember that the level of risk is dependant on the individual child. And it’s important to seek the advice of a dentist well acquainted with both early intervention and airway sleep disorders if you’re worried about your snoring toddler.
What Are the Complications of Poor Rest Oral Posture and Mouth Breathing for Your Child?
Though mouth breathing may seem harmless, as a long-term habit it can cause several developmental and health issues:
- Dry mouth – The lack of saliva caused by breathing through the mouth can interfere with the normal function of their mouth microbiome and the natural protection against gum disease and cavities.
- Teeth grinding and jaw pain.
- Irregular bite and poor facial development.
- Development of an airway sleep disorder (ASD) such as sleep apnea – chronic mouth breathing encourages the tongue to flop backwards, partially blocking the airway. A lack of oxygen at night caused by ASD can result in:
- Impaired development of the prefrontal cortex – which is responsible for learning and processing new information.
- Reduced connections made throughout the brain.
- Sleep deprivation.
- Increased cortisol and adrenaline levels, resulting in symptoms of hyperactivity, anxiety, aggressive behavior, ADHD, and learning disabilities.
- A lower IQ.
If you suspect your child is struggling with an airway sleep disorder, early intervention is key. The sooner your child is treated, the more easily reversible the symptoms. I’m happy to use guided growth techniques for children as young as 30 months.
How Can I Help My Child Breathe Better at Night?
The most important thing you can do for your child is advocate. Your child needs you to see this through, by ensuring their health is given a thorough investigation. Work with an interdisciplinary team for the best care: an AirwayCentric® dentist, allergist, and an ear, mouth, and throat (EMT) specialist. Above all, I cannot stress this enough: Your child must complete their treatment in order to make a permanent change to their health, breathing, and brain health.
In terms of specific dental treatments, we can use one or more of the following, where applicable:
- Rapid maxillary expansion (RME) – Where a palatal expander is used to widen your child’s upper jaw. The function is made ‘rapid’ because the expander can be adjusted manually – typically by 0.5-1mm a day. The quickness of the treatment means that it need only be in use between 3-6 months.
- Orofacial myofunctional therapy (OMT) – A series of simple exercises for the mouth that your child may even find fun! The exercises include improving the ability to breathe, suck, chew, swallow, and speak. The therapist focuses on teaching your child the correct oral rest posture to improve nasal breathing and facial development.
- Guided appliance therapy – By using an oral appliance at night, we can open up your child’s airway and encourage them to breathe through their nose. The results can be almost immediate – better sleep, improved concentration, and a calmer disposition.
If you’d like to learn more about our AirwayCentric® approach, pick up a copy of GASP!: Airway Health – The Hidden Path To Wellness by Dr. Michael Gelb and Dr. Howard Hindin. If you’re struggling with a mouth-breathing child or are concerned with sleep apnea in the New York area and are looking treatment, fill out our contact form, or call to make an appointment with Dr. Gelb on (212) 752-1662.