If someone was to say ‘snoring causes crooked teeth’ in children I’m sure many would laugh incredulously. Surprisingly there is truth to the statement. To understand why one must understand the amazing uniqueness of the Human body.
First there are the bones that makes the face. Flat bones and long bones are much more identifiable but there is another type of bone that is unique to the upper and lower jaw called cortical bone. It is a very pliable type of bone that responds to pressure. This is why habits like thumb sucking and extended bottle/pacifier usage can cause malocclusion in children. This is also why braces work.
Next one must understand the reason behind the snoring. Snoring is a response to some type of obstruction of the airway preventing proper breathing. A stuffed nose caused by rhinitis can cause snoring ;which stops once the cold clears up. When the snoring is habitual then the cause usually can be attributed to enlarged adenoids and or tonsils. There are instances when the tonsils and adenoids are normal yet snoring is still present. In this case the cause is ankyloglossia or commonly known as an ankylosed or tethered tongue .
The tongue is a very unassuming organ that is a workhorse in our body. It works constantly to help our body to function and allow one to be able to communicate, masticate, taste, swallow, breath and sleep. It also serves as a template for the growth and development of the palate in the growing child. In fact, the position of the tongue is critical to proper formation of the palate. But the problem doesn’t stop there. When this one ‘minor’ function of the tongue is interrupted then a host of complications ensue starting with, of course, snoring.
When a child is upright and the mouth is closed, the tongue is exactly where it is supposed to be. The palate will be a nice wide arch ( roman arch). But if a child is a mouth breather during the day and will certainly be a mouth breather during the night and (possibly a snorer as well) then the palate’s development is compromised.
The palate in this child will be narrow with a high vault ( Gothic arch)
It’s also important to keep in mind the roof of the mouth ( palate) is also the floor of the nasopalatine bone. This is related because if the palate is constricted then the nasopalantine bone is also constricted, further impeding breathing. Usually people with a high palatal arch will have a long narrow face with misaligned teeth.
Ironically a tethered tongue does quite a bit of damage right from e beginning of life. It is a direct cause of sleep apnea in new borns which should be a great concern for parents as well as healthcare givers. If left untreated, the results may express themselves in a variety of symptoms including but not limited to: cognitive impairment, ADD, ADHD, metabolic and cardiovascular complications, disruptive behavior, chronic fatigue and poor academic achievement in school.
I’m sure at this point all this information may seem overwhelming and quite incredulous but the most important point to remember is that the airway is critical to proper breathing. If it is blocked then the oxygen flow to the brain is reduced. During the early weeks of life, the infant brain and nervous system is growing at a very rapid rate. Proper sleep and breathing is a determining factor to the health and development of the growing child. The earlier the diagnosis, the faster the treatment. Incidentally, in many cases, once the tethered tongue is released, many symptoms disappear.
Diagnosis and treatment has to be a multidisciplinary approach. As is the case, the first medical visit of the new born is by the pediatrician. The first dental visit should also be at the same time. A dental examination is not just about teeth but an assessment of the entire oral health as it relates to the body, which has an effect on growth and development of the child. The pediatric dentist, pediatrician, and many times the pediatric ENT, all play a crucial role in diagnosing and treating many childhood problems that if caught early enough can be greatly reduced or even eliminated at a very early age. A healthy body starts with a healthy mouth.