Snoring Infants and Behavior Problems

My wife still chides me, "Is everything related to mouthbreathing?".  She is the director of a preschool program.  She sees the best and the worst of children ages 4,5 and 6.  Here is a study that relates the nighttime breathing patterns of infants to their daytime behavior.


This study, out of Einstein, where I now lecture to the ortho residents, created quite a media splash and deservedly so.   Take a look at it here.


Then take a look at my online comment to see what they are missing in their study here.


Yes, my dear, it all starts with mouthbreathing.

Untangling the Mess

Untangling the Mess

I guess you have to start out by saying, "There are no accidents" when you look at how our children are growing.  There is a reason for everything.  The reasons are a balance of genetics and the expression of the genes after exposure to the environment.  If you've read my blog, you know that I am concentrating heavily on the effects of non-genetic factors in the development of crooked teeth.

I consider crooked teeth to be a symptom, the end result of a number of interactions of various body systems that occur throughout one's young life.   I look at the difference between what the genetics is SUPPOSED to produce (straight teeth, a full healthy face and jaws)  and what has eventually come to be (underdeveloped facial bones and crooked teeth.  This is the basis of "Darwinian Dentistry" and "Evolutionary Medicine".

The interactions between our bones, our muscles, our breathing, our eating, and all of our habits within the "experience" of life makes us who we have become. It has shaped our bodies and faces. It determines our overall fitness and health. That makes common sense, no? This is true of all the various Chronic Non-Communicable Diseases of Civilization (cardiac disease, diabetes, obesity, etc.)

My challenge, as an orthodontist, is not just to look at crooked teeth and try to untangle them, but to find all those interactions that have led to the crooked teeth and try to untangle THEM.  If we untangle the REASONS the teeth get crooked first, we can help them grow straighter in the first place, and then once straight (with or  without braces) we can help them STAY straight for your lifetime.

This puts my work at the end of a list of issues to be handled: 

• the bones (chiropractor, cranio-sacral, podiatry)
• the muscles (physical therapy, body work, posture, fitness)
• breathing (Buteyko, ENT, sleep hygiene, asthma, heart rate variability), 
• eating (nutritional selection and routines, allergies)
• habits (myofunctional therapy, TMJ, parafunctions)
• and then....straightening the teeth.

So when a patient comes in, what I am looking at is the end product of 4 or 8 or 12 years of development in the presence of one or more noxious habits or exposures that have blocked normal growth.  It is over breathing? Sensitivity to milk products? A chronic stress reaction? A forward head posture?  

In order to "see" something on a medical/dental exam, you have to know it exists. That's the beginning of diagnosis.  Then we have to know where the signs and symptoms come from. And then assign the appropriate symptom to the appropriate cause.  And then treat the cause.

Well, is there any wonder why this will be an interdisciplinary effort?   We have to help each other "see" what's there.  We have to be open to allowing others to help us establish the treatment plans and protocols we use.  An that's how we are going to untangle this mess called crooked teeth.

A Work in Progress

This is from a letter I sent to a colleague who was unfamiliar with what is going on in Integrative Orthodontics....


"For years, I stayed within my circumspect orthodontic circles.  Now I'm meeting people ffrom all the healing arts with whom I have common goals: searching for the etiology and allowing the body to heal itself by removing blockages and bad habits.  

For me, it's mostly removing bad habits.  I'm firstly concerned with resting tongue posture in the growing child.   Since the tongue is the scaffold on which the maxilla and upper teeth take their support and guidance, having the tongue on the palate at rest is fundamental.  So teaching oral posture and proper swallowing habits is the central strategy.

But I also have to look at what may keep the tongue away from the palate.  Open mouth posture at rest and especially during sleep is an endemic problem.  This may be secondary to upper airway distress, allergies, asthma, chronic hyperventilation (over breathing), swollen lymphoid tissue, environmental stressors (both physical, like in food, and toxic substances, and emotional stressors). There are also the postural issues of ascending and descending musculo-skeletal imbalances and habits that I'm sure you are all too familiar with.

So my program (still in the developing stages) takes a broader approach: it includes Oral Myology (for tongue posture and function), Arch Expansion, (to undo previous damage to jaw growth), Breathing Correction ( to slow down breathing and improve oxygenation of tissues), Postural Training (straight body:straight teeth) and Nutritional Coaching (to lessen the toxic and metabolic load, if possible).   At least that is what I'm working toward.  

And what I find is that if I start early enough, the teeth will improve before we even have to talk about braces.

I look forward to further conversation and to learn about your way of thinking,

Sincerely,

Barry 

--
Barry Raphael DMD
1425 Broad Street
Clifton, NJ 07013