Posts for: June, 2014
One of the most common parental concerns is the habit of many children, even late into childhood, to suck their thumbs or fingers. Many parents have asked us, “Could this affect their teeth?”
The answer, unfortunately, is yes — thumb sucking can contribute to a malocclusion (bad bite) that could eventually require orthodontic treatment. Before making any assumptions, however, we need to understand the bigger picture.
To begin with, infants have a different swallowing mechanism than adults and older children. When you as an adult swallow, you'll notice the tip of your tongue positions itself just above the back of the top front teeth. An infant, however, will thrust their tongue between their upper and lower jaw as they swallow (also known as an infantile swallowing pattern or primary tongue thrust). The infant normally begins changing to an adult swallowing pattern when their primary (baby) teeth begin to erupt.
However, if a child's swallowing transition is slower than normal and the tongue rests between the jaws for a longer duration, it can inhibit the full eruption of teeth, believed to be the main cause of an open bite (a gap between the upper and lower teeth when the jaws are shut). The thumb during sucking resting between the teeth can have the same effect.
Thumb sucking may not necessarily lead to a malocclusion — for example, an abnormally developing jawbone could be the culprit. If prolonged thumb sucking does become a concern, however, there are steps we can take to reduce the impact of the habit. We can install a thin metal “tongue crib” behind the upper and lower incisors that will not only discourage thumb sucking, but also help retrain the tongue not to rest between the upper and lower teeth. There are also exercise routines known as orofacial myofunctional therapy (OMT) that can retrain specific muscles in the mouth to encourage more normal chewing and swallowing patterns.
These steps may not prevent future orthodontic treatment, but they could reduce its extent. The key is regular dental checkups and consultation to ensure your child's teeth and bite are developing normally.
If you would like more information on the effects of chronic thumb sucking on the mouth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “How Thumb Sucking Affects the Bite.”
In dentistry (as well as other branches of medicine) pediatric conscious sedation is becoming more widespread than ever — but some people aren’t yet familiar with this beneficial therapy. Conscious sedation can remove anxiety and produce a feeling of calm and relaxation during dental treatment; however, unlike general anesthesia, it doesn’t cause the loss of consciousness. That means patients can still breathe normally and can respond to certain stimuli, while feelings of pain and anxiety are blocked.
Conscious sedation is often employed for invasive procedures such as tooth extractions or root canals — which cause some people a great deal of apprehension, no matter what their age. It can be especially useful for children, however, who may have a more limited ability to understand (and cooperate with) their dental treatment. Because the medications are commonly administered orally (by mouth), there’s no needle to provoke fear. And when it’s over, there is usually little or no memory of the procedure that was done.
Pediatric conscious sedation is typically administered in an office setting by a dentist with special qualifications. The American Dental Association, the American Academy of Pediatric Dentistry, and the American Academy of Pediatrics have jointly established criteria for its use. Specialized training and continuing education are part of the qualification process; additionally, the dental office must be equipped with advanced life-support equipment and trained staff, who can help in the unlikely case of an emergency.
While your child is receiving conscious sedation, he or she will be monitored by a designated staff member who keeps a close watch on vital signs like blood pressure, oxygen levels, pulse rate and respiration. This helps to ensure that the level of sedation remains safe, yet effective. When the procedure is over, the medications wear off quickly; however, children will certainly need a ride home, and shouldn’t return to school until the next day.
As new medications are developed, more dentists receive special training, and the cost of associated equipment becomes more reasonable, the practice of pediatric conscious sedation is becoming more widespread. For many kids, it could mean the difference between having fearful childhood memories of the dental office that linger on through life — and remembering almost nothing at all.
If your child has dental anxiety or requires invasive procedures, pediatric conscious sedation may be a good option for you to consider. For more information, call our office to arrange a consultation. You can learn more in the Dear Doctor magazine article “Sedation Dentistry for Kids.”
You may get a laugh out of jokes about snoring, but in fact snoring and “Sleep Apnea” (“a” – without; “pnea” – breath) is no laughing matter. Nights of chronically disturbed sleep results in accidents, lost productivity and even depression, as well as problems at work and with relationships. Chronic snoring as a result of sleep apnea, results in sleep deprivation and health problems such as high blood pressure, congestive heart failure, heart attacks, brain damage and strokes.
What causes snoring?
Snoring results when soft tissue structures block the airway (windpipe) in the back of the throat. These structures include tonsils, soft palate, the uvula (the little punch-bag shaped structure at the back of the throat), and fat deposits. As you relax in sleep these tissues collapse onto themselves and the tongue drops back, causing a blockage in the air passage to the lungs. These obstacles to airflow create the familiar sound that we know as snoring.
What is Sleep Apnea?
When the obstruction is severe, it can block airflow completely. Obstructive Sleep Apnea (OSA) occurs when your upper airway is so seriously obstructed that there is significant loss of airflow, or even a complete arrest of breathing for 10 seconds or more. Reduced airflow into the lungs causes low levels of oxygen in the blood reaching the brain. Your brain, saving itself from suffocation, wakes you briefly out of deep sleep, followed by a loud gasp as the flow of air starts again. This can happen more than 50 times an hour. Low oxygen levels and fragmented sleep cause most of the dangers of sleep apnea.
What can be done to combat sleep apnea?
Medical and dental treatment includes:
- Staying physically healthy: Being overweight contributes to OSA, so start by losing weight and exercising.
- Oral Appliance Therapy: Specially designed (retainer-like) appliances are designed to maintain an open, unobstructed, upper airway during sleep.
- Continuous Positive Airway Pressure (CPAP): CPAP bedside machines send pressurized air through a tube connected to a mask (covering the nose and sometimes mouth), keeping your airway open.
How can we help you combat your snoring and sleep apnea?
The first step is assessment and diagnosis. Dentists, specially trained in sleep medicine, are in a unique position to help diagnose and help treat snoring and sleep apnea as part of a medical team. Contact us today to schedule an appointment if you think you have a problem with snoring and OSA — or if your spouse thinks you do. You can learn more by reading the Dear Doctor magazine article “Snoring and Sleep Apnea.”