By Dr. Erika Rowe
I triple dog dare you to breathe solely through a coffee stirrer straw for ten minutes. Did you try it? Do you have the worst headache of your life? Would you be willing to breathe like that overnight and then attend a continuing education course and be graded on what you learned? Well here’s a shocker: many children spend every minute of their sleep struggling to breathe due to tethered oral tissues (TOTs) or tongue ties. The average 7-year-old has 7mm of airway space to breathe with. When they lie down and their tongue is not sealed to the roof of their mouth, their airway collapses down to 6mm! That leaves a 1mm coffee straw to get oxygen through all night. Take a moment and think how hard it was to function and focus after 10 minutes!
You may have an idea that oxygen deprivation is not a good idea for anyone, but when you take a closer look at Sleep Disordered Breathing (SDO) in children there is a terrifying list of consequences to our children not getting enough oxygen while they sleep. The condition ankyloglossia or tongue-tie is a remnant of tissue in the midline attaching the undersurface of the tongue to the floor of the mouth. It restricts the movement of the tongue and prevents it from being able to seal to the roof of the mouth and allows an individual to breathe properly through their nose while sleeping. This tiny bit of leftover tissue affects how we breathe, if we can fully cleanse our teeth, how we speak, how our upper jaw and therefore our lower jaw grows, our endocrine system, being misdiagnosed as having ADD/ADHD, potty control, and training issues, if we get allergies, if we will get lots of ear infections, if our tonsils and adenoids enlarge to just name a few.
For many people, they discover their child has a TOT when they have difficulty breastfeeding and deal with pain, and sadly sometimes the end of a journey they wanted to take. For others, they don’t discover it but overproduce, suffer from many bouts of mastitis, and deal with babies who are labeled “colicky”. Some even are given acid reflux medications that do carry some significant side effects of their own. I have heard from lactation consultants in Phoenix that they are not even allowed to call a new parent’s attention to their baby’s tie in the hospital setting. The lucky ones are identified early and matched with a great team including a release provider, a lactation consultant, and a chiropractor, physical therapist, or bodyworker who is familiar with Oromyofacial therapy. When aftercare is properly managed by the parents and their team these babies are in a great place for optimum jaw growth, a much happier breastfeeding journey, and get to avoid all the consequences of an untreated tongue-tie.
So I am sure by now it has crossed your mind so if my child has a tongue tie and didn’t get it released as a newborn does it matter? Here’s where you have to ask yourself do you like to prevent health problems before they happen or do you like to fix things after they become a problem. Dr. Kurt and I have always run our practice based on the philosophy that our #1 job isn’t doing fillings or crowns, it’s preventing the need for them. There are always going to be people who don’t change their oral care habits and plenty of teeth to treat. We want to teach our patients how not to need us for restorative care. So we strongly believe if there is a way to help jaws grow and not need orthodontic care, a way for tongues to move freely and not need extensive speech therapy and most importantly grow a big healthy airway, future issues with SDO won’t happen and affect your or your child’s systemic health. Oh yeah did I mention there’s a very high genetic connection with TOTs? So if your little one had a tie, you or your husband or both likely do too.
Your tongue is the muscle in your mouth that determines how ideal your upper jaw grows. If it doesn’t provide the pressure it would when properly sealed a person will end up with a high vaulted or v-shaped palate and a very narrow nasal floor, which also increases upper airway resistance, and a small lower jaw with no room for all the adult teeth to be properly aligned. If the tongue is in its proper sealed position we get a nice wide and flatter upper jaw, nasal floor, and our lower jaw is able to grow and has space for all our teeth. All these things together influence how large your airway will become. How effortlessly and well you can get enough oxygen throughout your lifetime. This is a huge influence on your systemic health from birth to death.
It is time to ask ourselves are tethered oral tissues really just a breastfeeding issue?
There is a great resource thehealthystart.com/quiz to see if your child is exhibiting signs of Sleep Disordered Breathing (SDB).
Drs. Kurt and Erika Rowe, parents to Kole (12) and Lilly (9) received their DMD from the University of Pennsylvania School of Dental Medicine in Philadelphia, PA. Their practice Rowe Family Dentistry is in Paradise Valley, AZ. rowefamilydentist.com