Patient Education


Betsy Tedman, DMD, LLC

Child sleeping with dog

I’ve been treating dental disease for over 28years, and some of the harder dental problems to control have to do with tooth wear/grinding, both in children and adults. In 2016 when I learned at one of my continuing educational classes that compromised airways could be the root cause of these issues, I paid close attention and set out to learn more. And this is what I learned.

As we have probably already discussed, your child’s airway and/or breathing habits can not only affect your child’s sleep quality, but it can affect the growth of the jaw. Breathing through the nose is number one for normal cranio-facial development and airway formation…starting at birth! The reason this is so important is that breathing through the nose allows the tongue to push against the roof of the mouth, guiding the upper jaw forward and out, to form a ‘u’-shaped arch. In other words, the tongue is the scaffolding for the for the shape of the upper jaw. On the contrary, breathing through the mouth allows the tongue to come down away from the palate and out of it’s ideal location, causing the upper jaw to grow down (instead of forward) and to constrict into a ‘v’ shaped arch. This eventually causes a “gummy” smile due to the downward growth, and/or crowding of the front teeth. Thus, people that seem to have larger tongues, don’t really have larger tongues…the mouth is smaller and constricted AND invading the airway. Consequently, the restricted airway gets worse should the adenoids and tonsils become enlarged.

So, Moms and Dads, what do you do to promote nasal breathing in your kiddos?

  • Breast feeding is the best way to maintain a healthy airway from the start. Remember, nasal breathing is crucial so that the tongue may remain at the roof of the mouth…even for adults!
  • Addressing tooth grinding…Grinding of the teeth, especially when the teeth are wearing down is definitely not a good sign in children. If your child has worn teeth and cavities, more than likely they have a sleep breathing disorder!
  • Observe your child breathing, both awake and asleep:
    • Snoring and loud breathing is not a good sign. Of course, if your child has a cold or sinus infection, noisy breathing is expected. Care should be taken, however, to train them to breath through their noses when they’re not sick. (See my pediatric breathing exercise sheet) Many children with chronic sinus infections and “allergies/asthma” have undiagnosed breathing issues! I strongly recommend referral to an ENT.

For those patients who already have jaw growth changes, the orthodontist can intervene and place appliances that can re-direct the growth of the jaws. We have the luxury of having board-certified orthodontists use our office to see orthodontic patients once a month…Drs. Hamilton, Wilson, and Hendrickson do a great job of taking care of both pediatric and adult patients. Not only do they straighten teeth, but they are able to evaluate the growth with 3D imaging of the teeth, jaws and the airway.

So, I guess I’ve added another personal/professional goal to my dental career…to not only be integral in keeping pediatric mouths and teeth healthy, but to make sure the airway remains healthy, as well!

clenchbroken teethClenching or grinding of your teeth can cause an array of issues not only with headaches, but jaw pain and worn/broken teeth due to the repetitive, physical forces that occur. Clenching and grinding can also overstress and cause changes to the TMJ, or temporomandibular joint. When this occurs, the bite will, of course, change, because the joint hinges the teeth together, “snowballing” the tendency to clench.

Clenching and grinding can occur during the day or night. Daytime is an ideal time to make yourself aware of the tendency and, through awareness and practice, alleviate most, if not all of the grinding. Ideally, when not eating or talking, your teeth should be apart, your lips together, your tongue at the roof of the mouth right behind the front two teeth, all while breathing through your nose. Examples of higher tendency times that clenching occurs would include working at a computer, reading, driving long distances, napping, as well as lifting weights and jogging! At night, though, during sleep, we don’t have that protective awareness to stop the forces of clenching and this is when most of the damage is done.

I have learned in my continuing education classes this past year that the studies are showing that clenching, a lot of times, can be a protective reflex in response to lack of adequate oxygen. An obstructed airway, either by the tongue while laying down against the airway during sleep or by enlargement of tissues in the pharynx that constrict the air passages may be the cause for the grinding. This scenario complicates things even more, because, inadequate oxygen to the body can cause many general health issues, as well.

During the new patient exam process in my office, or at a regular hygiene appointment, I can evaluate these issues and identify the correct steps to take to get to the root of the grinding problem! Please call me with questions or to make an appointment at 785.284.2323.