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New Directions for the Care of Sleep and Breathing

advanced airway orthodontist

How it all begins

First, consider the structure like plumbing. The pipe we breathe through begins at the tip of the nose and goes to the opening of the lung. It may be blocked, obstructed or it may be too narrow and small for air to pass through it. When this happens, there is a survival instinct to breathe through the mouth and the body adapts to it at expenses of our overall health.

So, what is so bad about mouth breathing?

A lot.

Nitric Oxide

To begin, cold, dry, and dirty air is brought to the lungs. This causes inflammation, which leads to a volume of defensive systems to start working. While preferably, air brought through the nose becomes moistened, warmed, and cleaned before entering the lung.

Most important and recently discovered, is the gas called Nitric Oxide (NO). It is created in the sinuses of the upper jaw. It enters the airway through an opening in the middle of the nose and then travels down to the lung. The function of NO is unique and critical to sustain life. It is the gatekeeper to our immune system. It is anti-viral, anti-bacterial, and. More importantly, it is a vasodilator, which effects the heart rhythm, heart rate, and blood pressure.

Only when inhaling air through the nose, NO cleanses the air passing by the adenoids and tonsils, killing the bad bugs along the way. Then, it enters the lung for its key function. It enhances the ability of oxygen (O2) to enter the bloodstream and the carbon dioxide (CO2) to escape and be exhaled. None of these immune or O2/CO2 functions can take place efficiently through mouth breathing because the NO isn’t there.

Nose Breathing

Nose breathing is essential for the immune system to provide clean, warm, moist air. It also allows NO to the lung during the day, as well as during sleep. The mouth breathing at night; instead, prevents the proper sleep pattern and depth. This is the story of the origin of so many health problems that develop from the lack of nose breathing and its importance.

Now WHY is an orthodontist telling you this? Because crowded, crooked and spaced teeth are often the most easily seen signs of a Breathing and Sleep Disorder along with facial and jaw imbalances.

Kids with this type of dental and facial characteristics usually have some other symptoms that are linked to breathing difficulties; such as:

  1. Snoring

  2. Restless sleep

  3. Daytime sleepiness

  4. Night tremors

  5. Hyperactivity during the day

  6. Speech problems

  7. Bed wetting

  8. Overweight

  9. Poor school/sports performance

  10. ADHD behavior

  11. Headaches

  12. History of respiratory infection

Sleep disorder treatment

At this early stage, the treatment is very simple. It consists of eliminating the obstruction that is preventing the child from breathing through their nose. In addition, guiding the facial development with orthodontic appliances.

If the breathing problem is not solved during growth, there are other signs and symptoms that can develop. For example, did you know that flat, worn, chipped teeth are caused by clenching and grinding the jaws during poor restless sleep because the nose or throat are obstructed?

Well, to prevent suffocating when lying down during the night, the lower jaw moves from side to side and forward to open the obstructed airway in order to breathe, but the breathing occurs through the mouth. The brain knows this is a critical serious problem and it stays awake, but lets you be unconscious and in a light state of restless sleep. Sometimes, night guards are prescribed which can be very effective. Still, be aware that studies have shown that night guards that are not made by a sleep specialist can worsen apnea by more than 50%, even if the snoring disappears.


On the other hand, if you have been diagnosed with Obstructive Sleep Apnea or your sleep partner tells you that you stop breathing or gasp during your sleep, this is another life-threatening problem and must be corrected promptly. Your physician, maybe has, or will prescribed you to use a Continuous Positive Airway Pressure (CPAP) mask for sleep disorder treatment. This may be necessary to your survival. However, you should also look to find what and where the obstruction is.

Wouldn’t it be great and lifesaving to find the obstruction and fix it, to minimize the CPAP wear or even avoid its use? Studies have shown that 85% of the obstructions are in the nose. Those patients wearing the CPAP mask probably understand, the pressure is high, the strap is tight, and still they are unable to breathe well, and much less, sleep. Unknowingly they may well have a repairable obstruction.

The CPAP mask must be worn a minimum of four consecutive hours in order to have any beneficial effect on heart health and have a minimum of seven hours of quality sleep for REM sleep hormones to be produced and effective. If not, the insulin and leptin levels are imbalanced and the brain stores food.

And you wonder why you still gain weight and the diet doesn’t work!

Also, you awaken tired, remain so through the day, and your memory is becoming poor. Furthermore, you may fall asleep driving or in a conversation. Additionally, the risk for life-threatening conditions increases.

Life threatening conditions to sleep disorder

  1. Arrhythmia

  2. High blood pressure

  3. Heart attack

  4. Stroke

  5. Gastric Reflex (GERD)

  6. Obesity

  7. Daytime Fatigue

  8. Work accidents (Pilots, drivers, machinery operators)

Help is available here and now at Walker Orthodontics at the offices in Lunenburg, MA and Harvard, MA. We encourage children’s examination as early as age 3-4 for sleep disorder treatment.

The information provided in this article is not meant to be medical advice and is for educational purposes only. If you would like to learn more about this and other orthodontic-related topics, feel free to contact Walker Orthodontics, with convenient orthodontic offices in Harvard & Lunenburg, by calling 978.345.7988 or clicking here to request your complimentary, no-obligation Walker Orthodontics Smile Assessment.

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