My journey towards sleep dentistry began when my son was 5. His preschool teacher asked me if I had been helping my son with the sight words [5 words per week]. I informed her that we would spend 2+ hours each weeknight working with him on the sight words. We would play games, review index cards, read, write, rewrite, and so forth. I vividly remember the teacher’s expression of shock and astonishment. My son, with as much training and effort we were providing him, was merely getting 1-2 sight words correct on his quizzes. She didn’t say much to me, but later that week, the administrator pulled me aside and suggested that I should perhaps have my son tested for a learning disability. It had never occurred to me that our daily routine was not the norm. I figured, he’s a boy, he likes to have fun more than do homework or study like most other kids, perhaps he is a little active, but nothing unusual or out of the ordinary. [Some time later, while discussing with another parent, I was told she spends 10 minutes reviewing with her son the night before a quiz, and her son gets a perfect score each time].
During this time, I spoke to my sister who is a practicing pediatric dentist in Napa Valley, CA. She told me to look into sleep studies and informed me that there are researches suggesting that sleep may affect a child’s daytime focus.
This is where our journey to find answers and solutions within different specialists began. We consulted a psychologist, an allergist, ENTs, medical sleep doctors, an orthodontist, dentists specializing in sleep disorders, and oral maxillofacial surgeons. Our son had many of the elements and signs for someone suffering from Sleep Disordered Breathing/Sleep Apnea:
- ALLERGIES - He had allergies that would flare up his airway causing asthma like symptoms.
- The allergies would cause his nasal passages to be inflamed/swollen, hence, reducing the amount of oxygen intake
- That allergen induced inflammation along with thickening of mucus due to the drop in body temperature [less movement at night vs. day] exacerbated his asthma.
- NIGHT SWEATS - The night sweats would cause his pillow to be frequently soaked. This was especially true around ages 3-5.
- At night, due to the decreased oxygen level, his body is working twice as hard to pump oxygen to the rest of his body, similar to when you are exercising.
- This is also the reason why adults with sleep apnea have a higher tendency of cardiovascular disease, as the heart is working overtime.
- TEETH GRINDING – The teeth grinding had reduced the size of his baby teeth significantly.
- Due to the reduction of oxygen, our brain’s first defense mechanism is to alert our body to move to open the airway, in which case “grinding and clenching.”
- TONGUE TIE – The push of the tongue is what develops the jaw in a growing child. The tongue is responsible for developing the shape of the palate.
- He had a speech delay, and we were also aware he was tongued tied.
- When a child’s tongue is “tied” down, it has limited range of motion and cannot reach the palate adequately. It does not stimulate and push the teeth and jaw out properly during early development resulting in under development of the jaw and airway. Palates in cases of a tied tongue will be high-vaulted and narrow. Subsequently, Lip ties will draw the lips back onto the teeth, resisting outward growth of the jaw.
- RESTLESS NIGHTS - He would toss and turn, waking up on opposite ends of the bed.
- Same brain/body reaction as teeth grinding.
- BEDWETTING - Bed wetting incidents occurred regularly.
- Bedwetting occurs because the brain is prioritizing oxygen distribution to essential bodily functions such as the heart and brain, therefore bladder control is impaired.
- ADHD - The scheduled psychology test of 6 hours was completed in 3 hours. While waiting for the results, we expected the news to be either really bad, or really good.
- The psychologist that tested him informed us, “your son has ADHD, but for now we’ll refer to him as provisional ADHD since he is still very young.”
- Both the pediatrician and the ENT physician encouraged us to start medication.
- SLEEP APNEA - An overnight sleep study at a sleep lab revealed and confirmed that he had sleep apnea.
We followed all the recommended directions including:
- ENT - tonsil and adenoid removal. This is in effort to create more space for oxygen to pass through his airway.
- ALLERGIST - weekly allergy shots to help build immunity towards allergens/pollen he is allergic to. This is to reduce the inflammation caused by his body against allergens – swelling up his air tubes [hence reducing air flow].
- FRENECTOMY – dislodging the tongue tie. When a tongue is un-tied it can regain its range of motion and promote proper facial development.
- SLEEP DOCTOR – He was recommended to use a CPAP at night to help ensure that there is sufficient oxygen in his system and not depleting him of the necessary oxygen for brain development and body growth. However, we struggled greatly with compliance, and feared potential facial hypoplasia.
Unfortunately, despite our best efforts, his new sleep study, while slightly improved still showed obstructive sleep apnea [OSA]. This is where I searched, researched and sat through numerous sleep apnea courses and learned about the Healthy Start Program. Healthy Start is a lifelong, non-surgical, non-medicinal, permanent solution.
In short, Healthy Start is a series of oral appliances similar to a sports/night guard with a very specific design structure during each phase. The appliance trains the tongue for proper swallowing, slowly expands the palate, and guides teeth to optimal positioning. It’s a win-win because now, my child will grow up with NO SLEEP APNEA (as a child and adult), he will UNLIKELY NEED BRACES or retainers. Most importantly, he is getting the quality of sleep he needs, helping his overall brain and body health. Nathan is 7 years old now, and has begun wearing his Healthy Start oral appliance nightly and we have seen small consistent victories day to day in school, at home, and as his dentist – I can slowly see his palate expand!
This approach is what you would call a holistic approach, and while my staff may feel like my wife and I get carried away when people ask us about sleep and pediatric sleep apnea; it’s because we know there is a better way improve the overall health and quality of life.
For the longest time, what most people associate with dentistry today is the treatment of diseases. Common things we see include: cavities, broken or infected teeth, jaw joint pain, swollen gums, among others, which I can help fix day in and day out. But what if, we start looking at the root causes of these diseases and guide you along a path to sustainable oral health and wellness. I am excited and happy to walk you through this path, are you?