I’ve written before about mouth breathing in children, as well as OSA in children, but there’s a lot more to the story than just breathing. Many very common conditions and behaviors that happen in infancy can have a profound effect on one’s jaw health and teeth alignment as they get older. These issues weren’t always dealt with in the past, and as a result, I see their effects in patients today.
Here are my top-five oral health concerns to be on the lookout for, in infants and small children.
1. Tongue Tie
A short lingual frenulum didn’t always used to be considered a problem, but we’re beginning to understand that it can interfere with a baby’s ability to nurse properly and cause other irregularities in the mouth. When the tongue is too short, it doesn’t push up against the roof of the mouth when you swallow, and this can have an effect on palate development. This can lead to orthodontic problems, such as open bite, as well as speech problems. The solution? A very simple surgical procedure can restore full range of motion for the tongue.
2. Mouth Breathing
It may look cute to see your little one swept away into open-mouthed dreamland, but there’s nothing healthy about mouth-breathing in children. Mouth breathing usually happens because the airway becomes obstructed during sleep, so the child breathes the only way he can—through the mouth. Nasal breathing is better for the body, so if your child seems incapable of doing it, there’s probably an obstruction. Often it’s the tonsils or adenoids. It can also lead to overbite, and has been linked with cognitive and behavioral problems in school. Mouth breathing and snoring are often connected to apnea, which deprives the body of adequate sleep and oxygen.
3. Tongue Thrusting
Nearly all babies thrust their tongue forward when they swallow until about 6 months of age. As they start to learn how to eat solid foods, it typically goes away. However, if it doesn’t go away, it can interfere with proper teeth alignment and speech development. One of the reasons why it’s really important to bring your child to a dentist at a young age is that parents don’t always notice tongue thrusting, but a dentist or doctor can spot it right away.
4. Thumb Sucking
More a behavior than a condition, but I decided to include it because it’s easy to spot and be aware of. I’m no wizard with easy answers for how to discourage a child who wants to suck on his or her thumb. That’s your struggle as a parent, but I can show you pictures of the orthodontic problems that result from thumb-sucking. They aren’t pretty. It can also cause a child to develop a lisp, which most parents aren’t excited about.
5. Acid Reflux
Are colic and acid reflux (GERD) the same thing? The jury is still out on this one, since colicky babies can’t really explain what their symptoms are. Some hypothesize that the distress of a colicky baby may be gastroesophageal pain and/or gas. Regardless of whether your infant would be described as “colicky” there are a few distinct signs of acid reflux you can be watchful of:
– Wet burps and hiccupping
– Abnormal arching of the back
– Coughing, gagging, or choking
– Excessive spitting up or vomiting
– Disturbed sleep, prefers to sleep on stomach or with head elevated
In any event, acid reflux can be damaging to your child’s oral health, as well as his quality of life. Once the teeth start coming in, they will be vulnerable to damage from any stomach acids that make their way up the throat and into the back of the mouth.
Overall, any problem that affects the teeth and a child’s bite can lead to TMJ problems in adulthood if not properly dealt with. I see this a lot in my practice and often wish I could turn back time. If you notice any of these problems in your little ones, talk to your pediatrician, talk to your dentist. They may not seem like a huge problem on their own, but they can lead to bigger problems down the road.
About the Author: Dr. Mickiewicz owns a private practice in Sacramento and lectures across the nation on TMD treatments. He is a diplomate of the American Academy of Pain Management and holds membership in many professional associations for dentistry, sleep medicine, and TMD. In addition, Dr. Mick, as his patients call him, founded Pacific Orofacial Pain Consultants, a team of experts in various disciplines, who tackle the issue of TMD pain and treatment, to help sufferers find relief from chronic pain. To talk with Dr. Mick, call his Sacramento dental office at 916-469-9178.
