Month: March 2018

Tongue Tied?

What exactly is a tongue tie?

The tongue helps with all sorts of things….eating and swallowing, speech, and breathing. But what if your tongue is literally tied down….unable to perform the necessary tasks?  That is the definition of a tongue tie.

Everyone has a small tissue attachment under the tongue known as the lingual frenulum.  It is normal, except when the length of the frenulum is shortened or the attachment is too close to the tip of the tongue.  Both of these abnormalities can affect tongue movement.  A tongue should be able to easily left to the roof of the palate when eating, drinking, swallowing, resting (this includes breathing….through the nose).  However, if the frenulum attachment is too tight the tongue does not have the proper range of motion and so rather than rising up to the palate during function it will actually protrude out (known as a tongue thrust).

5-17313 - KIRA BELL - Initial - Occlusal Lower

This picture shows a severe tongue tie.  She was 16 years old at the time of her tongue tie release.

5-17313 - KIRA BELL - Initial - Intraoral Right

This is the flaring of her front teeth and open bite she developed as a result of tongue tie and improper tongue movement.

Improper movement of the tongue can lead to other issues.  A continual tongue thrust can lead to the movement of teeth, creating an open bite.  If the tongue is unable to lift properly to the palate to open the airway for nasal breathing it continues to sit low in the mouth which can contribute to narrowing of the airway and be a factor in causing improper mouth breathing.

Fortunately there is a fix for a tongue tie!  A simple procedure can be done to release the attachment so that the tongue can function freely as it is supposed to.  The earlier this can be done in babies and infants the better so that they develop proper feeding, speaking and breathing habits.  However, the procedure can be performed at any age and can be quite freeing….literally!  However, the older you are, the more your tongue has developed bad habits, and you may need several visits with an oral myologist to re-learn proper tongue function once it has been released.

Baby Food…to mush or not?!?

Lets talk for a minute about baby food.

Have you ever noticed that children in underdeveloped countries who are often photographed have a perfect smile, and perfectly straight teeth?  Clearly there generally isn’t access to an orthodontist….so how can this be?  And why is it that children from developed countries like the States often need orthodontic care?

Often in underdeveloped countries, babies are breast-fed until they are several years old.  They are strapped to mom’s back and given things like sugarcane and biltong to chew on to keep their attention.  Here in the States and in other developed countries our babies often aren’t breast-fed for as long, and we feed our babies rice cereal and other pureed foods.  (Please know that I am not comparing facial development with nutrition.  Sadly, so many of these underdeveloped countries face malnutrition, especially in their children, however, I do want to focus on the normal facial development that often occurs.)

Beautiful, broad smiles that often develop are due to several things.  Breast feeding over bottle feeding really helps develop the arch form of the mouth.  It makes the palate broad and flat, allowing all of the teeth to erupt into their proper positions.  By having a baby chew on food rather than be served mush, he/she is developing facial muscles which intern is developing the bony structures underneath.  Chewy things challenge the skeleton to develop…mush does not.

This is why breast feeding is ideal as long as you are able to and feel comfortable doing so. I understand that this may not always be possible for a myriad of reasons.  I also recommend that you give your baby foods that challenge facial development.  Allow them to chew on foods as they eat rather than spoon-feeding pureed foods that are easily swallowed without really any muscle use.

Here is an amazing book that discusses just this!  (link below to purchase)

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Affiliate Link for Purchase

Doesn’t everyone snore?

Snoring, you know….that thing your dad does when he falls asleep in the recliner, or your husband does after a few drinks.  Or maybe you know you do it….but you are in snoring denial.  Snoring never seems to bother the snorer…just those that happen share a room with that person.  Most people consider it normal, but is it??

The quick answer is NO.  But lets look a little more into it.

DSC_0637 

And since I’m all about being real…Yes, this flattering picture is me (taken on a trip with friends in India)….and yes, I snore.  However, I am currently on a mission to fix that…and why I want so badly to share what I am learning.

 

What is snoring exactly?  Snoring is a clinical symptom of something called sleep disordered breathing (SDB).  Sleep disordered breathing encompasses several breathing abnormalities including upper airway resistance syndrome, and sleep apnea.  We will discuss these in more detail in later blog posts.

Snoring results from changes in the upper airway that, in a sense, are due to a decrease in size or collapse of the upper airway (this can be due to an anatomic size abnormality).  Tissues that normally should not touch, end up becoming close or touching creating a vibration known as snoring.  There are many ways that snoring can occur.  Some reasons why snoring can occur are:  A collapse in the airway itself due to lack of tonicity.  Excess weight around the neck (due to being overweight or obese) applying pressure onto the airway.  Inadequate anatomic airway size.  It can also be caused to improper tongue position (sitting down and back), or a longer than normal soft palate.  And if that isn’t enough… to compound the problem, if you are breathing through your mouth and the tissues become dry they because much more likely to stick together because they are no longer hydrated and moist (yep….I just used that word).

Unfortunately, as we grow older we lose muscle tone….which make us more prone to snoring.  We often gain weight as we get older….which applies more weight and stress to the airway.  Double whammy!!  And no….it isn’t just a man thing.  Women, as we go through menopause our hormones change….and as it was said to me oh so nicely by my mentor….”if the airway problems aren’t corrected before menopause, you will become a fat old man”.  Snoring tends to be more of a male issue….until menopause and then it also becomes a female issue.  And with that we also see an increase in cardiovascular disease in women….which can also be linked to sleep disordered breathing.  We’ll talk more about this later.

One thing I do want to say with conviction is….even though snoring is not good in adults….it is NEVER normal in children.

Lets figure out what is causing the snoring…  Is in inability to breathe through the nose? Is it enlarged tonsils?  Is it poor tongue position?  Is it weight?  Is it an anatomic problem?  Lets fix the problem if we can….rather than trying to manage it later in life with something like a cPAP.  We’ll dive more into this when we discuss sleep apnea.