Airway Dentistry
Also known as dental sleep medicine, Airway Dentistry focuses on diagnosing and treating sleep-disordered breathing like snoring and sleep apnea using oral appliance therapy. It’s a specialized field within general dentistry that addresses the underlying causes and symptoms of sleep-disordered breathing and aims to improve sleep quality, reduce snoring, treat sleep apnea, and potentially address other health issues related to breathing problems.
MyoMouth Piece
It is early interceptive orthodontic treatment which utilizes myofunctional guidance appliances to promote proper growth and development of facial bones and musculature via proper tongue position and nasal hygiene so that teeth can erupt into ideal positions.
Modern soft diet of western industrialized civilization, not using muscles to chew the foods of our ancestorial hunter/gatherer diets, has resulted in smaller underdeveloped jaws. Smaller jaws result in decreased airway space from your nasal passage down to the oropharynx.
With trouble breathing through our nasal passage, we resort to breathing through our mouth. Mouth breathing can contribute to overactive facial muscles, improper tongue position as well as improper swallowing pattern. Adenoids and tonsils can be large, swollen and inflamed, making breathing even more difficult. Snoring and teeth grinding are warning signs that air is not moving freely through our breathing pathway. Improper swallowing pattern with the tongue not in the proper position can allow fluid to build up in the ears and not be drained leading to chronic ear infections.
Modern medicine has lost sight of the cause of these types of symptoms and focuses more on treating them. There is a laundry list of symptoms that researchers are starting to link to poor quality of sleep in kids. Anything from snoring, sleeping with their mouth open, to having dark circles under their eyes (venous pooling), interrupted sleep pattern and frequently waking up during the night with bed wetting. As a baby it could be present as a tongue tie, not latching properly or breastfeeding well, or being colic from improper swallowing. Kids who have behavioral issues at school or poor academic performance; those that are concerned about having ADD or ADHD, could all be linked to the child not sleeping or breathing well at night. Ear tubes, tonsil and adenoid removal, ADHD medication, CPAP machine are all band aid treatments addressing the symptoms but not the root cause. We are looking to treat the cause, underdeveloped jaws, with our MyoMouth Piece.
As far as teeth are concerned, smaller underdeveloped jaws cause crowding and thus there is not enough room for teeth to develop and erupt properly. Crowded teeth make brushing and flossing more challenging thus posing a higher risk for tooth decay and gum disease. Mouth breathing drying out the lips and the oral environment also leads to an increased risk for decay to form. Facial asymmetry can be noted with smaller lower jaws and no jaw line as compared to the upper part of our head and face. Traditional orthodontic treatments can call for removal of teeth unnecessarily to more easily make room.
With MyoMouth Piece we are striving to break the mold of the traditional old school thought process of “wait and see” once all the baby teeth are gone. About 90% of the growth and development of facial bones and musculature have been completed by the time a child turns 12 and loses most of their primary dentition. Moving teeth orthodontically once most of the bone has developed can pose several issues long term. The first and most common is orthodontic relapses, especially if retainers are not worn continually. Secondly, gum recession can easily be created if a tooth is moved slightly out of the center of the bone. By facilitating the bone to grow, we have a stable foundation for teeth to erupt properly into position and resist the urge to relapse.
What we are trying to accomplish with the MyoMouth Piece is producing a healthy child that grows up to be a healthy adult. By growing and developing the facial bones and musculature properly, we will have a foundation for teeth to erupt in the proper position. We strive to avoid having any permanent teeth removed unnecessarily and avoid 2-4 years of traditional bracket and wire orthodontics. If we grow and develop properly, we can even have enough room for our wisdom teeth to come in and not have to have them removed surgically.
FAQs
What's the earliest age you can begin wearing myomouth piece?
As early as ages 3-5 depending on the child and their development.
How long do you have to wear myomouth piece?
Myomouth piece is worn at nighttime while sleeping and 1 hour during the day. It will be worn every day/night until age 10-12 or when growth and development has caused symptoms to subside.
What kind of symptoms would a child have that may need myomouth piece?
– Sleep with their mouth open or snore
– Have trouble sleeping through the night
– Wet the bed
– Struggle to focus or not perform well in school
-Have dark circles consistently under eyes
-Have crowded baby or permanent teeth
-Grind their teeth
-Have a deep bite
-Hyperactive or considered ADD/ADHD
-Chronically sick with ear or throat infections
-Difficulty feeding as an infant (colic, tongue/lip ties)
How much is myomouth piece and does insurance cover it?
-$3500 for the entire treatment span (almost half the cost of traditional orthodontics)
-Discount and payment plan options are available
-Most insurance plans have an orthodontic allotment that is once-a-lifetime use. We have discovered that it is better to save this for what is called Phase 2 or final tooth position orthodontics which could be either with us or an orthodontist.
-Treatment includes all guides needed, any lip or frenum releases, as well as fixed expanders if necessary.
Is the myomouth piece uncomfortable to wear?
It is not uncomfortable to wear; however, a smaller child may need coaching to build up to wearing as directed. The myomouth piece is silicone based.
How many myomouth pieces are included in the treatment plan?
Typically, a child will go through a series of 3 mouth pieces as they grow and develop.
Will this myomouth piece take the place of needing orthodontic care (braces and brackets)?
There is no guarantee it will take the place of orthodontic care; however, it will allow the teeth and mouth to develop fully, and it may be less likely that traditional orthodontic care is needed in the future.
How is this myomouth piece different than tooth pillow?
The treatment concept and devices are the same; however, tooth pillow is a telehealth dentistry service that is limited to a 2-year period virtually through an app. While it is still an option, we recommend myomouth piece because we will follow your child from the start of treatment at whatever age until completion around age 12.
If I don't wear the myomouth piece every night, will it affect my treatment result?
Yes. We recommend wearing the mouthpiece as many nights as you can. We realize that life happens, and trips are taken. Missing 1-2 nights/ month will not hurt the long-term results. However, wearing the device only half of the time will likely affect the treatment outcome.
How can we tell if the treatment is working and/or your child is non-compliant with wearing the device?
-Subjectively-symptoms listed above will likely subside once treatment is on course.
-Objectively-measurements are taken at follow-up appointments based on age. A deviation in these measurements is indicative of non- compliance and/or results that are not favorable. Therefore, additional fixed expander retainers may be necessary to get back on track and are included in the treatment price. Fixed expander retainers are more tedious to clean, require the parent involvement to turn the device, and are non-removable.
What does grinding the teeth or wetting the bed have to do with sleep and breathing?
The connection here involves the release of the stress hormone cortisol. When a child is not breathing well while they sleep, their body is not getting enough oxygen. When the body detects this, it senses it as stress and causes a chain reaction of “fight or flight response” to release cortisol to ramp up blood flow and oxygen saturation. Larger muscle groups fire or twitch uncontrollably, resulting in teeth grinding. Cortisol’s effect on peripheral smooth muscle tissue, such as that of the bladder and urinary system, causes the muscle to relax thus emptying the bladder contents.
What are the dark circles under my child’s eyes from?
The dark circles are known as venous pooling. Let’s go back to the stress hormone cortisol to connect everything together. Cortisol release causes smaller blood vessels to vasoconstrict, allowing more blood flow and oxygen to be diverted to the bigger vessels and main organs/muscles. With the constriction, deoxygenated blood flow is limited. Deoxygenated blood is typically darker and thus shows through on smaller, more fine and thinner tissue around the eye lids.
How do we get started?
If you are an existing patient, you can call and schedule a consultation with Dr. Hawks to ensure that your child will benefit from this treatment. Following that, a records appointment is made were more detailed pictures and measurements are taken and your guidance appliance myomouth piece is delivered.
If you are not a current patient but would like to be seen and evaluated for MyoMouth Piece, please call our office to schedule a new patient comprehensive exam and radiographs where Dr. Hawks can provide consultation on the need and benefits of our myofunctional guidance appliance therapy.