Focus on the child's health, not just teeth.

As a paediatric dentist I tend to see kids as early as 6 months. Sometimes infants are brought in within weeks of birth for tongue ties, natal or neo-natal teeth. Rarely, but parents do come in early to prepare for teething troubles. Truth be told, dental care is neglected until there is discomfort. This is largely seen in the cluster ages of 3-5 years and 9-13 years. However, the cranio-facial (head and face) skeleton reaches 60% of its adult size by age 4 years and 90% of its adult size by age 12 years. Hence diagnosing disruptive signs during these phases (ages 3-12) helps in changing the trajectory of the child’s growth.

Generally, crooked teeth are 70% less likely to develop in individuals who were breastfed compared to those who were breastfed for a short duration of time or were never breastfed. But because there is so much controversy around the link of cavities and breastfeeding, mothers are simply told to stop feeding. Factors like poor oral hygiene, tethered oral tissues (tots), mouth breathing, maternal oral health and vitamin deficiencies that play a significant role infant dental decay are rarely discussed.

Nasal breathing is considered the normal respiratory pattern. However, chronic mouth breathing, a marker of dysfunction for the muscles of the face, is never brought up as a sign of poor oral health. Parents tend to wait for the child to outgrow issues like nasal obstruction, (deviated septum, allergic and chronic rhinitis, adenoids), enlarged tonsils and food intolerances, instead of treating them. Without the cause being corrected the child's growth takes place around it. These includes a high arch palate (deep roof of the mouth), long and narrow face, increased gap between the upper and lower jaw, crooked teeth, speech issues, feeding issues, sleep issues and of course breathing issues. Although, all these signs may not be seen in every patient, it is imperative and hence I screen children for possible breathing and sleeping issues.

Approximately 12% to 15% of children are affected by sleep disordered breathing, with the highest prevalence in preschool-aged children between the ages of 3 and 5 years. Sleep disordered breathing has a negative contribution on the overall growth and development of children. Therefore, early screening of infants to assess for tongue or lip tie, breastfeeding practices (which promotes positive development of the mouth and face musculature), and elimination of pacifier (unless medically needed) or thumb/digit sucking, are proper steps in ensuring proper development of the child.

With a disordered breathing(SDB) pattern the chance of the airway (windpipe) to collapse during sleep eventually increases. It is a common finding that children with snoring/ audible breathing will not have conclusive sleep tests. But research shows there to be a significant link in daytime cognitive and behavioural changes in those children with difficulty in night-time breathing. Bed-wetting, night terrors are also a few of the many struggles children with SDB face. Sleep disordered breathing is a huge set of signs and symptoms. It is often difficult to tell where normal ends and pathology begins.

How can you check for signs?

1. Is there a history of difficult/painful/latch issue in breastfeeding?

2. Is there a history of breathing/snoring/ adenoids/tonsils/allergies/tongue tie?

3. Is there a challenge while feeding or is your child a picky/messy/fast/slow eater?

4. Many teeth issues/ cavities?

5. Are there no gaps in your child's milk teeth?

6. Does your child snore?

7. Do you feel your child sighs/ stops breathing while sleeping?

8. Does your child have crooked teeth?

Send in your yes and no answers on toothishh@gmail.com. I'll help you accordingly.

This is a small way to let parents know why a thorough oral health examination, is needed for children.