Why?

2. Why?

3. The position of the teeth and the size of the jaws indicate whether or not there is stability in the body. If teeth come in straight, in a jaw that is the correct size, it is likely that the body is in balance, the muscles are not being overworked, and the breathing is efficient. If, however, the teeth are crowded and the jaws are misaligned, too small or too big, it is likely that the body is not in balance, that the muscles are not working properly and that breathing is compromised.

4. Why is there instability in the body? Mouth breathing Thumb sucking Tongue thrust low tongue posture Tongue tie low muscle tone Poor posture Open mouth posture Bottle feeding

5. WHAT WAS THE PRIMARY PROBLEM? NASOPHARYNGEAL OBSTRUCTION THAT LEADS TO MOUTH BREATHING Nasal constriction or congestion Enlarged tonsils and adenoids Deviated septum Tongue tie Narrow airways allergies

6. Nasopharyngeal obstruction and its effectsS. Kent Lauson, D.D.S., M.S.

7. MOUTH CLOSED COURTESY OF Dr. John mew MOUTH OPEN NOTE LONGER FACE AND STRAIN AROUND LIPS AND CHIN AGE 8 AGE 15 Age 7 age 11

8. MOUTH BREATHING FACE AGE 10 AGE 17 BOY HAD GOOD FACIAL DEVELOPMENT UNTIL AGE 10, BUT RECEIVED A GERBIL THAT HE KEPT IN HIS ROOM. DEVELOPED ALLERGIES, STARTED MOUTH BREATHING AND NEGATIVE FACIAL CHANGES OCCURRED. AGE 6 AGE 9 ALLERGIES CAUSED PATIENT TO KEEP HER MOUTH OPEN AND JAWS AND FACE CHANGED SHAPE PHOTOS COURTESY OF DR. JOHN MEW

9. Mouth breathing celebrities

10. What’s up with mouth breathing? Articles available upon request Primary snoring and obstructive sleep apnea are frequent findings in mouth breathing children -Dr. suemycioffiizu, et al. Nasal breathing during wake and sleep is the demonstration of normal respiratory functioning in a child, and persistence of mouth breathing is an indicator for the need for further treatment of sleep- disordered breathing. -dr. Christian Guilleminault open-mouth breathing during sleep is a risk factor for obstructive sleep apnea (OSA) and is associated with increased disease severity and upper airway collapsibility. -Dr. - Dr. EJ kim, et al. MOUTH BREATHING INCREASES A PERSON’S RISK OF DEVELOPING SLEEP DISORDERED BREATHING OR SLEEP APNEA

11. ADULTS WITH SLEEP APNEA USED TO BE CHILDREN WITH SLEEP DISORDERED BREATHING who likely were mouth breathers WHAT CAN WE DO AS A COMMUNITY OF PROFESSIONALS TO IDENTIFY AIRWAY COMPROMISE AND PROVIDE SOLUTIONS TO IMPROVE OUR PATIENTS HEALTH?

12. What’s the big deal? Articles available upon request children with behavioral sleep problems and sleep disordered breathing show twice the risk of ADHD -Dr. Karen Bonuck Sleep bruxism (tooth grinding) is associated with sleep apnea, microarousals and oxygen desaturation. -dr. steven bender primary snoring in children is associated with problems in memory, language, visual and spatial acuity, and poor academic performance. -Dr. Philip Cooper Tongue tie impacts the growth of the face and airway which increases the risk of upper airway collapsibility and leads to development of sleep disordered breathing. -dr. Christian Guilleminault tonsil and adenoid removal resolves about 90% of sleep disordered breathing, but three months later there is relapse of 50%. -Dr. Steven Sheldon Pediatric obstructive sleep apnea in non-obese children is a disorder of oral-facial growth. -dr. Christian Guilleminault

13. Who are we?How can we collaborate? DENTIST Early childhood educator EAR, NOSE, THROAT PHYSICIAN GASTROENTEROLOGIST LACTATION CONSULTANT MYOFUNCTIONAL THERAPIST NURSE PRACTITIONER OCCUPATIONAL THERAPIST OPTOMETRIST ORTHODONTIST OSTEOPATH PEDIATRICIAN PHYSICAL THERAPIST PULMONOLOGIST RESPIRATORY PHYSIOLOGIST School nurse SLEEP PHYSICIAN SPEECH THERAPIST

14. Georgeanne Limbach Jackie Moy MYOFUNCTIONAL THERAPISTS THANK YOU