By: DeWitt Wilkerson, DMD
This topic originally appeared on PankeyGram.org. Dr. Wilkerson granted permission for igniteDDS to share with our readers.
In my practice, we spend time taking patients’ health history, interviewing them to screen for breathing conditions and behaviors, and examining them for airway disorders. During these portions of our comprehensive preclinical and clinical evaluation, we caringly explain why we are concerned about the health of every patient’s breathing and not just their teeth.
The Benefits of Nasal Breathing
Nasal breathing has many benefits that you can tell your patients.
- It helps control breathing rate.
- It increases the amount of oxygen released into our tissues by raising carbon dioxide levels in the blood.
- It boosts the production of red blood cells, improving oxygen delivery.
- It filters out airborne pathogens and clears nasal congestion.
- It enhances overall lung function and can even improve conditions like asthma.
- It can enhance lung capacity, benefiting athletic performance.
Factors like a deviated septum, nasal trauma, allergies, or infections can compromise our airways, making it harder to breathe properly.
The Risks of Improper Nasal Breathing
Improper nasal breathing increases risks that you can tell your patients.
- It can change facial structure and swallowing patterns.
- It can crowd teeth, tongue thrusts, dental decay, and TMD.
- Improper nasal breathing, particularly mouth breathing, can indeed increase susceptibility to infection and inflammation in the throat and tonsils. It can also exacerbate these conditions by causing dryness, irritation, and facilitating the movement of bacteria and viruses from the mouth into the throat.
- It can cause breathing difficulties, especially during sleep.
Obstructive Sleep Apnea (OSA)
Many of our new patients are unaware that obstructive sleep apnea impacts overall health including stress levels, increased blood pressure, headaches, cardiovascular disease, heart failure, stroke, type 2 diabetes, weight gain, metabolic syndrome, adult asthma, acid reflux, and the brain fog and memory loss associated with dementia/cognitive decline. They don’t realize that nasal breathing problems might be mistaken for ADHD in children.
I advocate for all dentists to play a significant role in helping patients improve their nasal breathing, particularly by addressing issues related to the structure and function of the oral cavity and airway.
Actions Dentists Can Take
Multiple actions are appropriate for dentists. They can educate and counsel patients on the comorbidities of periodontal health and periapical oral disease, vascular disease, breathing disordered sleep, GERD, dental malocclusions, bruxism, poor diets, lack of exercise, excessive weight, high blood pressure, diabetes, smoking, and stress.
- As part of our comprehensive preclinical and clinical exams, we can evaluate our patients for signs of breathing issues, such as mouth breathing, snoring, or obstructive sleep apnea. You may use various diagnostic tools, including questionnaires, physical examinations, and imaging studies like cephalometric X-rays, to assess the airway and identify potential obstructions or abnormalities.
- We can recommend orthodontic interventions such as braces and clear aligners to correct skeletal and dental malocclusions that contribute to airway disorders. With proper alignment, more space may be created within the oral cavity for the tongue and thus facilitate better nasal breathing.
- We can collaborate with sleep medicine specialists, pulmonologists, and other healthcare providers as part of a multidisciplinary approach to managing sleep-related breathing disorders. This collaboration may involve coordinating diagnostic testing, monitoring treatment outcomes, and adjusting therapeutic interventions as needed to optimize patient care.
- We can undertake the study of how to fit oral appliances such as mandibular advancement devices to help alleviate snoring and mild to moderate obstructive sleep apnea for your patients who are under the care of a sleep physician.
- We can collaborate with a myofunctional therapist or undertake the study of myofunctional therapy to recommend exercises that involve exercises to strengthen and retrain the muscles of the tongue, lips, and throat. By improving muscle tone and coordination, myofunctional therapy can help optimize breathing patterns, reduce mouth breathing, and enhance nasal breathing efficiency.
- In cases requiring advanced management or surgical intervention for complex airway issues, we can refer patients to otolaryngologists, maxillofacial surgeons, or other specialists with expertise in treating airway disorders.
Their Best Interests at Heart
In our practice, we seek to be sensitive and support patients in vulnerable conversations. We assure them that we will do our absolute best to optimally diagnose, treat, and manage complex health situations. We actively treat oral diseases and recommend a plan to improve their nasal breathing, sometimes referring to specialists as described below. Over time, we revisit their airway conditions as patients grow in understanding and trust that we can help.
In our clinical practice, we have found that patients readily understand the purpose behind assessing for airway disorders and our nasal breathing discussions, and although it may take a while over multiple dental visits before they accept a plan of treatment, they understand from our behavior that we have their best interests at heart and genuinely want to help them.
To become a health-centered dentist and deliver patient-centered care, I recommend you join us at The Pankey Institute for two immersive days of Integrative Dental Medicine course to address the link between oral and systemic inflammation and build a foundation for helping your patients achieve proper nasal breathing through effective oral appliances.
