Providing therapy for airway improvement can be a single treatment or multi-disciplinary based on the needs of the individual. The dentist and orthodontist can provide treatments regarding releasing tongue and lip ties and expanding the growth of the arches. Oral appliance therapy can be provided in some cases for patients with slight to moderate sleep apnea or in patients with failure to comply with CPAP. Other dental specialists can also provide various treatment modalities when it comes to expanding the airway. If constrictions are noted involving the nose and/or throat, your dentist may refer you to an ENT physician for evaluation.
Habit training is first and foremost in all treatment modalities. If the individual is unable to nasal breathe with the lips sealed and the tongue on the roof of the mouth, the functional limitations need to be addressed. However, if the issue is in the habits themselves, these can easily be addressed. Often, myofunctional exercises or myofunctional therapy is utilized to strengthen the soft tissues/muscles of the mouth. At times, this can be enhanced by the use of removable “habit trainers” that keep the pressure of the lips off the teeth and help position the tongue away from the teeth and against the palate. In all forms of additional treatments, we emphasize the importance of myofunctional therapy to accomplish or increase success of other treatment modalities. Research has shown the effectiveness of this therapy.
Please read below before mouth taping:
Taping your mouth at night may seem unconventional and impractical but before dismissing this practice, get informed and see if mouth taping could help you. For many individuals, habitually nasal breathing throughout the night (and day) leads to a more restful and rejuvenating sleep (as well as provides the ability to filter allergens and take advantage of the release of nitric oxide).
**IF YOU HAVE A NASAL OBSTRUCTION and are unable to breathe through your nose, do not attempt to mouth tape. An evaluation by an Ear, Nose, and Throat specialist (otolaryngologist) will be necessary.
**DO NOT mouth tape for children under the age of 5.
**Avoid mouth taping if taking sleep medications and/or with heavy alcohol consumption.
There are various options for mouth sealing at night. Somnifix and Woody Knows are two brands available for sale online but an inexpensive option is using 3M's one inch micropore tape. Additionally, Nexcare has a skin tape for sensitive skin types.
Initially, it may be necessary to do some nose clearing exercises to be sure you may get air in through your nose. In Close Your Mouth, McKeown goes through the different methods of nose clearing. There are various methods demonstrated online as well. It is important to learn how to naturally unclog your nose or utilize saline sprays, Xlear nasal spray or Flonase if necessary before mouth taping.
Although the objective is to be able to ensure that no air escapes through the mouth and that air is brought in through the nose, it is practical to begin this exercise of mouth taping by applying the tape vertically. Grab a suitable length of tape and fold the ends in. If using 3M micropore tape, stick and unstick to your clothes for easier removal in the morning. It may be pertinent to begin taping 20-30 minutes before bedtime initially and slowly increase the length of time before you are comfortable enough to fall asleep with the tape.
Utilizing the nose is very valuable in your overall health and well being. It is the first line of defense against sickness. When you bring in the air through your nose, bacteria and allergens are being filtered. The nose also secretes nitric oxide which has many important functions in the body such as vasodilation, immune defense, skin protection, and more. Additionally, the nose has a whole host of other functions such as smell, taste, and even hearing. Habitual mouth breathing usually leads to chronic allergies and congestion. It is important to employ nasal breathing to take advantage of your bodies biggest defense against airborne allergens.
Research now shows that the lip and tongue are major players in the development of the mouth. When either, or both, are restricted functionally or anatomically, it is important to consider a frenum release procedure. This is typically a quick in office procedure completed with a dental laser incorporating myofunctional exercises to strengthen and tone the muscles of the face and mouth. Please see the section on Myofunctional Therapy for more information.
There are many options when considering arch expansion for children. The treatment depends on a variety of factors dependent on age and development stage. The earlier treatment is rendered, the better. In adults, although more extensive, arch expansion is possible and a great treatment option to increase airway volume in some cases.
For individuals who have gone through the steps of our protocol and have not found full resolution, an advancement appliance could be utilized to control apnea if present. This sleep appliance brings the lower jaw forward to allow the tongue to come forward and clear the airway. By this point, the nasal airway space has already been addressed. The objective is to address all other aspects of the upper airway to potentially eliminate the need for an appliance.
*Oral appliance therapy can be an option for some patients who are not compliant with CPAP.
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