Snoring is never normal, especially in children. It is mainly caused by obstructions in the upper airway during sleep, which may be related to enlarged tonsils, enlarged adenoids, nasal inflammation and congestion, mouth breathing, low tongue posture, and possibly tethered oral tissues (tongue ties and/or lip ties). Having narrowed jaw bones can also cause the tongue to collapse down and back, blocking the airway passage, especially during supine sleeping position.
When snoring continues to worsen, there is a higher risk of developing obstructive sleep apnoea. Children suffering from this sleeping disorder do not get good quality sleep, often restless, waking up multiple times during the night, may develop dysfunctional issues (such as bed-wetting and teeth grinding) and can be hyperactive during the day. Consequently, they develop behavioural problems and may struggle to keep up at school.
The mouth breathing aspect of the problem is also concerning for proper oxygenation of the organs within the body. Respiratory gases are not regulated appropriately with mouth breathing, which impact on the functional development and health of bodily organs. The impact may even lead to serious illnesses, such as high blood pressure, Alzheimer’s disease, type 2 diabetes, stroke and heart attack.
A referral to an Ear Nose and Throat specialist, or a sleep physician, is usually indicated for initial assessment, diagnosis and possible management of the upper airway. A sleep study may be required to determine the severity of the sleep problem. If there is a significant obstruction of the upper airway, reducing this blockage is essential as part of improving the patency of the breathing passage.
From a dental perspective, widening the narrow jaw bones through orofacial myofunctional pre-orthodontic therapy, can also help in improving the upper airway patency, which may lead to the resolution of snoring, improved sleep quality, and optimizing functional health, with the following goals:
- Tongue up against the roof of the mouth
- Lips always closed, except during eating and talking
- Breathe through the nose
- Swallow properly
Tethered oral tissues, such as tongue ties, lip ties and/or cheek ties, may need to be released to allow effective re-training of these orofacial muscles.