A concerned mother of 16-month-old twin boy and girl presents seeking advice from a physiologic dentist, Dr. Tracey Hughes. Both twins were born with a tongue tie, which was released at two weeks of age. However, her son’s tongue tie came back and was released again with a laser at six months of age.She noticed when she began introducing solid foods, and her son was not able to tolerate anything textured or thick as it would cause him to gag so bad he would vomit severely. She did not notice this eating behavior with her daughter, so this was a cause for concern to her.Upon further discussion, she indicated her son snores and often sleeps with his mouth open. Her son is a mouth breather and is much more active than his twin sister and even more active than other toddler boys she has observed. The mother reported she consulted with an ENT for both her children, however, no diagnosis of any concern was made.Louisville physiologic dentist Dr. Tracey Hughes had some important advice for this mother of 16-month-old twins. First things first, the tonsils and airway are very much a concern in this toddler.
Let’s dive into this a little further. In this post, we will explore the effects of mouth breathing in children and how it relates to the airway.
Are snoring and mouth breathing in children normal?
Snoring is NEVER normal in a child and should be evaluated immediately. Snoring is the sound made by a constricted airway in a child, and most likely caused by enlargement of the tonsils and/or adenoids. Mouth breathing in children is a result of an inability to breathe through the nose. The most common cause? Enlarged adenoids. Mouth breathing during the night for as little as 2-3 hours is enough to affect facial and jaw development, resulting in a more extended facial appearance in children.
Can a restricted airway cause severe gagging?
Snoring and mouth breathing are both signs of airway issues that need to be addressed immediately. The enlargement of tonsils will obstruct the upper airway, resulting in an extremely overactive gag reflex, which is the body’s protective response from choking. Imagine trying to swallow solid food with tonsils that obstruct 80% of your airway. Children with enlarged tonsils have a sensitive gag reflex because of this!
So what can be done for enlarged adenoids and tonsils? For starters, the little boy should be taken entirely off dairy for one month. ALL dairy, including yogurt, ice cream, cheese, and milk. If no improvement noticed, then eliminate gluten and dairy for the 2nd month.
I recommended eliminating dairy and gluten first because they are the two most common causes of allergies in children today which can also result in reflux. Milk and gluten allergies/intolerance are prevalent and cause enlargement of adenoids and tonsils. If milk and/or gluten are the culprit, it will be evident during the elimination period. In most cases, the adenoids and tonsils will regress, eliminating snoring, gagging, reflux, mouth breathing, and behavior concerns. If no improvement with the elimination of dairy and gluten, a closer look at pet allergens in the home may be indicated.
Should tongue tie be addressed?
To determine if the child’s tongue tie needs releasing, the tongue will require a thorough evaluation. If the tongue is still tied, it has not been able to contact the normal position high in the mouth as well as stay in contact with the palate. The palate is the area where food touches while you are eating. Since the palate is not familiar with the tactile contact of the tongue, it will not be able to tolerate solid foods that touch it, and the child will gag. If no improvement is seen after the elimination of dairy and gluten, I would recommend the child is evaluated for tonsillectomy and adenoidectomy.
Addressing these airway issues early in childhood will prevent deficiencies in facial and jaw development, which is why I am so passionate about addressing these issues in children. I see a substantial prevalence of adults suffering from temporomandibular joint dysfunction and obstructive sleep apnea due to untreated childhood airway compromise and awkward tongue position.
Schedule A Consultation
If you notice signs like snoring, mouth breathing, or behavioral changes in your child, consider visiting our Louisville dentist office. If you are concerned your child may struggle with any of the above signs of airway compromise, please call Dr. Tracey Hughes for an early airway/jaw development evaluation. To schedule an appointment, call 303-732-5388 or request an appointment online.