Speech 4 Fun-Myofunctional and Speech Therapy

So proud of this sweet young lady. She’s worked so hard and I miss her already. Graduation day is bitter sweet 😞

https://youtu.be/C250OOIvViA?list=TLGGqo2Dvc9s3UIwMTA3MjAyNA

The Story of Headgear This video explains how a child's face needs to grow forward in order for her to have a fully grown airway. Certain types of orthodontic treatment stunt the...

Graduation Day for this sweet and spunky little guy. Such a hard worker.

Graduation Day for this sweet boy! So proud of all his hard work ! I will miss he and his family. I love what I get to do everyday!

Power of the Tongue Online Workshop We know the tongue is directly involved in chewing, swallowing, speaking and breathing.But, we don’t tend to think of the tongue when it comes to helping resolve pelvic floor issues. Or relieving shoulder strain, neck tension or persistent SI joint pain.

We have another graduate! This sweet girl worked so hard! We are so proud of her !

Should my child have adult teeth extracted to alleviate dental crowding before braces?

I ceased accepting orthodontist referrals to extract adult premolar teeth prior to braces when I started my dental sleep medicine training in 2012. But I still encounter many parents who have been recommended these extractions.

These photos are from a teen patient that presented to me for tongue-tie consult. Mum had a gut instinct the four premolar extractions recommended to alleviate dental crowding prior to braces was not the right direction. She deeply regrets not following her intuition.

I want to thank her for her consent to use these images, despite the bind she is in, to help other parents make more fully informed decisions.

These images help illustrate that when we extract teeth to relieve crowding, we often end up with excess dental space. A common approach to aligning the teeth and closing the spaces is to retract teeth, making the tongue space smaller.

This approach fails to address the underlying problem. The jaw has not grown properly. And at the root of this, is oral dysfunction – where the jaw and mouth muscles did not provide the functional stimulus to promote optimal jaw development in the earliest years of childhood. This is often linked to tongue-tie and mouth breathing.

In this case, mum had persisted with breastfeeding despite enormous difficulties. This child was constantly crying with air swallowing and reflux like symptoms. Her transition to solids was difficult, and it felt like there was no relief in sight. Tongue-tie was never identified. There has been a long history of disturbed sleep. She has been a chronic mouth breather, but this has never been addressed.

Ongoing issues include daytime fatigue, difficulties with emotional regulation, learning, and symptoms of anxiety and depression with involvement of a psychologist. Nobody has properly evaluated her sleep quality and breathing.

The problem with extracting teeth and making the mouth smaller is that the tongue already has insufficient space to rest and function properly. During sleep, it’s impossible to restore closed mouth breathing without the tongue being forced back and creating some degree of throat obstruction. Reducing tongue space with retractive orthodontics exacerbates the problem in a child already struggling.

What are the take home messages for parents?

✅ Look beyond straight teeth: Dental crowding is often a symptom of poor jaw development. Our jaws are the floor of our nasal passages, housing for the tongue, and bony support for our collapsible upper airway or throat. Good jaw development is essential for optimal sleep and breathing.

✅ Early intervention is key: Braces are normally offered around age 12 when 90% of facial growth development is complete. 60% of the adult sized face is formed by age 6 years. Healthy jaw development begins in early childhood.

✅ Holistic evaluation is the future: Ensure orthodontic evaluation and treatment plans consider factors such as tongue-tie, mouth breathing, and sleep quality.

✅ Get a second opinion: Tooth extractions are irreversible. Avoid rush decisions and seek multiple opinions if any uncertainty exists.

A message for health care professionals:

Consider joining Inspiration by Integration 2024: A Practical Guide to Children's Airway Health in Melbourne, August 30-31st. It will provide valuable insights and practical guidance for enhancing children's airway health. Through collaborative discussions, let's share knowledge and experiences to ensure fewer missed opportunities and better outcomes for more children. Take advantage of earlybird rates available until May 12.

A little picnic this morning in therapy.

Picture bird app —- take a pic then it tells you what it is and what it eats and how it sounds. We are having so much fun learning about birds. It’s fascinating how the same birds seem to visit each day .

One of my sweet little boys brought me flowers from his house . I love them !

Every parent should check how their child breathes at night.

What's the first thing you check in life threatening situations?

The AIRWAY!

Obstructive sleep-disordered breathing (SDB) includes a range of nocturnal breathing abnormalities, ranging from habitual snoring to obstructive sleep apnea.

Snoring is becoming common in the pediatric population. Peak incidence is between two and eight years of age, likely due to the size of lymphoid tissue relative to airway diameter. Reports of the prevalence of primary snoring in children range from 4 to 12 percent.

Obstructive SDB is generally suspected initially based on symptoms and signs.

OSA is defined as periodic episodes of nocturnal airflow restriction (hypopneas) or obstruction (apneas) in association with sleep disruption, arousals from sleep, oxygen desaturation, and possible hypercapnia.

Currently, a polysomnogram (PSG, also known as a sleep study) is required for a definitive diagnosis of OSA.

In children the warning signs are clear with a thorough history.

Certain conditions can predispose kids to a higher risk of OSA.

Children with obesity (especially if severe) are far more likely than lean children to have OSA, with reports of prevalence that range from 13 to 59 percent.

Of interest, children with congenital syndromes, craniofacial abnormalities, and/or neuromuscular disorders also have a significantly higher risk for OSA than those without, with prevalence estimates of 30 to 100 percent in Down syndrome.

What is concerning is that many kids have crooked teeth and poor jaw structure have an increased risk of obstructive sleep apnea.

In younger age groups, it is highly recommended that a child has an ear nose and throat assessment.

Surgery at these ages has been shown to help reduce the occurance of OSA.

Adenotonsillectomy is generally considered first-line therapy for otherwise healthy children who have moderate or severe OSA and adenotonsillar hypertrophy.

If your child snores, have them checked by and ENT.

Supporting jaw growth, training nasal breathing, and tongue posture is the long term plan to make sure that sleep disordered breathing does not return.

Does your child snore?

Graduation day for this beautiful soul!

Any Tmobile users out there ? Did you know every Tuesday you get free gifts? Download the t-life app . This was today’s gift. Ready for the eclipse:)

Crooked teeth don’t happen via fate, they occur due to our environment.
⠀
In dental practice these images have become normal.

Our children today don’t develop jaws that fit 32 human teeth.⠀
⠀
In late adolescence we see it when wisdom teeth don’t fit. In late childhood we see it with crowded crooked teeth requiring braces.⠀
⠀
What we are witnessing is one of the most important health trends of human history. When our jawbones don’t develop, our airways are less developed. The roof of the mouth is the floor of the nasal sinuses, and reduces the volume to breathe through.⠀
⠀
The result is an increased pressure in the airway, and can lead to obstructed breathing during sleep, or sleep apnoea.
⠀
How prevalent would you guess sleep apnea is in the world?
⠀
Here are the figures reported in the Lancet: “Using AASM 2012 diagnostic criteria and AHI threshold values of five or more events per h and 15 or more events per h, we estimated that 936 million (95% CI 903–970) adults aged 30–69 years (men and women) have mild to severe obstructive sleep apnoea and 425 million (399–450) adults aged 30–69 years have moderate to severe obstructive sleep apnoea globally.

The number of affected individuals was highest in China, followed by the USA, Brazil, and India.”⠀
⠀
A billion people.⠀
⠀
Sleep apnea is now known predispose to heart attacks, stroke, high blood pressure, obesity, type-II diabetes, depression, anxiety, teeth grinding, and Alzheimer’s disease.⠀
⠀
We are in a pandemic of poor craniofacial development and it’s time to wake up.

Many people in the community are learning how to reduce and potentially reverse the consequences of slow jaw growth.

We can prevent this in our children.

To follow this story you can listen to my new podcast

Have you noticed signs of crooked teeth in your kids?