Giannetti & Booms Blog

Welcome to our blog, where you can learn more about how orthodontics help people enjoy healthy, beautiful smiles.

 

Snoring is Never Normal in Children

If your child snores, something’s wrong, and your orthodontist may be able to help you figure out what it is.

When my daughter, Isabella, was a baby, she snored and occasionally gasped in her sleep—it was obvious she couldn’t get enough air. I took her to the doctor, who diagnosed her with obstructive sleep apnea, a sleep disorder caused by a person’s airway collapsing while they sleep.

At age two, Isabella had surgery to remove her tonsils and adenoids in an effort to unblock the airway leading from her nose to her throat. She improved for a while, but then symptoms returned. As the years progressed, she began snoring again and gasping in her sleep, and she was constantly sick with a runny nose and watery eyes.

By age ten, she didn’t want to participate in sleepovers because she was embarrassed: classmates made fun of her snoring or said they couldn’t sleep next to her because she was so loud. She was sleep deprived, her schoolwork suffered, and she didn’t like to participate in activities that required exercise. I took her to the doctor and received various medications and nasal sprays, none of which seemed to make any difference. As Isabella moved into her teen years, her symptoms worsened and I dedicated myself to finding a solution.

As luck would have it, I had registered for a seminar as part of my professional continuing education, and one of the speakers shared information about sleep apnea, explaining that the adenoids could grow back if they were removed in young children. I started putting the pieces together and realized Isabella must have obstructive sleep apnea, again.

The adenoids are glands located in the roof of the mouth, behind the soft palate where the nose connects to the throat. When everything is functioning properly, adenoids trap germs coming in through the mouth and nose; however, when the adenoids are enlarged, they can prevent air from coming in as it should.

One of the best tools to begin diagnosing obstructive sleep apnea is three-dimensional radiography called a cone beam scan, used by most orthodontists. I had the very technology I needed right in my office to figure out whether Isabella’s adenoids were causing her trouble. When I looked at her test results, I was astounded to find that she was getting absolutely no air through her nasal passage; she had 100 percent blockage. This was not a problem medication could solve. She needed another adenoidectomy.

At age 15, she had the surgery, and her life improved instantly and dramatically. It’s been two years and she is a different kid. She’s almost never sick. She’s a straight-A student. She exercises. She’s alert and happy. And, she’s having the most amazing time experiencing the world through her newly discovered sense of smell.

As a parent and an orthodontist, I encourage you to be an advocate for your child’s health. Well-meaning, well-trained medical professionals do not know your child the way you do. If you feel like something’s wrong, trust your instincts. If your child’s symptoms don’t improve, insist on a new approach.

The classic symptoms of sleep apnea include:

  • Loud or frequent snoring
  • Choking or gasping while you sleep
  • Bedwetting (especially if a child previously stayed dry at night)
  • Morning headaches
  • Daytime sleepiness or tiredness
  • Trouble concentrating
  • Behavioral problems, sometimes diagnosed as attention deficit disorder

It breaks my heart to think of how long Isabella suffered unnecessarily, and I know she is not the only one. Fortunately, orthodontists who keep up with continuing education are now well versed in the symptoms related to obstructive sleep apnea, and we can alert you to the possibility that you may need to follow up with your child’s pediatrician or an otolaryngologist (ear, nose, and throat doctor), so your child can get the treatment they need to enjoy life to the fullest.


 

Thumb sucking: How to help children quit

When babies suck their thumb or a pacifier, it can help soothe restless or nervous feelings, but as babies grow into toddlers, thumb sucking can get in the way of normal facial and oral development. If you are reading this and you have an infant who may be able to switch from a thumb to a pacifier, I highly recommend making the switch. At some point, you’ll be able to take the pacifier away. Clearly, this is not the case with their thumb. HOW TO STOP SUCKING If you have a dedicated thumb sucker reaching age three, it’s time to help your child make a transition from thumb sucking to a new stress relieving technique, one that won’t damage their bite, teeth and jaw development. At your local bookstore, you can find several books on the subject. Many of the parents I work with like David Decides About Thumbsucking by Susan Heitler or The Berenstain Bears and the Bad Habit by Jan Berenstain. These books help children understand why they suck their thumb, that it is a normal part of childhood for many kids, and that there comes a time to give it up. Also, the books give children strategies to cope with giving up a habit that, frankly, just feels good. By age three, children have reached a developmental stage to self-soothe without thumb sucking; they just need some encouragement and support. These books help parents provide that support. Once the child decides to quit, the process is far easier. At age three, children often like the idea of becoming “big kids.” Many have recently moved away from diapers or are in the process, and stopping thumb sucking can be part of this changeover. By reading these books to your children and rewarding efforts to quit thumb sucking, you can keep things positive. ADDITIONAL STRATEGIES The longer your child sucks their thumb, the more difficult it can be to quit and the more harm it can do. When a child reaches age six or seven and still sucks their thumb, parents sometimes come to my office asking me to install an appliance that makes thumb sucking so uncomfortable that their child will finally stop. Before we consider this drastic measure, I typically ask the child if they want to stop. Children must decide to stop sucking on their own at this age. Once they make the decision to stop, our intervention will work. If your child does not WANT to stop sucking, it does not matter what you or I do, they will continue the habit. If a child says, “yes,” I can help with techniques to break the habit such as putting athletic tape around the thumb before they go to bed, or covering the thumb in a bad tasting film designed to prevent nail biting. These strategies help children by serving as reminders. Click here for a whole list of ideas. If the child doesn’t want to quit, it’s best to try to assess why. Is he or she trying to exert control over their life? Does he or she feel vulnerable, nervous, anxious, or insecure and lack other ways to cope? Occasionally, it can be a power struggle and they are not going to stop because they know we desire it. Addressing these issues will help your child quit thumb sucking.

 

WHY DO KIDS GET BRACES TWICE?

Have you ever wondered why kids get braces so early these days, and sometimes get them twice? Are orthodontists just out to make more money? What’s going on?!

When many of us were in school, kids got braces for a couple years in middle school or high school, and that was that. So, for many of us, the idea of getting braces in elementary school seems strange. But when you understand how the human mouth develops, it makes sense.

The upper part of the jaw, called the maxilla, has soft spots that eventually harden and interlock with the rest of the jaw (much like the soft spots on a baby’s skull). Some problems are far easier to correct while the maxilla is still pliable, including under-bites, cross-bites, narrow palates, and the type of crowding that might necessitate having teeth pulled if left untreated.

The American Association of Orthodontists recommends that every child see an orthodontist for a consultation at age seven, because by age nine the window for easy, effective treatment has often passed. Problems can still be treated, but not as comfortably.

If you’re wondering whether your child might need braces, you’ll be happy to know that most orthodontists offer a free initial consultation—and a referral is not necessary. Our consultation includes an hour-long assessment that comes with a full set of x-rays. Once we know the problem(s) we’re dealing with, we work with you to decide what makes sense for your child and your family.

If your child needs treatment, but isn’t ready yet, we begin growth guidance monitoring (evaluating the child every six months to monitor facial and dental development). This allows us to get to know your child, work with your general dentist, and correct oral problems at the optimum time. Like the initial evaluation, this monitoring is free of charge.

When we complete the initial evaluation, we discuss your child’s whole diagnosis with you. Early treatment is appropriate for some problems, while other problems can only be corrected after all the adult teeth have fully grown in—usually around age twelve. That’s why we sometimes recommend that children have braces in two phases: one phase to correct the under-bites, cross-bites, narrow palates, and crowding; then a second phase to correct crooked teeth.

When it comes time for treatment, we recognize that you know your children better than anyone. If you think your child can handle the responsibility of a removable retainer at age eight, we can go that route, depending on the diagnosis. If you believe a retainer will likely end up in the school cafeteria trash can by the end of the week, we generally recommend braces.

So, no, we’re not out to make more money. We’re dedicated to giving your child the healthiest smile we can with the least discomfort. Having a healthy, beautiful smile helps children thrive. It increases health, comfort and self-confidence. If you’d like to learn more, contact us for a free consultation today.


Giannetti & Booms