ALL STUFFED UP AND NOWHERE TO BLOW: THE ROLE OF THE STUFFY NOSE IN AIRWAY DYSFUNCTION

By Dr. Susan Maples

The word is out! 24/7 nasal breathing is everyone’s aim, and for a litany of health reasons. For only the nose holds such magic abilities to warm, humidify and purify the air. But in babies and growing children, 24/7 nasal breathing (with lips sealed and the tongue resting on the palate) plays perhaps a weightier role in dodging lifelong breathing and sleep disorders. The muscles responsible for habitual resting, sucking, and swallowing functions literally form their growing bones into the ultimate shape of their tongue-box and nose-space.

Fortunately, we are born with the ability to breathe through our noses—otherwise, we wouldn’t be able to eat. (Recall that a newborn must suck and swallow with their mouth, while simultaneously breathing through their nose). Sometimes we can intervene to ease lip closure, good tongue posture, and suckling. We have witnessed good results from surgical tongue- and lip-release, and/or supportive craniosacral and myofunctional therapies.

Mouth Breathing to the Rescue

But what if, one day, your baby wakes up with a nose that’s completely plugged? Thank God the mouth is available as a backup plan. Granted, it doesn’t oxygenate your child’s body with the same efficiency or offer the same air filtration, but it’s lifesaving in times of need. And hopefully, as in the case of a common cold, their stuffy nose clears up in a week or so, and your child experiences a homecoming … to 24/7 nasal breathing. But what if that rescue mouth breathing turns into a lasting habit?

Here’s where it gets confusing. Turns out, chronic mouth breathing becomes responsible for the stuffy nose itself!

This concept we call “nasal disuse” is one we don’t fully understand, but that it’s real, and we concur. In fact, after reading James Nester’s book Breathe, we felt like we lived it vicariously during his self-inflicted nasal disuse experiment.

To clear goopy nasal passages, especially before sleep, we could put more emphasis on nasal clearing practices such as habitual saline sinus flushes before bed. Sterile saline washes away mucous, allergens, and other debris. It’s also thought to help moisten the mucous membranes, although there is some opposing consideration that overuse of saline rinses can dry the nose.

We need more research to discover if the addition of a natural lubricant such as coconut oil, almond oil might be safe and effective for long-term use. Xylitol nasal sprays are evidenced to help with mucous and reduce inflammation.

The Plot Thickens …

In analyzing this shift in my kids (patients) from healthy nose breathing to chronic mouth breathing, I kept asking myself, “What else might I be missing?” Then, while writing the book, Brave Parent, Raising Healthy Happy Kids (against all odds) in Today’s World, the research led me to some interesting answers.

Turns out, there are other pediatric airway diseases/ disorders whose incidences have skyrocketed with alarm in the past forty years… Allergies and Asthma. Both epidemics began their steady climbs in the 1980’s, right along with Sleep Disordered Breathing and Obstructive Sleep Apnea.

Bang! I immediately started looking at food and

environmental allergies as a significant stimulant for the chronic stuffy nose—that stuffy nose that necessitates rescue mouth breathing … that spurs further nasal disuse … and ultimately drives the cascade of craniofacial respiratory deformity.

According to the CDC, we’ve experienced a 50% increase in food allergies between 1997 and 2011. Now one in every twenty kids has a food allergy. Beyond a stuffy nose, a child with an allergic reaction visits the emergency department every three minutes in the US. The most common food allergens for children are wheat, eggs, milk, peanuts, tree nuts, fish, shellfish, strawberries, sesame, and soy.

We must remind parents that genetics is not believed to play a significant role here because our genetic makeup certainly hasn’t changed much in the fifty years we’ve witnessed this skyrocketing trend.

Incidentally, I mentioned the asthma epidemic in kids because Allergic (or Extrinsic) Asthma is also triggered by allergens and thus also deserves our attention. Remember, Asthma is irreversible.

How is This Happening?

Today it’s a better-known concept that the increase in food and environmental allergies also has to do with a lack of exposure to early-life microbes. While we are born in a relatively sterile environment, we swiftly become a massive bug factory. It’s mind-blowing to think that for every human cell, we carry more than TEN microscopic bugs along for the ride. (The ratio is 1:1 for bacteria and 10:1 favoring viruses.) It seems the more assorted our bug populations become, the healthier we are presumed to be. And vise versa!

Sounds counterintuitive, doesn’t it? But it should come as no surprise because it is just as we observe in nature. Forests, lakes, oceans, and other wildlife habitats flourish with a wide diversity of life forms. Whenever you see that lack of diversity, you witness firsthand a suffering habitat.

As such, there’s a heap of good research pinning the big rise in allergies, asthma, autoimmune deficiencies, inflammatory bowel diseases, autism, diabetes, certain types of cancer, and even obesity on our deficient microbiome. To learn more, tap into the Human Genome Project and stay tuned as this field of study continues to explode.

The root causes (and solutions) of our modern microbial inadequacy are many: overuse of antibiotics, processed foods, a glut of C-sections, decreased connection to the outdoors, and over-sanitization of our environment (i.e., commercial dishwashers, hot clothing driers, oversanitization of surfaces).

But that’s not all. We’re also staring at a huge decrease in agricultural diversity in our diets. Sadly, 75% of our food comes from only twelve plant species and five animal species.

What Can We Do?

It’s hard for physicians to keep up with the changing recommendations for allergy prevention and treatment. In 2000, the American Academy of Pediatrics agreed that we should delay the introduction of cow’s milk until age one, eggs until age two, and shellfish, fish, peanuts, and tree nuts until age three.

But in 2008, the pendulum began to swing the other way. It was determined that the current guidelines were ineffective, and maybe even contributing to the worsening crisis. A recent landmark study showed children who received a delayed introduction to peanuts had a higher chance of developing an allergy compared to children who received an intro to peanuts between four and seven months.

Hence, the new recommendations by the American Academy of Allergy, Asthma and Immunology are that allergenic foods should be introduced like other whole foods. Present them one at a time, gradually, in small quantities, starting at four to six months (soon after vegetables and meats), and ideally before they are seven months old.

Back To Airway…

Do you see how all of this is connected? Through expanded learning, it’s exciting to see our role in the ability to help kids identify food allergies/sensitivities and uncover new strategies that might aid their Sleep Disordered Breathing.

Thank you for your dedication to continual learning about children’s sleep and breathing disorders. We, airway-astute dentists, can make a really big difference, helping kids grow up healthy and happy (against all odds) in today’s world!

About the author:

Dr. Susan Maples is a passionate health educator and leads a successful, insurance-independent practice in Holt, Michigan named Total Health Dentistry. She brings preventive and restorative dental expertise, a passion for mouth-body total health, a master’s degree in business/marketing, and 35+ years of experience in private practice. Susan currently serves as President of the American Academy of Oral and Systemic Health. She is the creator and founder of Total Health Academy, a complete online solution for dental teams to integrate all aspects of Total Health Dentistry, and developer of the Hands-On Learning Lab™ and SelfScreen.net. She is the author of BlabberMouth!

77 Secrets Only Your Mouth Can Tell You To Live a Healthier, Happier, Sexier Life. And Susan just released a new book titled, Brave Parent! Raising Healthy, Happy Kids (against all odds) in Today’s World.