Parents can observe children in both their daytime activity and nighttime sleep to see if there's a potential underlying breathing disorder, says Dr. David Rawson, of the TMJ & Sleep Therapy Centre in London, Ontario.
During the day, a parent can watch if their child is sitting upright and if their mouth is closed when not eating or talking. Open-mouth breathing is a common finding in children who have a blocked nasal airway. Also, dark circles, or shiners, are another indicator of chronic nasal obstruction.
At night, while the child is asleep, a parent can see if they're sleeping on their back or side, watch for restless body motion and listen for any gasping or sucking sounds. Dr. Rawson says anything not natural may be an indication of a potential airway problem.
Additionally, parents can look into the child's mouth to look for enlarged tonsils, which would appear as two large red circles that are touching, making little space for air or food.
Orthodontics can play a role in opening up the airway but has changed since years past. Dr. Rawson says crowded teeth used to be treated by removing the teeth without realizing there would be a restricting of the cranial bones and the sides of the face, making the floor of the nose rise up and close off the airway. This gives the patient a great smile but it constricts the physical bony box given for their body.
In Dr. Rawson's practice, he doesn't do extractions but rather uses expanders on the upper jaw, which allows the face to open up and stay open, which offers a good result both aesthetically and functionally.
Dr. Rawson's practice is based on a holistic structural arrangement of the body and he really doesn't support surgery or suggest it. He also doesn't support the use of medications, other than "oxygen."