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More Than Teeth is dedicated to bringing world-class information and access to dental sleep professionals and 2024 is shaping up to be an exciting year! We are starting the year off strong with a [Guest Post] from Dr. Shwetha Rodrigues, DDS titled “Navigating Beyond Genetics”.

In Today’s Edition:

• Myofunctional Therapy 101

• Myofunctional Therapy in Pediatric OSA

• Myofunctional Therapy in Adults with OSA

• Navigating Beyond Genetics | Dr. Shwetha Rodrigues, DDS

• CE Events

• Myofunctional Exercises for Snoring and Sleep Apnea

7-minute read👇

Clinical Corner

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key takeaways🔑

What is Myofunctional Therapy?

Myofunctional Therapy (MFT) is a revolutionary approach in the field of dental sleep medicine. It involves a series of exercises that target the orofacial muscles, aiming to improve their tone and function. The primary goal? To establish proper tongue position, enhance nasal breathing, and promote optimal oral muscle function. These improvements are crucial in managing sleep-disordered breathing conditions, particularly OSA.

The Connection to OSA

In OSA, the relaxation of throat muscles during sleep leads to airway obstruction, causing breathing interruptions. Myofunctional Therapy addresses this by strengthening the muscles around the airway. Stronger muscles in the tongue, throat, and face can significantly reduce the severity of OSA. They help maintain an open airway throughout the night, thus enhancing breathing stability during sleep.

Beyond Muscle Training

MFT is not just about exercises; it's a holistic approach. It often includes education on proper breathing techniques, dietary considerations, and lifestyle changes that complement the physical training. For instance, nasal breathing exercises not only improve airway patency but also enhance overall oxygenation and sleep quality.

Why It Matters for Dental Sleep Professionals

As a dental sleep professional, incorporating MFT into your practice offers a non-invasive, adjunctive treatment for OSA. It empowers patients to play an active role in managing their condition, which can be particularly appealing for those seeking alternatives or complements to traditional therapies like CPAP or oral appliances.

1/ Myofunctional Therapy in Pediatric OSA

What Happened: This study conducted a systematic review and meta-analysis to evaluate the impact of myofunctional therapy on children with obstructive sleep apnea (OSA). Researchers analyzed articles up to April 20, 2020, from databases like PubMed/MEDLINE, Scopus, and others. They focused on key sleep study parameters: apnea-hypopnea index (AHI), mean oxygen saturations, and lowest oxygen saturations (nadir O2).

Results:

• AHI Reduction: The analysis of 10 studies involving 241 patients showed a significant decrease in AHI, from 4.32 to 2.48 events/hr. This represents a 43% reduction. The mean difference in AHI was -1.54/hr.

• Oxygen Saturation Improvement: There was a slight increase in mean oxygen saturation by 0.37%, indicating better overall oxygen levels during sleep.

• Nadir O2: No significant change was observed in the lowest oxygen saturation levels.

2/ Myofunctional Therapy in Adults with OSA

What Happened: This study aimed to evaluate the effectiveness of myofunctional therapy (MT) as a treatment for obstructive sleep apnea (OSA) in adults, incorporating a systematic literature review and meta-analysis. The review, adhering to PRISMA guidelines, focused on polysomnographic data, snoring, and sleepiness outcomes in adults undergoing MT for OSA.

Results:

• AHI Reduction in Adults: There was a notable decrease in the apnea-hypopnea index (AHI) among adults, from an average of 24.5/h to 12.3/h, marking a mean difference of -14.26. This significant reduction (P < 0.0001) indicates nearly a 50% decrease in AHI post-MT.

• Improvement in Oxygen Saturation: The lowest oxygen saturation levels improved from 83.9% to 86.6%, with a mean difference of 4.19 (P = 0.0005).

• Snoring Reduction: Polysomnography revealed that snoring decreased from 14.05% of total sleep time to 3.87%, with a consistent decrease in snoring in all studies reporting subjective outcomes.

• Sleepiness Improvement: The Epworth Sleepiness Scale scores improved significantly, dropping from 14.8 to 8.2.

Featured Article

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Navigating Beyond Genetics: Holistic Insights for Crowded Teeth

Rethinking the Role of Genetics: 

The role of genetics in dental health, particularly concerning crowded teeth, is being reexamined to include a broader perspective that incorporates environmental factors. While genetics provides the fundamental blueprint for tooth development, influences such as nutrition, breathing habits, and tongue position play pivotal roles. Lifestyle changes, particularly in Western societies with altered dietary patterns and breathing habits, are recognized as significant contributors to overall well being. 

This holistic approach underscores the importance of understanding how both genetic predispositions and environmental factors interact to shape dental alignment. Recognizing these multifaceted factors allows for a more comprehensive understanding of oral health, enabling proactive measures and interventions to enhance dental outcomes and potentially impact overall health. 

Breathing Right and Tongue Posture: 

Proper breathing involves nasal breathing, allowing for optimal air filtration, humidification, and warming. Mouth breathing, on the other hand, can lead to issues such as dry mouth and improper tongue posture. The tongue ideally rests against the roof of the mouth, aiding in the development of the upper jaw. Deviations, often influenced by factors like prolonged pacifier use or thumb-sucking in childhood, can impact facial and dental structure. Incorporating practices like myofunctional therapy or mindful breathing exercises can help correct these habits and contribute to overall oral health 

For children, mindful breathing can be introduced through simple exercises. Encourage them to take slow, deep breaths through their nose, counting to three as they inhale and exhale. You can make it engaging by associating breaths with playful visuals or storytelling. Additionally, teaching them to breathe quietly through their nose during activities like reading or play can gradually instill the habit of nasal breathing. It's essential to keep it light, age-appropriate, and consistent for effective incorporation into their daily routines. 

Nutrition's Impact on Oral Health:

Incorporating baby-led weaning alongside breastfeeding is a holistic approach to infant nutrition and development. Breastfeeding provides essential nutrients and immune support crucial for a baby's overall well-being. The act of breastfeeding also involves the natural coordination of oral muscles, contributing to oral motor skill development. 

When baby-led weaning is introduced alongside breastfeeding, it complements the nutritional benefits of breast milk by gradually exposing the baby to different textures and tastes. The combination encourages the development of oral motor skills, including proper tongue movements and jaw coordination. Moreover, the diverse sensory experiences from both breastfeeding and self-feeding during weaning contribute to a well-rounded oral development. 

By maintaining a balance between breastfeeding and the gradual introduction of solid foods through baby-led weaning, parents can support not only the nutritional needs of their infants but also promote healthy oral habits and proper jaw development. 

Functional Orthodontics in Action: 

Functional orthodontics stands out for its proactive approach, prioritizing optimal jaw function and alignment. This method aligns with the natural blueprint of the oral structures, aiming to enhance overall oral health. It proves especially valuable in counteracting the effects of changing habits in modern society. 

By concentrating on not just the aesthetics but the functionality of the jaw, functional orthodontics seeks to address the root causes of orthodontic issues. This approach often involves techniques that promote proper jaw development and muscular balance, contributing to improved overall oral health. 

In the context of functional orthodontics, addressing sleep-disordered breathing (SDB) symptoms becomes integral. Functional orthodontics, by focusing on optimal jaw function and alignment, plays a proactive role in mitigating issues like snoring, teeth grinding, ADHD-like behavior, allergies, and even elevated blood pressure associated with SDB. 

By promoting proper jaw development and muscular balance, functional orthodontics contributes to maintaining an open airway during sleep. This aligns with the broader goal of enhancing overall oral health and preventing cascading effects of improper jaw position on both sleep quality and metabolic well-being. Integrating functional orthodontics into care plans becomes a strategic approach to not only address dental

alignment but also to positively impact interconnected aspects of sleep and metabolic health. 

In the context of evolving habits in modern society, where factors like altered diets and breathing patterns can impact oral health, functional orthodontics becomes a strategic response. It goes beyond merely straightening teeth, considering the harmony between the jaw, muscles, and other oral structures. By doing so, it aims to prevent and address 

issues at their source, providing a more comprehensive and lasting solution to the challenges posed by contemporary lifestyles. 

Role of Airway centered Dentists: 

Start Early, Act Proactively: 

Early intervention remains key. Monitoring and addressing potential issues during childhood, especially in a society where natural habits are evolving, lay the foundation for a lifetime of solid dental alignment. Understanding these nuanced aspects helps navigate beyond genetics for a comprehensive approach to oral health. 

In our evolving lifestyles, having an airway-centered dentist is beneficial for guiding proper jaw growth and development. Many face ongoing health issues linked to impaired jaw development, often seeking symptomatic treatment. It's time to adopt a simpler approach to health, emphasizing proactive measures and considering the impact of lifestyle changes on oral well-being. 

Note from Dr Rodrigues 

Understanding the problem is the starting point, and whether in children or adults, concerns may manifest differently, but the underlying issue often remains consistent. 

One particular concern that deserves attention is mouth breathing. This habit can lead to various cascading health, dental, and psychological issues. Meeting patients where they are and exploring these underlying issues is my approach. 

Addressing issues like mouth breathing is crucial. Alongside promoting proper breathing and tongue posture, these factors collectively support healthy maxillary development, reducing the risk of dental crowding.

For patients, 

If you're experiencing the effects of mouth breathing, struggling with disrupted sleep, or dealing with crowded teeth, professional guidance is essential. Proactive measures can prevent, manage, or rehabilitate potential future issues. 

I offer online consultations designed to comprehensively understand and address your unique situation 

For professionals, 

Navigating treatment options can be complex. If you have any questions or wish to connect with Dr. Rodrigues, click the link below!

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Don’t have a Myofunctional Therapist available? Have resources like this for you patients to practise!