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Connecting the dots: The crucial link between oral health and airway function in children

Dr Rafif Tayara, Pediatric Dentist & Oral Health Ambassador. (Image: Dr Rafif Tayara)

Fri. 24 January 2025

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Dental Tribune Middle East had the pleasure of speaking with Dr Rafif Tayara, a distinguished consultant pediatric dentist with a passion for holistic care, and a book author, and a mother of three.  In this insightful interview, Dr. Tayara shares her journey into pediatric dentistry, her dedication to airway health, and her collaborative approach to providing comprehensive care. She sheds light on the crucial connection between oral health, sleep, and overall well- being, offering valuable guidance for both parents and aspiring dentists.

Let’s start with your personal story. What inspired you to pursue pediatric dentistry, and how did you become interested in exploring the connection between airway health and dental care?

Pediatric dentistry was always a specialty that inspired me since I was an intern at a children's hospital in Canada. After I became a specialist pediatric dentist and started my private practice in the GCC, I noticed that I was seeing a relapse of caries in children despite good hygiene and a healthy diet. From there, my investigation into sleep dentistry and airway health began, and I started adopting a more holistic approach to pediatric dentistry. I learned to unlearn what I had been taught before and tried to connect the dots again based on evidence-based data and updated knowledge.

Airway health is not typically associated with dentistry at first glance. Could you explain how the two are connected and why it’s particularly important in pediatric care?

In our quest for optimal health, we often compartmentalize different aspects of our well-being. We see dentists for our teeth, doctors for sleep issues, and specialists for airway problems. However, these elements are deeply interconnected. The state of your oral health, the quality of your sleep, and the functionality of your airway are intricately linked, creating a holistic picture of your overall health. Understanding this connection can lead to better health outcomes and improve your quality of life.

Oral health significantly influences sleep quality. One common issue is obstructive sleep apnea (OSA), a condition where the airway becomes partially or completely blocked during sleep. This blockage often occurs due to the position of the jaw or tongue, enlarged tonsils, or excess tissue in the airway. Individuals with OSA experience repeated episodes of interrupted breathing, leading to fragmented sleep and reduced oxygen levels.

Dentists play a critical role in identifying and managing sleep- related disorders. They can spot early signs of sleep apnea, such as worn teeth from grinding (bruxism), a large tongue, or a small jaw. Dental appliances, such as mandibular advancement devices (MADs), can help keep the airway open during sleep, significantly improving sleep quality and reducing the risk of related health issues. In children specifically, the earlier we    detect airway issues, big adenoids, or large tonsils, the earlier we can help the child restore their sleep quality, correct dysfunctions, and guide their facial growth.

“We can now, through this holistic approach of pediatric dentistry, reguide the jaws of the child early in life to optimize airway, sleep, health and wellness for life.”

You advocate for a holistic approach in your practice. What does a holistic approach to airway health in pediatric dentistry look like in day-to-day patient care?

We look at a child coming into our practice with different eyes. We don't just see "teeth"; we discuss with parents the child's lifestyle, cognitive behavior, quality of sleep, breathing patterns, posture, tongue function, speech, and diet. This allows us to understand how their teeth and jaw status are a consequence of their overall health.

Working as a multi-disciplinary team, combining ENT specialists, pediatricians, and myofunctional therapists, is key to a successful and stable treatment plan.

For parents and caregivers, what are some early signs of airway issues in children that might go unnoticed? How can a dentist help address these problems early on?

One of the earliest signs parents may notice is if their child is mouth-breathing at night, snoring, or grinding their teeth. A pediatric dentist is one of the first healthcare providers who can detect a problem in tongue function and breathing patterns during their clinical and radiographic exams.

How does compromised airway health in children affect their overall well-being, including physical development, sleep, and behavior?

Compromised airway health in children increases the incidence of cavities and infections in their mouths, affects their concentration span, cognitive behavior, energy levels during the day, and brain function.

Mounting research links obstructive sleep breathing with a wide range of consequences, such as:

  • High blood pressure and other cardiovascular problems
  • Metabolic disease
  • Poor growth (related to growth hormone secreted during deep sleep)
  • Increased risk of neurocognitive and behavioral problems
  • Speech and language concerns
  • Poor facial development

Chronic mouth breathing, often due to nasal congestion or structural issues, can also lead to sleep disorders. It forces the mouth to compensate for the restricted nasal airflow, affecting the quality of sleep and leading to conditions such as snoring and sleep apnea.

A holistic approach often involves working with other healthcare professionals. How do you collaborate with other specialists, such as ENT doctors, sleep specialists, or orthodontists, to ensure comprehensive care?

Our team includes all those specialists who assess the child within their area of expertise. Pediatric ENT doctors assess the airway for enlarged adenoids and tonsils for example, as well as testing for allergies, once the pediatric dentist has suspected an iarway obstruction during his initial exam. We usually coordinate our treatment plan based on each specialist's role and schedule the treatment stages accordingly.

For parents, what advice would you give to ensure their child’s airway health is not overlooked? And for aspiring dentists, what steps would you recommend to integrate a focus on airway health into their practice?

Start integrating oral health check-ups within the medical check-ups of your child early in life, with the first dental visit at one year old, or if you see teeth appearing in your child’s mouth before one. Gain knowledge on topics like sleep and airway health before or during pregnancy planning. Look for a specialist pediatric dentist who focuses on a holistic approach for your child.

In conclusion, understanding the vital connection between oral health, sleep, and airway is essential for achieving optimal health. By taking a holistic approach and addressing these interrelated factors, you can improve not only your oral health but also your sleep quality and overall well-being.

Thank you.

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