The way teeth come together is called occlusion. It is my professional view, after more than a quarter of a century as a practising dentist, that at least 80 percent of Guyanese have a “bad bite,” or malocclusion. There are many possible causes for malocclusion in children: some sort of airway obstruction during the child’s development period, allergies, bad habits such as thumb sucking, and so forth. The normal way of breathing is through the nose. When a child has a stuffy or runny nose for prolonged periods of time, he or she starts breathing through the mouth and that could pose a big problem for the teeth.

If one cannot breathe through the one’s nose properly, it cannot do its job of filtering environmental pollutants any more. Instead, the adenoids (glands in the throat) and the tonsils receive the pollutants and toxins inhaled along with the air. The adenoids and tonsils get enlarged in order to fight these pollutants. That is a normal immunological reaction of the body meant for protection, but it closes the airways further and increases the risk of sleep apnea. This is a serious condition especially in children. There is even the possibility of the child suffocating and dying in their sleep.
Now, let us look at how mouth breathing can cause bite and tempero-mandibular joint (TMJ) issues. During the stages of nasal breathing, the tongue rests against the palate. The outward pressure of the tongue from the inside balances the inward pressure of the cheek muscles from the outside. This creates a nice U-shaped arch of teeth. During the stages of mouth breathing, the lower jaw comes down, and the tongue settles on the bottom teeth, to allow air to pass through the mouth and into the airway.
With the outward force of the tongue out of the picture, there is no counteracting force to balance the inward force of the cheek muscles. This causes the arch of the teeth to constrict and become V-shaped, with less room for all the teeth to act in alignment. As the tongue rests on the lower molars, it prevents those molars from erupting completely. As a result, a mouth-breathing individual has to over-close the mouth to get his or her back teeth to come together. The situation can become increasingly worse if left unchecked. This creates an excessive overbite which is among the most common reason why children wear braces.
Therefore, something that started as a reaction to simple, seasonal allergies for a prolonged period of time, (say for a few months), can actually make an individual a mouth-breather for life and create malocclusion in his or her mouth. In such a case the abnormal position of the tongue causes an abnormal swallowing motion. The tongue pushes on the sides of the teeth and creates indentations in its lateral borders, known as scalloped tongue. This is what dentists look for during a comprehensive dental examination.
Braces and other orthodontic appliances can fix the problem. Sometimes selective extractions might be involved. The younger the patient (about 9 years old) usually results in the fastest and most successful treatment. The older the patient the treatment becomes more complex and may even require surgery. The best approach is always prevention. Observe if your child is a mouth-breather. If such a condition is allowed to continue the consequences could include he or she having to undergo corrective treatment with braces.
Written by Dr. BERTRAND R. STUART D.D.S.