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Missing Teeth = Poor Health?

Ever since I began seeing patients in my new position at Montefiore medical center, I’ve been surprised by how many patients have missing teeth. In fact, many have no teeth at all, and often have to wear dentures, especially if they’re in the elderly years. Not too surprisingly, these same patients also have a number of chronic medical conditions, such as hypertension, diabetes, high cholesterol, heart disease, as well as numerous medications for these respective conditions. Many are obese.

Being in a major tertiary-care referral-based hospital, it’s expected that patients will have complex medical issues. But this observation only supports what dentists have been saying for years—that poor dental health equals poor general health. Not only do I see multiple missing teeth, there’s also significant jaw narrowing and crowding of the soft tissues of the mouth. Having smaller airways due to missing teeth and smaller jaws can aggravate significant medical problems, such as hypertension, diabetes, high cholesterol, and heart disease.

We’re seeing an epidemic of jaw underdevelopment these days, with dental crowding and numerous orthodontic and airway issues that arise as a result. The rise in premature babies, modern feeding habits, nutritional factors, and various toxins in our environment can prevent proper facial growth and development. It’s no wonder that we’re seeing increasing rates of ADHD, autism, and various other developmental delays. These are the same kids that will go on the develop high blood pressure, diabetes, obesity, high cholesterol, and heart disease later in adulthood.

You could argue that having bad teeth is a consequence of the particular population that we serve, but knowing what we know about the importance of proper jaw development and dental health, it’s likely that poor dental issues also predisposes people to chronic medical problems.

 

What do you think about my observations? 

How Breast Feeding Improves Children’s Behavior

There are numerous studies on the health benefits of breast feeding, and here’s another one that supports my sleep-breathing paradigm, that your overall state of health is directly proportional to how well formed your jaws are as you age (and subsequently your breathing passageways).

Researchers from Oxford University in the UK found that infants who were breast-fed for at least 4 months had a 33% less chance of having behavioral problems by age 5. They speculate that breast milk has higher amounts of healthy fatty acids, growth factors and hormones that contribute to healthier brain development.

The one thing that all these studies fail to address is that bottle-feeding can cause malocclusion and jaw narrowing. The smaller your jaws, the less room there is for your tongue, which can cause breathing problems when the infant is placed on his back. Add muscle relaxation from deep sleep, and you’re going to deprive infants of quality deep sleep which is vital for proper brain development. With the addition of back sleeping in infants to bottle-feeding, it’s likely that this combination is a major reason for the significant rise in pediatric developmental problems that are so rampant these days.

If you have obstructive sleep apnea, were you breast or bottle-fed as an infant?

Dog Sniffing, Sleep Apnea, & Facial Profiling

Someone just emailed me a link to an article showing that dogs can be trained to detect colon cancer in breath and stool samples, even in its’ early stages. He asked if this could be applied to sleep apnea. I though long and hard about this. There are so many metabolites in urine, stools, sweat, saliva, and even cerumen from untreated sleep apnea that could possibly be detected by dogs, but not any one of these substances would be specific, like cancer cells.

However, there’s an even easier way: Look at the person’s facial features. Look for narrow and/or recessed jaws, flat cheekbones, narrow nasal width, mouth breathing, or forward head lean. Inside the mouth, the classic findings would be multiple missing teeth, dental crowding, a high arched high palate, narrow and crowded dental arches, tongue scalloping, and a relatively large tongue that prevents you from seeing the uvula. Tongue scalloping alone has been found to predict apneas in 89%, oxygen desaturation in 89%, and abnormal AHI is 67%.

If you combine these exam findings which can take just a few minutes to observe, along with simple screening questionnaires such as the Epworth Sleepiness Scale or the STOP-BANG, you could probably screen for and pick out from 1/2 to 2/3 of all sleep apnea patients. Currently, it’s estimated that only about 10% of sleep apnea is diagnosed. Notice I didn’t mention being overweight, being male, or even the fact that you have to snore.

These days, I play an informal game with myself whenever I see patients. Just by looking at the medical history and external facial appearances, I try to guess who has sleep apnea versus who doesn’t. It’s scary, but I’m close to being about 95 to 98% accurate.

I know this may sound dangerously like facial profiling, but since I’m able to help many of these people breathe better and sleep better, I’ll continue to engage in this practice. Try it on yourself and then on your family members, and then on your friends. With some practice, you can be just a good as me.

Breast-Fed Boys Grow Up To Be Smarter

Here’s a study that showed that boys that were breast-fed as infants for at least 6 months do better in school compared with boys that were bottle-fed. Enhanced nutrients in breast mild and mother-infant bonding were thought to be reasons for this finding. Breast-fed girls also has mild increases in test scores, but the results were not statistically significant.

One major omission from the conclusion of this study is the fact that breast-feeding protects against developing obstructive sleep apnea. Dentists have long said that bottle-feeding promotes malocclusion and dental crowding. The smaller the jaws, the less room there is for the tongue, and the more often you’ll stop breathing at night.

Another important point is that pumped breast milk is not the same as breast-feeding. Unfortunately, our society and modern time don’t make it easy to exclusively breastfeed.

What are your thoughts on this? If you have sleep apnea, do you remember if you were breast or bottle-fed?

Good News For Breast-Feeding Moms

Here’s some good news for new moms: That women who breast-feed sleep the same amount as those who bottle-feed. This is an important issue since bottle-feeding has been shown to cause or aggravate dental crowding and malocclusions. Having smaller jaws (think smaller mouth) crowds the tongue and other soft tissues of the mouth and throat, aggravating or promoting obstructive sleep apnea.

This brings up a very sensitive issue, which implies that infants should be breast fed by using the natural breast, rather than pumping and using a bottle. Most modern women don’t have the luxury, time, or the resources to breast feed exclusively for 6 months or longer. Work schedules, caring for other children, and other demands of modern society makes breast-feeding difficult.

My feeling is that women (with spousal support) should do everything possible to breast feed, but shouldn’t feel guilty for not being able to do so. Everyone has unique circumstances, and ultimately, not everything we want to do is under our control.

What are your thoughts on this issue?

Nutritional Lessons From Africa

 

Traditional cultures in certain parts of the world practice contraception by breast-feeding. Most doctors will tell you that breast-feeding is not a reliable form of birth control. However, the way a woman breast-feeds is vastly different in the developed areas versus underdeveloped parts of Africa. 

 

In the US, most women who breast-feed on demand begin to taper off to intermittent feedings after a few months or at most 1-2 years, either supplementing with solid foods, or pumping and giving the milk through a bottle. I’ve written about how bottle-feeding is thought to aggravate dental crowding and malocclusion. 

 

In certain parts of Africa (such as in Batswana), women breast-feed on demand, with the child strapped in slings to the mother’s chest, feeding on demand until he or she becomes too heavy or becomes more independent. Typically, this lasts about 2-3 years. My patient confirmed that women would typically have 3-4 children evenly spaced over a span of 10-12 years. Repeated, short bursts of breast-feeding promotes prolactin release, which is an effective form of contraception. In developed countries, the interval between feedings lengthen over the first year, increasing the odds that pregnancy may occur.

 

He also noted that for the most part, the natives are very healthy, with few stresses, and they generally eat off the land, without too much processed foods or refined sugars. He even feels stronger and healthier when he lives and eats there. The main health problems that he sees are mainly infectious: malaria and HIV. 

 

Dr. Brian Palmer, a dentist that has spent his entire career researching the link between bottle-feeding and obstructive sleep apnea, has stated that in some areas of the world, people can’t afford infant formula, let alone regular food. The only source of nutrition for infants and toddlers is breast milk. Notice that despite the fact that the children are stick thin, they all have nice smiles and bright teeth.

 

Compare this with pictures of young children (in Dr. Weston Price’s book) who eat lots of sweets and processed foods—you’ll see crooked, stained teeth with lots of cavities, along with narrowed jaws and faces.

 

Take note of a native rural African’s jaw structure, and compare the facial width and jaw structures against multiple generation African-American faces. It’s a pretty stark difference.

Breast-feeding Tax Credits?

Here’s an interesting new tax law: Oregon senator Jeff Merkley sponsored a bill that would create an income tax credit for "50 percent of the qualified breastfeeding promotion and support expenditures of the taxpayer for such taxable year." You can read more about it here.

 

While promoting breast-feeding is a worthwhile cause, I’m not sure Dr. Brian Palmer would agree with the basic principle of this proposed bill. He argues that the physical act of breast feeding is just as important as the breast milk itself. He’s spend his career showing how bottle-feeding can aggravate dental crowding and malocclusion. This is one of the main reasons for the development of obstructive sleep apnea. Listen to his interview here.

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