Savvy’s Story:
As Told by Her Mom
I thought I had done everything right. My pregnancy was very easy and went full-term. I didn’t drink alcohol, smoke, or take any type of prescription or recreational drug. Our beautiful daughter, Savvy, was a bouncing eight pounds nine ounces at birth and I breastfed her until she was 32-months old. She hit all of her milestones early and was incredibly articulate and bright. We couldn’t imagine that anything could be wrong.
THERE WERE SIGNS BUT NO ONE READ THEM
At 18-months a leading cosmetic dentist, Dr. Brian McKay, saw her for just a minute in his office and said, “She is going to need some work as she gets older. There is a Dr. Bill Hang in California. You should take her there around six years of age.”
I looked at my cute, brilliant daughter and thought, what can he possibly mean? Oh well, I don’t have to worry about it until she is six. I know now that the highly trained eye of my cosmetic dentist saw a child who breathed through her mouth, had an accentuated cupid upper lip, a rolled lower lip, high dental arches, small jaws, and a facial structure common to those with compromised airways.
Her pediatricians did not see it. Her pediatric dentist did not see it, or if she had, she did not mention it. Even the emergency room doctors at Seattle Children’s would not know what they were seeing. But the trained eye could readily see it and know that it would lead to a hypoxic brain injury—at the very least.
About a month after I stopped breastfeeding her, Savvy suddenly came down with pneumonia/RSV. (The doctors at Seattle Children’s weren’t quite sure which one it was.) Prior to this hospitalization, she had never been sick.
My next clue didn’t come until she was six when she collapsed running a race. We immediately took her to a pediatric cardiologist and a pediatric pulmonologist. Her heart and lungs checked out fine. At the time, we lived in Scottsdale. Our pediatrician suggested that maybe it was a light case of desert fever. Thankfully, she recovered quickly.
As her baby teeth fell out and her secondary teeth came in, they created an almost cartoonish grin known as a severe Class II malocclusion. She could not close her mouth and continued mouth breathing.
Savvy at 18 months
I later learned that a child who breathes and sleeps with an open mouth typically snores or sleeps fitfully, tossing about and waking frequently, cannot get the restorative sleep that is needed for healthy growth and development. This is called Sleep Disordered Breathing (SBD). In severe cases, it is called, Obstructive Sleep Apnea.
Mouth breathing means about 18% less oxygen is going to the brain. This can also lower your child’s IQ by as many as 10 points compared to their IQ with proper sleep. I had no idea at the time!
Savvy in the third grade
Having recently moved again and starting third grade in Austin, Texas, Savvy’s new classmates began to laugh at her cartoonish grin. We took her to see the highest-rated local orthodontist, and we mentioned hearing about Dr. Hang in California. We were told that the orthodontist would be happy to discuss Savvy’s case with Dr. Hang but nothing would change. Savvy would need double jaw surgery, also known as orthognathic surgery or MMA, but could not have that done until she was fully grown, which is usually at the age of 17.
In the meantime, the orthodontist could give her a “nice smile.” A rapid expander was applied to her upper palate and retractive orthodontic braces were placed on her teeth. Over the next several months, there were frequent appointments for adjustments.
About a year later, they were removed, and Savvy had a nice smile. But soon after, she began collapsing with physical exertion. I attended her end-of-the-year fitness day celebration at school. She tried to jump rope for a minute and collapsed on the floor; looking almost like a fish out of water, she laid there gasping for air. She was humiliated and embarrassed. Later she tried a relay race. She collapsed again.
We went immediately to her new pediatrician in Austin. He diagnosed exercise induced asthma and prescribed inhalers. He told us to take Savvy to the track and do a run walk routine several times per week. She was also found to be allergic to cedar trees. However, during the exam, no one looked in her mouth and noticed the scalloped tongue, the worn teeth caused by grinding (also known as bruxism) or checked her partially blocked airway even though she was mouth breathing.
That summer, I took her to Sweden to see friends and family. As we rushed through the airport, she could not keep up. She had to go slowly. We had no idea what was really happening.
What I know now is:
Even the loss of as little as two or three millimeters of space in the mouth caused by pushing the teeth back with retractive orthodontics can force the tongue farther back into the throat and block the airway.
Savvy
Savvy was on her way to having an airway that was 50 to 80% blocked by the time she was 12 years of age.
Then something new happened. Wanting to play on the volleyball team with her friends, she began spraining her ankles frequently. Her knees were developing abnormally, too. Her pediatrician recommended crutches. Once again, no one recognized her mouth breathing, exhaustion, brain fog, anxiety, and growing depression.
She could no longer remember to turn in her completed assignments and often zoned out in class. That’s when we took her to Texas Children’s in Houston to see the world-renowned pediatric pulmonologists seeking the definitive answers as to why Savvy couldn’t seem to get enough air. Following an extensive examination, they said she was a mystery and prescribed even stronger inhalers, and recommended she reduce the stress of being at a very demanding prep school. No questions about sleep, collapsing, sprained ankles, knee issues, mouth breathing, etc. were asked. They said she was likely stressed out and exhausted by her heavy school schedule.
Rather, to the trained eye, she suffered from obstructive sleep apnea (OSA) and was beginning to show signs of ligamentous laxity and hypermobile Ehlers-Danlos Syndrome. When your brain and body are not getting enough oxygen because you breathe through your mouth, waken frequently, and cannot get the restorative sleep you need, your muscles do not develop properly to support your joints. I now understand that compromised airways are often linked to muscle laxity.