The Parent Guide to Child Dental Visits: From Cleanings to Check-Up- Know More Than Your Dentist and Ease Anxiety

Visiting the right pediatric dentist got my children’s health in order. We had information and a plan to end sleepless nights, behavioral issues, rounds of antibiotics and medications.

We are in an incredible time in healthcare. Science and clinical evidence are finally connecting some sleep, breathing, behavioral, and developmental health issues oral development. How do you get the proper screening your child deserves?

Airway Focused Practices

Understanding the importance of proper oral development for an optimally wide airway is essential. The tongue is the blueprint for the optimal development of the oral cavity. In proper resting posture the tongue sits up against the roof of the mouth and it guides the growth of the maxilla and development of the face.

While there are many dentists throughout the United States, there are few that are airway focused and trained in the etiology of narrow oral cavities. This knowledge is critical in getting your child care that encompasses their overall wellness and goes well beyond the presence of cavities or not.

Know What To Look For

An airway focused pediatric or general dentist will ask a more detailed medical history than expected. They need to understand any known birth, breastfeeding, developmental, sleep, oral habit, and dental history. As they progress through this complete medical history they get a picture of any further screening needed for treatment or referral.

Induction, birth traumas, and difficulty latching for breastfeeding can be indications for tethered oral tissues, mouth-breathing, and poor oral development. Developmental delays and behavioral problems can be indicators for certain dental appliances and possible sleep study referral. Oral habits, grinding, snoring, mouth breathing at night are indicators of possible sleep study referral, cavities, and a potential need for early orthodontic intervention.

Have a thorough knowledge of your child’s full medical history prior to going to your appointment. Observe mouth posture, sleep, and eating habits. The more you can fill in the blanks, the more accurate your dental provider can be with their suggested treatment and referrals.

When You Have Suspicions

If you suspect that your child may be tongue-tied, have cavities, or an airway centered disorder, do not give them too much information. When parents come in nervous for their children, that anxiety is not only felt by the child, it feeds into their mood. Most pediatric offices are full of staff trained to show, tell and do. Relax and be honest with your child, without giving too much information.

The show, tell, do technique is taught in dental schools that requires all steps in the dental visit are shown to the child and verbally told before they are done. Dental hygienists are typically very engaging with young anxious children and can ease fears by explaining the cleaning. The “scary” instruments, dental chair, x-ray machine, and dentist are all discussed in a special lighthearted way using age-appropriate wording and analogies where necessary. In most cases, it is confusing to the child to have their parent explain something one way and the dental staff explains it differently.

This includes any treatment that is determined by the doctor. Should your child have cavities, need a tongue tie release, or is referred to be seen by a specialist, do not discuss the treatment needs in front of the child. Allow the child to play in a waiting room or common area while you discuss any concerns you have and get all your questions answered. The best way to translate a need for treatment usually involves phrasing such as:

“Your teeth are sick and we will return for medicine”

“This doctor thinks you’re special and would like to see your tongue and/or teeth again for a special visit.”

“You were chosen to see another special doctor”

Identifying The Right Dentist

When it comes to rectifying prior negative experiences, the right dentist is important. Not all pediatric offices are created equal. You can call the office and request an after-hours appointment with the dentist to consult with them about your prior experiences and how you want future visits to go. While you may not get a long meeting with the doctor, you will get to speak with them and get a “feel” for the office.

Also, call the office and find out if they are airway focused and if they commonly see patients that have similar issues as your child. The front desk should be familiar with how the doctor treatment plans common cases. They may be able to give you a heads up about what you can expect for treatment recommendations.

When it doesn’t feel right, let them know you appreciate their time and carry on. You will never regret traveling to get your child the best care.

The Real Reason Why You Need Braces

Braces have never been and never will be unavoidable. They are not some genetic guarantee you receive upon birth. They are merely the result of oral habits developed from birth; particularly those dealing with the tongue.

After years of braces and the last straw in lost retainers, there’s a reason why your teeth shifted. I hope you’re sitting… because the culprit is not your lost retainer it’s your tongue!

The tongue is now and will continue to reign as the MVP in oral and facial development. Never to be dethroned by any orthodontist or supplier of braces.

It’s a lot to take in. Similarly to discovering that you lived with Santa and the Tooth Fairy you’re whole childhood (i.e. they weren’t real). How is it that the tongue is so powerful that it has this profound impact on the size of the mouth, the shape of the face and the structure of your teeth?

What kind of barn is your mouth?

Imagine a simple drawing of a house without a roof. It has a simple 3-line open rectangle shape. Two lines that meet at a point would complete the roof and create a pointed top, thus creating an almost pentagonal shape. Now imagine a simple drawing of a barn with a nice rounding that completes the roof. Ideally, we want our palates to develop into a barn shape with the nice arched round roof. Our dental arches should form with a U shape.


The tongue is the foundation for that development. The tongue should naturally sit up along the palate when we are optimally nasal breathing. The constant pressure of the tongue on the arch facilitates growth around the tongue into that perfect U shape.

Our tongue in that sense is the blueprint for palatal development and should fit in the palate without overlapping the teeth.

When the tongue is low in the mouth, we lose the foundation, and like the open rectangle house, without that round support the palate forms a narrow and almost pointed “roof” shape. It would create an A shape, narrow arch with a high palatal vault. This narrows the available space for the teeth and causes dental crowding and often malocclusion. Ashapedarch

The mandible (lower arch) follows the growth of the maxilla (upper arch). So the growth, or lack thereof, in the palate will be matched, in most cases, by the mandible. Those with underbites, or a wider mandible that contains the maxilla (either in part or fully), often have a tongue that is lying low. The pressure from the tongue on the mandible, along with prolonged spacing between the teeth, cause the mandible to extend and restricts the growth of the maxilla further.

Crowding is not new

A narrow arch does not develop overnight. A high palate (roof of the mouth) and tight primary dentition (baby teeth) can predict the formation of a narrow arch and crowding of permanent teeth.

Typically a pediatric dentist may inform you that your child will need braces in the future. However, an orthodontist that is not trained in early intervention orthodontics will most likely not treat this until the child has developed around 12 permanent teeth. Treatment usually involves a palate expander that forcibly pushes the palate open, ideally, to the width it should have grown.

Retention is maintained by a retainer. When teeth “shift back” to some form of malocclusion it is often because the tongue has not maintained that palatal width with the pressure we discussed earlier. Our teeth are in constant motion and with a lack of stability from the tongue, they will gravitate to their position of origin. Granted, if expansion was done, the teeth do not shift back to origination. But they will move out of the alignment established with braces.

TMJ pain that’s hard to swallow

A low tongue posture is often accompanied by a “reverse swallow.” This improper swallow occurs when the tongue thrusts forward either against the teeth or between them to swallow. Every thrust forward causes the mandible to shift backward and compress the temporomandibular joint (TMJ) in an unnatural way. Multiple cases of this pressure will compound and affects the longevity and stability of the TMJ. Thus feelings of pain, clicking, and popping occur and cause frustration.

retruded mand

The reverse swallow also creates a long narrow face with a mandible that is recessed or retruded. In profile, this would appear as a lower lip that is not aligned with the upper lip. Even in people whose teeth appear straight, this form of a malocclusion does require braces as well. Over time the way the teeth occlude, or bite together, would cause undue harm to the jaw and discomfort during chewing.

What to do

Establishing proper tongue posture with good habits, early intervention, or myofunctional therapy leads to proper oral development in young children. However, it is never too late to attain proper tongue posture to improve wellness. A wide palate means a wide nasal floor with open passages and greater airway space. Ultimately reducing and/or eliminating the potential for sleep apnea, chronic infections, anxiety, asthma and more.

Contact me to find out how myofunctional therapy can help you with your braces or read our introduction to airway post to discover the many paths to airway health.