Mouth-breathing, teeth-grinding and snoring in 5 year old

Hi parents,

We are awaiting a referral to a pediatric ENT and will also bring this up with our son's dentist when we see her in a month and a half, but I'm crowd-sourcing parent experience in the meantime.  For about the last year we've noticed our 5.5 year old son audibly (loudly) breathes with his mouth open and at night goes thru periods of time where he loudly grinds his teeth and occasionally snores. The mouth-breathing and snoring seem to happen even if he doesn't seem congested.  He doesn't have any allergies that we're aware of, nor any other chronic medical conditions, although we feel he is also neurodiverse (he will have neuropsychology testing in the coming months to assess for ADHD/ASD and anxiety).

Do any parents of neurodiverse kids have experience with mouth-breathing while awake, bruxism and occasional snoring?  Besides the ENT and pediatric dentist, has anyone noticed improvements with craniosacral therapy or chiropractic adjustments (and if so who do you recommend)?  Thanks in advance!

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Parent here, not a medical professional. We did have one of our children need ear tubes so have experience with a pediatric ENT and minor surgery - this was actionable because child couldn't hear, ie., affecting daily life and function. None of the things you describe sound actionable to me (parent of 12 & 14 yos). I might mention it to the pediatrician if I thought the child was not getting adequate sleep because of any of these items but you don't mention that. I wouldn't even worry about the teeth grinding since it's baby teeth. I would 100% not take a child to a chiropractor.

Found these, hopefully they may be helpful. 

https://my.clevelandclinic.org/health/diseases/22734-mouth-breathing

https://www.smileonstl.com/blog/the-different-types-of-snoring/#:~:text=....

Highly doubt chiropractic would assist with any of this.

Btw, I also have ADHD and anxiety and grind my teeth in my sleep. I do not have any of those breathing or snoring symptoms. I do wear a nightguard or retainer at night to prevent the grinding from damaging my teeth. Breathing/snoring could possibly unrelated to neurodiversity and simply be an issue of the other causes listed in those websites. 

Best of luck! 

Please schedule a consult with Dr Dwight Jennings. My 13 year old had the same issues you described as well as chronically blocked/clogged ears and is now half way through his treatment plan with Dr Jennings. Now that he has room in mouth for his tongue to lay flat with the support of a Myo functional therapist he is learning how to position his tongue and re learning how to breathe with his mouth closed. Mouth breathing leads to much more serious health issues later on namely sleep apnea, if not treated. The first thing Jennings had us do was get a 3D x ray of my sons head. Turns out his airway was 1/3 the size it should be because his jaw was compacted into his throat and was blocking nasal passage ways hence the clogged ears. 
Dwight Jennings 5105226828

We just saw an ENT at Children's for our 5 year old because of very loud snoring and interrupted breathing during sleep, which has been an issue of years. We are also awaiting an evaluation for ADHD. 

Something that was helpful for our ENT appointment was I brought in a video of what we were seeing. This made it very clear to the doctor that is likely he has sleep apnea and a sleep study was needed. The ENT specialist told us about 50% of kids with ADHD also have sleep apnea. That treating that can help with some with symptoms. If the apnea is mild or moderate,  we'll likely teat with allergy meds which seem to work even without an allergy. More severe cases would mean surgery on tonsils and anodes. He said the snoring isn't too much of a concern and our kids had a very large uvia, which is probably causing the snoring.

Hope this helps with what to expect. We haven't sought out other options for treatment yet but are looking forward for more info from the sleep study.

What about adenoid removal? My son has his taken out when he was 2. 

It sounds like your son may be a candidate for myofunctional therapy, which can help with those issues. My neurodiverse son was referred for treatment by his orthodontist, and he saw Virginia Downing in Oakland. My other son ended up seeing her as well, once I realized that mouth breathing is not typical and can indicate an issue. Good luck!

My daughter fits your sons profile, both the description of sleep and the neurological profile. She also had large tonsils and had poor sleep with trouble falling asleep and night waking for her whole life. We got an ENT referral, did a sleep study, and got a sleep apnea diagnosis when she was 7 years old. A tonsillectomy/adenoidectomy solved most of her problems (she still grinds her teeth some). She is almost 12 now and still sleeping well. While we have also given her a lot of other support due to her neuro diagnosis, I believe addressing the sleep apnea has been an important part of her treatment and well-being. Feel free to private message me.

I breathed through my mouth my entire life so much so I didn’t even realize you were supposed to breathe through your nose! I had poor sleep and snored. I read a book about it and it suggested buying special tape to keep your mouth closed at night. It works great and I sleep so much better now. It is safe (you only tape part of your mouth and can open your mouth easily if you need to). I sleep so much better and never snore now. 

Here is what we have done for our two children, at the initial advice of a speech therapist:

We began orthodontia with Dr. Claire Ferrari (Albany) who practices Airway Orthodontics by expanding the palate gradually with an appliance. Excellent care from her and a new doctor who recently joined the practice. https://ferrariorthodontics.com/

Simultaneously we worked with Virginia Downing, a myofunctional therapist in the Oakland hills, to help them learn new ways of using their tongue muscle. If the tongue is not resting on the top palate at most times day and night, the palate will contribute to mouth breathing and sleep disordered breathing or sleep apnea. Virginia is a tough cookie and it takes a commitment to home practice, but more than a year later both kids can use their tongue properly, sometimes with reminders to keep mouth closed while chewing or watching tv) . http://orofacialintegrity.com/ 

Virginia assessed them both as having a posterior tongue tie which we got released through a frenulectomy. Not fun, but worth it. My son did not have a great experience with the doctor but my daughter did.

We have also done a sleep study and they were both diagnosed with mild sleep apnea and some allergic inflammation in their noses, which we have to figure out how to address. I'm not a fan of nasal sprays, but they have made a difference. Due to this diagnosis we are continuing to work with Dr. Ferrari on maxillary expansion to give more room for their tongues to rest in their mouths while addressing the allergies--which I did not know either of them had because they're not 'sniffly' and they didn't know their noses were blocked because that's all they have known.

There's a growing body of literature on the benefits of these approaches, but it's not for the faint of heart (or of pocketbook). Still, I feel like it's worth while as I now recognize that I too have sleep disordered breathing and a similar tongue/palate configuration...and all the characteristics of interrupted sleep (fatigue, lack of focus etc) I hope that by treating them early they'll avoid greater consequences down the line, and hopefully we'll see cognitive benefits as well. 

If you'd like more info feel free to PM me.