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Tarun Agarwal, DDS

8304 Creedmoor Road
Raleigh, NC 27613
Telephone: (919) 870-7645

Healthy Start to Lasting Oral Health

As a father and a dentist, Dr. Nate Leedy of Raleigh Dental Arts can relate to the parents who come to him with concerns about their children’s breathing and other oral habits.

Dr. Leedy with his two sons—5-year-old Harrison (left) and 3-year-old Beckett—who are proudly wearing their Healthy Start appliances.

“I’ve noticed added awareness in parents recently,” Dr. Leedy says. “I think the word might be getting out, because I have more and more parents asking me about their children grinding their teeth or perhaps mouth breathing. We’re not a pediatric office but we do see families who care about all aspects of dental health for their children, and these issues are of interest and concern.”

And that’s why Raleigh Dental Arts offers the Healthy Start System, which uses a series of removable appliances to address common tooth alignment and airway issues in children 2 through 12 years. Dr. Leedy uses the system with his own children, ages 3 and 5, so he can personally speak to its challenges and benefits. But why is such early dental intervention necessary?

Early Habits Can Impact
Health Long Past Childhood

Seemingly innocent childhood oral habits leave visible signs of concern for Dr. Leedy. “We look for signs of airway restriction including poor tongue posture, tongue thrust, and teeth grinding. You’ll see pediatric teeth that are worn down much like an adult. It is likely that what is happening is that they’re trying to get air and the jaw will move around to try to compensate for a restricted airway. Those are signs we commonly see.”

In time, he points out, habits such as grinding of teeth and other signs can translate to larger health challenges. “For example, childhood thumb sucking can lead to teenage orthodontic work, as most people know and may have even come to expect. Tongue thrust or poor tongue posture can also have consequences—impairing speech quality.”

And nighttime mouth breathing has multiple health impacts. “We weren’t designed to breathe exclusively through the mouth,” Dr. Leedy observes. “The nose is designed to filter and keep the air that we breathe clean and moist. With mouth breathing, the airway becomes compromised as the tonsils and adenoids become dry and inflamed. Other unhealthy habits may develop that affect the position of the tongue, jaws and teeth.”

How Does Healthy Start Work?

With a new child patient, Dr. Leedy first performs an extensive assessment that includes a parent questionnaire, consultation, and an exam with digital models, photographs, and X-rays. When the data reveal a potential benefit of treatment, Dr. Leedy will send information to the Healthy Start laboratory to fabricate a custom appliance for the child.

Healthy Start oral appliances and their cases.

The first appliance is soft and squishy, he reports, used to address tongue position and breathing. “We can give the younger children what’s called a habit corrector—which is used at night—and all it does is put the tongue in the right place and put a little bit of pressure on the arch to get it to expand properly and allow the child to get better airflow at night,” explains Dr Leedy. “It basically trains the musculature of the tongue, the lips, and the oral cavity. You are, in fact, training the child to breathe properly with this appliance.”

Once these issues are addressed, the child will transition to a harder appliance, if needed, to help with tooth guidance. Then, for retention, “they wear the appliance at night, and for a few hours during the day, to keep everything in place as they’re growing. From start to finish,” he explains, “we may be able to attain a favorable teeth relationship in just 24 to 36 months, ideally concluding before puberty and an adolescence that may no longer include braces.”

Compliance is the Key—And the Challenge

Avoiding expensive and painful orthodontic work may sound ideal, but how likely is that? “The earlier you intercept the problem the greater the probability that it can be corrected,” Dr. Leedy observes, “but the caveat is that it is more difficult for the younger kids to consistently wear the appliance. So we’re finding the six- to seven- year-old years are the ideal. At this older age, the youngsters better understand the issues they are dealing with, which encourages them to participate in the healing process And, they’re enthusiastic about the change, too, because we tend to see positive changes quickly.”

Most important, he stresses: “Success requires both compliance and proactive, involved parenting. I can speak to this issue from personal experience. Both of my children—three and five years old—have been prescribed corrective appliances. My three-year-old was a chronic thumb-sucker and his baby teeth aren’t straight. We’ve struggled with compliance, but are still working with him.”

Working with his own five-year-old helped Dr. Leedy better understand the right timing for Healthy Start. “In the timing of this corrective process, every child is different. With my child, when we started a year ago, he would not wear the appliance consistently; now he is much more compliant.”
Even so, he notes that the habit corrector has improved his son’s tongue positioning and aided in the expansion of his jaw. Considering past and present, Dr. Leedy anticipates that the guided appliance will work well for his son in the next stage.

“The goal is to intercept developmental problems early—but not too early to undermine compliance by the child—and in the right sequence to aid in the proper development of the teeth and jaw, and preclude the need for teenage orthodontia,” says Dr. Leedy. “Essentially, movement of teeth in young patients is both orthodontic and orthopedic, because we’re helping to guide the bones and the teeth into place.”