When patients come in for their exams and cleanings, there are many things we look at to determine the status of their oral health. You might be surprised to learn that we even look at things such as your airway, which if compromised, can cause complications later in life. The concept of what we eat, what we feed our children, and how it relates to our airway is fascinating! Here, we look at the relationship between what a woman eats during pregnancy, what babies and children eat, and how that relates to airway development.
Data from the Monell Chemical Senses Center in Philadelphia shows that the foods a pregnant woman consumes during pregnancy are programmed into the baby's tongue before they are even born. It has been assumed in the past that the sugar fructose doesn’t reach the baby because the placenta doesn’t have the transporter for fructose- GLUT5 transporter. However, the placenta does have GLUT7, 9, and 11 transporters, which transport fructose even better. Now there is data that shows what the mother ate and what the mother likes is what the baby likes.
There is some “pre-programming” going on within our brains that drives this process in infancy and into adolescence, akin to the addiction pathway. It is not just what you feed the baby, it’s what you feed the pregnant woman before she gives birth that matters too. This means that we need to start eating better, starting with mom and even with the baby’s food. In order for a baby to grow they need food and oxygen. In order to have enough oxygen, we need a good airway. If you do not have a big enough airway, then you end up with obstructive sleep apnea. We now have babies and young children who have obstructive sleep apnea because their airway did not grow.
So Why Didn't Their Airway Grow?
The answer is because the hard palate at the roof of the mouth did not get wide enough. This was caused by an absence of adequate pressure from their tongue during breastfeeding. As it turns out, because bottle feeding uses a different type of nipple, it doesn’t generate quite enough pressure to grow the incisive suture that’s in the hard palate. Therefore, the width of the palatal vault is decreased, leading to a decreased airway width. In this way, breastfeeding is better because it allows adequate pressure to be put on the palate for proper expansion and growth, which allows the airway to grow naturally wider.
How is Fructose Related, Here?
Well, research shows that fructose negatively affects parts of our cells called the mitochondria, in a way that impairs the cells from using oxygen properly. Fructose causes mitochondria to undergo heavy oxidative stress which can lead to liver and metabolic dysfunction.
Another issue affecting airway size is baby food. After breastfeeding, we give our kids pureed food. This is a problem because the kids don’t have to chew. Chewing is very important for growing the airway. There are four muscles: the masseter, the temporalis, and the medial and lateral pterygoids, that get stronger and bigger and pull the airway apart to make it larger when you chew. Prior to 1901, when pureed baby food debuted, mothers would actually chew up a little bit of the food, and put it in the baby’s mouth. Babies would “chew” this already pre-chewed food with their gums, and that increased the strength of these muscles making their airway wider. When we look at dental fossils from pre-baby food days, the chin, the mandible, and the size of the jaw is markedly larger compared to today. This is a sign that our airway has been compromised, which then creates the risk for chronic disease later on in life, largely related to food, and processed food at that.
What Do We Do When Our Jaws and Airways Are Already Developed and Compromised?
It is semi-reversible. Once the cartilage in the mandible is fixed and once the maxilla has expanded to its maximum capacity, it fills in with hard bone and can only be expanded through surgery. BUT, if you get to kids before puberty, appliances can be used to grow the width of the palatal vault by applying pressure against it in an attempt to try to increase the airway size. This is something we evaluate in our patients each time we see them, especially young kids and even babies. Evaluations by orthodontists can begin early to help catch a child’s development and growth and help it along so that their jaws and airways develop properly and we can prevent these airway problems. Of course, the other component is diet as we’ve discussed.
So, the key takeaways here are:
- What we ingest matters even from within the womb! And it can have implications all the way down the road to late in life.
- Diet can affect how we grow. Not just the content of what we eat, but HOW we eat our food.
- When we develop growth issues that cause problems with our airway, interventions are available at various stages to help correct the problem. Some of these interventions are invasive, but if it is caught early enough they are routine procedures that can improve outcomes tremendously.
- Mennella, JA. (2016) The development of taste and flavour senses and the factors that influence the development of food preferences and satiation during early childhood. In: Consideration of the evidence on childhood obesity for the Commission on Ending Childhood Obesity: report of the ad hoc working group on science and evidence for ending childhood obesity, 44-62. World Health Organization, Geneva, Switzerland.