The Airway Connection: How Breathing & Eating Habits Affect Health for Life with Dr. Julia Sadove-Lopez • Ep 76

Snoring might be a warning sign! Airflow resistance can negatively affect sleep, learning, inflammation, and even nervous system stress. But it's never too late to help counter those effects.

Episode #76

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Dr. Julia Sadev Lopez is the founder of Oris Wellness, a consulting company dedicated to empowering parents with the knowledge and confidence to make informed decisions about their child’s oral and airway health. She was originally trained in Biological and Airway Dentistry. Here’s what she shared with me on the Om WOW Podcast.

Mouth Development Has Changed

Airway dentistry is about thinking of the roof of the mouth as the floor of the nose. The functions of our breathing are intimately tied to how our growth and development has taken place and how our jaws form. Dr. Julia was fortunate to find her way into a research opportunity.

Some of you may have read the book Breath by James Nestor. In it, he speaks about some of the pioneering research done by two dentists, Dr. Kevin Boyd and Dr. Mariana Evans. Dr. Julia joined Dr. Kevin Boyd's team to do research comparing anthropological skulls from the Penn Museum to modern day patients, looking at how our bones and jaws are different in today's world. It was one of those things you can't unsee once you start to understand how things have changed.

Modern Jaws Full of Crowded Teeth

Dr. Julia says the biggest thing is that back then there was no crowding of teeth. There was room for all of the teeth, including the wisdom teeth. Everything fit in a beautiful arch form. Today, teeth are often squished together, and braces have become the new normal.

And it really is treated as normal. Parents expect to budget for that expense. Dr. Julia puts it this way: "Common isn't normal. We have to rethink the idea that this is strictly genetic, because there are some other things at play."

I'm intrigued by how the teeth used to fit like they're supposed to, because pretty much everybody I know had the crowding. I had it too. I went through years of braces and had the back teeth removed because they didn't fit. So this was interesting for me.

Understanding Craniofacial Development

Craniofacial is a way of describing the bones of our skull, or cranium, and the bones of our face. People don't pay much attention to them. If we break a muscle in our arm or a leg, we notice. But there are so many little bones in our skull and even in our face that we just don't think about what's going on in there in terms of development.

We often expect that the development of those bones is predetermined genetically. While there is a genetic component, Dr. Julia explains that there's a lot more that comes into play when we think about how we use our muscles during the development phase, how we're chewing, how we're swallowing, how we're breathing, and impacts from our environment. The use of the soft tissues and how things are functioning is going to influence the growth as well.

Nose Breathing vs. Mouth Breathing

When Dr. Julia went into dental school, one of the things that surprised her most was the head and neck cadaver lab at the start. We're so used to seeing our nose as just a little projection from our face. But our nasal cavity takes up a lot of space inside of our skull, and we just don't think about that.

Our nose offers a variety of functions beyond just smelling stuff. Our nose is designed to humidify the air that we breathe and to filter it, so it catches a lot of debris from the environment. It's also creating certain natural chemicals in our body, like nitric oxide, which affects blood vessel health and other things.

Our bodies are designed to breathe through our nose. Mouth breathing is a backup system. When we start to breathe through our mouth instead, it doesn't function as well. A lot more particulate matter from our environment can get in. It can irritate the throat and the lungs. It can even cause the tonsils and adenoids that reside in our throat to swell as they try to protect us from all of that debris that was supposed to be filtered.

There's a cascade of effects here. For a variety of reasons we may start breathing through our mouth instead of our nose, but then it becomes a harder cycle to break. We've opened the default pipe, and going back to training ourselves to breathe only through our nose is a lot more complicated. It can have a surprising effect on a number of different parts of our health.

Mouth Breathing, Snoring, and Poor Sleep

At night a lot of people, even if they breathe through their nose during the day, turn into mouth breathers as soon as they lie down to go to sleep. I never thought about all the junk that ends up in your body because your nose isn't filtering it out. I've heard that the environment of our bedrooms, with the dust mites, the dust, the pet hair, the pollen, and all that microscopic stuff floating around in the air that you can't even see, can be a lot. So we really benefit from breathing through our noses to filter some of that stuff out.

Dr. Julia adds that people who are more likely to mouth breathe at night are more likely to snore, which is a warning sign. A lot of people think snoring is just a normal part of life, but it's your body's warning sign that there's some resistance to the airflow and something's not going right.

That can have different effects through different phases of life. In children, it could lead to interrupted sleep and look like more bedwetting, or their attention and learning during the day might be impacted. In adults it might have cardiovascular effects or daytime fatigue.

Warning Signs Before Obstructive Sleep Apnea

Dr. Julia says that if someone develops a diagnosis of obstructive sleep apnea, that means there's a certain number of moments at night while they're sleeping where they're not breathing in, so there's a pause to their breathing.

If we zoom out a little before we get to that point, we might see that snoring is a warning sign. If someone is clenching or grinding their teeth, that's another example of a warning sign. Even restless tossing and turning is a sign that perhaps breathing is at play. If someone moves around a lot at night while they're sleeping, it may be because the body finds a way to prioritize what it needs to prioritize.

If your oxygen levels are dropping, your body's going to find some way or another to wake you up and get you breathing again. You might notice it as being really awake in the middle of the night and not being able to get back to sleep. For some people it's more subtle and it's just the quality of sleep. You might stay in bed for eight hours and think you're getting that sleep, but if your sleep is interrupted, that's going to have so many effects on your health.

Learn About Airway Health Early

This is why Dr. Julia is trying to educate parents early, so that children don't grow up with the symptoms that some of us adults already have. And everything she shares is meant to help, not shame parents.

How we chew as children and feed as infants can make a difference as to which muscles are being used in our mouth. For example, breastfeeding versus bottle feeding.

If we know that as an infant there were problems with feeding and we had to rely more on bottle feeding, or if we have a picky eater who doesn't like to chew solid foods and prefers a softer diet, then we know what we're up against. We can take a more proactive stance and introduce the right tools or therapies to intervene early on, while a child's face is still growing, and really set a child up for better growth.

There are options for adults, too, but so often this goes under the radar. Then you have an adult with symptoms that are misunderstood. Nobody's connecting the dots.

Sleep, ADHD Symptoms, and Hyperactivity

The population that has attention disorders is already likely to have sleep issues, Dr. Julia says. The symptoms often overlap, and in children it's more likely to manifest with hyperactive behaviors than just fatigue. It seems backwards. If someone thinks a child has too much energy, no one's thinking they're not getting enough sleep. It's the opposite default assumption.

Sleep also affects more than attention. If there are interruptions to sleep, we know that so many of the hormones in our body are affected. Even children who are slower on the growth curve might be that way because their sleep isn't great.

Why Is Sleep Apnea So Common?

Even as we talked about sleep apnea, the mask and the whole system, I couldn't help thinking about how many people I know now who have one. Lately in my world, everyone I'm talking to says, oh yeah, I finally got my sleep test, I got my sleep machine, and I'm sleeping better. It's not just a handful here and there. It's a lot of people I know, which is surprising to me, because I don't think I ever even heard of sleep apnea until about 10 years ago.

Dr. Julia says that can be a reflection of the changes that have happened to how we're growing and developing. We don't learn a lot of this in dental school, and we don't learn a lot of this in medical school. So these symptoms get put in little silos: this child has this problem, or this adult has depression or dementia, and things are maybe not connected back to sleep.

How Pacifiers and Weaning Contribute

The American Academy of Pediatrics recommends pacifiers early on as protective against things like SIDS. But the recommendation stands that weaning should start around six months of age, and that's really early. If you look around at the age at which most children are still using pacifiers these days, it's a lot later.

A pacifier sits in the mouth and serves a purpose, and the child might grow attached to it because it makes them feel good. There are physiological reasons why they like it. But it also takes up some of the space in the mouth, and the tongue position is going to be affected. With bones and mouths so squished these days, the tongue should be resting in the roof of our mouth. That should be a driving force for the growth that takes place to get that nice arch form our ancestors had.

If the tongue is resting low because there's been something in the mouth, or because that's become the comfortable new normal for that child, then the growth is affected. So the easiest thing is to ask whether we can soothe and remove the habit earlier, and recognize that maybe we don't want to rely on it all the time.

Beyond that, we can look at introducing a concept like baby-led weaning, where the baby is introduced to solid foods earlier rather than going through all the purees and softer food textures. There are safe ways to introduce solid foods early. It's normally only applied to the initial introduction of foods, but at all ages we should be making sure we have texture variety in the food we eat. There are safety considerations for what's safe at different ages, but if we have the awareness to make sure this is part of what's being factored into growth and development, it can be a helpful counterbalance.

What's Wrong With Sippy Cups?

Another example is sippy cups. Sippy cups were developed for the convenience of parents, not for the development of a child. By all means, if you need a sippy cup because you're in the car, do what you need to do. But if you're at home or eating a meal at the table, try training to drink out of an open cup or a straw. You'll activate different muscles and get the muscles acting more naturally, versus having a little spout stuck in the way we take the action of swallowing. It's an interesting thing to think about, how we swallow.

All my children had the little Tupperware sippy cups way back when, and as Dr. Julia said, it was convenient, to prevent spills. This was every day, all day in the house. So there's a big education piece here, getting the word out to parents about some better practices for things we didn't know about.

Dr. Julia also has a free ebook guide for anyone who's curious about other things. The whole guide is things you can control or think about at home, without having to go to a medical provider or a dentist, to start making some changes. It's there to empower parents to start taking action early.

Alternative Help for Sleep Apnea

If you're an adult dealing with an airway component like sleep apnea, Dr. Julia says it's never too late to explore whether there are other things you can do.

There's a type of physical therapist called a myofunctional therapist. It's not very commonly discussed. Dr. Julia graduated dental school without even knowing they existed. It's typically a speech therapist, a dental hygienist, or somebody else with training in the mouth who has become an expert in the muscles in and around the mouth, so they can help retrain those muscles for better breathing, better chewing, better swallowing, and better function all around.

Myofunctional therapy on its own has been shown to result in a reduction of the metric used for classifying sleep apnea. Someone suffering from sleep apnea symptoms can actually improve their condition with therapy, and that may never be discussed with them. Sometimes there are other alternatives, like a dental appliance that can reposition the jaws differently.

In growing children, a dental appliance can affect the growth trajectory. In adults you can still have an appliance that pulls your lower jaw forward, which results in your tongue sitting forward. That can open up your airway space a little bit more and make the whole process of breathing take place with more ease. It's never too late for patients of all ages. Obviously we want to get ahead of it so a child who doesn't have to share that fate doesn't, but there are options for all ages.

Whole-Body Connections to Mouth Breathing

Posture is one more example. Dr. Julia points out that there's a lot more attention paid now to text neck and how our posture is changing with screens. But the way we breathe is another reason we may position our head forward, without even knowing it. If we're more likely to breathe through our mouth, we may lean forward a little bit, because that positions our airway and makes it easier to get air in through the airway tube that runs from the nose and mouth down. None of this is about just the teeth. It's the way we grow and develop.

When we're younger there's a lot of exploration that takes place through the mouth. Toddlers put everything in their mouths. Then there's the trajectory of how we grow, which we don't give enough credit. Take tummy time. Parents focus on developmental milestones and making sure crawling is happening.

How we position our body can be affected from early on by certain actions we take or don't take. Kids are in car seats and seated toys instead of out and about crawling around. Some of that affects how our body grows. And how we breathe affects our muscles too: nose breathing activates different muscles than mouth breathing!

Retraining Nose Breathing at Any Age

Dr. Julia says it's possible for teenagers and adults to retrain their bodies to breathe more through the nose. There are also ways to modify growth and development at all ages through certain dental appliances. Retraining our breathing method is a powerful tool for our nervous system, to decrease the amount of stress our body is up against. Right now we're up against so many sources of inflammation and stress that if the one thing we can control is learning to breathe differently, that's a really powerful tool.

Rest and Digest vs. Fight or Flight

I was intrigued by how our breathing affects our nervous system. Dr. Julia says the biggest way to look at it is that our nervous system has a fight or flight switch and a rest and digest switch. When we're breathing properly through our nose, our exhale should be longer than our inhale, which is very rare if you start paying attention to how you're breathing.

If we can get that right, we're more likely to activate the rest and digest system and put our body in a more relaxed state. So many of us breathe through our mouth, or higher up in our chest instead of in our diaphragm, which puts stress on our body. It also activates a lot of muscles differently. That can be connected with chronic pain symptoms and things we don't even have on our radar to connect. If someone is having headaches or certain problems, perhaps simply learning to breathe differently can be a powerful tool.

Oxygen's Role in Chronic Health Conditions

I don't know a single person who doesn't have an issue somewhere in their body with inflammation. Dr. Julia says we fail to see oxygen as our most important nutrient, because we breathe it in instead of digesting it. Oxygen drives so many functions in our body.

If we're subconsciously putting our body into a lower oxygen state, it's not always going to register that our oxygen levels are low. We're just doing it inefficiently. There's a certain level of fatigue that our body starts to catch up on, and things start to give. Maybe you were fine up until menopause, when some of the elasticity in the muscles of the neck changes. Maybe somebody was breathing fine until hitting menopause, and now they have more challenges. If that stress is constant, because we're not getting oxygen in the most efficient way, it can trigger inflammation in the body.

There are links with cardiovascular disease, stroke, dementia, and different things. It really does go hand in hand with so many of the chronic inflammatory conditions that can be going on in our body.

Chewing is Complex!

Mouth breathing changes the bacteria that are living in our mouth, and the mouth is the beginning of that gut tube. If we're not getting the right foundation, and if we're not chewing food correctly, that can lead to constipation or bloating. Our ancestors used to chew for four hours a day easily, and now our meals are quick, on the go, and soft.

Dr. Julia explains that chewing is thought to be such a simple activity that you don't spend any time thinking about it, but chewing and swallowing are very complex. Look up YouTube videos called Tongue in an MRI machine. They show people while they're singing, swallowing, and playing an instrument, and you just see these muscles moving around in crazy ways. You'd never think about how much is going on in there.

The way we swallow can affect things like how our ears drain, so ear infections might be one of those things people don't think about connecting. How we chew, beyond driving the growth, also affects gut health. It's also important to think about asymmetries in the body. A lot of people tend to start chewing on one side only, and that sends growth signals to one side versus the other. If we catch that early and make sure we're chewing on both sides, something seemingly so simple can make a difference.

Sometimes there's a reason for it. If we look inside the mouth, there may be something like a dental crossbite, where the teeth are poorly positioned on one side of the mouth. For that child it's easier to chew on one side, and we always follow the path of least resistance to do what's easier for our body.

A lot of this gets brushed aside because we assume we innately know how to breathe, chew, and swallow. But it should be a process that's developed over time with the right introductory steps, and so often we bypass a lot of that with things like applesauce pouches. Those didn't exist when my kids were little, but I see them all the time now. By all means, use the conveniences, but have the awareness that they shouldn't be the all-the-time default.

Fascia, Tongue Ties, and Torticollis

I was curious what Dr. Julia could share about the fascia that's actually in the head and the jaw. Fascia is one of the fascinating discoveries that has come to light more recently.

Fascia runs through our whole body, and there are different ways it comes into play for the work Dr. Julia does. One is that fascia runs from the tip of our toes to the tip of our tongue. That's what people mean when they talk about the fascia lines in our body.

Something that's more of a buzzword lately is the tongue tie. We all have a little stringy part underneath our tongue. It's the scaffolding of how our tongue is formed. For some people it dissolves away more quickly than others, and for some it persists and never dissolves all the way. There can be effects on range of motion if that fascia line is held really tight.

In dental school, Dr. Julia was initially taught that a tongue tie was only when the tip of the tongue was held by that little string, so that people truly can't lift their tongue. That's a very severe tongue tie. Tongue function is important, and a restriction like that is absolutely going to make somebody a mouth breather and affect their digestion. There are a lot of implications. We've started to understand that there's a variance, not just that most severe presentation, and that it can affect range of motion even when it's not visually obvious.

Sometimes it gets dismissed early on by a pediatrician or someone else. On the other hand, a lactation consultant might be the first person to identify a problem like this. That's one way fascia comes into play: a true physical restriction for the tongue.

Another way, more subtle and nuanced, is something like torticollis. If you've noticed a child with a favored side, maybe every time you take a picture they're always looking to the left, or when they go to feed they only feed facing the same side, that's something to look at. Sometimes when children have head shape differences, you'll see them get a helmet to help with head shape. It might also be because they are consistently going back to the same side.

That can be tight fascia as part of the equation. We can work with an occupational therapist or a physical therapist who works with children to try to change that early on. If something like that is tight, it's going to start building asymmetries in our body early on and influence the growth trajectory. It may drive symptoms from something in the tongue, or if it's tension in the neck or elsewhere in the body, it may affect how we grow and develop and move through other milestones.

Dr. Julia calls fascia underappreciated in the medical community, and I agree it's an important factor.

Key Takeaways

• Breathing through the nose matters at every age, for kids and adults alike.
• The earlier we step in, the better, but it's never too late to make a difference.
• Pacifiers, sippy cups, and other conveniences have their place. Just use them with awareness.
• Offering a variety of food textures helps support healthy growth and development.
• In children, poor sleep can show up as hyperactivity instead of tiredness.
• Retraining how we breathe is a powerful tool, and it's possible no matter how old you are.

The link between how we breathe, how we grow, and how we feel is far deeper than most of us realize. Once we understand those connections, we can make informed choices that support our children's growth and our own health.

Dr. Julia is the founder of Oris Wellness, a consulting company dedicated to empowering parents with the knowledge and confidence to make informed decisions about their child's oral and airway health. Through one-on-one sessions, she provides objective guidance on treatment options and helps families connect with qualified airway-focused providers. Her mission is to bridge the gap between professional expertise and parental intuition. Originally trained in Biological and Airway Dentistry while practicing in Chicago, she now calls Portugal home.

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