cavities in babies & kids: could an oral restriction be the cause?

A look at all the possible factors

Early Childhood Caries (ECC) is an infectious dental disease affecting millions of children across the world.

Everyone knows that poor oral hygiene causes tooth decay. But what if you are proactive about brushing, flossing, and fluoride, and you or your child STILL get frequent cavities?

There could be more at play.

Beyond brushing, flossing & fluoride

Oral hygiene is extremely important for healthy teeth and gums. But there are other factors impacting children’s dental health to look into that aren’t as widely talked about, including:

  • Epigenetics
  • Nutrition
  • Oral restrictions 
  • Mouth breathing


Most of us are familiar with the nature vs. nurture debate. Rather than an “either/or” scenario, science is revealing that your health is shaped by BOTH nature (genes) AND nurture (environment). In a nutshell, epigenetics is the study of the complex interplay between your genes and your environment.

This relatively new field seeks to understand how behavior and environment affect the way cells in your body “read” DNA. Some experts describe genes as light switches that can be turned “on” or “off” based on external factors such as your experiences, behaviors, and diet. There is much to learn about how your environment can influence the way your genes are expressed. This applies as much to your oral health as it does to your overall health.




What does epigenetics have to do with cavities?

Some people are born with genes that make them more susceptible to cavities. Through no fault of their own, they inherit genetic factors that make their teeth more prone to tooth decay.

Your genetics can affect:
  • Oral restrictions
  • Tooth shape
  • Enamel formation
  • Immune response
  • Oral microbiome


Oral restrictions like tongue tie appear to be related to the MTHFR gene mutation. Depending on the shape of your teeth, it may be easier or harder for particles to get stuck and cause decay. Specific mutations in the way that enamel protein is produced can make your tooth structure unstable and softer than usual, which makes it more vulnerable to acid from bacteria. Other genes can affect the immune response, making you more susceptible to harmful bacteria in the mouth, leading to tooth decay and periodontitis. Genetic traits also influence your oral microbiome, including the composition of the saliva in your mouth.

Epigenetics gives us hope because it means that genes are not necessarily a life sentence of tooth decay — we may have more ability to influence how some genes are expressed by modifying our behaviors, oral function and environment. Diet may have a big role to play in this.



In his book The Dental Diet, dentist Dr. Steven Lin explores the idea that what we eat impacts not only our overall well being, but our dental health in more ways than we know. For example, the modern diet of processed, mushy foods is causing us a great deal of harm, including improper jaw and tooth development.

By shifting away from processed, sugary foods and incorporating whole foods with enamel and bone-building vitamins and minerals we can essentially “feed our teeth” and make them more resistant to cavities. According to Dr. Lin and many other dental professionals, you need chewy and fibrous foods to strengthen your jaw muscles for optimum development and airway health.

Avoiding processed sugary foods and nutrient-poor carbohydrates is just ONE part of the equation. The other part is learning how to eat whole foods rich in minerals, fats and vitamins, as well as natural probiotics and prebiotics that support a balanced and diverse mouth and gut microbiome. 




Oral restrictions

Oral restrictions such as tongue tie, lip tie, and buccal tie can increase your propensity for cavities for many reasons. That’s why cavities can be a symptom to look out for if you suspect that you or your child could have an oral restriction.

Oral restrictions can inhibit important functions such as breathing, swallowing, chewing, sleeping, self-cleaning. This impacts the body and systems in many ways.

Tongue tie, buccal tie, and lip ties can influence:
  • Tongue mobility
  • Acid reflux
  • Tooth grinding
  • Jaw development and tooth crowding
  • Mouth breathing




Tongue mobility

If you begin to pay attention to your tongue, you’ll realize it stays quite busy throughout your day. Not only does your tongue help you talk, swallow, and chew, your tongue does a lot of self-cleaning too. Day in and day out, and especially after meals, your tongue naturally and automatically slides over the teeth and oral walls. It is continuously wiping down the teeth, gums, and oral walls, removing particles and mixing them with saliva to be swallowed. This, combined with the enzymes in saliva, help keep bacteria in check.

When the mobility of the tongue is restricted due to a tether that is too tight or too short, the tongue is unable to do its job to properly clean the mouth. This means that more food particles remain on the teeth, where they ferment, release acids, and create cavities.  


Acid reflux

Another symptom of an oral restriction is acid reflux, which is common among newborns and infants who struggle with breastfeeding. The acid that comes up with reflux is meant to stay in the stomach where it helps you digest your food. Stomach acid is very strong — so strong it can dissolve small pieces of metal. So when it washes up again and again onto the teeth it weakens the enamel and increases the risk of dental caries. Babies with reflux problems will often scream and cry in distress, which adds to the vicious cycle of discomfort as they inhale air into the stomach.

Oral restrictions can cause tension in the tongue and neck, which has both emotional and physiological consequences over time. When tissue is “tied” in a bundle, such as a tight or restrictive oral tether, babies have a hard time relaxing. They spend more time in the sympathetic “fight or flight” state and less time in the parasympathetic “rest and digest” state. Over time, reflux destroys the natural enzymes in the mouth. This, in turn, affects absorption in the stomach, leading to stomach sensitivity and even “picky” eating habits.


Tooth grinding

Tooth grinding is commonly due to poor jaw position and an irregular bite. It is often found in people who experience anxiety. In some cases, the underlying issue is an airway obstruction due to an undiagnosed or untreated tongue tie. Grinding (also known as bruxism) is what happens when the body is constantly struggling to maintain oxygenation to stay alive (especially during sleep). This is why people affected by a tongue tie often grind their teeth at night — it is their body’s natural attempt to keep the airway open when they fall asleep. As you can imagine, the wear and tear of chronic bruxism weakens the tooth surface, making it more vulnerable to dental caries.



Jaw development & tooth crowding

Because bone structure is shaped by muscle movement, an oral restriction can cause improper jaw development. When the jaw is underdeveloped and misshapen, it can lead to tooth crowding and facial deformities. When teeth are in disarray they may be at odd angles or too close together, which makes it easier for food particles to get caught and harder to clean, even with good brushing and flossing habits. This, in turn, leads to a higher incidence of tooth decay.


Mouth breathing

Simply put, mouth breathing is when you bring air into your body through your mouth, instead of your nose. Ideally, we inhale and exhale exclusively through the nose with our mouths completely closed. The nose is built to filter air. It moistens and warms the air to the body’s temperature. It reduces the amount of bacteria that enter the body with each breath. It is also designed to help the body safely release carbon dioxide with each exhale.

Many cases of mouth breathing are caused by an oral restriction such as a tongue tie, buccal tie, or lip tie. This is because an oral restriction can obstruct your airway, making healthy nasal breathing difficult or nearly impossible.

Mouth breathing is enmeshed within a complicated web of issues including:
  • Oral restrictions
  • Tooth decay and gum disease
  • Improper jaw development
  • Crooked teeth
  • Facial deformities
  • Sleep apnea and snoring
  • Throat infection
  • Heart problems
  • Asthma

Mouth breathing affects practically all of the body’s systems. Because the mouth was not designed to efficiently bring air into the body, mouth breathing decreases oxygenation. This means that less oxygen is able to get to the lungs, blood, and cells throughout the body. Many people who mouth breathe have enlarged adenoids and tonsils. When air passes through the mouth instead of the nose, the tonsils are forced to do the job of the nose to filter the air before it enters the body.

When it comes to cavities, mouth breathing increases the bacterial load in the mouth and disrupts the balance between aerobic bacteria (that require oxygen) and anaerobic bacteria (that do not require oxygen). It also dries out the tissues in the mouth and decreases the saliva available to both remineralize tooth enamel, clear away food particles and sugars, and neutralize bacteria with enzymes. It should come as no surprise that mouth breathing and early childhood cavities often come hand-in-hand.


The long-term effects of early childhood cavities and oral restrictions

Cavities in childhood can be a sign of something worse to come as your child grows older. Babies and toddlers who develop cavities are more likely to have them in their adult teeth. That is why being proactive about getting to the root cause of early childhood caries is so important.




The shift towards preventative dentistry

Conventional dentistry (like conventional Western medicine) is symptom-based. Instead of preventing or addressing the root cause of dental diseases, most dental education focuses on treatment for problems, rather than prevention. That is why so many dentists spend the majority of their practice “filling and drilling,” reacting to cavities rather than helping parents identify and address the root cause of their child’s chronic tooth decay.

Thankfully, public demand is driving alternatives. There are a growing number of dental professionals offering a preventative approach. Terms such as Holistic, Integrative, Functional, Natural, and Biological are becoming more common in dentistry. These dental health professionals take a proactive approach. They support parents with qualified and practical nutritional education. They screen and identify oral restrictions and mouth breathing as early as possible. They favor epigenetic interventions such as behavior modification to help prevent early childhood cavities.

If you suspect that your child’s cavities could be caused by an oral restriction, the team at health:latch can help you empower yourself with education, create your circle of support and thrive.


Finding help & treatment for ECC

The team at health:latch can help diagnose and determine the best treatment plan for overcoming ECC issues.

Treating early childhood cavities (ECC) requires a multi-disciplinary approach that gets to the "root cause" of its presence. If you suspect an oral restriction could be the cause of your child’s chronic cavities, surround yourself with healthcare providers who can help.

To set yourself up for success, you want a team that communicates with each other across disciplines for a holistic health approach. A custom approach to address accompanying issues like oral restrictions, speech & language issues, and airway health & sleep will help your family have the best possible outcome.


Learn more about the health:latch clinic and how we can help with your family's specific needs here.

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