Anxiety Tongue Breathing Together
Anxiety breathing is a very uncomfortable feeling. The heart races, breathing may be shallow or noticeable so that attention is drawn to it. It may come out of the blue for no good reason, and anxiety can affect our patients’ quality of life in a negative way. What’s a dental hygienist to do? Start by lowering your tolerance for a restricted tongue.
A tongue tie, which is different from a condition called ankyloglossia where the tongue is completely restricted, contributes to anxiety because the tongue cannot affect the back of the throat, the passage of the airway.
If a patient presents with a tie and that patient is an adult, chances are they can talk and eat, which is a very low bar for making decisions on revisions. In dentistry as an industry of clinical professionals, there seems to be a very high tolerance for a restricted tongue.
What about adults?
The literature is unclear on whether there’s a benefit for revising a tie in adults. Therefore, no one is writing up papers and the variables between those who do are unmatchable. According to Suter and Bornstein in their 2009 paper: The lack of an accepted definition and classification of ankyloglossia makes comparisons between studies almost impossible. Because almost no controlled prospective trials for surgical interventions in patients with tongue-ties are present in the literature, no conclusive suggestions regarding the method of choice can be made. Another example of why medicine will not take dentistry seriously.
Hyperventilation is more common than you may think. And it affects more than you think it does. From anxiety to back pain, a restricted tongue revision may be the missing link to a good quality of life. Breathing is triggered by carbon dioxide in the blood, carbon dioxide also releases oxygen from red blood cells; this is called the Bohr Effect. If you LOVE biochem use this link and see how breathing affects pH. Also if you’re old school and want an easy way to understand use this one.
The short story is that hyperventilation can contribute to dental decay AND anxiety. Yours is not to treat, yours is to know who to refer that patient too. Refer them to an orofacial myofunctional therapist. If you don’t know of one around your area find one who can do an evaluation online. Take great intraoral and extraoral photos and send them to the clinician to collaborate on care. Because anxiety is not just for the psychologists, noticing and making timely recommendations makes the dental hygienist a true collaborator and whole health practitioner.
Shirley Gutkowski, RDH focused practice on Orofacial Myofunctional Therapy