The Pediatric Breathing Project: Changing Lives One Airway at a Time with Dr. Piya Gandhi, DDS [Ep 1]

The Pediatric Breathing Project: Changing Lives One Airway at a Time with Dr. Piya Gandhi, DDS - Episode 1

The Importance of Pediatric Airway Health

In this episode, Dr. Piya Gandhi explores pediatric airway health, emphasizing the critical impact good sleep quality has on a child's development, behavior, and overall health. Sharing personal experiences and patient success stories, Dr. Gandhi discusses the significance of early intervention, the role of oral and facial structures, and the importance of interdisciplinary approaches in treatment. She highlights the need for awareness and education among parents and practitioners, offering guidance on identifying signs of compromised sleep and seeking appropriate care.

• 00:00 Introduction to Pediatric Airway Health
• 01:04 Signs of Compromised Pediatric Sleep
• 01:54 The Role of Oral Facial Growth and Development
• 03:00 Case Study: Lillian's Transformation
• 05:42 Case Study: Dylan's Journey
• 07:58 Comprehensive Approach to Airway Health
• 10:07 Personal Story: Dr. Gandhi's Daughter
• 14:53 Conclusion and Call to Action

________

The Pediatric Breathing Project with Dr. Piya Gandhi explores how airway health, jaw development, and sleep impact childhood wellness. Parents and practitioners will learn to spot early signs of sleep-disordered breathing and discover practical solutions for healthier futures.

If you’re a parent, dentist, pediatrician, or healthcare professional passionate about giving children the best start in life, this podcast is your guide to better breathing, better sleep, and better development.

Piya Trehan Gandhi, DDS

BOARD CERTIFIED PEDIATRIC DENTIST, AIRWAY AND TONGUE TIE RELEASE SPECIALIST

Instagram | TikTok | LinkedIn | YouTube | Website

Chapters

• 0:00 Introduction to Pediatric Airway Health
• 1:04 Signs of Compromised Pediatric Sleep
• 1:54 The Role of Oral Facial Growth and Development
• 3:00 Case Study: Lillian's Transformation
• 5:42 Case Study: Dylan's Journey
• 7:58 Comprehensive Approach to Airway Health
• 10:07 Personal Story: Dr. Gandhi's Daughter
• 14:53 Conclusion and Call to Action

Transcript

The Pediatric Breathing Project: Changing Lives One Airway at a Time

[00:00:00]

I'm Dr. Piya Gandhi and welcome to my podcast.

So, pediatric Airway health is really looking at a child's sleep as a whole. As a parent myself, I was never educated on what my child's sleep should look like. I was basically told the numbers of hours that they should sleep by age, but I had no idea what that sleep should look like, , and how the quality of it can really impact my child's growth, development, behavior, and really overall body health.

So the golden rule for pediatric sleep is children should be silent and still there are multiple factors that affect how they sleep. Structural neurological behavioral. From a pediatric dental standpoint, we are really looking at a lot of the bony structure and muscle function of the entire oral facial region that can [00:01:00] impact how your child is sleeping, growing, and developing.

The first signs of, compromised pediatric? Sleep is mouth breathing, and that can happen during the day and at nighttime teeth grinding, which is something that is fairly easy to pick up on because it's usually, uh, audible and pretty loud. And then when we hear things like snoring movement, so lots of kids, parents think it's cute that they end up falling off the bed or upside down.

We really want their sheets to be. Quite neat in the morning and then to be fairly still while they're sleeping after that night, waking bedwetting. And eventually we start to see behavioral changes. Children that are, not reaching the deepest level of sleep end up replicating signs of ADHD or ADD.

So one concept that's really crucial when we're looking at oral facial and [00:02:00] airway growth and development is form follows function. And what that really means is that our musculature, particularly the tongue muscle, is really, really important in guiding the growth and development of the upper and lower jaw.

The nasal passages and the airway. So this is why we screen all of our patients from birth for things like tongue tie or a tongue that is not strong and moving well because we know if we have a lazy tongue or a tongue that has the inability to move dynamically, it is going to impact how the upper jaw grows, how we breathe.

Through our mouth versus our nose. So we really need the tongue to be up in order to breathe through our nose. So when we're talking about early signs, we can even look at an infant and see is their mouth open or closed? It already should be closed, and they should be practicing nasal breathing from birth.

So if we see a mouth open on a baby, we wanna know why and start retraining that habit right [00:03:00] away.

So Lillian was honestly one of the first patients I ever treated. And they found us through another friend of theirs that is a dentist but does not do any of this type of work. So they traveled about an hour and a half to see me, and at the time she was five. And she had started kindergarten and was just struggling on every aspect.

She was not sleeping well, so as a result, her mom was not sleeping well. She could not concentrate in school. She was having lots of meltdowns, and just couldn't get a handle on just regulating her body and herself. And so, you know, at this point her mom was just looking for some answers and,

when I first met Lillian, she obviously, you know, had a hard time sitting in the chair and really allowing me to do the things that I need to. But, you know, as part of being a pediatric dentist is really working with the child and meeting them where they are and taking it step by step to really help these families and help support them.

And [00:04:00] so we ended up fabricating an expander for her. And she also had a tongue and lip tie. And she, um, was in orthodontic, , expansion for about a year. We take things very slowly so that the child can handle it really well and their body doesn't go into shock. And then afterwards we did, um, some myofunctional therapy to help retrain the nasal breathing and the tongue movement.

And then we did a tongue and lip tie release, which is. Minimally invasive in the office. And when I first met Lillian, I thought, oh, I don't know if she's gonna be able to handle doing this tongue and lip tie release even though it's minimally invasive. But by the time we had gotten there, the expansion had helped her sleep so much that she sat in the chair.

She let me do the procedure. And , we followed up with Lillian every year and her school performance has gone through the roof. She's a straight A student. She is outgoing, she. Sleeps well. Her mom has now gone down her own airway journey and um, it [00:05:00] has truly changed not just Lillian's life, but her entire family's life.

And, um, that was just one of the first moments where I realized what an impact I can have as a pediatric dentist, just purely screening all my patients and educating their families on how important, um, sleep quality and sleep health is.

another, patient story that is just again, and. I bring this one up because many people think, oh, we have to wait until our child can sit in the chair, or they have to be a certain age for us to do this, but every night of poor sleep matters.

So we wanna get on top of this as quickly as possible. So, , I treated a little boy, his name is Dylan. , The mom actually brought in his older brother, , for a regular dental exam. And we noticed that older brother had a narrow palette and we started talking about things that. You know, a narrow palette can, , increase risk for what we call sleep [00:06:00] disordered breathing.

And, , the little brother, was at the visit and the mom said, actually, Dylan's really struggling with all of this. And he was not even two yet. And he was audibly snoring at night. They were concerned about like, maybe do they need to remove tonsils and adenoids? But we do know that when a child is really young, under two.

The risk of tonsil, adenoid, regrowth is much higher. So,, she didn't even know that this was a possibility. And so we ended up treating both boys and Dylan. We had to insert his expander in a, what we call knee to knee position, so on his mom's lap. , And when we initially started, Dylan was waking up like.

Six to seven times a night. And so that meant that again, mom was waking up six to seven times a night, nobody was sleeping. And we put in what's called a spring loaded or leaf expander. So it auto expands on its own. And we put it in and , Dylan did beautifully. We expanded over six months [00:07:00] and by two, he was sitting in the chair by himself.

He was sleeping through the night. He did not need a tonsil adenoid removal. , It was like a totally different kid. And , again, it's just one of those things where it's not just about the patient sitting in your chair, it's about educating, because many parents don't even know that this is an option or that's a problem that they need to address.

And when they do have knowledge about orthodontics, the misconception is that we have to wait until these kids are 7, 8, 9 to really start anything. Well think about a child with seven years of poor sleep. What is that doing to their body and their overall function? And their social interactions. , , everything is related to sleep, so we do not want to go one more night in compromised sleep if we don't have to.

So if you are a parent that has identified some of these signs, maybe it's mouth breathing, snoring, teeth grinding, or you're noticing behavioral changes in your child and you're wondering, well, what do I do next?

It's really important that, . [00:08:00] Your next steps involve not just one provider, but multiple providers, because airway health is multifactorial. When someone comes into our practice, , we do partner with a lot of other individuals and professionals in the field, whether that's physicians or therapists, , so that we are working as a collaborative team.

But if you come to us as your first stop, , what we're looking at is what are the risk factors that we're seeing already? So we're asking you what you're seeing at home. We're having you fill out a sleep questionnaire. , We are looking clinically at the measurements of the jaw width. Do we see signs of grinding or screening for tonsil and adenoid, , enlargement.

Even though I'm not an ENT, I can identify those things and then we can figure out what we need to do to address them if we need to address them now or delay them. , We're asking about allergies. , And then, you know, we're coming up with a comprehensive treatment plan. , If you are someone that is not in the Houston area, , looking [00:09:00] for an airway focused dentist and a pediatric dentist is great, but there are a lot of general dentists that also do this that can handle some kids as well, because unfortunately this is not taught in pediatric residency, so you're not gonna find every pediatric dentist that does this.

But those that have taken it upon themselves to educate, , they may be a general dentist, so I would just search for, , an airway focused dentist or someone at least that screens for tongue ties, , and is cognizant of growth and development. Another good place to start is with therapists, so myofunctional therapists.

There's usually like a, a larger network sometimes in smaller towns., Where maybe a dentist is not immediately close by. , But whoever you go to, you wanna make sure that they're looking at the big picture and not just focusing on one little area. , Because just expansion is not always the answer.

Just ENT tonsil, adenoid removal is not always the answer, [00:10:00] just therapy. So we have to kind of put all the pieces together to really make sure that we're checking all the boxes.

So,, I opened my first practice in 2017 and airway health and functional pediatric dentistry was nowhere in the business plan. , At, at the time I already had my two daughters who are now 12 and nine, but my older one, Cyra, , she was not able to breastfeed. She showed all the classic symptoms of what I know now is, , infant tongue tie, , but didn't know anything about it 12 years ago when she was born.

, And so, uh, you know, I, I wasn't able to breastfeed. We had trouble, , with some solid food eating. And again, I was just told to kinda push through and as a society, we have come up with lots of compensations for our children, pre-processed food pouches, bottles, and so we did all those things. But the thing that really struck [00:11:00] me was when she was about three years old, she started snoring audibly and her behavior just tanked.

She was in preschool at the time and would come home every day and just. Meltdown. It was like nothing we could do would reach her. , And I knew at least what poor sleep on a child in terms of tons and adenoid obstruction looked like. So I knew the snoring wasn't normal. And , my husband at the time is a physician and he initially was like, no, she's fine.

And then we went on vacation and she kept him up the whole night snoring and he was like, maybe we should go to ENT So I'd already made an appointment. We went to ENT. They took out her tonsils, adenoids. She also had 90% fluid blockage in her right ear. So she was deaf in her right ear. And so obviously that was playing a role.

What I didn't know at the time though, was to look at the other things. So we did that. The audible snoring went away, but the behavior [00:12:00] really didn't change much. And you know, that mom instinct that I ignored as a first time mom when she was born. I. Was a little bit older and wiser and I was like, there's, there's something else.

There's gotta be something else. And um, it just so happened that I started, you know, treating infant tongue ties and I decided to take a course by Dr. Surgi about children with airway dysfunction and tongue ties. And I sat in that room, this was 2018, and he literally was listing every symptom that was my daughter.

And it, first of all, I was shocked that I had been to 12 years of school and I, no one had ever talked about this. But I was also as a mom, just like struggling that I had missed this on my own child. So I came home, Cyra had a posterior tongue tie and a lip tie. And, , at the time we were not really looking at the big picture and doing a lot of [00:13:00] interdisciplinary care.

So I released her tongue and lip tie with sort of minimal pre , therapy and. Similar to the tonsil adenoid release, we got like a little bit of improvement. Clinically, the areas looked good, the wounds healed well, but we're talking about function here and we, I was still missing something. So as a mom and as a practitioner, I did a lot more education.

And , now we have a full interdisciplinary approach because we know it's not just one thing. It's not just the procedure. It's not just the therapy. It's not just, . You know, the chiropractic care, we had to put all of it together. So then, , I learned all the things and, uh, no one would expand my 4-year-old.

So that's when I started learning how to do expansion and I expanded her and we did chiropractic care and myofunctional therapy, and I released her again at seven and, . It was life changing. I feel like I finally met [00:14:00] my child at seven years old because she was sleeping well. And when kids don't sleep well, when they have sleep disordered breathing, they do not fall into deep sleep.

So that is the thing that is compromised by pediatric sleep apnea, is they stay at superficial levels of sleep and their body has no time to restore. So they have trouble regulating themselves as a parent. It feels. It leaves you feeling helpless because nothing that you do can get through to them and help regulate them.

So, , it is really, really important that we pay attention to these things. I've lived this as a parent and I, I cannot imagine what Cyrus life would be like if I hadn't been able to intervene. , I, she would not be the ballerina on point that she is today. And the happy go-lucky preteen. , And as a family we would, we would be struggling.

And so my mission as a practitioner is to educate parents [00:15:00] and let them know the realities of how poor sleep can impact their child's health and their whole family unit. , And I can't treat everyone, and that's why I educate other practitioners and I want more people to be aware of this and screening and being able to treat, , because it is.

It is impacting a lot of, a lot of children.

So if you are a parent or practitioner and this speaks to you, you wanna know more for your child or for your patients, , please follow us. Share this podcast with all of your friends and colleagues because we are looking to change lives one airway at a time.