TOM COLQUITT, DDS
THE NEED FOR NASODIAPHRAGMATIC
BREATHING; HOW TO HELP DEVELOP IT
T Sleep
he early focus of “Dental
Medicine”, thanks to
Dr. Thornton’s development
of the first TAP appliance,
was to bring the mandible
and tongue up and forward
to provide a passive
pharynx and a patent
airway during sleep. During
that era we were thinking
more about providing “air
in – air out” as the goal,
and not considering how
to maximize the efficiency
of gas exchange during
breathing.
Now we know that if we
open the airway with
an appliance which still
permits oral breathing,
we are missing out on the
opportunity to provide the
maximum benefits for our
patients.
Nasal inhalation cleans,
humidifies, and warms the
inspired air.
Oral inhalation does not.
Nasal inhalation mixes
Nitric Oxide, secreted by
the paranasal sinuses, with
the air before it encounters
the tonsils, adenoids, and
oropharyngeal airway on
its way to the lungs. The NO
kills invasive pathogenic
microorganisms before
they can reach these
structures, minimizing
the risk of inflamed T&A
and respiratory tract
infections. It is also a
potent vasodilator which
enhances the transference
of O2 from the alveoli to
the hemoglobin in the
erythrocytes, maximizing
the O2 saturation potential
of the brain and organs.
Oral inhalation does not.
Mouth Shield with MyTAP
Nasal breathing should be
driven by the diaphragm
to fully fill and empty the
lungs, and which is also
the pump for the lymphatic
system.
Oral breathing typically
is from the top 1/3 of the
lungs using the intercostal
muscles, diminishing the
body’s attempt to ward off
and deal with infection and
inflammation.
Nasal exhalation keeps
the nasal airway moist
and warm and limits the
overbreathing of CO2 to
maintain blood pH.
Oral breathing dries out the
mouth and nasal passages
and can expel too much
CO2, creating the crisis of
hypocapnia.
The blood becomes acidic,
bodily systems which
include tubes constrict to
compensate (often causing
nasal congestion), and the
O2 that actually makes it to
the hemoglobin does not
get released to the tissues
due to the Bohr Effect. The
SPO2 may look great on
oximetry, but the entire
body is undergoing hypoxic
inflammation.
Once we understand
this, the need to not only
provide airway patency but