External nasal dilators
A clinical aid for dentists, patients
ALLEN J. MOSES, D.D.S.
In the normal, healthy condition, humans are nasal breathers. The nose is an incredible organ. In addition to its olfactory function, it is the carburetor of the body. It properly humidifies, filters and warms inspired air. It also plays a role in immunity, voice resonance and certain hormonal responses. The mouth is merely a backup breathing organ. There are numerous opportunities in clinical practice for dentists to aid mouth breathers. A new addition to the dentist’s clinical armamentarium is the external nasal dilator, more commonly known as a nasal breathing strip (Breath Right Nasal Strips, CNS Inc., Minneapolis).
Mouth breathers often can be difficult to treat. Oral breathing fogs the dentist’s mirror and hinders visualization of the working field. Patients whose nasal breathing is obstructed need to keep their oral airways open to breathe, so they are swallowing or gagging continually during most dental procedures.
When the nasal breathing strip is taped over the nose, it lifts the skin on the nose and opens the nasal passages.
My clinical tip is for dentists to place an external nasal dilator on mouth breathers’ noses (Figure
) before beginning any procedure. This will make it easier to perform dental work. The ingenious concept behind the nasal breathing aid is two flat spring-action strips under a specially contoured piece of adhesive tape. When the strip is taped over the nose, it lifts the skin on the nose and opens the nasal passages. In my experience, the improvement is dramatic and patients really appreciate it.
The external nasal breathing dilator also can be used as a diagnostic aid. Dentists can play a significant diagnostic role in treating obstructive sleep apnea. There are many possible causes of the obstruction; nasally obstructed breathing is one. Snoring, by definition, is obstructed sleep breathing. The obstruction often is nasal in origin or caused by hypertrophied tonsils. Dentists have some important diagnostic tools to help them decide to what specialist—otolaryngologists, surgeons, pulmonologists, allergists, pediatricians, internists or family physicians—to refer their patients. Panoramic radiographs can detect such breathing problems as a deviated septum, congested sinuses and swollen nasal membranes. Because external nasal dilators successfully improve breathing problems of anterior nasal origin, they provide dentists with another important tool for diagnosing breathing problems, making proper referrals and helping their patients become more comfortable.
CONCLUSION
Nasally obstructed breathing causes mouth breathers to choke, gag, aspirate and swallow frequently during dental procedures. The need to keep their oral airways open causes the dental mirror to fog, making visualization difficult for the dentist. The use of external nasal dilators can make dental appointments an easier and more pleasant experience for both dentists and patients. The success of an external nasal dilator used for these purposes also differentiates anterior nasal obstructions from others.
DO YOU HAVE A TIP TO SHARE?
Do you have a time- or work-saving clinical technique to share with your colleagues? Submit it to JADA’s Clinical Directions department. A Clinical Directions item should be a maximum of two double-spaced typed pages and should include no more than one figure or illustration. Submit items to Clinical Directions, JADA, 211 E. Chicago Ave., Chicago, Ill. 60611.
FOOTNOTES
Dr. Moses is in private practice, 233 S. Wacker Drive, Chicago, Ill. 60606-6302, e-mail "ajmoses{at}tmjchicago.com". Address reprint requests to Dr. Moses.
