When you bring home a new baby, there are so many things to consider. Chief among them is every parent’s concern that the baby will nurse or take a bottle well. For some babies, this concern is well founded. Affecting an estimated 30% of people in the U.S., a high-arched palate (also known as a high-vaulted palate) can make nursing or bottle-feeding a challenge. A diagnosis of high-arched palate does not have to mean continued feeding problems or speech issues, though. Keep reading for more about high-arched palate and what it could mean for your baby – now and as they grow up.
What is a high-arched palate?
High-arched palate refers to a narrow, tall roof of the mouth (the hard palate). The structure of a baby’s mouth develops very quickly in utero and continues to be formed during the first year of life. High-arched palate is a congenital condition that is present from birth.
There are a number of other syndromes that have high-arched palate as one of their symptoms, including:
- Crouzon syndrome
- Down syndrome
- Apert syndrome
- Treacher Collins syndrome
- Marfan syndrome
- Incontinentia pigmenti
In some cases, high-arched palate can also develop after birth due to certain behaviors. Chronic and excessive thumb sucking and pacifier use can contribute, as can breathing through an open mouth more often than not.
A baby’s tongue helps to develop proper oral anatomy by filling and gently maintaining the shape of the palate. If the mouth is frequently open with the tongue resting broad and flat on the floor of the mouth, the palate can continue to narrow and expand.
What are high-arched palate symptoms?
High-arched palate symptoms prey on the main fear of parents by causing difficulties in feeding. Both breastfeeding and bottle-feeding rely on the baby developing a proper suction with the nipple. A high-arched palate makes this proper suction difficult (if not impossible). This may be just the first sign of trouble to come.
As your baby grows and the palate continues to become higher and narrower, a chain reaction begins to evolve.
Nasal breathing becomes difficult
The upper palate doubles as the floor of the nasal cavity. As the upper palate expands, the nasal cavity shrinks. This leads to more open-mouthed breathing and more expansion in the upper palate.
Nasal congestion is difficult to clear
Smaller nasal passages become congested and swollen and are difficult to clear. This again causes mouth breathing and the potential for upper respiratory infection.
Sleep difficulties arise
As the condition progresses, the potential for a child developing sleep apnea increases. Many patients with high-arched palate have to sleep on their side to get enough oxygen, and snoring is common.
Bones begin to harden and change
A baby’s bones are soft when they are born but get harder as they grow. More midface structural changes to the face can occur as they bones get hard, including narrowing between the eyes and a downturned mouth.
Speech issue develop
Older children may struggle with speech (specifically consonants) and develop a speech impediment for any sounds that utilize the upper palate in contact with the tongue.
Increased chance of poor oral health
As regards oral health, high-arched palate can result in swollen gums and crowded molars as a child grows. This, in turn, can lead to more tooth decay in hard-to-reach areas of the mouth and eventually lead to periodontal disease.
How do I get a high-arched palate diagnosis?
A high-arched palate diagnosis is often made visually. For many babies, it is quite obvious that the palate is higher than usual.
Researchers have also developed a consistent, if complicated, measurement system to quantify what it means to have a high-arched palate (which, in addition to calling it a vaulted palate, they also refer to as a pseudo-cleft). Researchers looked at several different measurements – palate shelf length, shelf width, arch height, and arch angle – to determine what the mean (middle) measurement of these features was. They identified a high-arched palate as one that has measurements that are two standard deviations above the mean measurement.
This measurement eliminates guessing in favor of a consistent and measureable diagnosis. For new parents (or anyone who has waited anxiously for test results), this proper diagnosis can offer a sense of relief and a path forward towards high-arched palate treatment.
What are high-arched palate treatments?
High-arched palate treatment can be tricky. In the absence of any other symptoms and with a baby who is having no feeding difficulties, treatment may be unnecessary. If your baby or child is having challenges due to a high-arched palate, here are some high-arched palate treatments to try.
Tongue repositioning and strengthening exercises
The tongue is key in most oral functions, from swallowing to speech. A tongue that is broad and flat has difficulty forming consonants and contributes to a narrow palate.
Some basic tongue repositioning exercises can help to strengthen and retrain the tongue back to its proper position. Only attempt these after talking to your dentist.
Palate expander
If a high-arched palate has caused no problems in infancy but begins to trouble your adolescent as they begin orthodontic treatment, your orthodontist may recommend a palate expander. A palate expander is an appliance that spans the upper palate. A key inserted into the expander helps to gradually open the palate up.
If these treatments are unsuccessful and a high-arched palate is beginning to cause speech or respiratory issues, you may want to consider oral-maxillofacial surgery to expand the upper palate arch. This will not necessarily shrink the height of the arch but will open the upper palate and create more space for the nasal passages. This could help relieve congestion and make breathing easier. It may also ease any sleep apnea that has developed.
Your Scottsdale weekend dentist, AZ Dentist, is here for you and your baby. If you see signs of a high-arched palate or experience feeding difficulties, contact us today to schedule an exam at one of our Phoenix area clinics.