Airway Orthodontics

<ul>
<li>Expert Dentists | Dr. Alexandra Bassett is a highly skilled and experienced dentist who is passionate about airway dentistry and helping her patients find relief.</li>
<li>Flexible Availability | We have morning & evening appointments and online scheduling for your convenience.</li>
<li>Caring & Compassionate Team | We value integrity and strive to provide the best dental care possible for all our patients.</li>
<li>Affordable Dental Care | We feature competitive pricing and offer the Paloma Plan, an insurance alternative, if you are uninsured.</li>
</ul>

Sleep disordered breathing (SDB) is full or partial obstruction of our airway during sleep. The most infamous type is obstructive sleep apnea (OSA), where your throat closes, and you stop breathing altogether. But there are many types of SDB – minor as well as major like OSA. All affect your health by decreasing the quality of your sleep.

OSA is associated with significant medical issues, including high blood pressure and congestive heart failure. Studies show that OSA can reduce a person’s life expectancy by several years.

Before 400 years ago, crowded teeth were virtually absent in humans. It wasn’t until humans started eating less fibrous (more processed) foods that a huge increase in dental crowding began. Other studies that followed nonwesternized cultures as they westernize their diets show decreased jaw size in just one generation!

A smaller jaw causes a few key problems: A smaller nasal passage (the top of the jaw is the bottom of the nasal cavity) and a smaller area for the tongue to exist. Both of these decreases in volume for proper breathing have been linked to SBD.

Some common symptoms of SBD include but are not limited to the following:
<ul>
<li>Loud snoring.</li>
<li>Episodes in which you stop breathing during sleep – which would be reported by another person.</li>
<li>Gasping for air during sleep.</li>
<li>Awakening with a dry mouth.</li>
<li>Morning headaches.</li>
<li>Difficulty staying asleep.</li>
<li>Excessive daytime sleepiness.</li>
</ul>
It is important to see a dentist who is experienced in providing treatment for sleep disordered breathing. Call Paloma Dental today to make an appointment with Dr. Alexandra Bassett.

The majority of the people that grind when they sleep show some SBD when tested. Symptoms include clenching, grinding, clicking or popping, dislocation, jaw or ear pain, dizziness, tinnitus, and/or frequent headaches.

Choices for TMJ disorder treatment are overwhelmingly varied. A night guard is commonly prescribed for patients with TMD, which helps relax the tight muscles. There is also occlusal equilibration, Botox injections, medications, physical therapy, acupuncture, and surgeries. All of these treatment options focus on the symptoms but not the cause of the TMD – which is sometimes an underdeveloped jaw.

If you would like to learn what can be done to improve the relationship between your teeth and your jaw joint, please ask us. Usually, the treatment to correct this issue requires some orthodontics (clear aligners to change the position of teeth) so there may be an aesthetic bonus as well. By deciding to correct this problem, you may end up avoiding future dental needs that are much more invasive and expensive.

One option is MMA (Maxillomandibular Advancement) surgery – this is considered the only “cure” for Obstructive Sleep Apnea. All other options, including the ones we offer at Paloma Dental, help manage or decrease Sleep Disordered Breathing, but do not cure it.

Other options for palliative treatment include:
<ul>
<li>Orofacial Myofunctional Therapy (OMT), which works to slowly retrain your facial muscles to function and swallow in a healthier way.</li>
<li>Continuous Positive Airway Pressure (CPAP), which needs to be worn over the face to “blow open” the airway while sleeping at night.</li>
<li>Mandibular Advancement Devices (MADs) that keep the lower jaw forward to open the airway, allowing better breathing. One common issue with MADs is changing the bite since the jaw is being held forward all night. Some dentists also worry that long term MADs can actually alter the morphology of the upper jaw, making it even smaller over time.</li>
</ul>

Clear aligner therapy increases the amount of space for the tongue to rest, decreasing its tendency to fall into the throat while relaxing. Just a few millimeters make a huge difference! This has been shown to help many patients sleep better and have less pain, tension, and discomfort in their jaw joints.

Orthodontics has traditionally been the study of how to correct issues with the teeth alignment, NOT the jaw development. This is “retractive orthodontics.”

Dentists are now becoming more “airway-focused” – we think about how our decisions and treatment impact the health of our patient’s breathing. Airway disease directly contributes to premature dental destruction, so treating it closes the circle of proper dental care – we treat the bacterial problems such as cavities and gum infections, but we also treat the functional problems that can lead to premature wear as well.

Of course, not all jaw and sleep issues are caused by an underdeveloped jaw. We always do a full assessment of a patient’s situation to see if Invisalign treatment would help this condition. We work with several other doctors, including an orthodontist, oral surgeon, periodontist, and ENT to recommend the most promising treatment for our patients.

When Will the Insanity of Retraction End? https://www.aaosh.org/connect/insanity-of-retraction
Obstructive Sleep-disordered Breathing: https://www.ncbi.nlm.nih.gov/books/NBK441909/
Origins of dental crowding and malocclusions: an anthropological perspective; https://www.semanticscholar.org/paper/Origins-of-dental-crowding-and-malocclusions%3A-an-Rose-Roblee/1322041e2ad86a44420e857b73257af0054980aa
Sleep apnea; https://www.mayoclinic.org/diseases-conditions/sleep-apnea/symptoms-causes/syc-20377631
Prevalence of temporomandibular disorders in obstructive sleep apnea patients referred for oral appliance therapy; https://pubmed.ncbi.nlm.nih.gov/19888485/
Changes in human skull morphology across the agricultural transition are consistent with softer diets in preindustrial farming groups; https://www.pnas.org/content/114/34/9050
The Great Leap Forward: the anatomic basis for the acquisition of speech and obstructive sleep apnea: https://pubmed.ncbi.nlm.nih.gov/14592320/
The anatomic basis for the acquisition of speech and obstructive sleep apnea: evidence from cephalometric analysis supports The Great Leap Forward hypothesis: https://pubmed.ncbi.nlm.nih.gov/15994120/