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Airway and Sleep Therapy

Airway and Dental Health

The Airway carries air exchange between the oral and nasal cavities and the lungs. Proper function of the airway is an absolute requirement for proper development of the teeth and jaws.
When the airway is compromised, an improper growth pattern develops causing dental and overall health issues. Once
the airway has compromised the dental form and function, the abnormal dental form and function maintains the abnormal airway function.
Therefore, the effects produced by the airway compromise now work to maintain that distortion in the system. Other effects produced by airway compromise create their own set of issues. For instance, mouth-breathing is both a symptom and effect of airway compromise. This dental health distortion breeds dental maladies such as increased decay, periodontal disease, and orthodontic distortions.
Areas of overall health that are compromised by airway distortion include postural issues, sleep related issues, breathing problems, snoring, and sleep apnea. The size of the airway determines the volume of air exchange possible. The size of the airway is significantly impacted by the structures that surround it. These structures can impose on the airway space and thus restrict air flow. Correcting imposing structures means allowing for natural increase of airway space thus increasing air flow and allowing for healthy patterns to develop.
Most airway issues are environmental, not genetic. This means that things in our life experience create the problem, like the foods we eat, the air we breathe. This also means that we can influence their development back to the way it was intended, if we do the right thing. The first step is to open the airway.
The nasal passages are frequently compromised by the palate being pushed up into the nasal cavity as the arch form of the upper teeth narrows (from mouth breathing). Proper orthodontic treatment widens the arch form and drops the palate down, thereby enlarging the nasal passages.
The second area of airway that can be influenced is the area behind the tongue. This is the source of snoring & sleep apnea. It is caused by the jaw posturing too far back which allows the tongue to posture too far back as well. The volume of space between the back of the tongue and the back of the throat is reduced and problems result.
These issues are treatable through conservative methods aimed at restoring natural balance to the system.

Significant Structures that Impact the Airway:
    •    Upper & Lower Jaws
    •    Upper & Lower Dental Arches (teeth)
    •    Nasal Cavity / Palate
    •    Tongue
Common Health Issues Related to Airway Compromise:
    •    Asthma & Allergies
    •    Middle Ear Infections
    •    Sleep Disorders
    •    Sinus Problems
    •    Postural Problems
    •    Dental Crowding
    •    Overbites, Crossbites, & Open Bites
    •    Enlarged Tonsils
    •    Chronically Tired or Insomnia
Common Dentally Driven Airway Issues:
    •    Asthma & Allergies
    •    Middle Ear Infections
    •    Sleep Disorders, namely Snoring and Sleep Apnea
    •    Chronic Sinus Infections or Congestion
    •    Inflamed or Enlarged Tonsils and/or Adenoids
    •    Post Nasal Drip
    •    Chronic Coughing or Throat Clearing

The Airway Connections

I discovered very early in my career that everything I was taught in dental school wasn’t necessarily true.
I was taught, for example, that receding gums were a sign of old age and poor brushing habits. It didn’t take long to learn
that brushing technique had little to do with receding gums.
I quickly found that receding gums have something to do with the bite because when I changed the bite on a tooth, the recession stopped. The same for sensitivity. The same for abfractions (those little notches in the tooth at the gumline).
As time went by, the discoveries continued.
Stress from the bite was more about the upper teeth and lower teeth as groups, not individual tooth problems.
Individual tooth problems are just a manner in which the problem is expressed. It was not so much how each tooth hit its opponent, but how the lower teeth as a group interact with the upper teeth, and what that meant in terms of jaw posture
and jaw-joint function.
Most recently, the underlying cause of the jaw function problems has surfaced. It is now understood that distortions in facial growth patterns produce compromised airways. Because the airway exists above and behind the mouth, anything that results in distortions of the mouth will affect the airway.

Chain of Events:
    •    Development of the face progresses from conception on through adulthood.
    •    A multitude of environmental influences affect the growth, and distortions result.
    •    The most significant distortion is a downward and backward growth pattern.
    •    This produces overbites, narrow jaws, long faces, small airways, and mouth breathing.
    •    Once the distortions get started, they continue like a vicious circle.

The more you mouth breathe, the more you distort and shrink the airway. The more the airway collapses, the more you will mouth breathe, and the cycle continues. The end result is a plethora of orthodontic and health problems.
Allergies, asthma, chronic fatigue, snoring, and sleep apnea are the airway problems. Clenching and/or grinding the teeth, sensitivity, receding gums, periodontal disease, and tooth decay are the dental problems. Headaches, neckaches, backaches, fibromyalgia, and carpal tunnel syndrome are some of the postural problems.
This knowledge influences how we treat children orthodontically to avoid airway compromise as adults and how we treat adults who already have the distortions and resulting symptoms. This understanding is why the airway is an integrated factor in all the treatment I provide.

-Bruce Johnson, D.D.S.