Sleep, Breathing, and Invisalign®

Airway dentistry is a branch of dentistry combining orthodontics and sleep apnea treatments to improve nasal breathing and promote health in children and adults.

Sleep-disordered breathing (SDB)  is any disturbance or interruption in your sleep caused by impaired breathing. Sleep-disordered breathing is a spectrum running from snoring to numerous long pauses in breath at night, which has dramatic negative effects on a patient’s health at any age.

Obstructive sleep apnea symptoms are common but not normal. There is a misconception that sleep-disordered breathing is always related to snoring—but not all sufferers of sleep apnea snore. There is a general lack of education and lack of awareness for most doctors and dentists, and it’s much easier for people to miss their own less severe signs and symptoms.

You stop breathing in your sleep. The severity of the problem depends on how many times per hour this happens, how long you go between breaths, and how low your oxygen levels get.

Children present most often with crowded teeth, tooth grinding, and snoring. Other symptoms present as ADHD, irritability, tantrums, and bedwetting. Signs in adults include snoring, high blood pressure (aka hypertension), unexplained weight gain, daytime sleepiness, hypothyroidism, cardiovascular disease, insulin resistance, and reduced glucose metabolism.

We take a holistic view of your health, working alongside physicians when necessary, to ensure that we improve not only your dental health, but your sleep, breathing, and overall wellness. We make extensive use of orthodontic tools to achieve this. When we do cleanings and fillings, we minimize the use of x-rays and prefer fluoride alternatives; we use BPA-free fillings made from chairside ceramics; we clear infections whenever possible; we avoid the use of mouthwash for the benefit of your oral microbiome; and we never push treatment if it is marginally beneficial. Learn more here.

We believe in starting treatment earlier than most, because by age two, the jaws are 55% developed (and girls develop faster than boys 😉*). Our treatments often include expansion of both jaws, complemented by myofunctional therapy to ensure long-term success. We use removable and fixed expanders on children and Invisalign for adults.  

*source: Liu YP, Behrents RG, Buschang PH. Mandibular growth, remodeling, and maturation during infancy and early childhood. Angle Orthod. 2010 Jan;80(1):97-105. doi: 10.2319/020309-67.1. PMID: 19852647; PMCID: PMC8978730.

While dentists have long known about the link between sleep-disordered breathing and oral development, recent work by psychologists, neurologists, ENTs, and pulmonologists has solidified medical consensus around this relationship. In particular, Dr. Christian Guilleminault of the Stanford Sleep Medicine Center, emphasized the role of dentistry and orthodontic tools to address airway obstructions. His interdisciplinary work is at the cornerstone of The Airway Dentists’ clinical philosophy.

Though CPAP is the first line of treatment for sleep apnea, patient compliance is low. Furthermore the CPAP treats symptoms, not the root cause. At The Airway Dentists, we use oral appliances like Invisalign and mandibular advancement devices to treat the root cause by making room for the tongue and soft tissue so that they don’t block the airway during sleep.

Who better to treat an issue that arises in the mouth, involving teeth, jaws, and soft tissue? The Airway Dentists have extensive training in sleep-disordered breathing and oral appliance therapy. For adults, we manage sleep apnea care in conjunction with a physician. For children, where the underlying problem stems from oral development, orthodontics is the first step.

Patients with teeth are eligible! We will need to check on the health of your gums to determine stability and review your medical history for any potential issues. We can start treating patients as early as 3 years old.

To determine your candidacy, schedule a consultation with one of our dentists. Regardless of your sleep and breathing symptoms, we would love to have you as a patient.

We’d be happy to meet with your child to screen them for eligibility and put together a care plan.

Probably 😉. We’ll begin with a sleep study so we can measure his or her symptoms. Schedule a consultation to begin sleeping in the same bed again.

We have to let them try before recommending more invasive therapies. Kids are remarkably compliant and if anything can get quite attached to their devices. Our team is well versed in incentivizing and motivating kids. We’ll give you tools and tips to track their progress. Stick with it and have patience—your persistence will be rewarded.

For kids, we begin with a sleep questionnaire, intraoral, and extraoral exam. We also take a CBCT as age appropriate to evaluate tonsils, adenoids, and orthodontic development. For adults, we’ll do the same exams and add an easy home sleep apnea test (a wearable diagnostic ring).

Palatal and lower jaw expanders expand arch width, grow skeletal bone, and aid in jaw development, which increases nasal breathing and makes room for adult teeth. The roof of the mouth is the floor of the nose, so by expanding the palate, we increase the volume of the nasal cavity.

Invisalign is a safe, effective alternative to braces. At The Airway Dentists we prescribe a unique, expansive clear aligner recipe that goes beyond straight teeth. Our program is specialized with breathing and sleep in mind.

Snoring?
✅ Yes! Snoring is caused by inhaled air vibrating against soft tissue that obstructs the airway. We stop patients’ snoring by helping that soft tissue to find its proper place in the mouth and allowing inhaled air to pass unobstructed. 

CPAP usage?

✅ Yes! With the help of your sleep doctor, we can help you potentially eliminate the need for CPAP with airway expansion, proper arch development, and oral appliance therapy.

Bedwetting?
✅ Yes! 50% of children in our appliances report resolution of symptoms within two weeks and 90% within eight weeks.

ADHD symptoms?
✅ Yes! Sleep disturbances can manifest in kids as hyperactivity and impulsivity. By improving sleep quality we can eliminate these symptoms.

Patients that have done myofunctional therapy have seen a more contoured jawline as the muscles lift the face.

Yes, you can use your insurance as partial payment toward your treatment. We’ll be happy to do a complimentary benefits check for you to determine your coverage.

For an oral appliance related to sleep apnea, our fees for standard treatment including Invisalign® go as low as $3300.