Airway-focused orthodontics has recently become a subject of considerable interest, particularly regarding its potential to address breathing issues such as sleep-disordered breathing (SDB) and obstructive sleep apnoea (OSA). While orthodontists play an essential role in identifying potential airway issues, recent independent research highlights that these conditions are multifactorial and require thorough evaluation and diagnosis by a sleep medicine specialist. This blog will explore the role of orthodontics in airway health, clarify common misconceptions, and discuss the ethical implications of the growing trend of airway-friendly orthodontics.
Breathing issues like SDB and OSA are complex conditions influenced by a variety of factors, including skeletal structure, soft tissues, body weight, and lifestyle. Orthodontists are often in a prime position to identify early signs of airway obstruction during routine assessments. However, it is important to understand that orthodontists alone cannot diagnose or treat these conditions comprehensively; a multidisciplinary approach, especially involving sleep medicine specialists, is necessary for accurate diagnosis and effective treatment.
One persistent misconception in airway-focused orthodontics is the belief that maxillary (upper jaw) expansion can universally resolve breathing problems. While maxillary expansion is an effective treatment for correcting clinical crossbites and addressing maxillary constriction, its efficacy as a treatment for airway issues in the absence of these conditions is not well-supported by current research.
Independent studies indicate that, although expanding the maxilla can improve nasal airflow in patients with anatomical constraints like a narrow palate, it is not a guaranteed solution for breathing disorders, particularly in patients without such structural issues. In these cases, orthodontic treatment alone is unlikely to address the root causes of breathing problems. Instead, a comprehensive treatment plan developed in consultation with ENT specialists and sleep medicine experts is essential for effective management.
The growing awareness of airway health has unfortunately led to the commercialisation of “airway-friendly” orthodontics. Some clinics and practitioners have begun promoting orthodontic treatments with the claim that they can cure or significantly improve breathing disorders. This trend raises ethical concerns, as it may lead to unnecessary treatments and mislead patients.
Recent research cautions against over-promising the outcomes of airway-focused orthodontic treatments. While orthodontic interventions can contribute to improving certain structural issues that may affect breathing, they should not be presented as a standalone cure for complex airway problems. Accurate diagnosis and appropriate treatment require a multidisciplinary approach, with the involvement of specialists trained in sleep medicine.
While orthodontics can play a supportive role in addressing structural contributors to airway issues, it is not a one-size-fits-all solution. Airway-focused orthodontics should be part of a broader, multidisciplinary approach that includes thorough evaluation by medical professionals. The trend of misusing orthodontic treatments under the guise of solving complex airway issues for commercial gain undermines patient trust and the integrity of the orthodontic profession.
As a practitioner, I advocate for evidence-based practices, patient education, and collaboration with other healthcare professionals to ensure that airway-related treatments are both ethical and effective. Misleading claims and unnecessary treatments do not serve patients’ best interests and can diminish the reputation of the orthodontic field.
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I recommend and prescribe orthodontic treatments to my patients as if they were my own family and I value meaningful relationships based on communication, confidence and trust.
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