Learn about snoring, sleep-disordered breathing and the orthodontist’s role in screening, orthodontic evaluation and coordinated care. Serving Citrus Heights, Fair Oaks and Sacramento.
Sleep is an important part of overall health and development.
Breathing during sleep can be influenced by a variety of anatomical, physiological and medical factors.
Because orthodontists evaluate the teeth, jaws, palate and facial structures, they may encounter patients whose orthodontic findings occur alongside symptoms that raise questions about sleep-related breathing.
That does not mean that every orthodontic problem is an airway problem.
It also does not mean that an orthodontist can diagnose a sleep disorder by examining the teeth.
Instead, an orthodontic evaluation can be one piece of a larger picture.
Sleep-disordered breathing describes a range of breathing difficulties that can occur during sleep.
Some people may snore without having obstructive sleep apnea. Others may have more significant disruption of normal breathing during sleep.
Obstructive sleep apnea is a medical sleep disorder involving repeated episodes of impaired breathing during sleep.
Because there are different types and causes of sleep-related breathing problems, symptoms alone are not enough to establish a diagnosis.
Snoring is a symptom—not a diagnosis.
When obstructive sleep apnea is suspected, appropriate medical evaluation is necessary.
Children may show sleep-related breathing concerns in ways that are different from adults.
Parents may notice:
None of these symptoms alone proves that a child has sleep apnea.
However, persistent or concerning symptoms should be discussed with an appropriate healthcare professional.lap, it is important not to assume that the breathing pattern itself tells us what is causing it.
Sleep-related breathing concerns can affect people at any age.
Teens and adults may experience:
Adults sometimes assume that chronic snoring is simply a normal part of getting older.
It should not automatically be dismissed.
If symptoms raise concern about a possible sleep-related breathing disorder, medical evaluation may be appropriate.
An orthodontic examination provides information about the teeth, jaws and facial structures.
Depending on the individual patient, Dr. DeLurgio may evaluate:
These findings may provide useful context when a patient has breathing or sleep-related concerns.
However, they should not be interpreted as a diagnosis of obstructive sleep apnea.
Mouth breathing may be more important to investigate when it is persistent or occurs alongside other An orthodontist may recognize orthodontic or facial-development findings that are relevant to the overall anatomy of the mouth and face.
For example, an examination may identify:
An orthodontist can also ask about symptoms such as snoring, mouth breathing or restless sleep.
This can help determine whether additional evaluation should be considered.
The question is not simply:
“Does this patient have sleep apnea?”
Instead, an appropriate orthodontic question is:
“Are there orthodontic findings or reported symptoms that suggest this patient may benefit from additional evaluation?”
An orthodontic examination is not a sleep study.
An orthodontist cannot independently diagnose obstructive sleep apnea simply by looking at a patient’s teeth, palate or facial structure.
Likewise:
Sleep-related breathing disorders can involve multiple factors.
A medical evaluation is necessary when a sleep disorder is suspected.
If a child has difficulty breathing comfortably through the nose, it is important to consider potential If a patient’s symptoms or history raise concern, the appropriate next step may be medical evaluation.
Depending on the circumstances, this may involve:
The medical provider can determine whether additional testing is appropriate.
In some cases, a sleep study may be recommended.
A sleep study is a diagnostic test used to evaluate what happens during sleep.
Depending on the patient and circumstances, testing may take place in a sleep center or may involve an appropriate home-based study.
A sleep study can provide information about breathing and other physiological measures that an orthodontic examination cannot provide.
This distinction is important.
An orthodontic examination evaluates orthodontic anatomy. A sleep study evaluates what is happening physiologically during sleep.
The two should not be treated as interchangeable.
Orthodontic treatment may be appropriate when a patient has an orthodontic condition that requires treatment regardless of their sleep symptoms.
Examples may include:
In some patients, correcting an orthodontic problem may also affect oral space or function.
However, that is different from saying that orthodontics universally treats obstructive sleep apnea.
The appropriate role of orthodontics depends on the patient’s individual anatomy, orthodontic diagnosis and overall care plan.
An ENT specializes in conditions involving the ear, nose and throat.
When a patient has difficulty breathing through the nose or other upper-airway concerns, an ENT may evaluate possible anatomical or medical contributors.
Depending on the situation, this may include consideration of:
An ENT evaluation and an orthodontic evaluation serve different purposes.
A pediatrician or primary care physician can evaluate sleep-related symptoms within the context of the patient’s overall health.
They may consider:
For a child with concerning sleep symptoms, this broader medical evaluation is an important part of responsible care.
Expansion can be appropriate orthodontic treatment for certain patients.
For example, a patient may have a narrow upper dental arch or crossbite for which expansion is clinically indicated.
When appropriate, expansion can develop the dental arch and create additional oral space.
But expansion should not be presented as a universal treatment for sleep-disordered breathing.
Whether expansion is appropriate depends on:
The orthodontic diagnosis comes first.
This question deserves a careful answer.
Orthodontic treatment can change dental and skeletal relationships, and certain treatments may affect oral space or function.
However, outcomes vary from patient to patient.
Orthodontic treatment should not be presented as a guaranteed way to prevent sleep-disordered breathing or as a universal cure for obstructive sleep apnea.
At DeLurgio Orthodontics, the question is therefore not:
“Which appliance treats sleep apnea?”
The more appropriate question is:
“What does this individual patient need, and where does orthodontics appropriately fit into their care?”
For children and adolescents, orthodontic evaluation has another important dimension: growth.
The jaws, dental arches and facial structures change throughout childhood and adolescence.
This allows an orthodontist to observe development over time and determine whether an orthodontic concern may require treatment now, later or simply monitoring.
Growth should not be presented as a guarantee that orthodontics will solve a breathing problem.
Rather, it provides an opportunity to identify and appropriately manage orthodontic concerns while the child is developing.
Adults can also have orthodontic findings that are relevant to questions about breathing and oral function.
An adult may have:
A comprehensive adult orthodontic evaluation can determine whether these conditions require treatment.
If an adult also reports loud snoring, witnessed pauses in breathing, gasping or significant daytime sleepiness, those symptoms deserve appropriate medical evaluation.
Sleep and breathing concerns can cross multiple areas of healthcare.
Orthodontist
Evaluates:
Pediatrician or Primary Care Physician
Evaluates:
ENT
Evaluates:
Sleep Specialist
Evaluates:
These professionals are not competing to determine who “owns” the airway.
They have different areas of expertise.
A multidisciplinary approach allows each professional to evaluate the part of the problem that falls within their expertise.
Parents may find it helpful to ask:
For adults:
Not Sure Where to Start?
An orthodontic consultation can help you understand your child’s dental and jaw development and whether the orthodontic findings warrant further attention.
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