Airway Focused Dentistry or Airway Dentistry is a new term for what we have been doing in Atlanta for 25 years. Airway (focused) dentistry simply means the dentist is looking beyond the teeth into the space behind, above, and below the mouth that is where our airway lives. It is remarkable to observe the growth and development from a young child with a tiny nose and chin into an adolescent and adult, as the face including the nose and mouth grow downward and forward when growth and function are coordinated.
Pediatric growth and development in dentistry takes this airway focus to heart: some specific areas of concern include tongue tie management, enlarged adenoids and tonsils and allergies as reasons for mouth-breathing, overall tone of the body and the role it plays on posture and how posture affects airway and vice versa, and general pediatric dental development. DEKA QuietNite Laser Snoring therapy can assist managing the enlarged tonsils. Functional growth appliances work very well in the middle childhood years to expand the palate, which then provides more space for the tongue to engage the roof of the mouth, which then creates a pressure gradient on the floor of the nose and thereby facilitates nasal respiration.
Just as much as we focus on the roles that oral activity plays on the posture, airway focused dentistry in our office means carefully examining the role the posture plays on the oral development. Conditions such as juvenile kyphosis and scoliosis have a direct impact negatively on the airway. Placing traditional bracket-and-wire orthodontics on children who are growing with either of these spinal disorders have been shown to lock these posture problems in even tighter. Severe scoliosis curves of 40 or greater are frequently considered for surgical intervention in the form of Harrington rods – these straighten but also FUSE the spine so that it looks better but functions far worse. Orthodontics with rigid wires can be compared to Harrington rods on the teeth – they may make the smile look better but at what price??? Because we can’t predict that price, we use lightwire ALF appliances and integrative physical postural therapy until the child is done growing and the curve of the spine has been managed to its best capacity before cosmetically straightening teeth.
In our adult population, we offer snoring and sleep apnea solutions for airway focused dentistry patients who are either not candidates for or intolerant to C-PAP therapy. In our adult population, we also evaluate the role that bruxism (tooth grinding) and TMJ dysfunction or jaw pain have on sleep issues. Because growth is mostly complete in adults, the functional appliances would not be appropriate; however, palatal expansion in the adults is possible through either Homeoblock therapy (which is tooth borne) or DOME Zero which is truly bone-borne expansion.
Some of the tests we use to determine what type of airway focused dentistry is appropriate:
Rhinomanometry – a device that allows us to measure the flow and resistance of air through each nostril as well as determine the resistance created by the soft palate and base of tongue
CBCT (3D Cone Beam X-ray) – this allows us to visualize adenoids which are hidden from clinical examination, as well as objectively measure the airway volume
Sleep survey – either with SleepImage or with HRPO (High Resolution Pulse Oximetry) to coordinate the autonomic nervous system response to airway issues
DEKA QuietNite (R) protocol – CO2 Laser Therapy stimulates collagen and tightens the muscles in the tongue, back of throat and can even shrink tonsils to enlarge the airway without anesthesia or surgery.
