Palatal expanders, commonly used in orthodontic treatment, serve a dual purpose in improving dental alignment and enhancing airway function. Patients with airway problems often present with dental crowding, narrow maxilla, and facial changes associated with chronic mouth breathing. Sleep quality can be compromised, resulting in chronic fatigue and associated issues of obstructive sleep apnoea, both in children and adults.
Airway obstruction or restriction can result from various factors, including narrow bony upper jaws (maxillary constriction), excessive secretions from allergic rhinitis, enlarged tonsils, adenoids, deviated nasal septum, or anatomical abnormalities. Restricted airway passages can lead to symptoms such as snoring, sleep apnea, chronic mouth breathing, and impaired oxygenation.
When the upper airway is blocked due to restriction, the patient often has to tip the head up and backward to breathe better through the mouth. Over time, chronic airway obstruction can significantly impact facial morphology, leading to distinct facial changes, particularly during childhood and adolescence. These changes may manifest as a retruded or small chin, a narrow and elongated face, an open-mouth posture, and dark circles under the eyes. Additionally, individuals with chronic airway obstruction may exhibit dental malocclusions, such as an overbite, cross bites, anterior open bite, and crowded teeth, as the facial muscles adapt to accommodate compromised breathing patterns. Addressing the underlying airway obstruction early on is essential to mitigate these facial changes and promote optimal craniofacial development.
Palatal expanders are orthodontic appliances designed to gradually widen the upper jaw (maxilla). Expanding the maxilla positively affects airway function by increasing nasal airway volume and improving breathing patterns. Furthermore, by creating additional space in the dental arch, palatal expanders address maxillary constriction and facilitate proper teeth alignment.
Palatal expansion widens the nasal cavity, enhancing airflow through the nasal passages and reducing reliance on mouth breathing. This promotes optimal oxygenation and ventilation during sleep and wakefulness.
Proper maxilla expansion during childhood or adolescence supports healthy facial growth and development, preventing the development of craniofacial abnormalities associated with airway obstruction.
Palatal expanders exert orthopedic forces on the maxilla, stimulating bone remodeling and promoting forward growth of the midface. This can contribute to long-term improvements in airway dimensions and function. This can be further enhanced with midface or maxillary protraction with a facemask.
Palatal expansion is most effective in children and adolescents whose maxillary sutures have not yet fused. However, depending on individual factors, adult patients may still benefit from certain expansion techniques.
A thorough assessment of airway function, dental occlusion, and facial morphology is essential to determine the appropriateness of palatal expansion for addressing airway issues.
Collaboration between orthodontists, sleep specialists, otolaryngologists, and other healthcare providers may be necessary to manage airway-related concerns comprehensively. Patients seeking orthodontic treatment for airway-related concerns should consult our Orthodontic Team, which consists of Orthodontists, and our Sleep Medicine Dentist, Dr Elaine Ng. Make an appointment with us to find out more.
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