Unveiling and managing upper airway problems in the orthodontic patient

Abstract

Obstructive sleep apnea (OSA) occurs when there is limitation of upper respiratory airflow due to partial or complete upper airway obstructions despite persistent respiratory effort. The signs and symptoms of what we now know as the sleep-disordered breathing (SDB) spectrum were recognized centuries ago. Snoring and OSA are events in a wide-ranging SDB spectrum with variable severity and overlapping signs and symptoms that can occur in both adults and children. Clinical assessment with a thorough history and examination is an important tool for evaluating adults with suspected SDB to identify those who need further evaluation and polysomnography. Symptoms associated with SDB can be classified into nocturnal and daytime symptoms. Lateral cephalometry is routinely used in treatment planning of orthodontic patients presenting for treatment of malocclusions. Orthodontic treatment planning takes into consideration breathing, tongue and soft palate, tonsils, and locations of potential choke points in the pharyngeal airway.