KIDS APNEA.COM   The website of Allen J.Moses, DDS


It was explained in the section TRADITIONAL ORTHODONTICS  that many orthodontists assume that they only address facial esthetics.  They wait until growth is complete or nearly complete to initiate treatment.  In contrast, early orthodontics utilizes growth in its favor.  By age four 60% of facial growth is done.   By age six 80% of facial growth is complete.  By age 11 or when the second molars have erupted, 90% of facial growth is completed.  Orthodontic treatment between the ages of 6 and 11 often results in a catch-up of growth to normal by the age of 12.  Treatment over the age of 12 virtually assures that there will be relapse.

Apneic kids cannot wait 8 years or more to breathe properly.  Early orthodontics addresses breathing, swallowing and posture problems as well as making more beautiful faces and smiles.  Kids are happier, smarter and better behaved when they sleep well.  Early orthodontics takes advantage of growth to make the job easier and reaps the physiological and psychological gains at as early an age as possible.

Facilitation of a patent nasal airway by adeno-tonsillectomy does not erase the old dysfunctional reflex patterns of swallowing and breathing.  Expanding the dental arches to achieve the ideal functional climate for breathing, swallowing and sleep is the clinical goal.  Expansion of the palate creates more space in the mouth for the tongue and facilitates positioning of the tongue anteriorly and laterally in the roof of the mouth.  Orthodontic expansion of the maxilla facilitates nasal breathing because the roof of the mouth is also the floor of the nose.  Palatal expansion widens the nasal passage and decreases resistance to oral-nasal airflow.  Reducing nasal resistance reduces turbulence of airflow and decreases collapsibility of the flexible oropharynx.   Kids whose airways no longer collapse at night also enjoy improved breathing during the day.

There is virtually universal agreement that the teeth and alveoli lie in a position of balance between the cheeks, lips, and tongue.  Harvold has shown that interventions that disrupt the ideal situation of nasal breathing, lips sealed, tongue in the roof of the mouth, head balanced on the spinal column cause malocclusions as well as adaptive functional and structural changes.

The science of functional orthodontics is about understanding ideal physiological function and its attendant structure, analyzing the dysfunction that caused the malocclusion and addressing treatment at correcting both structure and function as close to ideal as possible.  Early orthodontics is about doing it sooner rather than later to improve the quality of life and hopefully prevent neurobehavioral and learning disorders.


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