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The most common complaint is snoring and usually comes from the patient’s partner. Some patterns are fairly obvious, including leaving the mouth open, obesity, and irregula teeth. The upper jaw (maxilla) in nearly all patients is placed back, forcing the lower jaw (mandible) to swing back. This is worsened by sleeping on the back with the mouth open, a position which is almost bound to ensure that the tongue blocks the airway.

Children often display the early signs of future problems with Sleep Apnoea. Orthotropic treatment can usually prevent this by treating children while they are young.

Many other methods use ingenious ways of bringing the tongue forward, usually with appliances and currently quite a large industry has been built upon this concept. However this is only treating the symptoms of sleep apnoea and is unlikely to provide a long-term cure. Indeed the longer-term research has found that after wearing these appliances for a while the patient is often worse off than before (Robertson et al 2003).

The problem is that these appliances create a dependency and during the many years they are worn, they progressively retract the maxilla worsening the very problem they are intended to cure. What is unacceptable is that many clinicians are aware of this likelihood but continue to recommend them. Of even more importance is the need to prevent future problems for young children. Recently (Huynh et al 2011) found that apnoea was linked to “a long and narrow face, allergies, frequent colds and of course habitual mouth breathing”. It all seems so obvious and yet prevention in childhood seems so low in orthodontist’s priorities.

Early correction of apnoea with Orthotropics is so easy with some semi-rapid expansion to open the nasal airway. All that is needed is a committed patient who is prepared to make the effort to keep their mouth closed with their tongue on the palate. It also helps if they can lose weight, and sleep on their side. A tennis ball sewn into the back of their night wear can help with this but an appliance may be needed if they have long-term open mouth postures. The long-term reward is that their face will start to grow (remodel) forward creating a healthy child with a good looking face.

IT Team

So, what do you think ?