Airway And Orthodontics

A trusted friend of mine has lectured on airway and sleep medicine for a long time. I first saw him speak at the AARD meeting around 2010 and later at a few other meetings around the country. When I was a resident, he called me and told me that he’d be teaching at the Pankey Institute (30 minutes away from my residency program) and that I could bring a few of my co-resdients to come with me to listen to him teach us about airway and sleep medicine and get some free pizza. I invited everyone I could find and it ended up being me, one ortho resident and a dental student. People globally were paying  to hear this guy speak and we were getting a free lecture and dinner and only three of us were in the room. Why?
A better question is: “When there are so many studies that show how the broader medical community can help kids with airway issues and change the trajectory of their cognitive development and quality of life, why do so few choose to take an active role or even consider involving an orthodontist?”
Shortly after the aforementioned evening lecture, I clearly saw the signs of sleep issues with my younger daughter. My wife took her to the two “best” pediatric ENTs near our home. She explained, quite clearly, the issues we saw in our daughter: Bags under her eyes, difficulty waking up, terrible breath even after brushing, snoring, sleep position and on and on. Both ENTs told my wife that my daughter would “outgrow her problems”. I explained to my wife that the studies didn’t support this and it wasn’t until we moved to another state and  a new ENT saw my daughter that it was taken more seriously. Adenoids removed, my daughter changed overnight. Why did it take 3 visits to three different reputable ENTs before someone chose to do anything?
Sure, lots of medical professionals around me tell me that they “do a lot” with airway. I’ve met with pediatricians, ENTs and pediatric dentists and they all “focus” on airway. So, when I ask to discuss their intake sleep questionnaire, they say they don’t use one. When I ask them to tell me about the airway and sleep team they work with, they don’t have one. When moms come into my office, and I ask about simple thing such as snoring, enuresis or night terrors, they wonder out loud why I am the first to ever ask these questions about their child. I don’t have an answer. Why are GP “sleep doctors” so popular when all they really can do is make mandibular advancing appliances?
Venerable institutions such as Stanford have been churning out studies on this subject for decades, so why do the overwhelming majority of physicians not understand the role they play in helping children (and adults) lead healthier, more fulfilling lives by intercepting airway issues?
It is crystal clear that orthodontists can play a huge role in helping children overcome their airway/sleep problems and I think should be honored to play a role in coordinating the process. I can obsess for hours on Facebook forums about how to straighten teeth, but when a mom comes in and tells me how her child’s life has changed since they started getting more/better sleep, it feels like my real professional calling.
The onus as gatekeepers for airway health has clearly started falling on orthodontists and I, for one, am thrilled to be a part of it. Let’s work together to build the best interdisciplinary teams in our communities and figure out the how to get the word out through CE and public awareness campaigns.
The folks who need us the most generally don’t even know there is a problem and they’re relying on us to be their advocates.
THIS is what truly differentiates us from GPs doing ortho or companies pushing plastic appliances without a dentist being involved.
Best wishes,
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