Airway Obstruction and Obstructive Sleep Apnea

By Maribel Vann, DDS

Obstructive sleep apnea happens when the muscles of the throat along with the tongue relax and block air from flowing to the lungs. This causes a decrease in oxygen levels in the brain and is associated with

High Blood Pressure

Cardiovascular Problems

Strokes

Daytime Sleepiness

Automobile Accidents

Snoring

The main cause of sleep apnea is under development of the maxilla (upper jaw), which results in a very narrow airway passage and mouth breathing. Eighty five percent of the nasal airway is made up of the maxilla, which provides the floor of the nose and houses all of the nasal sinuses. The photograph of a side view skull x-ray (photograph A) shows a patient with a very narrow airway because the upper jaw is very narrow and is also detruded (pushed back). The airway is only 3 millimeters wide, and this patient is also a mouth breather. Normal airway should be between 12 to 15 millimeters wide.

Individuals with a narrow maxilla will have very narrow nasal passages, which limit the flow of oxygen and breathing capabilities. These individuals are also mouth breathers, which leads to an under developed upper jaw, leading to a narrow airway passage.

Soft tissues in the nose develop to their full size even if the bones do not. Lack of proper dimensions to the airway passages causes overcrowding, overlapping or deviation of the soft tissue areas. This can be illustrated by the example over packing a suitcase. An example of this “over packed suitcase” is a deviated septum. The septum is made up of cartilaginous tissue that separates the two nostrils vertically (nasal septum). The soft tissue develops to its normal size, but the upper jaw does not develop into its proper size. The septum has to manifest its dimension somewhere. It has two choices it either bends or becomes crooked to one side or the other (deviated septum). The result of this is the blockage of proper airflow to the nose causing the individual to breathe through the mouth most of the time.

The nasal septum is part of the upper jaw. It is usually treated as a separate entity through surgery that is why this procedure is not always successful. If the upper jaw is widened and advanced forward, the deviated septum will be corrected along with the widening and opening of the airway passages to its proper size. This is accomplished without surgery by using the Advance Lightwire Functional Appliance (ALF). See photograph B.