Most people think of orthodontics merely as straightening the teeth for a
nicer smile. Depending on how orthodontics is done, however, treatment may
lead to either a reduced airway or a larger airway.
Think of the teeth as a fence around the tongue. If that fence is narrow, is back
in the face, or is in some way made smaller (think removing teeth or pulling the
teeth back) the room for the tongue is smaller. If the tongue can’t fit within the
fence of teeth it may rest between the teeth (which may alter the bite and/or
facial growth) or get bunched up in the back of the mouth where the airway is
located, essentially making the airway smaller.
If the fence of teeth around the tongue is expanded the tongue has more room
in the mouth and doesn’t need to be back in the airway! Lateral expansion (i.e. wearing an expander) is quite common. Forward anteroposterior movement of the teeth also gives the tongue more room in the mouth.
Orthodontic treatments which tend to make less room for the tongue and may compromise the airway include extraction of teeth, “slenderizing” of teeth, closing spaces between teeth, or using anything to pull the teeth back in the face.
Orthodontic treatments which tend to make more room for the tongue and may open the airway include lateral expansion, forward movement of the teeth &/or jaws – anything that makes more room for the tongue to be in the mouth, not in the throat.
Not everyone who has orthodontics which makes less room for the tongue will have, or develop Airway-Centered Disorders. Unfortunately, no one knows who will or who won’t. Why take the chance?