Airway Orthodontics, the New Approach
This chapter aims to discuss the therapeutic or behavioral interventions that lead to a preventive approach to sleep-disordered breathing.
- PDF / 463,862 Bytes
- 10 Pages / 439.37 x 666.142 pts Page_size
- 87 Downloads / 161 Views
Airway Orthodontics, the New Approach Barry D. Raphael
This purpose of this chapter is to discuss the therapeutic or behavioral interventions that can be a part of a preventive approach to sleep-disordered breathing.
6.1
Introduction
No one would deny that many of the factors that lead up to a coronary blockage can be addressed by either therapeutic or behavioral interventions and that, certainly, prevention is a far better choice. But there has been an absence of such discussion regarding occlusion of the airway. The purpose of this chapter is to stimulate such a discussion and to paint a picture of what a preventive approach to sleep-disordered breathing would look like.
6.2
he Etiology and Predisposition to Breathing Disorders T During Sleep
It was once thought that obstructive sleep apnea was a disease of old, fat men. We have since learned that thin, athletic women can also fall victim to this problem as well as children. We have learned that while weight and age add to the susceptibility to obstructive sleep disorders, they are not the root causes. Difficulty breathing at night comes from resistance to airflow, and there are many circumstances that can make breathing difficult. Efforts at pinpointing the source of resistance are important to determining proper remediation.
B. D. Raphael (*) Raphael Center for Integrative Orthodontics, Clifton, NJ, USA e-mail: [email protected] © Springer Nature Switzerland AG 2019 E. Liem (ed.), Sleep Disorders in Pediatric Dentistry, https://doi.org/10.1007/978-3-030-13269-9_6
97
98
B. D. Raphael
Fig. 6.1 The causes of airway turbulence The Urgency of the next breath
The Stability of the Airway
The Size and Shape of the Airway
We have learned from flow physics and airway physiology that there are three main determinants of airway resistance: 1 . The size and shape of the airway (Anatomy) 2. The stability of the airway (Physiology) 3. The velocity and turbulence of the airflow (Behavior) Delving into the physics of each is not the point of the chapter. Instead, the way that each of these factors can be addressed well before the first apnea ever occurs with either therapeutic or behavioral interventions will be the goal. By defining opportunities to mitigate predisposing risk factors to airway resistance, we can begin to build a new paradigm in airway and sleep management. As such, the focus will be on prevention so that, just as we might prevent the heart attack, the end-stage disease of obstructive sleep apnea might never occur. From this discussion, a new field of Airway Dentistry and Orthodontics will emerge that can define a possible future for the way orthodontics is practiced (Fig. 6.1).
6.3
Anatomy: The Size and Shape of the Airway
Yes, losing weight and reducing fat deposits in the neck or removing tonsils are widely regarded as important, but we also know that craniofacial morphology is a primary risk factor for breathing problems as well [1–4]. Orthodontics has long been concerned with the growth and development of the face with regard
Data Loading...
