Expanders and Breathing in the Adult. Do Sleep Apnea patients need an orthodontist?
Our mission is to provide exceptional orthodontic care that promotes overall health, wellness and beautiful smiles. We focus on holistic approaches to orthodontic treatment, with a special emphasis on airway health and proper jaw and bone development. Our goal is to empower our patients to achieve optimal oral and systemic health through personalized, compassionate and cutting-edge orthodontic care.
The controversy regarding bone growth concerns the appropriate timing and methods for promoting proper jaw and facial development in orthodontic patients. Some orthodontists believe in using early intervention to guide the growth of the jaw and face, while others believe in a more conservative approach and only treating once facial growth has stabilized. Proponents of early intervention argue that it can improve airway function and prevent certain dental and skeletal problems, while opponents argue that the potential risks and unknown long-term effects outweigh the benefits. This controversy is still ongoing in the orthodontic community, and there is a lack of consensus on the best course of treatment.
As a consumer of orthodontic treatment, you need to know the facts. The potential negative outcome of gum recession and periodontal problems are often associated with late orthodontic treatment in adults when the bones are less malleable. Late treatment may benefit from more aggressive interventions, such as extractions or surgery, which can avoid the risk of gum recession and periodontal problems from overexpansion. It is important for orthodontists to consider the timing of treatment and to carefully evaluate each patient's individual needs and goals in order to minimize the risk of these and other negative outcomes.
It is well established in the orthodontic literature that expansion of the jaw in adult patients can have negative effects on the periodontal ligament and supporting structures of the teeth. The periodontal ligament is a delicate and complex structure that helps to anchor the teeth in the jawbone, and it is not capable of adapting to rapid or excessive expansion in adult patients.
Without surgery, or in some cases an Maxillary Skeletal Expander (MSE) expanding the jaws in adults can result in a number of adverse effects, including root resorption, gum recession, and damage to the periodontal ligament. These changes can weaken the tooth-supporting structures and increase the risk of periodontal disease, which can ultimately lead to tooth loss. Furthermore, adult patients are more likely to have existing periodontal problems, which can be exacerbated by jaw expansion. In some cases, individuals between the ages of 14-30 may be candidates for mini-screw supported expanders. One great resource of information comes from Dr. Won Moon, who has been a pioneer in mini-screw supported expanders. MSEs or mini-screw supported palatal expanders are amazing appliances that help even adults achieve true skeletal expansion. How does it work?
The maxillae is composed of 3 pieces, the premaxillary segment, the right and left maxilla. Between the left and right maxilla, is a serptentous suture called inter maxillary suture. In the mouth, the mid-palatal raphia indicates the area known as a growth site. Repeated radiographic studies have shown this suture fuses in early adolescence around 13-14 years old. These new appliances that utilize mini-screws are more powerful, and can help many older individuals (18-30) achieve the benefits of maxillary expansion.
Given these risks, it is important for orthodontists to exercise caution when considering expansion therapy in adult patients, and to carefully weigh the potential benefits against the potential negative consequences. In many cases, alternative treatments may be more appropriate for adult patients with specific jaw and dental concerns.