Family OSA

[nanwilson]

Never had braces or teeth pulled to make room.........so cross that one off my list. No siblings or parents with osa either, although my dad passed at age 53 from massive heart attack...so did his dad and one of his brothers. I don't have a small mouth either....you all know I have a big mouth (can't keep it shut) Don't know why I ended up with osa, but very happy its being treated .

[chunkyfrog]

My brother has a P/R 'brick", never had orthodontics.
I had the full ortho treatment--turned me from a tease target to reasonably cute.
The DDS did the extractions (all four 12-year molars) My ortho said he could have made them all fit.
Wouldn't I have had a nice jaw then?--and no garbanzo-sized torus to interfere with mask fit.
I bet I would have still had OSA, though--my blockage is farther back.

[Maxie]

I have 4 teeth removed as a child by my orthodontist but who knows if that made any difference. What I do know if that my pulmonologist said I have a narrow throat and he cannot see down it without a tongue depressor. I'm thinking that the narrow throat may be the hereditary part as I believe that my parents had undiagnosed OSA.

[jjlady]

When I told my dad I have sleep apnea, he said he has been on a cpap machine for about 10 years. I never knew!

[ChicagoGranny]

Perhaps it is considered hereditary and I just don't know. Lol

I can't find it this morning, but someone posted the answer I remember here one time:

Does OSA run in families?
Yes, the human family.

OSA is so prevalent in modern man that a better question would be the reverse, "Does the tendency to have fully functional airways run in families?" Answer: Only in families who have excellent craniofacial structure, receive excellent prenatal nutrition, breastfeed until the age of two and otherwise receive excellent nutrition during the pre-adult years.

Dr. Steven Park and Dr. Colin Sullivan have written about craniofacial problems affecting modern man. The brain has become larger taking up more space in the skull and breastfeeding and nutrition habits have changed negatively affecting jaw and airway size.

I would be skeptical of anyone who says they do not have sleep apnea in their family unless they have strong chins and cheeklines and perfectly straight teeth. Otherwise they may have had many in their family who died from sleep apnea and had listed on their death certificates heart attack, stroke or complications from type 2 diabetes. Remember, most cases of sleep apnea prior to 1990 were not diagnosed.

[ChicagoGranny]

Sylvie, I like your posts!

[sylvie]

Sylvie, I like your posts!

I very much appreciate that. What is so tragic is that the dental community is still allowed to perform these barbaric practices on people, deforming faces and crushing airways, whether you think that or not. Just google "sleep apnea," "braces," "extraction," "bicuspids" and see the plethora of forum posts, dental practices, and YouTube videos there are out there on this subject. Even "professional" sleep apnea forums chose to ignore the studies, papers, and articles on extraction orthodontics, which go back years. I have even been told that an article I posted is not relevant due to the fact that it is 14 years old. In this case it is relevant. This abominable practice is allowed to go on. I have been told by three dentists recently who I've seen for various oral appliances that I have the profile, the face deformation, the mouth problems, and the sleep apnea problems that are inherent with extraction orthodontics. One even went so far as to take a polaroid picture of my profile while in the office and show me the effects of extractions and braces. I actually knew everything he pointed out because I have been researching this problem so ardently. And whether you (other posters) want to argue these points or not, I do appreciate you continuing to post on this thread--the more replies, the greater the interest. Maybe I can save some lives.

[Sleep2Die4]

The typical citizen and probably even the typical CPAP user is just not aware that a small airway that is prone to collapse is the cause of OSA.

That we are so poorly cognizant of this both surprises and discourages me.

I am glad this issue is being discussed. Keep it in the forefront. You have no idea how many people use a search engine and stumble in here.

[sylvie]

The typical citizen and probably even the typical CPAP user is just not aware that a small airway that is prone to collapse is the cause of OSA.

That we are so poorly cognizant of this both surprises and discourages me.

I am glad this issue is being discussed. Keep it in the forefront. You have no idea how many people use a search engine and stumble in here.

Exactly. You read my mind.

[sylvie]

How Early Orthodontic Treatment Can Prevent Temporomandibular Dysfunction, Snoring, and Sleep Apnea: Two Different Treatment Philosophies

http://www.bioresearchinc.com/images/rondeau.pdf
http://www.c-luet.com/early-orthodontic ... sfunction/

Brock Rondeau, DDS
Published July 21, 2012

Excerpts:

Retractive Technique

The retractive technique is used by the majority of orthodontic practitioners worldwide. With this method, patients are treated between 12 and 14 years of age, after all the permanent teeth have erupted. The technique uses fixed orthodontic braces and, sometimes, cervical facebow headgear. For patients who present with large overjets, the upper incisors are retracted after either bicuspid extractions or distalization of the molars with headgear. The removal of two upper bicuspids results in a more constricted maxillary arch and a narrow smile. When the upper bicuspids are extracted and the upper incisors retracted into the extraction sites, this often results in a flattening of the upper lip and the nose appears to be longer. The extraction of the upper bicuspids often results in a more deficient maxilla to go with the preexisting deficient mandible, and therefore, there is no noticeable improvement in the patient’s profile. Many Class II skeletal patients develop temporomandibular (TM) disorders caused by underdeveloped mandibles, which in turn cause the condyles to be displaced posteriorly. When the maxillary incisors are retracted, the mandible can become trapped, which can create the TM joints problems, snoring, and sleep apnea later in life.

----------------------------------------------------------------------

When bicuspids are extracted in class II division 1 skeletal patients and the maxillary teeth are subsequently retracted, the patient may be predisposed to snoring and sleep apnea later in life. Before treatment, the mandible and tongue are in a retruded position. When the maxillary teeth are retracted, the tongue and the mandible are prevented from obtaining their normal forward position.

[sylvie]

An Embarrassing Admission

January 25, 2011

http://doctorstevenpark.com/an-embarrassing-admission

I was flipping through the channels this past weekend and just happened to land on PBS, where they were doing a special on the Lawrence Welk Show. I have to admit that I used to watch this show in the 70s, and still to this day, if I ever stumble upon this show, I’ll watch it for the great big band music and singing.
I initially began watching to listen to the music, but as I observed the singers, I was truly impressed by their wide jaws and fully developed cheek bones. If you look at younger adults these days, you’ll see how narrow their facial structures are, with many having underdeveloped lower jaws. It’s a frightening thought that this situation is now pandemic throughout the modern Western world. What this means is that having smaller jaws can lead to smaller breathing passageways, leading to less efficient sleep, with all the various medical, psychological, and emotional consequences of not ever being able to obtain deep, quality sleep.
How many of you observe people’s faces and analyze their jaw structures?

[sylvie]

My orthodontist is recommending to pull four of my teeth (Premolar teeth) can this solve the problem?
http://www.stopsnoring.com/jawstart.htm

Unfortunately no and it can create a major problem later in your life. If your orthodontist has recommended extracting few of your teeth to create room because your teeth are crowded you may want to have a second opinion. In a study of 6,200 patients with sleep apnea we have found that many of the individuals who had taken their teeth out for orthodontic reasons when they were younger have developed obstructive sleep apnea when got older. When a dentist pulls your teeth and pushes your front teeth backward it can make the internal size of your mouth where your tongue is located too small. If you already also have a receded chin and jaw when you sleep the tongue falls in the back of your throat and blocks the airway. We also noted that patient’s nose gets longer too because when the teeth are pushed back the upper jaw does not move as much hence causing a longer nasal tip and a protruded upper jaw. Unfortunately most orthodontists are not trained in sleep apnea and this point is completely ignored. Hundreds of patients are being told every year to have their orthodontics repeated to move the teeth in the opposite direction (Upper teeth forward) and consider jaw surgery to correct the position of the jaws as well.

[zoocrewphoto]

I had teeth pulled and braces, but I do not believe it is the cause of my osa. Why? Because I have always had a small mouth AND small airway. I have asthma due to a small airway.I have always struggled to take pills. As a child, I had a strong gag reflex because it was easy for stuff to hit the back of my throat. I had the extractions when I was 16. If I had not, I would still have a small mouth with crowded teeth. And a small airway with allergies that make it smaller when congested.

My mom has severe osa (no teeth extractions, and at age 72, they are still very crowded). My brother has osa, no extractions or braces. My sister snores, but nt scary yet, so not sure if she will develop it (no extraction). All of my grandparents have snored. I know my dad's mom had severe osa and multiple mini strokes. I don't know if they diagnosed sleep apnea back then. My dad's dad died 5 years before I was born, in his 40s, from a heart attack. My dad snores, but I have never heard the breathing problems that the rest of us had. One time, I thought there was a car in the driveway, running, and it turned out to be him snoring.

[catbirdgirl]

my mom has had a CPAP since the 80s I think. She was one of the few women diagnosed at the time. I have it. My dad had it but couldn't tolerate the mask.

[sylvie]

Changes in upper airway width associated with Class II treatments (headgear vs activator) and different growth patterns.
Godt A, Koos B, Hagen H, Göz G.
Angle Orthod. 2011 May;81(3):440-6. Epub 2011 Jan 24.
PMID: 21261483 [PubMed - indexed for MEDLINE]

Source
Department of Orthodontics, Eberhard-Karls-Universität, Tübingen, Germany. arnim.godt@med.uni-tuebingen.de

Abstract

OBJECTIVE:
To investigate the upper airways for anteroposterior width against different growth patterns and for alterations during various Class II treatments.

MATERIALS AND METHODS:
Cephalograms from three treatment groups (headgear, activator, and bite-jumping appliance) were evaluated by a single investigator at baseline and at the end of orthodontic treatment. Cephalograms were used to determine upper airway width at different levels in the anteroposterior plane. Patients in the headgear group were additionally divided into six subsets on the basis of y-axis values to assess the influence of different growth patterns.

RESULTS:
Small increases in pharyngeal width were noted at all vertical level segments, both at baseline and during orthodontic treatments. No significant differences in these small increases were noted across various treatment modalities and growth patterns.

CONCLUSION:
Upper airway changes did not significantly vary with the different treatment modalities investigated in the present study. Nevertheless, reductions in pharyngeal width potentially triggering or exacerbating obstructive sleep apnea syndrome (OSAS) are always possible in the headgear phase.