Airway and Children: Long-term Benefits
August 1, 2023
Learn about the stunning study in which 80% of involved children changed their breathing pattern from mouth to nasal breathing, and 50% saw a decrease in instances of colds, respiratory infections, nasal allergies, and asthma. In this video Dr. Bockow discusses the treatment that achieved these incredible results: Rapid Maxillary Expansion.
Dr. Rebecca Bockow is a dual-trained board-certified orthodontist and periodontist – one of only a handful in the country. She lectures nationally on periodontics, orthodontics, interdisciplinary orthodontics, airway, and skeletal growth and development.
"And what about the airway? Well, the roof of the mouth is the floor of the nose. Once again thinking about the skull anatomy here. And then the teeth become the house for the tongue. So the three-dimensional airway is affected very much by the oral volume. And and so looking at some studies here. This was published in 2013.
"In children with nasal obstruction when rapid maxillary expansion was completed. It reduced nasal obstruction. They saw a raise in the tongue posture and an enlargement of the pharyngeal airway space.
"The pharyngeal airway space opened, because as the tongue comes up and forward, it gets out of the back of the throat. Another series of papers here. This was 310 children. They all underwent rapid maxillary expansion.
"In these cases over 80% of them change their breathing pattern from mouth breathing to nasal breathing. 50% saw a decrease in instances of colds, respiratory infections, nasal allergies. and asthma. Positive effects were seen with improved sleep, eating, speech, nasocentral reflexes, and pituitary growth hormone levels.
"They saw increased pharyngeal dimensions once again, because the tongue came out of the back of the throat. And they saw a new resting tongue posture as the more space was created for the tongue. Another paper published in 2004, 31 children with the mean age of eight and a half presented with an AHI of 12.2. So they all had documented sleep apnea that was measured by a sleep study. 12 and a half, 12.2 events an hour means that these kids on average were waking up 12 times an hour.
"That's very high for a child. The only intervention in this study was rapid maxillary expansion. These children didn't require tonsils and adenoids to be taken out, and what they found was that at four month follow-up rhinometry was normal, AHI for all the children was less than one event an hour, and they also saw a measurable widening of anatomic structures.
"So pretty incredible, pretty compelling changes. This same group followed these patients for 12 years. They had yearly examinations from orthodontists, otolaryngologists, and sleep questionnaires, and the scores were consistently normal over time. The sleep study findings remained normal at 12-year follow-up, and they saw measurable skeletal with gain that remained stable at 12 years. So pretty incredible.”
Dr. Bockow loves to create beautiful smiles for her patients, setting them up for a lifetime of dental and airway health.
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