Collaborating for the benefit of our patients is a common goal. The more we can share knowledge, treatment and goals, the better service we can provide for our patients. Let's work together.
The hygienist is a "first responder" for the airway. The hygieniest has the opportunity to spend more time with a patient in a one on one setting. They get to know their patients and build relationships over time. The hygienist has the chance to identify and educate individuals that show signs of airway dysfunction. They may be the most important link between the patient and the decision by that patient to trust in the process of airway improvement. Additionally, hygienists can be trained in myofunctional therapy and treat patients in this regard. They are able to do this in a dental practice setting or in an independent setting.
Every aspect of dental treatment is related to the airway whether we realize it or not. Periodontal disease, caries, tooth crowding, high palatal arches, constricted arches, tongue ties, malocclusions, the TMJ's, and teeth with wear or erosion can all be signs of, or contributors to an airway issue. Understanding why they are linked to a constricted or collapsing airway is vital for the health of the patient as well as the longevity of the restorative work. Dentists do not have to practice "sleep dentistry" but rather should be aware of the signs and symptoms of airway dysfunction and be able to direct patients to a provider that can help them.
An orthodontist is a powerful player in the prevention of airway conditions. Orthodontists can intervene early in directing growth of the craniofacial complex thus preventing future conditions such as sleep apnea along with other co-morbidities. Additionally, an orthodontist that understands the causes of a tongue thrust swallow pattern can have this addressed through myofunctional therapy and a tongue tie release, if necessary. This can prevent relapse of orthodontic treatment while potentially improving other systemic issues that can accompany a reverse swallow. The orthodontist will prove to be a major player in the prevention of airway dysfuntion AND correction of anatomy that contributes to airway dysfunction.
Periodontal disease can not be improved for a patient that is habitually mouth breathing. The condition of the oral microbiome is never healthy if it is unable to utilize the protective properties of saliva. The periodontist can also be instrumental in the corrective treatment when patients present with constricted arches. The periodontist can work with the orthodontist to assist in dental arch rehabilitation through the various procedures and therapies they already provide.
The oral surgeon bridges the gap between dentistry and medicine and is imperative to treatment in skeletal discrepancies. The oral surgeon can also be involved in treatment regarding the temporomandibular joint. Additionally, understanding that there could be a link between joint degeneration and airway dysfunction can be useful when working with patients with TMD and craniofacial pain.
One of the most important players in prevention of airway disorders (along with the Pediatrician), is the Pediatric Dentist. If the Pediatric Dentist can recognize when a child is heading down the airway dysfunction path at an early age (based on their soft tissues, dental arches, and facial growth), they can address the habits or anatomical limitations and intervene. Catching these patients early in the process is vital and can save the child from a lifetime of sytemic issues. Pedodontists and pediatricians are the child's first line of defense against future chronic and systemic problems stemming from a poor airway. Often, the pediatrician or pediatric dentist are the first to be able to detect an airway constriction and intervene in order to allow the child better sleep breathing and improved neurocognitive growth and health.
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