(NOTE: This is the third of three articles on dentists, myofunctional therapy, and sleep apnea. Click HERE for Part 2)

Functional Appliances
Functional appliances attach to the teeth and force the patient to function (chew) with their lower jaw in a modified position. Although functional appliances may effectively correct "overbites," current research does not support their use in treating OSA or snoring.

Myofunctional Orthodontics
Myofunctional orthodontics relies on devices that use the muscles of the face to modify skeletal and dental relationships. The group's consensus was that current evidence does not support using this technique to treat OSA or snoring.

Arch Expansion
Arch expansion is an effective procedure for correcting arch constriction. As the name implies, expansion (whether by expander, braces, or clear aligners) increases the width of dental arches. Despite the popularity of this procedure to "prevent and treat OSA" in both adult and pediatric patients, the current literature does not support its use for treating OSA or snoring.

Myofunctional Therapy
Myofunctional therapy focuses on improving speech and swallowing to enhance orofacial growth. Myofunctional therapists (usually neither dentists nor physicians) prescribe exercises designed to strengthen and change the function of the tongue and lips. It was the consensus of the group that the use of myofunctional therapy to address OSA and snoring is not supported by current research.

Lingual and Buccal Tongue Release Surgeries
While the tongue's mobility is essential for proper breastfeeding, the frequency of diagnosis and treatment of "tongue ties" has increased by over 800% in the past 20 years. This increase corresponds directly with the increased affordability and availability of soft tissue lasers to dentists. (Another series of articles on this blog, found HERE, discusses these procedures at length.) The consensus of the experts was that the use of tongue and lip-release surgeries for the prevention and treatment of OSA and snoring is not supported by the current literature.

Ablative and Non-Ablative Laser Therapy
Ablative and non-ablative laser procedures provided to prevent, manage, or cure OSA and snoring focus on using a laser to affect the soft tissues (tongue, sides of the throat, and soft palate) at the back of the mouth. Ablative therapy involves removing tissue believed to be causing problems. Non-ablative therapy attempts to create scarring inside tissues, making them more rigid and less susceptible to collapse. The consensus of this paper is that the use of lasers in the back of the mouth to treat OSA and snoring is not supported by the current research.

Orthodontic Extractions
Although removing teeth has been the topic of numerous other studies, this paper examined the most current research to determine if any cause-and-effect relationship exists between extractions and OSA or snoring. It was the consensus of this group that there is no evidence in the literature suggesting that removing teeth causes OSA or snoring.

There is no evidence these novel therapies are effective for treating OSA
In summary, it is the consensus of this group of experts that there is currently insufficient evidence to support the use of any of these novel or emerging therapies as substitutes for intraoral appliances, CPAP, or MMA surgeries for the management and cure of obstructive sleep apnea or snoring. While your dentist may be well-meaning when they suggest one or more of them for you or your child, the current science does not support their effectiveness. Patients suffering from breathing difficulties should consult medical professionals trained in that field and not their dentist.

Three recent consensus papers fail to support the current airway dentistry fad
This is the third consensus paper in the past five years looking at the relationship between dentistry and airway issues. The American Association of Orthodontists first found that orthodontic procedures do not prevent, cause, or cure breathing issues. The second, published by the national organization for otolaryngologists (ENTs), found that the performance of tongue-release surgeries for the prevention or management of OSA is unsupported in the scientific literature. This third consensus paper, published by dental sleep specialists, found that none of the current novel treatments for OSA and snoring they examined were supported by available research. Are you seeing a pattern here?

NOTE: The author, Dr. Greg Jorgensen, is a board-certified orthodontist in the private practice of orthodontics in Rio Rancho and Albuquerque, New Mexico. He was trained at BYU, Washington University in St. Louis, and the University of Iowa. Dr. Jorgensen's 30+ years of specialty practice and 10,000+ finished cases qualify him as an expert in two-phase treatment, extraction and non-extraction therapy, functional orthodontics, clear aligners (Invisalign), and multiple bracket systems (including conventional braces, Damon and other self-ligating brackets, Suresmile, and lingual braces). This blog is for informational purposes only and is designed to help consumers understand currently accepted orthodontic concepts. It is not a venue for debating alternative treatment theories. Dr. Jorgensen is licensed to diagnose and treat patients only in New Mexico. He cannot diagnose cases described in comments nor select treatment plans for readers. Copyright laws protect the opinions expressed here and can only be used with the author's permission.