I wrote Clearing the Air because the shape of a jaw and the way a person breathes at night are closely connected, and orthodontists are often the first to see it. A narrow upper jaw, a recessed lower jaw, or a blocked nose can show up in a child’s smile long before anyone thinks to ask about sleep. The book is my attempt to share what I’ve learned with families across Metro Detroit.
Maybe you wake up tired and wonder why. Maybe your teenager grinds their teeth, or you’ve noticed a narrow smile that seems to go along with mouth breathing. This post explains what the book covers and how it connects to the care I offer at our four offices.
What Is Clearing the Air About?
The book is a guide to airway, snoring, and sleep apnea. Sleep apnea means breathing repeatedly pauses or becomes shallow during sleep. It walks through how to spot the signs, what causes them, how sleep testing works, and what options exist for kids, teens, and adults.
I wrote it for general education. It doesn’t diagnose anyone, and it doesn’t replace an evaluation. My goal is simple: do what is necessary, and nothing more.
Why Would an Orthodontist Care About Sleep?
Teeth and jaws share space with the airway. When the upper jaw is narrow, the nose and mouth are affected too. When the lower jaw sits too far back, the airway can be tighter.
Orthodontists also see children regularly as they grow. That gives me a chance to notice patterns early, such as mouth breathing, crowded teeth, or a crossbite (when the upper and lower teeth don’t line up side to side). Noticing is not diagnosing. It means I know when to suggest a closer look and when to bring in a pediatrician or an ear, nose, and throat doctor (ENT).
What Does the Book Say About Tonsils, Adenoids, and Jaws?
Children’s tonsils and adenoids (tissue at the back of the nose and throat) are larger than adults’. When they’re enlarged, they can block part of the airway. A narrow upper jaw can add to the problem, and a child can have more than one cause at once.
That’s why the right team may include an ENT, a pediatrician, and an orthodontist. In a large clinical trial of children ages 5 to 9 with sleep apnea, sleep studies returned to normal in 79 percent of children after tonsil and adenoid removal, compared with 46 percent with watchful waiting. I also share how expanding the upper jaw can be a reasonable first step for some children ages 7 to 10, depending on the case.
How Does the Book Approach Sleep Testing for Kids?
Sleep testing looks different for children than for adults. If your child needs a sleep study, a sleep lab is the recommended setting, since home sleep tests aren’t recommended for kids.
You can ask any of our four offices for the Pediatric Sleep Questionnaire, or take it online. It’s a short checklist that helps decide whether an evaluation makes sense. Our patient cards also list signs worth a closer look. For a full walkthrough of those signs, see our earlier post, Introducing Clearing the Air.
What About Teens and Adults?
The book isn’t only for parents. Adults can have sleep concerns too, and the options vary by cause and severity. They include nose treatment, a CPAP machine (air pressure that keeps the airway open), a custom oral appliance, weight management, and in some cases jaw expansion or surgery.
For teens and adults with a narrow upper jaw, MARPE may be one tool. It anchors an expander to bone with small screws. It isn’t right for everyone, and sometimes braces alone are the better fit. A 3D scan helps tell the difference.
We also offer WatchPAT, a one-night home sleep test for adults, at all four offices. Dr. Anil Rama, a Stanford sleep physician, interprets the results, and our team reviews them with you. It’s not identical to an in-lab study, and children need an in-lab study instead.
How Does This Connect to Braces and Clear Aligners?
My approach to braces and clear aligners looks at both how your smile looks and how your bite works. When it’s clinically appropriate, I also consider airway as part of treatment planning, including with Damon braces.
Technology helps. iTero digital scanning and 3D imaging give our doctors a detailed picture of your teeth and jaws at every office. Treatment recommendations always depend on the individual patient.
Where Can You Find Reynolds Orthodontics?
Reynolds Orthodontics has offices in Novi, Troy, Rochester Hills, and West Bloomfield. Dr. Jennifer Bonamici, Dr. Jensen Pecora, and I see patients across all four. Dr. Larry Spillane, our retired founder emeritus, helped build the practice’s reputation, and we’ve served Metro Detroit since 1991.
A little about my background: I earned my undergraduate and dental degrees at the University of Michigan and my orthodontic specialty degree at the University of Detroit Mercy. I’m a Diplomate of the American Board of Orthodontics, a Certified Damon Educator, and a nationally recognized speaker. I’ve also been consistently named a Top Orthodontist.
You can find each office on the locations page and meet the doctors and team. Prefer to talk with someone? Call 248-344-8400.
