Invisalign to help sleep apnea and dental extractions as a cause of sleep apnea

[SingleH]

Whilst searching about dental related issues, I stumbled across an interesting study regarding the use of Invisalign clear aligners to improve upper airway volume.  I believe the improvement was largely due to palate expansion resulting in more space for the tongue to rest rather than being bunched up towards the back of the throat.
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[url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9498122/]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9498122/

There seems to be a number of other orthodontic treatments which allow for palate expansion with the slightly more complex expanders enlarging the interior nasal cavity also.

One topic which seems to be discussed quite is negative impact of dental extractions such as premolar and wisdom teeth being removed as a child. One of the theories is that the process of extractions (and closing the gaps, and not replacing with an implant), results in the dental arches becoming smaller reducing the space for the tongue to sit, which in turn may potentially lead to development of airways restriction or sleep apnea later in life.

I was interested to hear feedback from people here if they also had dental extractions at some point in their life?

[stevew168]

I had very good results when I got a dental guard from my dentist. He asked if I might have sleep apnea, and had one made that covered the upper palate which pushed my tongue down. It definitely lowered my AHI until it eventually disintegrated. I will be getting a new one soon.

[Aeolian harp]

I was interested to hear feedback from people here if they also had dental extractions at some point in their life?

I had orthodontics way back in the 1960s when I was around 12 or 13. I had four premolars extracted as part of that work.  Then later I had my wisdom teeth removed as well, so I have 8 fewer teeth than the human standard of 32.  In addition, the orthodontist slanted my lower incisors inward, further encroaching on the room for my tongue. 

I'm pretty sure that this has contributed to my sleep apnea.  Gaining weight in middle age also probably didn't help: apparently your tongue also gains fat with the rest of your body.


About ten years ago, I had a dentist suggest to me that I probably had sleep apnea as a result of a small mouth and inward-slanting bottom incisors.  She wanted to use Invisalign to open up some more space in my mouth, particularly by changing the slant of my front teeth.  

I blew her off at the time because I didn't think I had apnea.  Since then, I have been diagnosed with mild sleep apnea and am using a CPAP machine.

I've toyed with the idea of getting some form of orthodontia, but I feel cautious about going that route because of the expense, the uncertain outcome, and the risk changing my bite for the worse.

[SingleH]

Thats very interesting about the custom dental guard.

When you say it covered the upper palate and pushed the tongue down, would this still allow you to breathe through your mouth, say if your nose was blocked or was it designed to basically seal the gap between your upper palate and keep the tongue pushed flat to stop if falling back?

[SingleH]

Hi Aeolian harp, thanks for your feedback.

I do think these extractions reduce the available space and thus impact the tongue space, but as there are no definative studies on the topic its hard to prove.

I agree with your concerns about changing your bite for the worse. Invisalign can only create space by tooth-borne movement "flaring of the teeth". Wheres on the other end of scale is true bone-borne expansion of the palate using using an in mouth screwed in MARPE or MSE device to split the palate suture. This makes the upper palate larger but is not an insignificant process and has potential serious side effects if not executed properly, it also has a very low success rate in anyone middle aged and beyond.

In regards to Invisalign, the issue with expansion via teeth borne movement is that you are just flaring out the teeth which can have negative effect on dental health and potential gum recession. With that said as, I understand that as we age our teeth tend to tip inwards, making our palate smaller over time. Due to this inward tipping there may be some benefit to use Invisalign to bring those teeth back into a more normal position due to the nature of it simply flaring the teeth back out a bit, but in actually fact just returning the teeth back to a more normal position that you had when you were younger.

Im guessing that there might be a sweet sport where returning teeth to a normal position, improving the arch shape and then perhaps even this would yield some degree of improvement in tongue space.

[stevew168]

I could still breathe through my mouth with the dental guard.

[RedNailz]

I had 4 permanent teeth extracted for orthodontics, but I think what contributes to my obstructive apneas  is the realignment of my bite.   Both the pulmonologist and the sleep doctor commented on my “overbite” being a factor.   I had an underbite that the orthodontist corrected, or maybe overcorrected.

[ButtonNoseBarbie]

I had 4 permanent teeth extracted for orthodontics, but I think what contributes to my obstructive apneas  is the realignment of my bite.   Both the pulmonologist and the sleep doctor commented on my “overbite” being a factor.   I had an underbite that the orthodontist corrected, or maybe overcorrected.

I also have a small overbite. How much does Invisalign reduce apnea scores?

[ButtonNoseBarbie]

Would Invisalign cure mild sleep apnea? 

How much points would score reduce? How long before you see results? 

If a person only has a small overbite is that good candidate for it. 

Is Invisalign a more cosmetic procedure or is it something covered by insurance or do hsa on it?

[SingleH]

I think it would depend on a case by case basis whether it is covered by medical insurance, if the invisilign is being used to treat dental problems then possibly yes.

There is no way to quantify whether invisalign would cure mild sleep apnea, but I think it would be unlikely. From what I have seen by altering the arch it is creating some more tongue space, so there is less chance of the soft tissues blocking the back of the throat. I dont think it will cure sleep apnea, but it may help to lessen it.