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Assessing your health beyond your teeth.
Orthodontics, Sleep Apnea, and TMJ - Oh My!
Your airway health and your overall health are very closely related

Your airway health and your overall health are very closely related

Most people don’t make the connection, but these three things are closely related! Under the care of Dr. Keith Gressell, you can love your smile and live a healthy life with adult airway treatment in Gig Harbor, WA. That is why each and every new patient experience includes an assessment of not only the teeth but also the jaw joint and airway.

Your teeth, bite, and airway are all connected.

For decades, we’ve seen people with crowded teeth, and for decades, the solution has been to make the teeth fit into the jaws – by any means necessary. We were looking at teeth, rather than stepping back to look at the larger picture: facial balance with properly formed jaws. Frequently, our jaws are not stimulated to develop to their full genetic potential. Find out more about why this happens HERE.

It’s not just about crowded teeth.

Unfortunately, crowded teeth are not the only casualties of undersized jaws. Airway problems, including apnea and pain from TMJ, are also a common result of making teeth fit into undersized jaws.

Why is Jaw Development So Important?

Let’s start from the top down.
Futuristic 3D image of a human breathing through their nose as it relates to airway health
Breathing through your nose

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When air is drawn in from the nose, it passes through the nasal passages, ideally with a smooth, laminar flow. Turbulent flow, from being drawn through too narrow a passageway or one with obstructions, can cause the airway to collapse.

Think of sucking on a smoothie and having a seed get stuck in the bottom. Even if the straw is only partially occluded, it can make the sides of the straw collapse. This is what can happen to our airway, and it is more likely to happen with a skinny straw or a narrow airway!

3D image of a human skull highlighting the nose and jaw
Your nose and jaw

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In addition, the nose has a critical job: to warm, humidify and filter the air entering our lungs. When the breath enters through the mouth, it can cause many other problems. These include increased blockage in the nose (making nasal breathing more challenging) and irritants accessing lymphoid tissue like tonsils causing them to swell. When the breath leaves from the mouth, it can cause dry mouth (or even dehydration) as well as dysregulation of the blood gasses resulting in “over breathing” and more acidic blood pH.

The floor of the nose is formed from the same bone as the roof of the mouth. When the jaw doesn’t develop a broad arch, the vault of the roof of the mouth grows tall and narrow. This impinges on the space at the floor of the nose, creating a narrow passage with turbulent flow.

This high vaulted palate also creates a deviated septum which can also impair nasal breathing. In addition, it makes proper tongue position (in the roof of the mouth) more difficult and can result in the development of tori, the bony growths at the roof of the mouth.

Child sleeping and mouth breathing - a sign of a poor airway health
It starts at a young age

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In kids, enlarged tonsils and adenoids can actually cause impaired jaw development.

If the child is breathing through their mouth, these reactive lymphatic tissues will not recede normally and the child is likely to develop the habit of mouth breathing, which is known to disrupt normal growth and development.

Example of jaw development as it relates to airway health
Upper jaw development

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So what would cause the upper jaw not to develop a nice broad arch? Certainly, genetics (and epigenetics) have something to do with it; however, without the correct resting tongue posture, the upper jaw will fail to grow and develop normally. This is so common in our culture that we often fail to recognize it as compromised growth and development. The tongue, resting on the roof of the mouth, forms the scaffolding around which the upper jaw develops. When the tongue is resting in the floor of the mouth, that scaffolding is not present, and the jaw fails to develop proper length and width, the teeth tip inwards, making a more narrow arch form. Then, we see dark shadows at the sides of the back teeth (called buccal corridors).

Even the most ideal, broad tooth position after orthodontics will relapse with inward tipping of the teeth, and the resulting dark buccal corridors will occur if the proper tongue position is not maintained. During growth and development, we also see the upper jaw grow downwards, creating a gummy smile. This often causes the lower jaw to grow downward and backward (called clockwise growth) creating a long face with flat cheekbones and flaccid, open lips (think Napoleon Dynamite).

A close up of a persons tongue to show that tongue positioning has an effect on airway health.
Tongue positioning

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A low resting tongue posture and a retrusive lower jaw push the tongue (which is attached to the inside of the front of the lower jaw) back into the airway. This constricts airflow at the back of the throat. It can start out as snoring but over time frequently develops into apnea or hypopnea (where the airway gets smaller but doesn’t fully collapse).

How Can Dr. Gressell Help?

From oral appliance therapy to partnering with other healthcare providers, we can help get you healthy.

  • Interdisciplinary Team
    Dr. Gressell works with an airway-focused team who looks at your entire diagnosis and helps come up with a plan that’s specific to your needs. Some of the doctors she partners with include otolaryngologists (ENTs), oral surgeons, orthodontists, periodontists, neurologists, and others.
  • Oral Appliance Therapy (OAT)
    This non-invasive device can help address some of the obstructions we mentioned above by positioning the jaw forward, helping to open obstructions.
  • Homeoblock™
    The Homeoblock™ dental appliance, similar to a retainer, works with your body to create physiological changes to your facial bones naturally. It’ll help with anti-aging, improved breathing and sleeping, and so much more!
  • Prolon and Weight Loss
    Dr. Gressell has researched nutrition extensively and without a doubt, periodic fasting for three or more days is one of the most beneficial practices to improve many health markers that one can undertake. Excess body weight is a primary contributor to airway problems like sleep apnea. Unfortunately, many people find fasting difficult or impossible.

    Enter Prolon! After decades of research, Dr. Valter Longo developed the Fasting Mimicking Diet, a 5-day “fast” in which you reap the benefits of fasting but with food. Weight loss, improved insulin sensitivity, immunity, and triglycerides are but a few of the benefits. Ask Dr. Gressell if Prolon is right for you!

  • Orthodontics
    Dr. Gressell offers Invisalign to help straighten teeth for those who qualify. He partners with top-notch orthodontists who follow his philosophy of airway.
  • Myofunctional Therapy
    This is like physical therapy for the mouth, tongue, and entire oropharyngeal area. Without correct oral and breathing habits, any airway treatments have limited efficacy. This includes CPAP, oral appliance therapy, and even the most advanced apnea treatments like Inspire (an implant that stimulates the tongue to clear the airway). To help establish and maintain these habits, a myofunctional therapist works with you to develop strength and resilience in the structures surrounding the airway.
  • Advanced Imaging
    This includes 3D x-ray (CBCT) and MRI when indicated.

Have Questions About Adult Airway Treatment?

Consult our FAQs below or give us a call (253) 857-6778.
  • Why is this a big deal now?

    Preindustrial society rarely suffered from the “diseases of civilization,” one of which is dental crowding.

    One reason is that in preindustrial societies, children had no alternative but to breastfeed, and do so efficiently and for a long time. No bottles or pacifiers that inhibit the development of a correct swallowing pattern were available. Their inability to breastfeed meant that they wouldn’t survive childhood. Breastfeeding would strengthen the muscles and structures of the mouth and jaws and help to develop proper oral habits like the correct swallow and tongue posture (resting on the roof of the mouth at all times).

    The lips would be sealed when not eating or speaking (except of course to laugh!). It was observed that Native American mothers would close their infants’ mouths after breastfeeding, gently sealing the child’s lips with their fingers. 

When children started eating solid foods, they chewed on fibrous stalks tubers and gnawed on bones. No melt-away Zwieback toasts and Cheerios! This helped to develop the muscles and bones of the jaws.

    Even now in countries where children grow up in proximity to sugar cane fields and chew the raw cane, they have more well-developed jaws than their more urban counterparts.

  • Is this covered by dental insurance?

    Much of the airway treatment is covered by medical insurance, subject to the deductible. Other aspects, like the care of a periodontist, orthodontist, or oral surgeon would be billable to dental insurance.

    Don’t have insurance? We do accept CareCredit to help make payments more affordable.

  • Do I need a referral?

    To provide you with the ideal outcome, a coordinated effort requires communication with a like-minded team. Dr. Gressell has worked hard to develop professional relationships with providers who understand the multiple, complex interrelated factors that influence airway. It is important to stay within this team of providers to assure the highest quality of care.

    Our dental office is located in Gig Harbor, WA, and serves many communities throughout the Pacific NW, including Gig Harbor, Bremerton, Port Orchard, Purdy, Port Angeles, and Tacoma.

Schedule Your Comprehensive Exam With Dr. Gressell Today
Take control of your health! We’ll help get you there.