Orthodontics and airway

It's hard to imagine that something simple such as straightening teeth can affect the entire body. This 45 year old patient has had two upper premolar teeth removed in preparation for braces in her teens. The removal of the teeth created space and then the orthodontist pulled back her upper teeth to bite with her lower teeth. This "trapped" the jaw into a retruded position and decreased her airway. The decreased airway has led to obstructive sleep apnea and TMD symptoms which have gotten progressively worse. The proper treatment should have been not to extract any teeth and instead allow the jaw to come forward to meet the upper teeth. Braces would then be applied to make sure the bite is correct once the jaw is comfortable at this position.