There’s nothing so rejuvenating than a good night’s sleep, but for many of those suffering with sleep-disordered breathing (SDB), sleep may not be refreshing. But did you know that your sleep position can play a role in a good night’s sleep?SDB disorders, such as obstructive sleep apnea (OSA), are caused by repeated episodes of upper airway obstruction during sleep. This interrupted sleep can result in health hazards such as daytime sleepiness, hypertension, stroke, heart failure, diabetes, depression, and the possible development of mental disorders.Having postural stability is important and is our foundation to be able to stand and walk independently. However, studies have shown that poor posture while sleeping or your choice of sleep position can lead to sleep deprivation, which in turn creates negative effects on a person’s daytime stability.   The results of poor sleep can reduce alertness levels and lower body temperature, which along with reduced oxygen saturation levels, can lead to unsteadiness an increased risk of falls, especially in older people. SDB has also been shown to alter reflexes and reaction time while driving, as reported in a study published in the BMJ Journals.How Your Sleep Position Affects Your HealthThe position in which you sleep can have an impact on your overall comfort and health, and certain sleep positions may be recommended for those suffering from sleep apnea.Sleeping on your BackSleeping on your back (supine position) is a good position for those who can breathe well. Your body gets good support, and by raising the feet above the heart, it can help alleviate swelling of the feet and ankles (edema) to reduce the impact of congestive heart failure. This is also the preferred position for infants and can reduce the risk of sudden infant death syndrome (SIDS). On the other hand, for those who have trouble breathing, sleeping on your back can allow your lower jaw and tongue to shift back and obstruct the airway, leading to sleep apnea.Sleeping on your SideSleeping on your left or right side (lateral position) with the legs drawn up into the fetal position may be a better solution to reduce the effects of sleep apnea and snoring. It helps keep your airways open. This position also has its drawbacks though. While lying on your side, your internal organs can shift and put pressure on the heart and lungs, causing the heart to work harder or reducing the lungs’ ability to take in air. Shoulder, hip and lower back pain can become issues in time.Sleeping on your StomachThe least common sleep position is on your stomach (prone position). It can avoid the problems associated with back sleeping and prevent organ shifts within the chest. It can also lead to neck pain, as the head must be turned to one side or another, and it may be harder to breathe with the weight of body limiting the diaphragm’s ability to take in air.Sleeping UprightYou can also sleep in a position where your head is upright, as in a recliner chair or with a wedge pillow or adjustable bed. This position prevents airway collapse and may diminish problems commonly associated with sleep apnea. The downside is that you can’t easily change positions.Address Sleep-Disordered Breathing with Airway & Sleep GroupFor diagnosis and treatment of sleep apnea symptoms, contact Airway & Sleep Group at (571) 244-7329. Or complete our convenient online contact form.  www.airwayandsleepgroup.com

Airway and Sleep Group/Dr. Liliana Calkins of Reston, Virginia was honored to be selected for the Best of Reston Award for two years in a row (2022 and 2023) in the Sleep Clinic category by the Reston Award Program.“On behalf of Airway and Sleep Group, I am delighted to know that our efforts to serve the Reston region are recognized with this award,” said Dr. Calkins. “We are diligent about providing exceptional care to our patients to improve their quality of life.”Dr. Liliana Calkins was recognized in 2019 by Continental Who’s Who as a Pinnacle Professional of the Year in the field of Medicine in recognition of her role as Specialist in Orthodontics and Craniofacial Orthopedics. She graduated first in her class at dental school at National Autonomous University of Mexico City (UNAM) earned her certification in orthodontics with honors. Dr. Calkins is a founding member of Airway and Sleep Group of Northern Virginia and a member of numerous prominent professional organizations.The Reston Award ProgramThe Reston Award Program is an annual program that honors the best of local business in the Reston community with the mission to recognize the small business community’s contributions to the U.S. economy. Companies that have shown the ability to use best practices, and those that implemented programs to generate competitive advantages and long-term value are chosen for the Best of Reston awards.Each year, the Reston Award Program identifies companies that have achieved exceptional marketing success in their local community and business category, with a focus on quality, not quantity. These local companies enhance the positive image of small business through service to their customers and the Reston community, and make the Reston area a great place to live, work and play.Various sources of information are gathered and analyzed to choose the winners in each category. Winners are determined based on the information gathered internally by the Reston Award Program team and data provided by third parties.About Airway and Sleep GroupAirway and Sleep Group is a practice in Reston, VA specializing in treatments for sleep apnea, craniofacial orthopedics, TMJ and orthodontics. Our goal is to treat our patients’ conditions by correcting the shape and functionality of their mouth, tongue, jaw and bite through state-of-the-art methods. Contact Airway & Sleep GroupTo learn more about the services provided by Airway & Sleep Group, visit our website or listen to our podcasts. Contact us at 571-244-7329 to schedule an appointment. In-person and virtual consultations are available.

What Is iNap?There’s a new patient-centered treatment to help anyone with mild to severe sleep apnea a patient-centered and user-friendly solution for comfortable, restful sleep: iNAP®.How iNAP WorksiNAP creates intermittent negative airway pressure, reducing and nearly eliminating sleep apnea symptoms by keeping the airway open, allowing patients to breathe naturally and sleep peacefully. During sleep, iNAP delivers a gentle suction inside the oral cavity that moves the soft tissues forward and stabilizes the tongue away from the airway. Simply insert the latex-free interface at bedtime and click the power button. The iNAP device is compact, light, and portable — it’s about the size of a smartphone with twice the thickness. It also requires the oral interface and tubing set, a saliva container (6”x3.1”x1.4”), and dry pads. It’s available by prescription through your specialist at Airway and Sleep Group.Produced by Somnics, iNAP is touted as “the most comfortable sleep apnea solution” available. There’s no mask or headgear, the device is portable, and the pressure is adjustable with an optional prescription device. No humidification is needed. However, those using it must breathe well through their nose at night.Patients can download the iNAP Lab+ app and pair it with their iNAP One® device to monitor their treatment. Information collected from the iNAP console can help evaluate usage and treatment data.Who Is a Candidate for iNAP?You may be an iNAP candidate if you’ve been diagnosed with obstructive sleep apnea. Speak with your sleep physician at Airway & Sleep to learn if this treatment is right for you. In clinical studies, it was effective for patients with mild, moderate, and severe OSA, but it may not work for all patients.The ability to breathe through the nose is essential for this treatment, as the oral interface seals the mouth, tongue, and soft palate during use. However, it does not interfere with braces or Invisalign® aligners. It may also be helpful for mild teeth grinding and bruxism.Will Insurance Cover iNap?The FDA cleared iNAP in May 2020. It has since been approved for prescription by all 50 states. Although iNAP is eligible for coverage for those whose employers offer HSA/FSA benefits, insurance isn’t yet covering the treatment. Thankfully, two options are available to help patients who have to pay out of pocket:The iNAP Club Membership: Resupplies are sent quarterly, with free shipping. A three-month trial is required, after which the patient can cancel anytime.  The iNAP Ownership Program (out-of-pocket purchase pricing): Patients can use the device for up to three months, and if they return it, they’ll be reimbursed the total price minus a $250 restocking fee. Somnics is currently working with commercial and federal insurance carriers such as Medicare to establish coverage and reimbursement for this new therapy and its supplies.Airway & Sleep GroupIf you’ve been diagnosed with Obstructive Sleep Apnea and wish for better sleep, solutions are available. And Airway & Sleep Group is here to help. Our physicians diagnose and treat sleep disorders and airway obstruction to help our patients improve their quality of life.To learn more about iNAP and to schedule your in-person or virtual appointment with Airway & Sleep Group in Northern Virginia, please contact us at (571) 244-7329 or complete our convenient online contact form. 

Airway and Sleep Group’s Dr. Liliana Calkins, Specialist in Orthodontics & Craniofacial Orthopedics hosts this podcast as an Introduction to Orofacial Myology with Mary Frances, founder of Sound Mouths.https://airwayandsleepgroup.com/https://soundmouths.com/

Get Relief For OSA SymptomsSnoring can annoy a sleep partner, but it can also indicate a more serious health risk. It’s often associated with obstructive sleep apnea (OSA). Thankfully, technological advances, such as tongue stimulation, have led to treatments that are providing relief!Obstructive sleep apnea (OSA) is prevalent in approximately 33% of American adults aged 30-69 years, with 55% of those cases falling within the mild range. It’s often associated with habitual snoring, poor quality of life, and a significant increase in the risk of cardiovascular and metabolic disease.Until now, treatment options have included positive airway pressure (PAP), oral appliances, and hypoglossal nerve stimulation, which only treated the disease while the subject was asleep. However, those using PAP did show improvements in sleepiness, functional status, cognitive function, and blood pressure when used for more than 5.5 hours per night. Surgery on the upper airway was rare. One of the problems with these treatment devices is getting people to use them. Adherence to medical recommendations is low, with studies showing that 50% of PAP patients use it fewer than 4 hours a night. What is eXciteOSA?Technological developments have presented a new treatment that can be used while the subject is awake: Signified Medical Technologies’ eXciteOSA®.eXciteOSA is an FDA-authorized prescription medical device designed to be used once daily for six weeks to retrain the tongue and upper airway muscles. After that period, therapy can be reduced to at least twice weekly for long-term maintenance.The tongue stimulation device is composed of four components:A control unit (suitable for multi-patient use)A washable mouthpiece (for single-patient use)A smartphone app that pairs with the control unit to control therapy via Bluetooth, enabling the user to initiate sessions and control intensity.A physician portal for remote monitoring and long-term patient managementFor more information, see our previous blog post on eXciteOSA.eXciteOSA® Offers Tongue Stimulation Treatment for Obstructive Sleep ApneaeXciteOSA is an intraoral neuromuscular electrical stimulation device designed for the once-a-day treatment of primary snoring and mild obstructive sleep apnea. It targets an underlying cause of OSA, specifically the inadequate responsiveness of the upper airway dilator muscle.The largest muscle in the upper airway is the tongue (genioglossus). It can experience greater fatigability and reduced endurance in those who have OSA. Research has shown that providing neuromuscular electrical stimulation, or tongue stimulation, can improve muscle endurance, as associated with an underlying shift from fast-twitch to slow-twitch muscle fiber composition. Slow-twitch fibers are used for sustained, long-duration activities and play a role in maintaining an open upper airway during breathing and closing off the airway while eating. Fast-twitch fibers are used for short-burst power activities like chewing, swallowing, respiration and speech.eXciteOSA applies electrical stimulation directly to the tongue for just 20 minutes per day while you’re awake. Those using eXciteOSA for tongue stimulation have shown significant improvements in snoring, OSA severity, sleepiness, and sleep quality.Related: NIH sleeping tongue studyLearn More About Tongue Stimulation to Help Treat OSA and Snoring with Airway & Sleep GroupIf you’d like more information about eXciteOSA and the latest treatments for OSA and snoring, contact Airway & Sleep Group at 571-244

Advanced Sleep Apnea TreatmentsSleep apnea is a dangerous condition as it can create complications in one’s health — some of which can be severe or even life-threatening. Since sleep apnea can create an increase in pressure in the blood vessels around the heart, even some of the heart chambers themselves, thus increasing your risk of high blood pressure (hypertension). It can also increase the risk of heart attack, stroke, and abnormal heartbeats/atrial fibrillation.At Airway and Sleep Group, we look for ways to help alleviate sleep apnea to improve your quality of life and protect your health. One such therapy we recommend is Signifier Medical Technologies’ eXciteOSA®, the world’s first clinically-proven daytime therapy for mild obstructive sleep apnea and primary snoring. According to recent estimates, 55 million adults in the U.S. suffer from obstructive sleep apnea, with more than half being mild cases. For these individuals, their quality of life suffers, with analysis showing a 224% increased risk of developing hypertension, an 83% more likely diagnosis of diabetes, and a 59% potential for abnormal fasting glucose.The eXciteOSA® technology has shown reductions in both objectively measured and bed partner reported snoring, along with significant improvements in disease severity and sleep quality. 79% of sleep apnea patients achieved beneficial results, and 90% experienced reduction in objective snoring time.What Is eXciteOSA and How Does it Work?eXciteOSA is a daytime therapy device for sleep disordered breathing, used to improve daytime sleepiness and sleep quality.One of the leading causes of OSA is the lack of endurance by upper airway muscles during sleep. The tongue falls back and blocks the upper airway. The eXciteOSA device uses neuromuscular electrical stimulation (NMES) to exercise and train the upper airway muscles, working both the intrinsic and extrinsic tongue muscles to help prevent airway collapse while sleeping. It physiologically retrains the tongue and upper airway to maintain the tongue’s natural position during sleep.See a video demonstration how eXciteOSA works.The stimulation device is used for just 20 minutes a day while you’re awake. It involves a mouthpiece device that’s applied to the tongue once a day for six weeks, and a smartphone app to control the stimulation intensity and provide guidance, information, and therapy reminders. It’s both comfortable and painless. Take the 2-minute assessment to see if you’re a candidate, then contact a healthcare professional at Airway and Sleep Group to schedule your sleep study and obtain your prescription.eXciteOSA is the only daytime therapy for primary snoring and mild obstructive sleep apnea authorized by the FDA (Food & Drug Administration). It’s also the only commercially-available device to be used while awake. Others are meant to be used during sleep.eXciteOSA: Daytime Treatment for Sleep Apnea With Airway & Sleep GroupAt Airway & Sleep Group, we take your health seriously and are always looking for the latest and best innovations to improve your quality of life. The eXciteOSA device is the first of its kind, and we’re glad to make this technology available to you to help with mild obstructive sleep apnea or snoring issues.If you live in Northern Virginia, contact Airway & Sleep Group. We serve residents throughout the Northern Virginia and the DC metropolitan area. To schedule your appointment to learn more and see if you’re an eXciteOSA® candidate, contact us at 571-244-7328, or visit airwayandsleepgroup.com

With the world’s focus on “going green,” we want to do our part. In addition, we want to provide our patients with the finest diagnostic tools available. That’s why at Airway & Sleep Group we combine the two by offering Green X scanning. What is Green X?Produced by Vatech, Green X is a highly-advanced 3rd generation compressed sensing technology that combines low-dose radiation X-ray scans with high-quality 3D images for use by dental and medical professionals. Benefits of Green XThe Largest Single Scan FOV RangeOne of the greatest benefits of Green X is its ability to offer a wide range of selectable fields of view (FOV). This enables doctors to choose the optimum FOV mode while at the same time minimizing the radiation exposure to areas not of interest. Scans from five FOVs can range from a single tooth capture to an entire facial view, and can include the full arch region, sinus and left or right TMJ to suit most oral surgery cases and multiple implant surgeries.Lowest DosageIt is a common belief that inferior images are associated with low radiation. However, this is not true of the Green X technology. With reduction of up to 70% lower radiation than other types of scans, achieving clinically-diagnosable image quality is possible. In addition, its FOV range ability to focus directly upon the area in question reduces overall radiation to other parts of the face and neck.Highest Quality ImageryGreen X is a highly-advanced 4-in-1 digital X-ray system incorporating panoramic (Pano), CBCT, Cephalometric (Ceph) (optional) and Model scan with high-resolution images.Pano = panoramic wrap-around X-ray of the face and teethCeph = lateral/side view X-ray of the faceCBCT = cone beam computed tomography using a cone-shaped X-ray beam to capture an overall view of the entire mouth, jaw, nasal and throat areas, in 3D images that show bone, airway and soft tissuesThe Fastest Scan TimeGreen X is fast, which minimizes exposure and offers quick diagnostic capabilities. Image speeds range from Ceph scans at 1.9 seconds and CBCT scans at 2.9 seconds, to Pano scans at 3.9 seconds.What the Improved Green X Imaging Means to YouNot all communities offer access to high-resolution imaging centers. But because we strive to provide our patients with the best and most improved diagnostic services available, we made the choice to invest in Green X Imaging.Your quality of dental care is important. So is your overall health. If we can provide superior imaging while reducing your exposure to radiation, it is in everyone’s best interest. And as technology continues to improve and innovate, Airway & Sleep Group will continue to upgrade its services. It’s our commitment to our patients and our community.Airway & Sleep GroupAirway & Sleep Group diagnoses and treats sleep disorders and airway obstruction through craniofacial orthopedics, TMJ treatments, orofacial myofunctional therapy, and interceptive orthodontics in order to provide our patients with quality sleep and an overall improvement in their quality of life. To do so, we find it important to invest in continuing education and improved technology.To learn more about Green X or to schedule an appointment with Airway & Sleep Group, please contact us at (571) 244-7329 or complete our easy-to-use online contact form. 

When the jaw is too narrow, your doctor or dental professional may suggest a palatal or maxillary expansion. This widens the jaw to make room for teeth in younger patients, to correct or improve the way the upper and lower jaws work together, and improve breathing. It can also broaden your smile.Maxillary Expansion in AdultsTwo types of palatal maxillary expansion techniques are generally used in adults: the MSE Expander non-surgical device (best for ages 17-35) and surgically-assisted maxillary expansion (SAME). MSE Expander: With the non-surgical expander, a fixed orthodontic appliance is attached to the back molars, crossing over the upper arch. It applies a gentle force to push against the teeth and expand the palate and the jaw.SAME: Because the bones are already developed in an older patient, SAME is used when appliance expanders are unable to do the job on their own, or for moderate or severe cases. In this instance, the doctors makes small cuts along the jaw to create symmetrical segments that can be broadened or adjusted over time.SAME is both safe and effective, and performed under general anesthetic. Following surgery and recovery, the treatment can take several months to a year to achieve the desired result, with incremental adjustments to expand the palate. Some minor discomfort may occur in the first few days as your body adjusts to the expansion pressure. You may even see spaces appearing between your front teeth over time as the bones separate. Once the expansion is complete, orthodontic treatments can close the gaps between your teeth. Good stability is expected in the long term, with no significant relapse.Why Would I Need Palatal Maxillary Expansion?At Airway & Sleep Group, we are most concerned with your ability to breathe and sleep properly. The palatal maxillary expansion procedure is often used to resolve issues related to obstructive sleep apnea (OSA) or temporomandibular joint dysfunction (TMD), or to open airways and the nasal cavity to improve breathing. Other reasons for its use can include modifications for crooked or crowded teeth, or a crossbite.A narrow bone structure in the face could be causing OSA or TMD. We may suggest a sleep study to study the amount of air flow during sleep, and how much carbon dioxide is in the blood. We’ll also monitor for sleep interruptions and things like brain activity and heart rate. If we discover that poorly-aligned teeth or a small jaw are the cause, we may recommend a maxillary expansion to solve breathing issues.Sleep Apnea and Adult Palatal Maxillary Expansion at Airway & Sleep GroupAt Airway & Sleep Group, we help improve sleep-disordered breathing issues through a number of treatment techniques, including adult palatal maxillary expansion. If you are suffering from sleep apnea, come talk to us.Airway & Sleep Group is conveniently located in Reston, Virginia to serve patients throughout Northern Virginia and the Washington D.C. metropolitan region. Contact us to schedule an appointment at 571-244-7329, or use our convenient online form.

Ease The Effects of Sleep ApneaSleep apnea and snoring are two conditions that can significantly affect the quality of sleep in children. Instead of allowing patients to suffer through sleep-deprived nights, medical practitioners like us are turning to therapies like Fotona NightLase® to help treat pediatric sleep apnea.What Is Fotona NightLase Therapy?According to the company, “Fotona’s NightLase® therapy is a non-invasive, patient-friendly laser treatment for increasing the quality of a patient’s sleep. NightLase reduces the effects of sleep apnea and decreases the amplitude of snoring by means of a gentle, laser-induced tightening effect caused by the contraction of collagen in the oral mucosa tissue.”How Does NightLase Work?Nightlase uses a patented, high-performance ER:YAG laser modality to optimize the length of laser pulses to the mucus membrane that lines the soft tissue of the oral cavity, called the oral mucosa tissue. The laser penetrates deeply into the skin to create a thermal effect that increases the targeted membrane’s temperature without damaging the skin’s surface. This heating effect stimulates collagen contraction and tightens the tissues to prevent them from over-relaxing and obstructing the airway during sleep.A full-course of NightLase generally requires three separate 30 to 45 minutes treatment within a six to eight week period. During treatment, the patient feels a warm and tingly experience in the throat, similar to the spray of warm water. There’s no downtime, and most patients experience no side effects other than an occasional mild sore throat or dry mouth. Your child can eat and drink normally immediately following appointments.With NightLase’s effective and non-invasive treatments, your doctor or dentist can produce a change in sleep patterns. No chemical treatment or anesthesia is required. NightLase, however, isn’t considered an all-time cure for traditional sleep apnea. Depending upon their individual physiological issues, patients may still require the use of an oral appliance to achieve better sleep.How Do I Monitor NightLase’s Effectiveness?Following NightLase treatment, monitor the quality of sleep. Most patients report a reduction in sleep apnea and snoring. If you notice that these conditions have worsened or have not significantly changed, let us know. The effects of NightLase aren’t noticed immediately, and final results can last up to a year. If necessary, the treatment can be repeated.Does My Child Qualify For NightLase Treatment?Through an oral examination, Dr. Liliana Calkins, a specialist in orthodontics and craniofacial orthopedics at Airway & Sleep Group, can help identify what factors are causing your child’s sleep apnea or snoring.If recommended, Fotona’s NightLase therapy can help reduce the effects of pediatric sleep apnea or the volume of snoring in pediatric patients by tightening soft tissues in the oral cavity. However, treatment depends upon the anatomical conditions causing these issues. For other conditions, like a tongue obstruction, alternative or additional treatment options may be recommended.NightLase Therapy Treatments for Sleep Apnea at Airway & Sleep GroupOur goal at Airway and Sleep Group is to improve sleep disordered breathing by providing the latest technology to help pediatric sleep apnea in Northern Virginia families. If you’d like to learn more about Fotona’s NightLase therapy treatment for sleep apnea, contact Airway and Sleep Group at (571) 244-7329. You can also complete our easy online contact form, and we’ll get back to you shortly.

If your child is suffering from inflamed or enlarged tonsils, or obstructed breathing, your first thought may be that he or she needs a tonsillectomy. Thanks to alternative treatment modalities like laser technology, however, your child may not have to undergo invasive surgery. Take a look at the latest pediatric laser treatments for sleep apnea and hypertrophic tonsils.What are Hypertrophic Tonsils?Simply explained, hypertrophic is the medical terminology for enlarged tonsils or tonsillar swelling.Symptoms of Hypertrophic TonsilsSymptoms of tonsillar hypertrophy can include:Difficulty feeding in the pediatric populationMouth breathing or noisy breathingRestlessness during sleep or sleep apneaExcessive daytime sleepiness even after 7 hours of sleep/hypersomnolenceLoud snoringBehavior changesPoor school performanceSleep Apnea and Hypertrophic Tonsils“Most cases of obstructive sleep apnea in children are associated with hypertrophic tonsils,” cites an article in American Family Physician. “Hypertrophic tonsils can be caused by recurrent pharyngitis and local inflammation, especially in children and young adults.” Although tonsillar enlargement may be asymptomatic, enlarged tonsils can fall back and block the oropharynx, or the part of the throat at the back of the mouth.  Unchecked, “tonsillar hypertrophy may also lead to respiratory and cardiac complications.”Pediatric obstructive sleep apnea (POSA) is a common chronic condition that causes repetitive episodes of partial or complete collapse of the upper airway during sleep, resulting in a reduction or cessation of airflow. Because the person finds it difficult to breathe, they typically awake throughout the night. POSA is a significant medical problem linked with permanent cognitive functional loss, decreased emotional regulation, and growth stunting if not treated in children.Minimally-Invasive Laser-Assisted Treatment for Pediatric Obstructive Sleep ApneaThe latest generation of surgical lasers offers faster, safer and less-invasive treatments for hypertrophic tonsils and obstructive sleep apnea. The use of their scientifically-proven ACW Nd:YAG and Er:YAG laser wavelengths provides extremely precise laser incision, and controlled thermal coagulation and bleeding effects to ensure a more successful and comfortable surgical treatment designed to shrink hypertrophic tonsils and immediately open the airway.Benefits of the laser-assisted treatment include:Minimally-invasive proceduresNo sedation may be requiredLittle or no bleedingLess patient downtimeFaster healingHigh-precision treatments with simultaneous disinfectionAt Airway & Sleep group, we utilize Fontana’s family of high-performance LightWalker® and SkyPulse® surgical laser-assisted uvulopalatoplasty systems for treatment of sleep apnea. The Fotona LightWalker® laser, previously used for inflammatory conditions and wound closure, is targeted specifically at the soft palate for mucosal contraction and keratinization. This approach has been reported to safely and effectively reduce symptoms and increase both airway volume by tightening and elevating the oropharyngeal tissues.While treatment for adults with obstructive sleep apnea (OSA) is generally treated with air pressure machines, like the CPAP, the first line of treatment for pediatric patients has commonly been the surgical removal of hypertrophic tonsils and adenoids. But either a partial or full tonsillectomy has both short- and long-term risks. Short-te

How the Professionals of Airway and Sleep Group Continue EducationYour trust in our abilities at Airway & Sleep is so very important. And our abilities to serve you are equally important. That’s why we invest heavily in continuing education. It’s a necessary component to both sides of the dental chair that our skills reflect the latest techniques and technologies to facilitate better health in our patients.We recently attended the three-day Tufts Dental Sleep Medicine Global Summit, a global summit held virtually from the Tufts University European Center in Talloires, France in July 2022. This continuing education conference represented leaders and emerging leaders in the field of Dental Sleep to discuss, share experiences, exchange ideas, and share needs on the most relevant issues in the practice of dental sleep medicine. The collaboration’s goal is to amplify education in the fields of sleep disorders, dental sleep medicine, somnology, and holistic patient care.An estimated 1 billion people around the world suffer from obstructive sleep apnea (OSA). And it has been documented that the cumulative long-term effects of untreated sleep disorders are associated with an extensive range of health consequences. Conferences like this one create worldwide unity in best practices, bringing continuing education to where the need is.Tufts School of Dental Medicine Continuing EducationFor more than 150 years, Tufts University School of Dental Medicine has been a leader in academic and clinical excellence. Through its series of for-credit continuing education courses, our doctors and practice professionals at Airway & Sleep Group can keep abreast of the latest practices and breakthroughs in dental medicine to better meet your needs.In addition to the Dental Sleep Global Summit 2022, the current continuing education courses include topics concerning clinical photography, digital smile makeover, hard & soft tissue abnormalities, and simplifying implant placement with the use of artificial intelligence in dentistry.Continuing Education Benefits Patients of Airway & Sleep GroupAt Airway & Sleep Group in Reston, Virginia, we diagnose and treat sleep disorders and airway obstruction—like sleep apnea—through correction of the shape and functionality of the mouth, jaw, tongue, and bite. We invest heavily in the latest technology and continuing education to ensure effective treatments to improve our patient’s quality of life with quality sleep.Areas we specialize in include:Zero to 5 early interventions in craniofacial orthopedics and orthodontics are designed to help your child sleep soundly without the problems of sleep apnea.TMJ Diagnosis and treatment to relieve jaw pain from Temporomandibular Joint and Temporomandibular Dysfunction (TMJ), and Temporomandibular Disorders (TMD)Orofacial Myology, offers patients simple exercises for improved sleep by identifying and eliminating harmful habits or disorders involving the facial muscles and jaw position, and airway collapse during sleep.Orthodontic Solutions surrounding dental airway and sleep medicine. Patients achieve an aesthetically-pleasing smile and enjoy quality sleep and better overall health.Listen to our Podcast Series!Get in Touch Today!If you’d like to learn more about the services offered at Airway & Sleep Group or to set an appointment or virtual consultation, please contact us at 571-244-7329. You can also request more information by filling out our

Patients don’t need to understand the latest in dental technology. What is important are the benefits it offers. Take compressed sensing, for example. With this technology, it is possible to increase image accuracy and reduce radiation doses by more than “an order of magnitude” without loss of useful information for radiotherapy.Understanding CT and CBCTTo understand compressed sensing, we must first understand CBCT. CBCT refers to circular “cone-beam computed tomography.” X-ray computed tomography (CT) is widely used to provide dental professionals with a scan of the bones, muscles, blood vessels and organs, or for fluid or tissue biopsies, normally to provide necessary information for diagnosis, treatment or surgery. The “CB” in CBCT refers to a circular “cone-beam,” a technology that enables dental professionals to take highly-accurate 3D images. The CBCT is one of the most recent diagnostic imaging modalities with the benefits of better diagnostics and lower radiation. (See: Why CBCT is the Best Tool for Orofacial Diagnostics.)What is Compressed Sensing?In a CBCT scan, it can sometimes be difficult to reconstruct the scanned images exactly, “due mainly to imperfections in the imaging process resulting from detector resolution, noise, X-ray tube’s focal spot, and reconstruction procedure,” explains a study offered by the National Library of Medicine. Images could end up slightly blurred. Compressed sensing is a processing technique that allows for efficient acquisition and reconstruction of a signal, and the image can be recovered from far fewer samples. The blurring issue can be solved or reduced significantly, resulting in reconstruction of the highest-quality CBCT images.“Compressed sensing is a technique for acquiring and reconstructing a signal that is known to be sparse or compressible,” describe the authors of an article published in the American Association of Physicists in Medicine. “It shows that super-resolved signals and images can be reconstructed from far fewer data/measurements than what is usually considered necessary.” As an interesting side note, compressed sensing has also been used in facial recognition applications.Airway & Sleep Group’s Investment in Compressed Sensing Technology Benefits YouIf you have an issue with your dental health, you want a dental professional offering the latest technology—like compressed sensing. The speed and accuracy of a correct diagnosis can be critical to your treatment and recovery.“Our office distinguishes itself from others in the market due to our heavy investment in the latest technology with the highest standards in imaging,” explains Dr. Liliana Calkins of Airway and Sleep Group. “By partnering with companies of the highest quality demands, our patients benefit from their breakthrough technologies. Not all dental offices are the same, or invest for their patients at the level we do.”Dr. Liliana Calkins is a partner of the Airway and Sleep Group, Facial and Airway Development Center in Reston, Virginia. She is dedicated to providing patients with the exceptional dental, sleep and orthodontic care using the latest innovations in medical technology.Contact Airway and Sleep Group at 571-244-7329 to request an appointment or virtual consultation.

Advanced Technology Aids in Proper Diagnosis“Pain related to the temporomandibular joint (TMJ) is common in the general population,” states an article published by the National Institutes of Health’s National Library of Medicine. Yet only about three to seven percent of the patients with associated pain seek medical attention. Advancements in imaging of the temporomandibular joint are helping dental and health professionals properly diagnose TMJ disorders and better understand the biomechanics of the TMJ. The modalities include non-invasive imaging methods such as radiographs, ultrasound, CT, and MRI, all the way to invasive imaging like arthrography.

Interdisciplinary Collaboration at Airway and Sleep GroupWhen working with dental patients, age can matter, especially in dental care for infants and young children and adults. And the critical ages from birth to five, before the adult teeth have erupted, sets the stage for the future. That’s why the interdisciplinary collaboration between pediatric dentistry and craniofacial orthopedics in orthodontics at Airway and Sleep Group’s “Zero to 5” program series is so important.The Zero to 5 ProgramIn the Zero to 5 program, early intervention is recommended to get a patient’s craniofacial growth off to the best start. Deficient craniofacial growth can affect a child’s airway development, leading to problems with sleep — like sleep apnea, tooth alignment, and the space for the tongue. It’s also shown as a root cause of some behavioral problems and learning issues.With an interdisciplinary collaboration between a pediatric dentist and a craniofacial specialist, you have the best of both worlds.Why Interdisciplinary Collaboration is so Important Between Pediatric Dentistry and Craniofacial Orthopedics in OrthodonticsA “regular” dentist’s office can be scary for a young child, with its professional and sterile demeanor. A pediatric office, on the other hand, is set up for children, with bright colors and toys, language that helps children relax, and technology sized for smaller mouths. Your pediatric dentist can also be the first to identify an issue in your child’s airway or craniofacial development. They’re familiar with normal growth and anatomy and can pinpoint a problem area early. This is where interdisciplinary collaboration comes into play. The pediatric dentist may call in a craniofacial specialist for evaluation. If anomalies or issues are found, a plan utilizing both dental specialties can be created to address them before they have the chance to impact your child’s growth and development.Every child’s mouth and bite are different and unique, and with interdisciplinary collaboration, you have the advantage of modern technology and child dental health experts of multiple disciplines at your fingertips.What Is Craniofacial Orthopedics in Orthodontics?First of all, what is orthodontics? Simply put, it’s the dental specialty that diagnoses and treats teeth and jaw irregularities in people ranging from children to adults. These abnormalities can include things like crooked, crowded, or impacted teeth, bite problems, and jaw misalignment.Craniofacial orthopedics is a sub-specialty of orthodontics that focuses on tooth and jaw development and growth, along with facial malformations like a cleft palate or cleft lip. A child’s jaw may not develop in an optimal proportion to the face, which can affect speech, chewing, or airway openness. Early intervention can lead to desired outcomes in facial harmony, bite coordination, normal dental functions, and airway openness.Through Airway & Sleep Group’s Zero to 5 program, we work with children and their pediatric dentists like Dr. Rishita Jaju of Smile Wonders to catch and treat potential complications early. This helps prevent the need for more serious or invasive treatments later on. Schedule Your AppointmentFor more information, contact Airway & Sleep Group at 571-244-7329. You can also fill out our online contact form, and we’ll get back to you as soon as possible.

Whitley Tineo contacted Airway and Sleep Group responding to our posts on Myofunctional Therapy and expressed interest in learning more about the program. Here’s what she said, “I just found one of your articles about the proper placement of the tongue and the ill effects of improper habits and I just needed to thank you. For many years I’ve dealt with overcrowding and feeling as if my tongue is too big for my mouth to the point that I was constantly noticing it many times a day and especially into the night. I tried the exercise about how the tongue should be properly placed and was more than astounded that for that time I was temporarily relieved of my issue! Of course I know that it is something I am going to have to practice several times a day for a while, especially considering the years I was doing it incorrectly. Thank you for listening,”If you would like to know more about Myofunctional Therapy at Airway and Sleep Group contact us at 571-244-7329 or visit airwayandsleepgroup.com.

In this Airway and Sleep Group Podcast Dr. Liliana Calkins interviews Dr. Francisco Eraso. Dr. Francisco Eraso is a specialist in orthodontics and oral and maxillofacial radiology. A member of the American Association of Orthodontics, American Academy of Oral Maxillofacial Radiology and the International Association of Dental Maxillofacial Radiology. He is a practitioner in Indianapolis and one of the founders of Beam Readers Diagnostic Services. Why do you consider CBCT an essential diagnostic tool for imaging anatomy of the craniofacial complex within dentistry or the specialty of orthodontics?Knowing anatomy is power. If you know your anatomy you derive different solutions. Anatomy all point you in the right direction for TMJ, orthodontics and airway.In order to be successful in orthodontics, you have to know your anatomy and the impact of anatomy on the orofacial complex.Teeth are not only to be straightened. Orthodontist who think they can do everything with aligners are wrong. The knowledge learned about a patients basic oral anatomy is essential in creating a diagnostic plan.A lot of people do aligners based on crowns by taking scans and a panoramic, however in the panoramic you do not see the boundaries of the mandibular bone and you pretend that you’re going to move teeth.Sometimes you are lucky and you have some movements, however if you don’t know where the root is in the bone it is very difficult to be efficient in the movement. The knowledge of where the roots of are positioned in the mandibular bone is essential.Why do you need 3D imaging for diagnostics?CBCT is an essential diagnostic tool for imaging anatomy, of both of the mandibular bone and the maxillofacial complex. We are not only bone and teeth, but we are surrounded by amazing structures like the airway, TMJ and maxillary sinuses. And the only tool that can show you the 3D structure is CBCT.You also learn about the floor of the sinus, which is within close relationship with the roots of the molars. Sometimes it is difficult to move the molars in the mesial direction or the distal direction because of the relationship of the roots with the cortical alignment on the floor of the maxillary sinus.If you don’t have a 3-dimensional knowledge or image or interpretation where the roots are, you are going to be blind in creating your treatment plan. You are going to move teeth in the computer, the crowns are going to move fantastically in the software but in reality the treatment is going to be very inefficient. So if you don’t take into account 3D anatomy, like with Invisalign, or any kind of aligner software, sometimes you have to do an infinite number of refinements to an orthodontic aligner treatment. Some people think that is fine, but in actuality it is orthodontists that are not doing a good job because they did not study the anatomy. That is why Using a diagnostic tool to uncover the underlying anatomy is essential in developing an effective orthodontic plan that achieves success.What is the trend that you see in the adoption of CBCT by dental care physicians and the implementation of radiology reports?Over the years we create habits and the habit of every dentist is to take a panoramic x-ray, bite-wings. Most offices are equip with these two diagnostic tools so that is what they use. However, these tools won’t give you anything. The only thing you can get from a panoramic is to count teeth. It won’t give you a good localization of impact teeth, or an excellent view of the temporomandibular joint, nor the maxillary sinus, or airway. Today, we don’t have an excuse not to have a CBCT, because CBCT’s are used everywhere. Getting a CBCT is like knowing the truth. The radiologist will give the knowledge to you, you just cannot fear knowing the truth. You want to have the best tools for diagnosis.How can you do

Some patients with malocclusion do not realize that their tongue might have limited space, causing them to continuously or very frequently bite or damage their tongue and lips. The lack of tongue space and proper chewing coordination is overwhelmingly due to lack of proper palatal size and improper tooth alignment. The position of the tongue at rest is considered to have a greater effect on the position of teeth than the short-term pressure of soft tissues around the mouth. It has been shown that in patients with severe maxillary constriction, the space required to accommodate the tongue close to the roof of the palate is inadequate, and tongue posture is lower than desirable which can cause frequent tongue and/or cheek biting. Chronic tongue, cheek or lip bites could lead to more damaging conditions like oral cancer. Cheek biting can affect people of all ages, but it may be more likely in children. When someone repeatedly bites their cheek, the area can become thick, scarred, and paler than the surrounding tissue. Sometimes, the affected area may become inflamed with purple spots. In more severe cases, dentists may notice eroded tissue in the cheek.Rapid Maxillary ExpansionRapid Maxillary expansion addresses the need for the proper palatal size, and correct tooth alignment. A study on the Stability of Maxillary Expansion and Tongue Posture concluded that a higher tongue posture can be obtained with Rapid Maxillary Expansion in children with no reported respiratory disturbances. Rapid Maxillary expansion addresses the creation of space inside the mouth leaving ample room for the tongue to eliminate the problem of cheek biting.Myofunctional AppliancesA study on The Effects of Early Preorthodontic Trainer Treatment on Patients that have front teeth which are tilted forward and protruding outward demonstrated that the preorthodontic trainer application lends itself to dentoalveolar changes that reduces this  poor alignment and improves the patient’s facial profile by promoting favorable mandibular growth changes. Much attention has been paid to the problem of controlling dentofacial growth interferences caused by abnormal lip and tongue function in the mixed dentition period. Various appliances have been presented for the treatment of this problem.  The main purpose of these appliances has been to eliminate oral dysfunction, establish muscular balance, and correct or diminish maxillary incisor protrusion with correct positioning.Myofunctional appliances have been used for many years. These appliances eliminate oral dysfunction, establish muscular balance, and correct or diminish maxillary incisor protrusion. Contact Airway and Sleep Group if you or a loved one has issues with tongue-lip or cheek biting—a myofunctional appliance can help.

There are more than 8 million CPAP users in the United States with numbers increasing by 8 to 9 percent yearly. Though, persons with sleep apnea that choose to use a CPAP machine can experience some of the common side effects.Nasal congestionNasal congestion is one of the most common side effects associated with CPAP therapy caused by the flow of dry, pressurized air through the sinuses. This can include the feelings of stuffy nose, runny nose, a burning sensation, or nosebleeds. Dry mouthWaking up with dry mouth or a dry throat typically is caused by breathing dry, pressurized air of a CPAP machine.Dry eyesAs escaping air blows across your face, a mask leak can dry your eyes while you sleep. You may not even notice, as the amount of leakage can change with your sleeping position throughout the night.  Bloating, Burping, and GasWhen the flow of continuous positive airway pressure becomes difficult to breathe against, it can end up redirecting into your esophagus and you end up swallowing air causing aerophagia. Aerophagia symptoms include bloating, burping, stomach pain, and passing gas. Difficulty ExhalingSome people may find it difficult to exhale against the continuous flow of air. This can lead to the sensation of shortness of breath even though enough air is allowed.Skin Irritation and AcneBecause your CPAP mask can collect skin oils, dead skin cells, and sweat while you sleep, this can can lead to the build up of germs and bacteria which can cause skin irritation, rash, acne, and sores. ClaustrophobiaClaustrophobia, or the extreme or irrational fear of confined places can cause new CPAP users to find it difficult to adjust to the feeling of wearing a CPAP mask and tubing. This is especially true for those who require a full face mask. While the feeling usually goes away with time and practice, the fear can make it difficult to get into the habit of regularly using your CPAP machine. Surgical OptionsThere are many surgical options for treating sleep apnea, depending on how severe your sleep apnea is and your overall health. Surgery improves disease severity, reduces early mortality risk and cardiovascular risk. Some of the surgical options include:• using radiofrequency waves to shrink or remove tissues in the back of your throat, opening up your airway•  removing extra tissue from the top of your throat and the back of your mouth.• jaw repositioning to create more space behind the tongue.• slightly tightening the tendons in the front of your tongue. This can prevent your tongue from rolling back and interfering with your breathing.• removing a portion of the back of your tongue. This makes your airway larger.• removing both your tonsils as well as tonsillar tissue near the back of your tongue. Your doctor might recommend this option to help open up the lower part of your throat for easier breathing.• straightening your nasal septum, which can help straighten out your nasal cavities and make it easier to breathe.•moving the hyoid bone and its nearby muscles at bottom of your tongue in your neck to open up your airway.If you are unhappy with using a CPAP machine for your sleep apnea and would like to learn more about surgical procedures to correct your condition, call our Reston office at (571) 244-7329 to schedule an appointment.

One out of 6 patients suffer from Orofacial pain disorders. Learn how Orofacial Pain Conditions originating from the head, face or neck like migraines or TMJ can be diagnosed, managed and treated.

Airway and Sleep Group is the first specialist in orthodontics accepting cryptocurrency locally for Virginia and the US. Making the exchange of cryptocurrency available to its customers, Airway and Sleep Group now accepts cryptocurrency payments via Ethereum, Cardano and Binance. WIth the annual inflation rate in the US surging to 6.2% in October of 2021—the highest since November of 1990—people are starting to be concerned about the value of their U.S. dollars and have become more interested in blockchain technology. It’s estimated that there are currently 2.2 billion individuals across the world don’t currently have access to traditional systems of banking or exchange. However, they do have access to the Internet or mobile phones. The potential to make asset transfer and transaction processing available to this vast market of willing consumers is available in the cryptocurrency ecosystem.Blockchain technology, or cryptocurrency, is a type of currency which uses digital files as money. Cryptocurrency is a form of payment that can be exchanged online for goods and services. In other words, cryptocurrency is a medium of exchange, such as the US dollar, but is digital and uses encryption techniques to control the creation of monetary units and to verify the transfer of funds. Digital signatures can be used to keep the transactions safe, and let other people check that the transactions are real.Like any currency, cryptocurrencies gain their value based on the scale of community involvement (like the user demand, scarcity or coin's utility). The value of anything is determined by supply and demand. If demand increases faster than supply, the price goes up. Cryptocurrency transactions lead to greater clarity in establishing audit trails, less confusion over who should pay what to whom, and greater accountability, in that the two parties involved in a transaction each know who they are. Cryptocurrency lends itself to more confidential transactions by being a unique exchange between two parties, the terms of which may be negotiated and agreed in each case which guards the privacy of your financial history and protects you from the threat of account or identity theft.To learn more about how to pay for goods and services from Airway and Sleep Group using cryptocurrency, contact us at 571.244.7329.

At Airway and Sleep Group, we are driven by and attribute great value to people in our industry that exhibit the best practices of visionary leaders. Great visionaries not only have a strong perception of what might make useful tools and practices for a prosperous future, but they remain open-minded and know when to bring the right people into the fold to achieve their goals.Elon Musk is one of the great visionaries of our time because he remains optimistic, focused, and skilled at communicating his ideas. He is also not afraid to take risks. As the co-founder of PayPal (PYPL) and Tesla (TSLA), as well as the founder of SpaceX, Neuralink, and The Boring Company, he has developed and built new technologies that inspire every aspect of our life in science and medicine.Incorporating ideas developed by the brightest minds of our lifetime in our field is part of Airway and Sleep Group’s office culture and values. It is what drives our philosophy of care, innovation and use of technology. Staying up-to-date with the current research on optimizing airway is paramount to our brand in offering parents and patients with the optimal solutions to their problems to resolve sleep quality issues, provide optimal orthodontic treatment and improve overall quality of life. Our efforts in providing the latest technology to alleviate pain, diagnose oral health and applying the best treatment plans for orthodontics are ongoing. We make it our mission to ascribe to be a visionary leader in our field.Visit www.airwayandsleepgroup.com to learn about the latest advancements and applied research on airway development, treatments for sleep apnea and facial development. Listen to our podcasts here: https://www.buzzsprout.com/1718886/episodes

Some people find it adorable when a baby sucks his or her thumb. Although that is a normal occurrence, the continuation of the habit into the toddler and elementary school years of a child could negatively affect their oral and facial development.Thumb sucking can cause some children to create what is commonly known as a dental openbite (a vertical space between the upper and lower teeth where the teeth do not touch). This open bite is a dental issue most difficult to correct.Other children will suck their thumb to the point that it appears that their top teeth are “sticking out”. This would require orthodontic treatment to correct. But the biggest issue that thumb sucking causes is changes to the bottom jaw that can affect the normal growth of the jaw which negatively affects the child’s face. This is caused by the thumb or finger preventing the lower jaw from coming forward and growing properly during thumb sucking.The negative effects to the teeth and jaw depends on the frequency, intensity and duration of the child’s sucking habit.  Frequency is the number of times the child is sucking during the day.  Intensity is the amount of force that is applied to the teeth and jaw during sucking.  Duration is the total amount of time spent sucking.  The more frequent, the more intense and the longer the duration of the sucking habit, the more likely it is to affect the child’s developing oral structure and jaw.Dr. Liliana Calkins is a Specialist in Orthodontics and Craniofacial Orthopedics at Sunrise Orthodontics Facial & Airway Development Center. As an esteemed member of the International Academy of Orofacial Myology and the American Academy of Dental Sleep Medicine she is trained to address pediatric facial development issues resulting from thumb sucking. Schedule a consultation for your child by visiting www.airwayandsleepgroup.com.

The study published in the Dove Press journal in 2014 concluded that there is no significant functional dependency between oxygen saturation and chest expansion for adults living with Cerebral palsy. In other words, oxygen saturation is not uniquely determine by chest expansion. Despite the decreased chest expansion and the significantly reduced lung volume in adults with cerebral palsy, they are still receiving sufficient oxygen supply. Moreover, a significant correlation between oxygen saturation and lung vital capacity and oxygen saturation and the deviation of lung vital capacity was also absent.The second question addresses in the study concerned the deviation of vital lung capacity and decreased chest expansion, in the persons with and without scoliosis. People with scoliosis showed a larger deviation of the measured chest expansion from the normal values than did the people without scoliosis. Though, there was no significant difference in the oxygen saturation for persons with scoliosis and those without.So the study concluded that decreased chest expansion does not affect the level of blood oxygen saturation.The natural question that arises is how does oxygen saturation remain at normal levels? All patients in this study underwent physiotherapy and performed respiratory exercises several times a week. Also, they frequently had different therapies like: Bobath physiotherapybreathing exercisesand speech and swallowing therapies to prevent contractures to retain their mobility and facilitate their breathing. Moreover, they were regularly examined by an experienced orthopedic surgeon and internal doctor. Considering the positive results that swimming exercises have been observed to have on the enhancement of lung vital capacity  in children with Cerebral palsy, the normal levels of oxygen saturation observed here likely reflect the training that these patients receive every week. The scientists concluded that physical therapy and training programs should therefore be a part of schools and centers for persons with physical disabilities. Moreover, since the mobility of individuals with Cerebral palsy is reduced, this suggests that they do not need the same physiological lung vital capacity and chest expansion as normally developed, healthy adults.

There are a number of reasons why breathing through the nose is more beneficial for your health as opposed to breathing through the mouth. Breathing through the nose helps to reduce exposure to foreign substances. It also humidifies and warms inhaled air. Moreover, a study reported in the Lancet showed that breathing through the nose improves lung capacity, functional residual capacity and residual volume.The study used 3 groups people. The first group had partially blocked noses who had been admitted for surgical relief of chronic nasal obstruction. Eleven underwent polypectomy. Eleven had septal surgery. And five had submucous diathermy to the inferior turbinates. The second group had vaseline packed gauze placed in the nose. And the third group had interdental wiring where the teeth were wired together to keep the mouth closed.Results of the StudyIn the 27 patients who underwent nasal surgery with partially blocked noses, the Total Lung Capacity (TLC) decreased by 8%. The functional residual capacity (FRC) decreased by 13%. And the residual volume (RV) decreased by 26%.Whereas, in the 7 patients who underwent overnight nasal packing, the study showed a decrease in TLC of 6% FRC of 13%, and RV of 28%.And in the 9 patient’s who underwent interdental wiring, the study showed that it led to an increase in TLC of 5%, an increase of FRC of 11%, and an increase of RV of 23%.ConclusionIt is sometimes assumed that functional residual capacity (FRC) increases with increasing severity of nasal obstruction. And residual volume (RV) falls after nasal septal surgery in both adults and children.As a result of the study, we can conclude that breathing through the nose as opposed to the mouth increases total lung capacity. It also increases functional residual capacity and residual volume. Complete exclusion of the nose from the breathing route was associated with a decrease in lung volume. Whereas, a relative increase in nasal resistance led to an increase in lung volumes.The implication is that in addition to warming, humidifying, and filtering the inspired air the nose has a role in maintaining FRC. Therefore, the action may indirectly, affect arterial oxygen saturation or increase air flow to arteries, veins, and nerves and increase oxygen uptake and circulation.Airway and Sleep Group helps individuals all over the country treat sleep apnea and regain the health benefits of getting a good night’s rest. If you suffer from inadequate sleep, interrupted sleep or wake up feeling tired, sleep apnea may be to blame. Contact us for a comprehensive diagnosis to determine the proper treatment for your condition. Visit www.airwayandsleepgroup.com for more information.

Research by the Journal of Clinical Sleep Medicine studied the effects of coexisting asthma and obstructive sleep apnea on sleep architecture, oxygen saturation and systemic inflammation in women. Three hundred eighty-four women ages 20 to 70 years underwent overnight polysomnography. The subject also completed questionnaires on airway diseases and sleep complaints. The study analyzed the effect of asthma, OSA, and the combination of asthma and OSA on objectively measured sleep quality and systemic inflammation.Asthma and OSA show higher levels of inflammationThe study found that the group with both asthma and OSA had higher CRP and IL-6. CRP is a type of protein that is associated with inflammation in the body and can cause unexplained exhaustion, pain, muscle stiffness, soreness and weakness. Very high CRP levels can also cause symptoms like headache or insomnia. IL-6 is an important mediator of fever and of the acute phase response. An elevated IL-6 may mean that the person tested has an inflammatory condition.Less Quality Sleep for those with Asthma and OSAThe group with both asthma and OSA also had a longer sleeping time in stage N1 sleep and stage N2 sleep. This group also had less time in REM sleep or “rapid eye movement” sleep than the control group with no asthma or OSA.Stage N1 sleep occurs right after you fall asleep and is very short (usually less than 10 minutes). It involves light sleep from which you can be awakened easily.Stage N2 sleep lasts from about 30 to 60 minutes. During this stage, your muscles become more relaxed and you may begin to have slow-wave (delta) brain activity.As REM is often considered the most important and most restorative sleep stage and individuals with both asthma and obstructive sleep apnea get less of it, the study concluded that individuals with both asthma and obstructive sleep apnea are strongly associated with poor sleep. Asthma and Obstructive Sleep Apnea sufferers also have higher levels of CRP and IL-6. These markers denote higher levels of systemic inflammation which can cause fatigue, fever, and joint and muscle pain.Treating OSAAirway and Sleep Group employs the latest technology in treating obstructive sleep apnea. Your path to a better night’s sleep begins with a comprehensive examination and diagnosis. Visit www.airwayandsleepgroup.com and visit our blog or podcast pages to learn more about how we treat obstructive sleep apnea.

Airway and Sleep Group uses Doppler Auscultation because it is an effective screening tool to diagnose TMJ Health and disorders. Doppler Auscultation allows Dr. Lillana Calkins to listen to a patient’s joints by using a stethoscope with a microphone that incorporates the Doppler wave effect. The sounds give us an indication of the amount of friction and quality of lubrication within the joint.Doppler Auscultation and Piper ClassificationsListening to our patient’s joints is an important step in the TMJ-Occlusal Exam process. Dr. Mark Piper introduced the use of a Doppler in dentistry in the 1980’s.  Therefore, Piper Classifications helps to assess a patient’s joint health when using Doppler Auscultation.  By listening to the joint, and noting when the pop or click occurs, we can determine where the disc is off. We Diagnose the TMJ problem as classifications of 1 through 5. For example:• Class 1 denotes a normal joint.• Class 2 and 3 means that the patient has lateral pole issues if the noises occur after translation has begun.• Class 4 and 5 means the patient has medial pole issues because the pop, or click occurs during rotation and the disc is displaced. An MRI or CAT scan can allow for a definitive diagnosis.The Easy TMJ-Occlusal Exam processAfter setting up the device, the patient will open and close their mouth slowly. If there are no sounds, we can assume that the patient has an intact joint that is well lubricated.If there are noises, then the next step will determine whether it is a medial pole issue or lateral pole issue. To test the Medial pole, the patient will place their tongue on the roof of their mouth and just open half way. The motion will be pure rotation. To test the Lateral Pole, the patient will open wide and close, then have the patient move to right, left and protrusive, which are all in Translation. TMJ Diagnosis with Doppler AuscultationIf you are experiencing jaw pain and think you may have a TMJ disorder, schedule a consultation to get a definitive diagnosis at Airway and Sleep Group. Our commitment to employing the latest medical technology will put you on the right path to resolving your pain issues.Visit www.airwayandsleepgroup.com for more information.

Magnetic Resonance 3D Imaging (MRI) helps orthodontists like Airway and Sleep Group predict changes in bony or soft tissues associated with treatment, over time. Orthodontic patients are generally children and are more susceptible to the harmful effects of ionizing radiation. Airway and Sleep Group makes every effort to minimize or eliminate the exposure of our patients to ionizing radiation. A patient’s ability to use MRI in orthodontic diagnosis and screening would be an important step in the right direction because it would completely eliminate the patient’s exposure to ionizing radiation. MRI puts the principle of ALARA which stands for “as low as reasonably achievable” into maximum effect in terms of radiation exposure. This principle means that even if it is a small dose, if receiving that dose has no direct benefit, you should try to avoid it.Magnetic Resonance Imaging (MRI) is more accurate than Periapical X-rays for measuring tooth lengths. By understanding how well braces, oral appliances, and other therapies are working throughout the treatment plan, practitioners can make adjustments along the way to ensure a truly successful outcome. MRI imaging allows for repetitive 3-D imaging of dental structures in any age group without worrying about potential harmful radiation exposure to monitor the progress of orthodontic tooth movement.Why MRI is the best for 3D ImagingMRI is the first choice of 3D imaging for assessment for implant placement. It is now also the gold standard for temporomandibular joint (TMJ) imaging because it is used to see the soft tissue component of the joint.There are many advantages to using MRI for 3D imaging. The first is its ability to image the TMJ and disk. Secondly, an MRI can also show the display of soft and hard tissues and give you the ability to see inflammatory processes. And thirdly, MRI is also safe to use for patients who are allergic to the contrast agent and can be obtained without repositioning of the patient.How an MRI worksMRI works by recording a resonance signal from the excited hydrogen atoms created by a magnetic field. The scanner is a magnetic field surrounding the patient. Gradient coils then turn on and off to vary the magnetic field. As the magnetic field excites atoms. it senses an equilibrium state energy. The energy from radio waves and the magnetic field then gets converted to a number.  A computer processes the number and then converts that to an image. MRI images the water in the tissues.Parents considering using MRI to diagnose orthodontic issues in their children can contact Airway and Sleep Group for a referral from Dr. Lilliana Calkins. Dr. Calkins dedicates her time to improving the conditions to support facial growth and airway development. She does this through the use of craniofacial orthopedics, orofacial myology and interceptive orthodontics. Visit www.airwayandsleepgroup.com for more information.

Airway and Sleep Group offers an easier way to treat TMJ pain—MLS Laser Therapy. Medical News Today states that around 12 percent of people in the United States experience TMJ disorders at any one time. Nine to 1, women experience more severe pain and restricted jaw movement than men. Though custom-made splints, physical therapy and surgery are some of the ways to permanently get rid of jaw pain, MLS Laser Therapy treatments are uniquely designed to facilitate healing and reduce inflammation at the cellular level.MLS Laser Therapy treatmentsThe MLS Laser is truly magnificent at what it does. Patients love this form of therapy because it is non-invasive and painless. It treats symptoms associated with TMJ dysfunction, such as craniofacial pain, inflammation, and muscular pain.By using a color touch-screen software interface, the MLS Laser accelerates healing, speeds tissue repair, and stimulates the growth of new cells. MLS Laser Therapy is a fast, easy, and effective way to manage TMJ pain.  Because it uses synchronized continuous and pulsed wavelengths, its results are magnified. Because the energy from the laser stops inflammation from happening, it allows the cells to begin the healing process immediately.Airway and Sleep Group uses this patented, FDA-cleared technology because it has an 85% – 90% efficacy rate in relieving pain and inflammation. MLS Laser Therapy eliminates risk from surgery and prescription pain killers, has no negative side effects, and alleviates patients’ jaw pain. It's also quick and painless, and immediately effective in some cases. As an added benefit, a typical session only lasts 15 minutes. The technology works by stimulating cell regeneration. This causes an increase in blood flow to the treatment area, which decreases inflammation and pain.Diagnosing TMJMLS Therapy Laser treatments allow doctors like Dr. Liliana Calkins of Airway and Sleep Group to finish cases faster, prescribe less medication, and restore patients' lives. Schedule a consultation to determine your medical diagnosis. Dr. Liliana Calkins looks at joint history, orthodontic history, pain history, and trauma history to determine whether MLS Therapy Laser treatments are right for you. Visit www.airwayandsleepgroup.com to schedule your consultation.

CPAP Recall Due to Cancer RiskMillions of breathing machines used to treat sleep apnea have been recalled due to testing showing that the machine causes users to inhale cancer causing toxins. Philips Dreamstation, a CPAP machine that was recalled, uses sound dampening foam that may degrade into particles and off-gas chemicals which are inhaled by its users. The FDA has noted the presence of black debris and particles within the device’s air pathway and says that breathing those in could result in serious injury which can be life threatening or cause permanent impairment. The effects could lead to irritation or asthma and could even cause carcinogenic effects. The Need for a Good Night’s SleepDr. David Clayman directs the Sleep Disorders Center at UCSF and has informed his patients of the possible side effects encouraging those with milder cases of sleep apnea to make the decision for themselves of whether to continue use of the machines as he cannot offer any guarantees whether the machines are safe.Sleep apnea is a serious sleep disorder affecting 25 million people where people’s breathing during sleep repeatedly stops and starts.nSome people with severe sleep apnea assume the risk of using their CPAP machines despite the risks for cancer as they believe that not getting enough sleep could result in greater health risks that could cause danger to themselves and others, like falling asleep while driving.It is important to note that people with CPAP machines tend to use an ozone cleaning system to clean them and that may be causing the sound abatement foam to degrade even faster.The Orthodontic Alternative to Using CPAP MachinesSleep apnea sufferers can turn to orthodontic treatments to treat their sleep apnea and avoid the risk in using a CPAP machine that can negatively affect their health in the long run. Why risk inhaling cancer-causing toxins from CPAP machines when making adjustments to the shape of your mouth has been found as a proven method of treatment to improve your airway?A review by the Department of Health, Life and Environmental Science, University of L’Aquila and the Academy of Orofacial Myofunctional Therapy showed rapid maxillary expansion (RME) as an effective treatment for obstructive sleep apnea syndrome (OSAS). The Rapid Maxillary Expansion treatment uses a device implanted into the roof of your mouth to widen the bones and tissue of your mouth to leave ample space for the tongue to relax. A space created between your two front teeth are then corrected using traditional orthodontic appliances.Do You Suffer From Sleep Apnea?Other alternatives to CPAP can include:• Dental appliance that repositions the lower jaw and tongue • Upper airway surgery to remove excess tissue • Nasal expiratory positive airway pressure with a disposable valve covering the nostrils • Treatment using hypoglossal nerve stimulationAt Airway and Sleep Group, we work with patients on treatments for sleep apnea regularly. Contact us for your initial consultation or visit www.airwayandsleepgroup.com for more information.

Teeth do not become crooked by chance. Modern research reveals most orthodontic problems are the result of incorrect jaw development. The most up-to-date evidence reveals hereditary factors or big teeth in small jaws are not responsible for crowded teeth or incorrect jaw development either. Moreover, braces and extracting teeth in teenage years does not solve the underlying causes of crooked teeth and incorrect facial development. So what is proven treatment for crooked teeth, improved airway and oral health?A Myobrace® Treatment is a preventive pre-orthodontic treatment that focuses on addressing the underlying causes of crooked teeth, often without the need for braces. Myobrace® treatment is also used as a way to improve oral health, facial development and aligning the jaws and teeth without extracting any teeth by unlocking natural growth and development and improving airway. Treatment is best suited to children aged 3 to 15 and involves using a series of removable intra-oral appliances that are worn for 1-2 hours each day plus overnight while sleeping.What Myobrace® treatment does:Corrects poor oral habitsDevelops & aligns the jawsStraightens the teethOptimises facial developmentImproves overall healthPromotes healthy eating habitsHow does it do this? By helping the child:Breathe through the noseCorrect tongue resting positionSwallow correctlyKeep the lips togetherYou shouldn’t wait until all permanent teeth have come through to begin treatment with braces. This can unfortunately lead to irreversible damage affecting not only the teeth, but also the child’s overall health and development.Poor myofunctional habits (poor oral habits) can be seen as early as three years of age before all permanent teeth are present. This means treatment of the causes can begin much earlier than originally thought.Myobrace® is designed to deal with incorrect myofunctional habits by teaching children to breathe through their nose, rest the tongue correctly in the roof of the mouth, swallow correctly and continue widening the jaws so they grow to their full and proper size. This results in sufficient room for the teeth, allowing them to come in naturally straight and often without the need for braces.How it WorksThe Myobrace®System consists of a series of intra-oral appliances that are worn for one hour each day plus overnight while sleeping. The appliances assist in correcting poor oral habits and expand the arch-form while exerting light forces to align the teeth and jaws. Separate appliances are used depending on the child’s age and type of orthodontic problem. Myofunctional therapy exercises are to be performed twice daily in conjunction with wearing the Myobrace® appliance and consist of a series of breathing, tongue, swallowing, lip and cheek exercises.Schedule an evaluation to determine if you or your child is suitable for Myobrace treatment. Call Dr. Liliana Calkinsof Airway & Sleep Group at 571-244-7329.

You only get one set of permanent teeth, so it only makes sense to make sure that you do all that you can to preserve them. This can mean avoiding tooth extraction whenever possible by the use of orthodontic treatment.Dentists, and even orthodontists, learned that the best treatment for overcrowded teeth was to pull one or more, or extract them, to make room for the other teeth. However, for every action, there is a reaction. Even though tooth extraction can minimize crowding, there can be negative results with teeth shifting out of position and creating improper tooth alignment, which can and will affect the bite. It is unfortunate, but the negative results aren’t always discussed.Orthodontic treatment reduces the need for tooth extraction. Your orthodontist may recommend a self-ligation braces bracket system called Damon System braces. These types of braces deliver faster treatment, greater comfort and consistent results.Damon braces are “tie-less” and use a slide mechanism that eliminates the need for elastic or metal ties that require tightening. This allows the teeth to move freely. The system’s high-tech, shape-memory wires move teeth with fewer adjustments and aligns teeth usually without tooth extraction or rapid palatal expanders.If you’d like to know more about the Damon system, reach out to the orthodontists at the Sleep & Airway Group.

Many people have malocclusions and are unaware of the cause. A malocclusion is the imperfect positioning of the teeth when the jaws are closed. An insufficient alveolar bone is a common find among patients with malocclusions. Cumulative alveolar bone loss results in a weakening of the supporting structures of the teeth and predisposes the patient to tooth mobility and loss. It is one of the hallmarks of periodontitis.These problems have previously been insufficiently treated. With Surgically Facilitated Orthodontic Treatment patients can now be treated properly and efficiently.Malocclusions with insufficient alveolar bone have traditionally been treated orthodontically by removal of permanent teeth which has a number of negative side effects. Removing teeth doesn’t address the constricted arch form that can negatively affect function, esthetics, and the critically important airway. Surgically facilitated orthodontic therapy solves the real, underlying problem of insufficient alveolar bone and expands the traditional “orthodontic walls.”SFOT is a modern advancement in dentistry that results in faster tooth movement by more than 50%. SFOT detects underlying issues of the alveolar bone and arch issues and enhances myofunctional improvement. The treatment aids in ideal tooth position, minimizes number of surgeries, engineers’ new tissue and expands arch form. It can aid in improving esthetic concerns as well.https://www.sciencedirect.com/science/article/abs/pii/S0889540613010524https://sunrise-orthodontics.com/https://airwayandsleepgroup.com/

A study by Stanley Yung-Chuan Liu, Christian Guilleminault, Leh-Kiong Huon, Audrey Yoon found that Objective Distraction osteogenesis maxillary expansion (DOME) is a reliable method to expand the nasal floor and hard palatal vault in adults with obstructive sleep apnea (OSA). DOME results in a reduction in the apnea-hypopnea index (AHI) and subjective report of improved nasal breathing.A narrow maxilla with high arched palate characterizes a phenotype of obstructive sleep apnea (OSA) patients that is associated with increased nasal resistance and posterior tongue displacement. Current maxillary expansion techniques for adults are designed to correct dentofacial deformity. We describe distraction osteogenesis maxillary expansion (DOME) tailored to adult patients with OSA with narrow nasal floor and high arched palate without soft tissue redundancy. DOME is performed with placement of maxillary expanders secured by mini-implants along the midpalatal suture. This minimizes the maxillary osteotomies necessary to re-create sutural separation for reliable expansion at the nasal floor and palatal vault. We report the safety and efficacy profile of the first 20 patients at Stanford who underwent DOME.Airway and Sleep group employs the DOME technique for improving airway and combatting the effects of obstructive sleep apnea. Schedule a consultation to develop a strategic plan for airway improvement by calling 571.244.7329.

Your smile is objectively one of the most important and unique features of your face, would you like it if you could have orthodontic appliances specifically tailored to your dental and facial anatomy? Now, it is possible with Insignia. Unlike other orthodontic treatment options, Insignia is designed specifically for you.Insignia digital bracket system offers a digital design and custom appliance treatment for you to receive your desired smile outcome with efficiency and consistency. There are four steps to the digital bracket system: Scanning, design, building, and bonding.The patient receives a CBCT which produces 3D images of the teeth, soft tissues, nerve pathways, and bone in one scan. With the scans, case specialists provide a design that you can review and edit using Insignias Approver software. This way you can see and approve the desired future outcome beforehand. After the design is approved, it is time to build the custom brackets, wires, and placement guides. Once the custom brackets are fabricated, they are ready for bonding. The brackets are accurately placed with indirect bonding jigs.Insignia is some of the most advanced technology, tailored to your specific smile. It is fast, comfortable, and predictable. Be sure to look at the websites below for more information regarding this treatment.Websites:https://sunrise-orthodontics.com/http://airwayandsleepgroup.com/https://ormco.com/products/digital-orthodontics/insignia/insignia-advantage/

The combination of clear aligners and HFV or MOPs can resolve a variety of issues associated with previous botched orthodontic treatments by achieving maxillary growth and palatal expansion. These treatments have shown to be proven effective in treating temporomandibular disorders that may occur after improper orthodontic treatment.Case Studies of Dr. Ben Miraglia showed that expansive orthopedic and orthodontic techniques can solve a variety of issues that came about after improper orthodontic treatments.The combination of palatal expansion, clear aligners and HFV or MOPs resolved issues like• temporomandibular disorders.• headaches and jaw pain.• intermittent jaw locking• improper arch width• narrow deficient smile• and crowded malocclusionAirway and Sleep Group employs the latest technologies and orthodontic treatments that will help meet patient demands for a shorter orthodontic experience without sacrificing the quality care. Micro-osteoperforation (MOPs) deliver results quickly and with fewer office visits, accelerating the rate of orthodontic tooth movement by up to 62%. MOPs can even improve patient outcomes with greater clinical predictability.With a small perforation near the difficult tooth movement, MOPs stimulate the maximum biological response1 while remaining microinvasive and palatable to the patient.High-frequency vibration (HFV) with VPro is another advancement in orthodontic treatment. Patients only need to use the VPro device for just five minutes per day. This therapy has also been shown to reduce treatment time by up to 64%.These two therapies combined with aligner therapy and palatal expansion reduce treatment discomfort, increase case predictability, optimize aligner seating, and reduce the need for additional refinement aligners. Patient comfort is key to a good treatment experience and often helps with compliance and engagement in the treatment. Five minutes of “soft pulsation” per day has been shown to reduce orthodontic discomfort by releasing the pain receptors that reduce inflammatory pressure.If you or your loved one experience feelings of discomfort after recently completing orthodontic treatment, contact Airway and Sleep Group to schedule a comprehensive diagnostic consultation at www.airwayandsleepgroup.com.

This excerpt was taken from: https://dbortho.com/blogs/orthodontic-digest/lectures-and-hands-on-session-with-mse-creator-prof-won-moon-achieve-even-maxillary-and-mid-facial-parallel-expansion In partnership with DB Orthodontics, MSE Creator Professor Won Moon presented The Moon Principles by Won: Evolution of Micro-Implants Supported Midfacial Skeletal Expander (MSE) with Retrospective Overview, the Latest Development, and Prospective Advanced Applications.This event took place last May at the Radisson Blu Hampshire, Leicester Square—a must-attend for orthodontists with an interest in creating even parallel expansion of the anterior and posterior regions.In his lecture, Professor Moon demonstrated how the MSE is set apart from many traditional expanders. He detailed the evolution of expanders, discussed the challenges associated with traditional methods, and how the MSE overcame these challenges. He presented many of his successful case studies, best practice and troubleshooting protocols for the MSE.What is the MSE?The MSE is a unique micro-implant assisted rapid palatal expander (MARPE). In approximately 2004, following the recent availability of Mini-implants in the USA, Dr Moon began investigating different methods of mid facial expansion. Following his early designs of MARPEs, and the growth of similar appliances globally, the term MARPE became a generic term, although designs and protocols differed greatly. The MSE was a natural development from the MARPE; it differentiated itself from the pack.The MSE gives parallel expansion in both the anterior and posterior regions, in comparison to the v shaped anterior expansion created with traditional MARPE, Hyrax or other expansion devices.MSE’s success lies in its bi-cortical engagement. The protocol for securing the MSI involves inserting four mini-implants into the palatal bone and the nasal cavity; creating effective parallel expansion, and creating more of a mid-facial expansion as well as a maxillary expansion. The MSE also creates relatively parallel expansion by expanding the inferior as well as the superior aspects of midfacial structure because of the bicortical engagements. This, in turn, maximizes airway enlargement.Professor Moon also explained how opening the patients’ airways has improved the breathing and quality of sleep of many of his patients.Combined with a face mask, the MSE becomes a powerful tool when treating class III patients. The MSE can create a significantly greater amount of forward movement of the maxilla; beyond the scope of traditional face mask approaches.It promotes posterior force loading instead of middle or anterior loading. Traditionally, typically expanders are positioned more anteriorly, and the MSE is positioned in a more distal area – expansion is created into the nasal bone area and back into the zygomatic arch.Professor Moon presented many clinical cases showing how the MSE has been used in the treatment of young, older and mature patients; even extending to patients in their 50’s. Dr Moon also covered common mistakes to avoid; including the recommendation of a manual driver instead of motorised, and the importance of choosing the correct length of mini-implant to ensure full engagement in both layers of the cortical bone.Airway and Sleep Group hails the research provided by Dr. Moon and promotes the development of a healthy airway using the same principles of craniofacial orthopedics. Call 571-244-7329 to schedule a consultation.

Have you been at the beach or in a parking lot and noticed those Y-shaped green plastic pieces on the ground? Have you wondered what they are? Don’t get grossed out, but they are used flossers! Created as a convenience item for people to “floss on the go,” they often end up littering our shorelines, parks and public areas. It makes one think that we’re not being very responsible to our planet.Too many items like these flossers are designed for single use, and end up in our area landfills, or worse, littering our lives. It is amazing how much waste is generated each year. In 2018 alone, more than 292.4 million tons of materials and products were discarded, reported an Environmental Protection Agency study. Broken down by materials, paper/paperboard topped the list at 23.1%, followed by food, plastics, yard trimmings, metals, wood, textiles, and glass.A 2021 story in the Washington Post claimed that one third of all the food in the U.S. gets wasted, and that fixing that problem could help fight climate change. “About $408 billion worth of food, grown on 18 percent of U.S. farmland with 4 trillion tons of water, never make sit to someone’s stomach.” And that “the carbon footprint of U.S. food waste is greater than that of the airline industry—accounting for about 8 percent of all greenhouse emissions.”“When food rots in a landfill, it produces huge amounts of methane—a greenhouse gas at least 28 times as potent as carbon dioxide,” the author said. “But in compost bins, microbes convert that organic matter into nutrient-rich soil, keeping the carbon out of the atmosphere and producing valuable fertilizer.”How do We Change to Be More Responsible to our Planet?One of the best, and easiest, ways to reduce waste is to look for alternatives to single-use products. Grab cups or glasses for water instead of buying bottled water, take a reusable grocery bag to the store, or use washable cloths for cleaning.Think of the “three Rs” when making your choices: Reduce, Reuse or Recycle. How can you reduce the amount of waste you produce? Choose items with minimal packaging or lessen the quantity of food you discard by purchasing less or making better food choices, and composting what you can. Opt for glass plates and cloth napkins over disposables. Recycle perfectly-good items back into the community by donating them to charities with stores. This not only keeps items out of landfills, it helps to raise money for community-based causes. Support this reuse by shopping at thrift stores—you’ll get a great product and a bargain.Becoming more responsible to our planet is a matter of making better and informed choices. Start by making little changes, like recycling, or bringing reusable bags to the grocery store. Don’t purchase large amounts of food at each visit. Make a meal plan instead. Package your food or lunch in reusable containers. Instead of tossing out damaged items, fix them instead. And stop littering. These are all small changes that can make a big impact.Related: 9 Simple Ways to Reduce Waste in Your HomeAs a medical practitioner, Dr. Liliana Calkins is dedicated to the health and well-being of her patients. She’s also aware of how much she, and we all, can do to help create a healthier environment overall and be more responsibl

Now that you have completed your orthodontic treatment, that your smile is perfect, you might wonder why your tongue still does not fit your mouth? Why do you keep snoring? Why did you develop tinnitus or temporomandibular joint pain during or after your orthodontic treatment?Please consider that this might be the result of a “complimentary” consultation, in which you did not receive a comprehensive diagnosis, treatment plan or referrals for interdisciplinary care from your treating orthodontist. Airway and Sleep Group is focused on the realm of airway and sleep medicine in orthodontics. It is hard to see my profession missing the crucial steps of thorough diagnosis, a protocol that focuses not only on your teeth, but the impact of the adequate function of the craniofacial-respiratory system on your health. My consultations are not “complementary”, they however,  complement your health, and will more than satisfy your needs if quality of care is your paramount objective.The lure of a “complimentary” consultation, can actually be against you as patient for the long-term results. I have read plenty of reports from my patients, who did not receive a diagnosis, treatment plan or radiology report read by a radiologist. All these parameters matter for your health. Our patients arrive at my care wearing appliances for Temporomandibular joint disorder that are not monitored, that are causing posterior open bite. Our outstanding specialty in Orthodontics needs to honor the services rendered to our patients for the betterment of their health at a comprehensive level.When you come to Airway and Sleep Group you can expect your treatment to correct the shape and functionality of your mouth, tongue, jaw and bite by selecting the state-of-the-art orthodontic treatment best suited to achieve the perfect smile for you. We instruct patients on orofacial myofunctional therapy and treating temporomandibular dysfunction as well.Call or text 571.244.7329 to speak with Dr. Calkins for a consultation. Our specialists will keep your best interests in comprehensive oral health care, with quality of airway and sleep dental medicine in mind. 

At an early age in a child’s development, incorrect muscle function in the craniofacial (head and face) region can create problems like an anterior open bite, an open-mouth resting posture, or inadequate swallowing patterns. The solution: Myofunctional Therapy to encourage adequate facial and dental growth.What does a Myofunctional Therapy Session Include?In each Myofunctional Therapy session, the patient learns three to four exercises that target specific structural issues. Session one is comparatively easy, with exercises becoming more challenging with each visit. The good news is that these exercises are proven effective with no more than five minutes work, twice a day, with the exception of one timed exercise that can be done at any time. The time investment is small, considering the benefits.A tongue that is resting down and forward is related to a narrow palate, and lack of lip seal. So instead of the tongue being in its correct position (at the top of the mouth), it tends to rest low and pushes forward when swallowing. This is known as tongue thrust swallowing pattern.As a result, if this issue is allowed to continue, it will cause a loss of muscle tone in the intrinsic muscles of the tongue, which in turn, can lead to a range of problems from digestive issues to teeth movement. In addition, when the tongue rests low, the lips are usually parted, an issue that can lead to serious health concerns like sleep apnea and ADHD, as well as change the shape of the face.Your tongue is a muscle that can create a surprisingly strong force. It typically goes through repetitive movements about 1000 times a day! The force exerted by improper movement of the tongue contributed to deformation of the surrounding structures like the jaw. That’s why it is so important to correct any tongue malfunction or habitual misuse early through Myofunctional Therapy for encouragement of adequate facial and dental growth.Correcting MalocclusionMyofunctional Therapy may be required as part of the correction of a malocclusion, a condition in which the upper teeth and lower teeth do not meet in an optimal way. It provides a stable environment for the bite after completion of orthodontic treatment to encourage adequate facial and dental growth. To be treated successfully, an orthodontist must be aware of the neuromuscular forces association with a malocclusion. More seriously, a malocclusion can affect respiration.Get Treatment with Airway and Sleep GroupDr. Liliana Calkins, of Airway & Sleep Group, is trained to diagnose and treat abnormal activities in the tongue’s pattern movements, the muscles involved in chewing, and the muscles around the mouth and in the cervical neck area. To schedule an appointment, contact Airway & Sleep Group.

You can’t go anywhere nowadays without seeing or hearing something about how we need to work together to protect our environment. Even in our practice at Airway and Sleep Group, we try to do what we can. One way is by promoting and using biodegradable, sustainable products.There are plenty of eco-friendly items available. Like bamboo toothbrushes. According to the website ibannboo.com, “A plastic bottle can take up to a thousand years to decompose. A biodegradable toothbrush helps reduce more than 4.9 billon plastic toothbrushes that are thrown away every year and end up in our oceans and landfills.” This site claims to sell more than 10 million bamboo toothbrushes throughout the world each year! It’s part of their mission to reduce plastic waste.“Bamboo is completely biodegradable, making it a perfect alternative for daily-used plastic products,” it continues. The handle is composed of 100% sustainable bamboo and can be placed in a home compost or commercial composting bin, although the bristles, made from nylon and charcoal cannot, and must be removed. But they are the best option available to date. If the bristles were to be 100% biodegradable, they would need to be made from animal hair, which would not be suitable for cleaning teeth, and would potential harm animals.Natural toothpaste is another way to support environmental concerns. Many natural toothpastes are chemical free–without glycerin, fluoride, alcohol and SLS (a surfactant known as sodium lauryl sulphate, the ingredient used as a foaming agent), and come in recyclable containers. Essential oils like peppermint, spearmint and orange give it an appealing flavor.Instead of plastic floss containers, invest in a refillable metal one, and fill it with biodegradable dental floss. Other sustainable dental-related items can include tablet toothpaste, charcoal whitening, water flossers, and chemical-free mouthwashes.Care for Biodegradable, Sustainable ProductsYou may have to take a little extra care of your biodegradable, sustainable products. Because they are made of natural materials, it is important to keep them dry and clean. Store your toothbrush upright in and open-air container, and store dry ingredients in a cool and humidity-free environment.Chemicals to Avoid in Tooth ProductsRead the labels on dental-related items you purchase and try to avoid these chemicals, if possible:• SLS – can cause canker sores and irritation. Toxic to aquatic life when rinsed down the drain.• Sodium Chlorite – can be toxic to kidneys. Used as a bleaching agent in paper manufacturing.• Sodium Hydroxide – also known as caustic soda or lye. Can cause mouth and abdominal pain, diarrhea and vomiting.• Trisodium Phosphate – a harsh cleaning solution. Can cause algae overgrowth in water systems.• Titanium Dioxide – a chemical used to whiten paint, and used in some toothpastes. A potential carcinogen, especially if inhaled.• Alcohol – Some mouthwashes contain up to 25% alcohol! Can be dangerous to children and can lead to dry mouth.Green DentistryThe Eco-Dentistry Association® provides education and standards for dentists who choose to be green dental practitioners. Its educational programs, research and member resources help dental professionals reduce the impact on our environment and offer alternatives to patients concerned with a wellness lifestyle.Dr. Liliana Calkins is a specialist in Orthodontics & Craniofacial Orthopedics. To learn more about biodegradable, sustainable and chemical-free dental products, contact her at Sunrise Orthodontics or Airway and Sleep Group.

As everyone knows, poor sleep quality and waking up repeatedly during the night can cause one to feel fatigue during the day. But did you know that waking up during the night can be caused by heavy snoring, choking, gasping or breathing cessation? Sleep-disordered breathing can cause you wake up often during the night and is characterized by recurrent episodes of upper airway collapse during sleep.Obstructive sleep apneaObstructive sleep apnea (OSA) is the most common type of sleep-disordered breathing. The following symptoms are often present for years before the patient is referred for evaluation. Some signs of OSA during the night are:• Snoring, usually loud, habitual, and bothersome to others• Witnessed apneas, which often interrupt the snoring and end with a snort• Gasping and choking sensations that arouse the patient from sleep, though in a very low proportion relative to the number of apneas they experience• Nocturia• Insomnia; restless sleep, with patients often experiencing frequent arousals and tossing or turning during the nightIf you have OSA, you may feel upon waking as though you are as tired as you were when you went to bed. You may have a headache upon waking memory and intellectual impairment, personality and mood changes, Gastroesophageal reflux or Hypertension. To know for sure whether you have obstructive sleep apnea, an overnight sleep study, or polysomnography, is necessary. The study would record sleep stages, heart rhythm, leg movements, airflow at the nose and mouth, breathing effort and breathing patterns.Treatment OptionsSome steps you can take to help manage or prevent OSA is to manage your sleep position: avoid sleeping on your back, or sleeping upright. You should also avoid smoking, alcohol and sleep deprivation.People with moderate to severe apnea should be treated with nasal continuous positive airway pressure (CPAP), however there are other ways to improve airflow using craniofacial orthopedics—like Rapid Maxillary Expansion.Airway and Sleep Group specializes in craniofacial orthopedics and use the latest treatment options to modify your airway by changing the shape, size and relationship of the bones in the jaw and face. Their airway improvement techniques help to create enough space in your mouth for the tongue to treat obstructive sleep apnea.Read more here: https://emedicine.medscape.com/article/295807-overview

There is now an app to help kids (ideally from 4 to 18 years old) achieve the best postural habits for optimum face and airway development resulting in long-term health.The GOPex program, Good Oral Posture exercises is a regimen that can help guide children to acquire the habits that will foster excellent facial and jaw development and in turn allowing them to achieve their full genetic potential with large attractive jaws, healthy airway and a full (including Wisdom teeth) set of 32 straight and stable adult teeth.Human biology explains that pressure stimulates bone cells to grow. We know that astronauts that travel into space lose precious bone cells due to the lack of pressure from gravity. In the same way, when our muscles do not have good tone and are not exercised properly they will not exert the weight that bones need to maintain their optimal shape.By understanding this principle Forwardontics developed GOPex to help our muscles through changing modern habits. A series of simple exercises can be incorporated into daily activities to train the muscles to hold the posture with the adequate tonicity to apply weight to the cells and in turn allow the maximum growth of the facial structures.GOPex app works by allowing users to send videos performing postural exercises: chewing, counting or reading. Each video users send will be reviewed by the GOPex app which will provide 90 days of guidance and feedback for improvement.Incredible results will be observed in 30 days, but the goal is to make good posture a lifetime habit. GOPex utilizes brain plasticity to re-set children’s resting posture for growing healthier and preventing chronic disease.Application will be active for 90 days, but long-term subscription membership can be requested for continuing maintenance.Airway and Sleep Group understands that airway development exercises can teach children (and adults) to breath in a way that will help them develop proper nasal respiration, which allows the air to enter the body in the healthiest most efficient way.Take advantage of Airway and Sleep Group one-on-one expertise in orofacial myology to create a healthier more attractive you. Better muscle tone and improving the quality of your rest will be noticeable in many aspects of your health, both on your looks as well as in the way you feel. Call us at 703-646-9950.To learn more about the GOPex app go to http://www.forwardontics.com/store.html

There are over ninety diagnosable sleep disorders in children. These sleep disorders can affect kids’ brains, hearts, blood pressure, craniofacial and somatic growth, alteration in appetites.Ninety-five percent of children with obstructive sleep apnea (OSA) are never diagnosed. Children will struggle to function and stay awake, they have significant learning, behavior, speech and mood problems. Usually these children will be more likely diagnosed with ADHD.Craniofacial orthopedics and orthodontics are effective solutions for treating obstructive sleep apnea (OSA) by changing the shape, size and relationship of the bones in the jaw and face and creating enough space in your mouth for your tongue to relax naturally during sleep.Parents are invited to have a craniofacial growth evaluation early in the life of children, parents might notice sign and symptoms like snoring, noisy breathing, night waking and think this is normal. We invite them to know, these symptoms are NOT normal, they are unfortunately common and need to be evaluated and treated.#craniofacialgrowth#Healtyairwayforkids#pediatricairwaynewYork#pediatric sleep medicine#airwayandsleepmedicineinorthodontics

Excerpt taken from: Persistent Central Apnea and Long-Term Outcome After Posterior Fossa Decompressive Surgery for Arnold Chiari Type 1 Malformation in a Pediatric PatientArnold Chiari malformation (ACM) is the most common cause of central sleep apnea (CSA) in otherwise healthy children. Although there are several case reports and series reported on this topic, there are limited descriptions of the long-term course of these children after the surgical interventions. Posterior fossa decompression surgery to relieve pressure of the herniating cerebellum on the brainstem is generally thought to significantly improve CSA in most cases, however, there are very limited data on the natural course of CSA in children following decompression surgery. There may be a subset of children in whom it may take much longer for CSA to resolve, and in some it may not resolve completely. Hence, these children need to be followed closely with sleep studies to document resolution of CSA.In the case report referenced, Dr. Abigail Strang and Dr. Umakanth Katwa describe a 10-year-old male with severe CSA who was subsequently diagnosed with type 1 ACM and underwent posterior fossa decompressive surgery. However after surgery, although there was improvement in his CSA, he still had a significant degree of residual CSA which required bilevel positive pressure therapy and took more than 7.5 years to resolve. This case report illustrates the need for close follow-up in these children and for providers to understand the natural course so they can accurately counsel families about expectations after surgical treatments.Read the study here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6457512/

Last year, many dental practitioners were forced to temporarily close in order to limit the spread of COVID-19. Now as the state enacts Forward Virginia, also known as Virginia’s phased-approach for reopening businesses, dental practitioners are making sure their policies and procedures align with the current state restrictions. Our team at Airway and Sleep Group and dentists around the world are using more protective procedures and equipment while finding better alternatives to ensuring our community receives dental care, especially for emergencies.While continuing oral and orthodontic care during lockdowns and social distancing guidelines is a challenge many dentists face, Airway and Sleep Group remains current on the guidelines and will adjust our procedures as necessary to ensure we keep our team and our patients safe. Our family-friendly dental practice is offering additional screenings prior to a patient’s appointment time, no patient appointment overlaps, an office layout that adheres to social distancing guidelines, and much more. Read our previous blog to learn more about our COVID-19 Best Practices.Here’s also what some dental practitioners are doing to bring dental care to their communities while making sure everyone remains safe:Mobile DentistriesDental practitioners are finding innovative ways to make dental care more accessible to their communities by going “mobile”, or becoming mobile dental clinics that provide standard procedures. Dental tools and other medical equipment used during a mobile visit are all HIPAA compliant.While the purpose of a mobile dentist is to physically bring dental professionals to their patients, it also comes with its many advantages as well, such as increased privacy and comfort for patients.Not to mention, it offers more flexibility for those who aren’t able to physically visit the dentist, like residents who live in assisted living, retirement communities, and rehabilitation centers.TelemedicineSimilar to mobile dentists, the purpose of telemedicine is to improve accessibility. Telemedicine allows dentists to meet with their patients in real-time without risking infection.The benefits of telemedicine include eliminating the commute to the practice, helping people save on transportation costs, and minimizing time spent away from work, school, and other daily activities.Telemedicine appointments are available at Airway and Sleep Group to enable patients to acquire advice and treatment without physical face-to-face interaction. And if a physical face-to-face appointment is necessary, Airway and Sleep Group organizes each physical meeting using a limited time at the office per patient.Choose A Family-Friendly Dental Practice in Reston, VAAs we continue to provide safe dental care procedures, we ask that our patients adhere to the CDC guidelines to ensure we are all doing everything we can to limit the spread of the virus. Come visit our professional orthodontic practice for your next routine checkup!Contact us today to discuss your oral health concerns and questions.

Faster, more predictable treatment with MOPsAirway and Sleep Group is proud to offer the Propel® Excellerator® Series, the first and only product line cleared by the FDA for useIn MOPs. While patient results may vary, adding MOPs to your orthodontic journey will allow you to reach your ideal smile up to 2.3x faster than orthodontics alone.What is MOPs?Micro-osteoperforation is a technique that stimulates bone remodeling, allowing the teeth to move faster andmore predictably into their ideal position. This innovative technology gives our team a way to help patients finishbraces or clear aligner treatment more effectively and efficiently.Simple In-Office TreatmentWe can complete a MOPs application in a matter of minutes during a regularly scheduled appointment. It is performed in 3 easy steps, allowing you to get back to your busy schedule in no time!Step 1: Evaluate the treatment areaStep 2: Rinse with Chlorhexidine and apply an anestheticStep 3: Create the MOPs or “dental dimples” in areas requiring stimulationIs it Right for Me?Whether you’re getting ready to start your orthodontic journey or are already in active treatment, MOPs mayhelp you reach your smile goals quicker. The MOPs technique works with your own biology by stimulatingthe bone surrounding the teeth. In most cases, you will be able to finish treatment with exceptional results in lesstime and fewer treatment visits. 

Many people have malocclusions and are unaware of the cause. A malocclusion is the imperfect positioning of the teeth when the jaws are closed. An insufficient alveolar bone is a common find among patients with malocclusions. Cumulative alveolar bone loss results in a weakening of the supporting structures of the teeth and predisposes the patient to tooth mobility and loss. It is one of the hallmarks of periodontitis.These problems have previously been insufficiently treated. With Surgically Facilitated Orthodontic Treatment patients can now be treated properly and efficiently.Malocclusions with insufficient alveolar bone have traditionally been treated orthodontically by removal of permanent teeth which has a number of negative side effects. Removing teeth doesn’t address the constricted arch form that can negatively affect function, esthetics, and the critically important airway. Surgically facilitated orthodontic therapy solves the real, underlying problem of insufficient alveolar bone and expands the traditional “orthodontic walls.”SFOT is a modern advancement in dentistry that results in faster tooth movement by more than 50%. SFOT detects underlying issues of the alveolar bone and arch issues and enhances myofunctional improvement. The treatment aids in ideal tooth position, minimizes number of surgeries, engineers’ new tissue and expands arch form. It can aid in improving esthetic concerns as well.https://www.sciencedirect.com/science/article/abs/pii/S0889540613010524https://sunrise-orthodontics.com/http://airwayandsleepgroup.com/

Orofacial musculature plays a pivotal role in maintaining a balance in positioning of the teeth. The wrong position or improper functioning of the tongue muscles and any imbalance which occurs in this, results in malocclusion, or the imperfect positioning of the teeth when the jaws are closed. This can impair a persons chewing, swallowing, and speech functions.Lingual frenulum lengths and Class III malocclusionAn assessment of Lingual frenulum lengths in skeletal malocclusion showed that the lingual frenum, or the soft tissue structure which tethers the ventral surface of the tongue to the floor of the mouth, was found to be longest in class III malocclusion. Class III malocclusion represents a complex three-dimensional facial skeletal imbalance between maxillary and mandibular growth along with varying degrees of dentoalveolar and soft tissue compensations. The maximum opening of the mouth was significantly reduced in the skeletal Class III subjects compared with Class I and Class II subjects. The lingual frenulum exerts erratic forces and a long lingual frenulum pushes the mandibular anteriors forwards, resulting in malocclusion. Following the orthodontic correction of malocclusion, Myofunctional Therapy, involving tongue exercises, can encourage adequate facial and dental growth to eliminate the improper functioning of the tongue muscles that had affected the teeth positioning.Orofacial Myofunctional TherapyRegardless of the genetic potential towards normal development, the wrong positioning and function of the tongue can affect the facial growth pattern. Orofacial Myofunctional Therapy can identify and eliminate the disorders involving the muscles of the tongue. In each Myofunctional Therapy session, the patient learns three to four exercises that target specific structural issues. Session one is comparatively easy, with exercises becoming more challenging with each visit. The good news is that these exercises are proven effective with no more than five minutes work, twice a day, with the exception of one timed exercise that can be done at any time. The time investment is small, considering the benefits.If your child has difficulty chewing, swallowing or has speech issues, schedule a consultation with Airway and Sleep group by calling 703-646-9950 for an oral evaluation. Orofacial Myofunctional Therapy can help!

Once you’ve found a reliable dentist’s office and signed your family up for it, won’t your dental problems vanish? Given the high-stress lifestyle that many of us lead, you may wish to put oral health out of your mind. However, your body’s painful response to that stress might force dentistry back in your head where it can’t be ignored.We notice how our patients’ day-to-day lives affect their mouths. And, in truth, your daily habits affect your oral health just as much as your diet. That’s why we offer cosmetic, restorative, and TMJ dental treatments as well. And with flexible scheduling, affordable options, and patient-focused care, Reston residents can choose their plan of care. Our services will put your mind at ease while also informing you of the effects that your lifestyle has on your oral health.Below, we discuss how stress and anxiety affect TMJ/TMD and then detail our treatment options:What are Stress, Anxiety, and TMJ/TMD?First, we define stress as the body’s response to the events and situations of daily life. While each of us can handle stress in small amounts, it can become overwhelming in response to any novel, threatening, and/or chaotic events. Its symptoms include trouble sleeping, headaches, muscle tension, and teeth-grinding (bruxism).Second, anxiety refers to worry and fear over events (or the outcome of events). Again, we all experience varying levels of anxiety in our lives, but large quantities can cause panic attacks that paralyze sufferers. Its symptoms include fear, tension, and trouble sleeping or concentrating.Finally, “TMJ” is short for temporomandibular joint and “TMD” for temporomandibular disorder. The TMJ connects your jaw to your skull; thus, a TMJ disorder refers to the misalignment and pain of this joint. This condition is considered a type of TMD, and its symptoms include headaches, facial pain around the cheeks or jaw, and difficulty chewing.How They Are LinkedAs we’ve discussed before, oral health involves more than just teeth. A healthy mouth includes properly-functioning jaw muscles and joints as well. Thus, dentists and anyone else interested in dental wellness should be aware of the symptoms and causes of TMJ/TMD.You may have noticed that stress, anxiety, and TMJ/TMD share some symptoms (including tension and headaches). Furthermore, cause-and-effect links may be drawn between these conditions. For instance, the muscle tension and bruxism of stress may bring about tension, jaw pain, and difficult chewing – which indicate TMJ/TMD.To make matters worse, realizing that one suffers from TMJ/TMD may cause further stress and anxiety. If left untreated, you may struggle to open and close your mouth, which you will definitely feel anxious over. Thus, these ailments both bring about and reinforce one another.SolutionsOn your own, treating these conditions may be tricky. But Airway and Sleep Group offers TMJ/TMD services for this very reason. During a standard check-up appointment, we can investigate whether you suffer from TMJ/TMD and, if so, provide relief from its discomfort.To do so, we will adjust your daily habits to prevent symptoms from worsening. These steps may include simple steps such as practicing good posture and avoiding gum-chewing. We’ll also investigate whether you grind yo

Myobrace® is a preventive pre-orthodontic treatment with the goal of targeting the causes of crooked teeth so that children can naturally grow and develop naturally, hopefully without the need for braces. It is designed for children ages 3-15, and is best utilized before children have all their permanent teeth.Four Stages of Myobrace TreatmentThere are only four stages of treatment that are usually completed in 18 months, on average. They include:Habit Correction – teaching the patient to breathe through the nose and not the mouth, training the tongue to rest in a correct position, swallowing, and keeping the lips together when not speaking or eating. This enables the jaw to grow to the proper size and the teeth to come in straight.Arch Development – In some patients, the upper jaw requires enlargement to allow sufficient space for the teeth and tongue. The Myobrace System is used to help develop the jaw.Dental Alignment – When permanent teeth erupt, the Myobrace for Teens is utilized to help align teeth into their natural position. Depending upon the child’s own requirements, final treatment may involve braces, but generally for a much shorter time than without the Myobrace treatment.Retention – No fixed retainer is required, as is often the case with braces, to maintain good oral habits and alignment. Myobrace treatment enables more stable orthodontic results and improved overall health.Our specialists at Airway and Sleep Group are experts at treating Orofacial Myofunctional Disorders (OMDs). These are disorders of the muscles and functions of the face and mouth that can affect facial skeletal growth and development, speech, TMJ, orthodontic treatment stability, facial esthetics, chewing and swallowing.If you’d like to learn more about Myobrace Treatment, Orofacial Myofunctional Therapy or Sleep Apnea Treatment, please contact Airway and Sleep Group at 703-646-9950. Or visit www.airwayandsleepgroup.com

In a preliminary study of the Stability of the mandibular dental arch following periodontally accelerated osteogenic orthodontics therapy (PAOO), it concluded that PAOO therapy resulted in significantly greater improvements during the orthodontic retention period, as judged using the ABO-Objective Grading System on study casts and panoramic radiographs. The study scored for 8 criteria  immediately after orthodontic treatment and at least 1 year of retention.Measuring ResultsThe ABO Objective Grading System for scoring dental casts and panoramic radiographs contains eight criteria: • alignment• marginal ridges• buccolingual inclination or the the angle between the long axis of lower second molars and a reference line tangent to the lower border of the mandibular body• occlusal relationships and contacts related to the grinding or biting surface of a tooth• overjet, or when the upper front teeth protrude outward• interproximal contacts, or the space that lies between teeth that is occupied by the gum, and•root angulation, or the portion of the tooth that is buried in the tissues.PAOO FindingsIn the study, non-extraction orthodontic patients were treated to resolve crowding with PAOO and without PAOO during an average of 19.6 and 16.4 months, respectively.Moreover, the amount of relapse following treatment was significantly greater in both control subgroups compared to both periodontally accelerated osteogenic orthodontics subgroups.A Mann–Whitney U test (used to compare whether there is a difference in the dependent variable for two independent groups) showed that the two groups were statistically homogeneous at post-treatment but at retention, the PAOO group was significantly better for alignment. Moreover, the Objective Grading System total score dropped precipitously (or improved) during retention in the PAOO group compared to the control group. Preliminary retrospective university research indicates that the mandibular dental arch is more stable after PAOO therapy in comparison to traditional orthodontics.It is surmised that the remarkable stability following PAOO is due to substantial “memory” loss of periodontal tissues and increased cortical bone thickness due to alveolar augmentation grafting.About Periodontally accelerated osteogenic orthodonticsPeriodontally accelerated osteogenic orthodontics is a relatively new procedure designed to minimize the time taken for orthodontic treatment. The orthodontist avails of the aid of a periodontist to perform decortication of the bone and places bone graft for rapid orthodontic correction of malocclusion.To discover the latest innovations in orthodontic treatments that reduce treatment times and produce long-lasting, airway-beneficial and aesthetically-superior results schedule a consultation at Airway and Sleep Group.

The Wilckodontics® system is an orthodontic procedure designed to move teeth very rapidly that considers individuals medullary bone state and tooth in gums positioning.Why Wilckodontics® ?Your orthodontist may be considering to use the Wilckodontics surgical procedure for any one of the following reasons:• when there is a lack of medullary bone with a a good blood supply over the outside of the root surface• when the root of the tooth is exposed due to gum recession following a previous orthodontic treatment and requires free gum grafting to replenish the gums• when gum shrinkage occurs due to poor oral hygiene or overlapping teeth being straightened and there is an absence of gums separating the teeth• when a patient has an overly gummy smile and extra gums need to be removed prior to or after orthodontic treatment• when a patient has signs of root resorption, when roots of the teeth may tend to resorb faster than the bone around them making it less accommodating to tooth movement• when overlapping teeth are being expanded within the arch (pushed toward the outside of the arch) to eliminate the overcrowdingWhat is The Wilckodontics® system?The Wilckodontics® system allows safe and rapid movement of the teeth and to achieve a stable aesthetic result. It facilitates the movement of the roots of the teeth through the surrounding bone using a periodontal bone activation technique.During an orthodontic treatment, the bone support over the inside and outside surfaces of the root is being maintained by the proper coordination of the removal of old bone and the formation of new bone to take its place. This, however, does not happen as predictably as one would hope, especially if a tooth is being moved more than just a minimal distance. Often at the completion of the orthodontic therapy, bone has been lost over the prominences of the roots, especially over the surface of the root that faces the direction in which the tooth has been moved. To lessen the impact of this likelihood, the Wilckodontics system creates a situation in which new bone can form over the prominences of the roots following the completion of the orthodontic work. This can be accomplished by placing various bone grafting materials over the prominences of the roots that, in time, converts to the patient’s own natural bone encouraging bone regeneration.By trying to ensure adequate bone support for the roots of the teeth following orthodontic work, it is hoped it will increase the long-term stability of the finished case and lessen the likelihood of severe gum recession.With the Wilckodontics® system, emphasis is placed on the quality of the completed case. By activating the bone, there is a temporary decrease in the hardness of the bone and an increase in cellular activity within the bone. This lessens the likelihood of substantial root resorption, especially in adults, where the bone is typically less vital than in adolescents. Consequently, the teeth can be moved through the bone both rapidly and safely. Bone grafting is performed in conjunction with the bone activation to strive to maintain the integrity of the jaws.The Wilckodontics® system was designed to move teeth very rapidly with the patient being seen approximately every two weeks while the number of adjustment appointments is still decreased in comparison to conventional orthodontics. It is applicable to the majority of orthodontic cases, but not all orthodontic cases. Contact Dr. Liliana Calkins at Airway and Sleep Group by calling 703-646-9950 to determine if the Wilckodontics approach is appropriate to your situation.

Obsessive-Compulsive Disorder is a common psychiatric disorder characterized by the presence of recurrent intrusive thoughts or images (obsessions) that are irrational and/or excessive. They can also manifest as behavioral rituals (compulsions) that help reduce anxiety. Together, these symptoms can cause distress and can significantly decrease quality of life and impact the individual’s everyday life. OCD can be seen in children as young as 4 or 5. Disruption to the sleep-wake cycle can be a result of OCD.Sleep problems have been found to be more common in girls and younger children with more severe forms of OCD. Sleep plays an important role in early growth and development. The disruption of sleep cycles at an early age, negatively affects the child’s growth pattern.Symptoms of OCD in children:Recurrent and persistent thoughts, urges, or imagesRepetitive behaviors they feel the urge to perform because of an obsession or specific rules they must follow rigidlyThe acts performed reduce their anxiety or destressSymptoms affecting sleep:Specific nighttime routines or compulsive ritualsl before bedDelaying bedtimeDisruptive sleepBehavioral problemsTiredness during the dayTreatment is best completed at an early age. Dr. Calkins as craniofacial orthopedist and orthodontist,  can examine the patient as early as 2 or 3 years old. Sleep disorders could be related to a poor function of the respiratory system. The craniofacial-respiratory system assessment and treatment can start as early as 2 years old.  For more information about treatment and scheduling a visit, click the links below:https://sunrise-orthodontics.com/https://airwayandsleepgroup.com/Sleep in Children and Adolescents with OCD

Is your child living with a tongue-tie? The term for this is restricted lingual frenulum. This occurs when the tissue connecting the tongue to the floor of the mouth is thick and restrictive, resulting in limited range of motion as well as many other potentially harmful consequences. A restricted lingual frenulum can impact the development of the face, speech, jaw, and tooth alignment and more.Early effects of tongue ties in infants and children can include:Difficulty latching while nursingProblems bonding with the motherFeeding too frequentlyProblems eating, chewing, and swallowing foodIssues with speech developmentSleep concernsCraniofacial alteration in growth of maxilla and mandible.Early detection of a tongue tie is important to minimalize the negative effects on growth. Tongue restriction heavily influences jaw growth and development and class II malocclusions. The lower jaw is not able to develop because the restriction of the tongue stops growth of the mandible.The treatment for a tongue tie is a frenectomy or frenotomy, with orofacial myology (muscle training), prior and after the tongue release. These procedures are minimally invasive and is performed to cut the lingual frenulum or completely remove it. It is best performed early in children and babies to prevent growth and development problems that may occur. According to reports, the frenotomy is best performed in the first week of the child’s life.For more information, please visit the sites below:https://sunrise-orthodontics.com/https://airwayandsleepgroup.com/Referenced Article:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5496731/

Advanced digital technology has become essential in successful orthodontic diagnosis, evaluation and treatment plans to help orthodontic professionals to discover what cannot be detected in a clinical exam. Cone beam computed tomography (CBCT) is an important tool for orthodontic diagnosis. It provides medical professionals a three-dimensional, volumetric view of the craniofacial complex with much more reliable information than conventional two-dimensional radiology or X-rays.CBCT is used to help diagnose patients with anomalies like cleft palates, abnormalities of the temporomandibular joint, or airway evaluation in obstructive sleep apnea cases, among others. Most often, CBCT is used to identify and localize transposed or impacted teeth. Using the data, orthodontists can also assess the best location for a temporary skeletal anchorage device.Some of the other benefits of CBCT:Images accessed from three planes and reorientedHighly-localized imagesElimination of distortion and overlappingSingle-scan study casts construction enabledDetection of root absorptionOrthodontist Liliana Calkins DDS of Airway and Sleep Group uses these advanced digital technology aids for craniofacial-respiratory evaluation. This enables her to use the technology in an orthodontic or orthodontic/surgery combination to treat growth and development issues with expansion of the airway.Dr. Calkins focus is to understand and treat the causes and pathology of prevalent malocclusions,”  She says “We evaluate our patients to discern the underlying causes and treat them using an integral health approach to create a beautiful, natural, healthy face, functional occlusion and viable airway.”As digital technology advances, so do the treatment options at Airway and Sleep Group, leading to better diagnosis, treatment plans and outcomes.

Dr. Liliana Calkins, member and founder, of the Virginia Interdisciplinary Airway and Sleep Group; knows the importance of early intervention in treating pediatric Sleep Disordered Breathing (SDB). She is participating in a first-of-its-kind program at Tufts University to help dentists understand the basics of normal sleep maturation, respiratory physiology, and craniofacial development throughout childhood. Excited to learn the new treatment options for SDB in pediatric patients, she will become familiar with various sleep disorders in children and adolescents and review cutting-edge research and techniques in evaluation and treatment. Early intervention is Dr. Calkins’ highest recommendations to all our families, since the growth and development of the craniofacial- respiratory complex occurs early in life, from 0-5 years-old.The Program will be presented by a team of multidisciplinary instructors representing medical, surgical, and dental backgrounds including: Dr. Umakanth Katwa MD, Paediatric Pulmonary and Sleep Medicine; Bobby A. Ghaheri, MD; David Hatcher, DDS; Rebecca Thorsen, MS, CCC-SLP, COM®; Fabi Moy, M.A., CCC/SLP/COM©; and Orfeu Buxton, PhD., Audrey Yoon, DMD.The burgeoning field of treating Obstructive Sleep Apnea (OSA) is of the utmost importance to Dr. Calkins as Sleep Disordered Breathing (SDB) is increasingly recognized as a chronic disorder of dysfunctional breathing during sleep in children and can range from habitual snoring to OSA. The spectrum of SDB can result in adverse neurocognitive consequences from sleep fragmentation and intermittent hypoxemia, as well as adverse craniofacial maldevelopment, abnormal breathing patterns, learning difficulties, ADD and ADHD, poor academic performances, bed wetting, excessive sleepiness, and behavioral, mood, and anxiety disorders.Despite these alarming facts, research has shown that children are not screened to the best of doctor’s abilities for SDB in their routine physical and dental check-ups. This makes it difficult to initiate the early intervention strategies necessary to improve children's overall quality of life and learning whilst preventing the development of significant and lasting morbidity.Dr. Calkins is excited to share her expertise from this Mini-Residency to recognize and treat Sleep Disordered Breathing effectively using this latest scientific research. Contact Airway and Sleep Group to receive a comprehensive evaluation for Sleep Disordered Breathing.

Combined with braces, accelerated orthodontics work to improve your smile in record time. While not everyone is a perfect candidate for this treatment, it's worth talking to your orthodontist about.One of the major deterrents of the use of orthodontics is time. Many people, mainly adults, are afraid of getting treatment because they, understandably, do not want to wear braces for a few years. For the longest time, there was no catalyst to reduce the amount of time treatment was needed. Accelerated orthodontics provides a solution.All accelerated orthodontic treatments and devices work to shorten the amount of time one needs to wear braces. Propel VPro+ is similar to the other accelerated orthodontic lines in that it cuts the time down; however, it is unique in the sheer amount of time that's saved through the routine use of it for a short period.In conjunction with your other orthodontics, accelerated treatments and devices will straighten your teeth in no time. Propel VPro+ devices are FDA-approved medical devices that are unparalleled in their expedience and user-friendliness. Propel VPro+ can help give users the improved self-confidence that comes with straight teeth in a sliver of the time.Propel VPro+Propel VPro+ is largely regarded as faster than other methods of accelerated orthodontics and can cut treatment time by up to 50%. Propel’s VPro Series is the first and only High-Frequency Vibration (HFV) product line to support both active treatment and retention in just 5 minutes per day. It's designed for at-home or on-the-go use.The device's features include a convenient 5-minute wear time, gradual and comfortable ramp up to full vibration frequency, and intuitive light notifications for easy operation. The VPro+ is Propel’s latest addition, featuring a sleeker design, waterproof Vibration Device, wireless charging, compact travel case, and mobile app.Visit Our Reston, VA Practice For Accelerated OrthodonticsOsteoclast activity is the controller of bone resorption, which is believed to be the controller of the rate at which teeth move. Through micro-osteoperforations (MOPs), Propel VPro devices stimulate cells into osteoclast and move your teeth into the desirable positions. This is a substantial reason why the device is seen as better than its competitors.Airway and Sleep Group is a certified provider of Propel devices like VPro. Schedule a complimentary consultation with Dr. Liliana Calkins at our Reston, VA office to determine if accelerated orthodontics is a perfect fit for you.

It is not only unattractive when someone’s mouth is hanging open loosely, when lips are apart in a resting pattern, it is a bad habit that can lead to more serious issues. Learning to keep the lips sealed is a behavior that can be altered through Myofunctional Therapy.A lips-apart resting posture is often the result of a nasal airway obstruction. However, once that obstruction is corrected, the lips-apart pattern can remain a persistent habit that must be further addressed.When nasal breathing is impeded, the body naturally accommodated by relying on mouth breathing—which changes the natural resting position of the jaw, tongue and lips. This change in position can influence growth patterns of the jaw and maxilla, often resulting in the development of significant malocclusion.Furthermore, long-term mouth breathing compromises the natural breathing process which relies on the nasal airway to cleanse and purify incoming air for the pulmonary system.Causes for Orofacial Myofunctional DisorderIt is often difficult to isolate one particular source cause for what is known as an Orofacial Myofunctional Disorder (OMD). In most cases, it results from a combination of factors including among them:A restricted airwayThumb sucking; nail or cuticle biting; teeth clenching or grinding; or tongue, lip or cheek sucking habitsLong-term use of sippy cups or pacifiersDevelopmental delaysNeurological problemsHeredityBenefits of Oral Myofunctional TherapyThrough Myofunctional Therapy, patients are learning to keep their lips sealed through a series of exercise that retrain adaptive patterns or muscle function or bad habits. This helps to create and maintain a healthy orofacial environment.The benefits of Oral Myofunctional Therapy may include:Correction/improvement of tongue and lip posturesAssistance in stabilization of teeth during and after orthodontic treatment or jaw surgeryIdentification of the need for speech treatmentThe orthodontists at Airway and Sleep Group are glad to share their knowledge and expertise on Myofunctional Therapy with you. Contact them at 703-646-9950 for an appointment.

More than 18 million American adults have obstructive sleep apnea (OSA), which can cause breathing cessation during sleep or abrupt awakenings accompanied by shortness of breath.According to Wikipedia, OSA is the most common type of sleep apnea, characterized by repeated episodes of complete or partial obstructions of the upper airway during sleep. It can cause breathing to stop and start repeatedly during sleep. OSA occurs in all age groups and in both sexes. In children, its occurrence can run between 2% to as high as 10 or 20% in habitually-snoring children.Symptoms of Sleep ApneaSome of the symptoms of OSA include poor sleep; fatigue during the day; or heavy snoring, choking, gasping or breathing cessation during the night.If you suspect you might have sleep apnea, visit your doctor. Bring along a record of your sleep or fatigue period and an updated list of medications you are taking—including any over-the-counter medications.DiagnosisOne of the most common diagnostic tools for OSA is a sleep study, which may require an overnight stay at a sleep center. Here, technicians monitor a variety of functions during sleep including sleep state, eye movement, muscle activity, heart rate, respiratory effort, airflow, and blood oxygen levels to determine severity. They will look for signs of breathing cessation during sleep or abrupt awakenings accompanied by shortness of breath. You may be able to start treatment following your first night in the sleep center.Sleep Apnea TreatmentA highly-effective treatment recommended by doctors for many patients is a continuous positive airway pressure device, or CPAP. The device consists of a mask that fits snugly over the nose and/or mouth that gently blows air into the airway to help keep it open during sleep.Other alternatives to CPAP can include:Dental appliance that reposition the lower jaw and tongueUpper airway surgery to remove excess tissueNasal expiratory positive airway pressure with a disposable valve covering the nostrilsTreatment using hypoglossal nerve stimulationLifestyle changes can also make an impact on obstructive sleep apnea. These can include:Lose weight. Where a CPAP can only treat OSA, weight loss can cure it in an overweight person.Avoid alcohol. Alcohol can cause frequent nighttime awakenings and makes upper airway breathing muscles relax.Quit smoking. Smoking worsens swelling in the upper airway, making apnea and snoring worse.Sleep on your side. Some patients with mild sleep apnea have fewer breathing problems when sleeping on their side rather than their back.At Airway and Sleep Group, we work with patients on treatments for sleep apnea regularly. Contact us for your initial consultation or visit www.airwayandsleepgroup.com for more information.

Sleep Bruxism (SB) is a sleep related movement disorder characterized by maladaptive and repetitive grinding or clenching of the teeth. The central nervous system influences SB, affecting oral motor activity, the sleep-wake cycle. It can also be influenced by genetic and psychosocial factors. There is not much evidence related to sleep bruxism in children.Diagnosing SB comes from the patient’s history and a physical exam. Here is some examples of patient history that relate to Sleep Bruxism to be aware of if you are bringing your child in for an exam:Grinding or clenchingMorning facial pain/discomfortHeadacheTooth sensitivityPresence of a fracture or tooth reconstructionDental wearIncreased size or growth of the jaw muscle (masseter)Joint sounds from TMJDiagnostic criteria for severe sleep bruxism include:Tooth noise during sleep occurring at least 3-5 nights a week for 6 monthsDental wearExhaustion of the jaw-muscles in the morningIncreased size or growth of the jaw-musclesPrevalence of SB in children varies. Bruxism is traditionally higher in children and decreases with age, but it is still important to combat SB early so that it does not develop into a more serious sleep disorder or inhibit important growth and development patterns in children.For more information on sleep bruxism and treatment visit the websites below:https://sunrise-orthodontics.com/http://airwayandsleepgroup.com/

Did you know that solely breathing through your mouth during the day and/or at night can have significant impacts on your oral and general health? We are meant to be nose-breathers. Nose breathing gives you the ideal exchange of oxygen and carbon dioxide Breathing through our noses increases oxygen in the blood by 10-18%! Mouth breathing disrupts the exchange and decreases oxygen absorption. This can lead to over breathing because you need to breathe more frequently in order to replenish the oxygen that is being lost. Breathing through the nose also filters air and removes 98-99% of allergens, bacteria and viruses from the air. When breathing through the mouth, the air is not filtered and more harmful.What is Long Face Syndrome?Mouth Breathing can also cause the development of a long face, otherwise known as “Long Face Syndrome”.Signs of Long Face Syndrome include:A long faceVacant stareOpen mouth (mouth breathing)Tongue rests at the bottom of the mouthDark circles under the eyesShortened upper lipFlaccid lipsChildren that suffer from Long Face Syndrome get 10-18% less oxygen to the brain. When the tongue position is down and forward it creates malocclusions and teeth crowding. The tongue positions and mouth breathing influences changes in facial structure and growth over time.Other symptoms of mouth breathing:Bed wettingSnoringAttention or behavioral issuesThe Importance of InterventionIntervening early is crucial, because the adult facial skeleton is already 60% mature at age 4, and 90% by age 12. Recognizing symptoms of mouth breathing at an early age, also let the child receive benefits from nasal breathing.Nasal breathing improves blood-oxygen level, filtration and restorative sleep which is key for child growth and development. When children do not have the benefit of restoration sleep it can result in problems in school, behavioral issues, poor brain development, and irritability.If you are concerned with your child’s breathing, facial development, or sleep and believe it may be linked to mouth breathing or other malocclusions visit the sites below for more information or to schedule an appointment:https://airwayandsleepgroup.com/https://sunrise-orthodontics.com/

What is the Mallampati Score?Health professionals use the Mallampati score in anesthesia to predict the ease of intubation. However, it can also be an indicator for determining whether or not your child suffers from Obstructive Sleep Apnea.The physical exam to determine a patient’s Mallampati score is simple. The patient should be sitting upright with their head in a neutral position, facing forward. Then, ask the patient to open their mouth and extend their tongue. The examiner will look to see what structures can clearly be visualized in the back of the throat.The degree to which the soft palate, or back of the throat is made visible, determines the Class number of their score. The higher the class number, the less you can see of the back of the throat. The higher their score, the more likely they will have sleep apnea, although it is not 100% predictive.Obstructive sleep apnea (OSA) symptomsObstructive sleep apnea (OSA) symptoms in children can include the following:Abnormal breathing during sleepFrequent awakenings or restlessnessFrequent nightmaresEnuresisDifficulty awakeningExcessive daytime sleepinessHyperactivity/behavior problemsDaytime mouth breathingPoor or irregular sleep patternsOSA DiagnosisHowever, to truly determine whether or not your child has obstructive sleep apnea, you’d have to have an overnight polysomnographic evaluation in the sleep laboratory. The evaluation would determine abnormalities in oxygen desaturation, observe patient’s sleep state, include an electrooculogram and electrocardiogram, measure the airflow at nose and mouth, and observe the chest and abdominal wall motion among other data collections.In the pediatric age range, abnormalities include oxygen desaturation under 92%, more than one obstructive apnea per hour, and elevations of End-tidal carbon dioxide (ET CO2) measurements of more than 50 mm Hg for more than 9% of sleep time or a peak level of greater than 53 mm Hg.If you suspect that your child may suffer from sleep apnea, contact Airway and Sleep Group for a consultation for a definitive diagnosis. We are here to help!To learn more visit this link: https://emedicine.medscape.com/article/1004104-overview

Obstructive sleep apnea in children is characterized by disordered breathing during sleep which consists of prolonged partial upper airway obstruction or  complete obstruction, disrupting normal breathing  patterns. The prevalence of pediatric OSA is rising due to the increase in childhood obesity.These are the risk factors and symptoms associated with Pediatric OSA as previously mentioned:Risk Factors for Pediatric OSA:- Physical airway obstruction- Craniofacial abnormalities and malocclusions- Obesity- Premature birthSigns and Symptoms for Pediatric Patients:- Hyperactivity- Difficulty with school- Depressed mood- Inattentiveness- Snoring, gasping, chokings sounds during sleep- Bruxism (Grinding of the teeth)Pediatric Obstructive sleep apnea can negatively impact craniofacial growth and development as well as overall growth and development. Research has shown that early treatment is imperative in order to combat the destructive effects of pediatric OSA. Treatments for Pediatric OSA can either be dental or surgical or a combination.Treatment options for pediatric OSA that have been studied for the past two decades include; Rapid maxillary expansion, oral appliances and distraction osteogenesis.Rapid Maxillary Expansion (RME) is for children with narrow, high maxillary arches. RME expands the arch by connecting a device to the maxillary teeth and surrounding tissue and applying orthopaedic force. RME significantly reduces the problems associated with OSA and has long lasting results.The next option is mandibular advancement with oral appliances. In children, mandibular advancement is a type of orthodontic therapy that helps improve and expand upper airway space and may be permanent if used early enough.Distraction osteogenesis is a surgical treatment option that treats abnormalities in the oral and facial skeleton. This is a more invasive treatment option for children with more serious developmental and growth concerns. Distraction osteogenesis has been proven to improve upper airway obstruction and other functional problems.Please visit our websites below for more information or to schedule an appointment:https://sunrise-orthodontics.com/http://airwayandsleepgroup.com/

A perfect smile isn’t always enough. Other considerations in the facial structure are required in order to be able to develop naturally, breathe properly and avoid sleep apnea. Let’s explore the Myobrace® treatment, a state-of-the-art technology designed to improve natural growth and function.What is Myobrace Treatment?Myobrace® is a preventive pre-orthodontic treatment with the goal of targeting the causes of crooked teeth so that children can naturally grow and develop naturally, hopefully without the need for braces. It is designed for children ages 3-15, and is best utilized before children have all their permanent teeth.The treatment helps to straighten teeth, develop and align the jaws, and improve facial development. It does this by helping children breathe through their nose, rest their tongue at the top of their mouth, swallow correctly, and keep their lips closed.The removable appliance that somewhat resembles a mouth guard or Invisalign tray, is worn for 1-2 hours a day and overnight, and children are asked to participate in Myobrace activities including breathing, tongue, swallowing, lip and cheek exercises that are performed twice a day to help them develop proper oral habits. With full compliance, excellent results can be achieved.Related Video: Myobrace – Straight Teeth the Natural Wayhttps://www.youtube.com/watch?v=ZPQEFU8OwWc

The iTero 5D intraoral digital imaging system is the first hybrid dental imaging system that simultaneously records three-dimensional, intraoral color and near-infrared imaging technology (NIRI) images of both the enamel and dentin of teeth. As it offers a comprehensive view of the oral anatomy, it is useful in a patient’s comprehensive preventive and restorative oral care. In addition, using the iTero TimeLapse technology, orthodontists can show comparisons over time, such as the simulated outcomes of Invisalign® treatments.Other benefits of the iTero imaging system:3D digital impressionsAids in locating and monitoring interproximal cavities/cariesBuilt-in intraoral cameraSimulation capabilityReal-time time lapseChairside scan evaluationNo harmful radiationIntraoral Digital Imaging via 3Shape TRIOSThe TRIOS 3Shape intraoral scanner is third way orthodontists can use digital technology to provide treatment by scanning teeth and sending the digital impression to the lab for fabrication of crowns, clear aligners like Invisalign, and oral appliances. The scanner can measure tooth shapes with digital precision, and provide 3D images with high definition to give orthodontists the tools for creating digital study models from the impression and advanced technology for accurate treatment planning and analysis on a case-by-case basis. In addition, the TRIOS scanner uses a RealColor feature that replicates the natural colors and shades in the mouth, making evaluation easier.Other benefits of the TRIOS imaging system:Quicker turnaround on fabricationFewer appointmentsAccuracy, meaning fewer remakes or adjustmentsPatient comfortLess intimidating for childrenOrthodontist Liliana CalkinsOrthodontist Liliana Calkins DDS of Airway and Sleep Group uses these advanced digital technology aids for craniofacial-respiratory evaluation. This enables her to use the technology in an orthodontic or orthodontic/surgery combination to treat growth and development issues with expansion of the airway.“My focus is to understand and treat the causes and pathology of prevalent malocclusions,” Dr. Calkins said. “We evaluate our patients to discern the underlying causes and treat them using an integral health approach to create a beautiful, natural, healthy face, functional occlusion and viable airway.”As digital technology advances, so do our treatment options, leading to better diagnosis, treatment plans and outcomes.

According to Ravi Agarwal, DDS, an Oral and Maxillofacial Surgeon, patients often turn to corrective jaw surgery to correct irregularities in their jaw and teeth to improve chewing, speaking, and appearance. However, an additional condition that many people don’t realize corrective jaw surgery can improve airway to combat the effects of obstructive sleep apnea.Obstructive sleep apnea, or when people repeatedly stop breathing while asleep, can occur when jaw bones aren’t properly working in tandem with muscles around the face and neck to support the tongue and airway. This can cause symptoms such as: excessive fatigue, loud snoring, morning headache, and sleepiness.Corrective jaw surgery can be a solution for patients with these problems. The surgery can realign the jaws and teeth, open up the airway, and relieve patients of their symptoms—so much so that some patients say their entire family sleeps better upon their snoring being corrected.The Mayoclinic reports that Maxillomandibular advancement surgery (MMA) can be an effective treatment for obstructive sleep apnea (OSA). “In MMA, the bones of the upper and lower jaw are repositioned to relieve airway obstruction. The procedure also suspends the attached pharyngeal airway muscles in an anterior position and simultaneously increases pharyngeal soft tissue tension.”Though the use of a CPAP machine is a non-surgical option for those hoping to improve their airway and aid in obstructive sleep apnea during sleep, young, and middle-aged adult patients (early 50s) may prefer maxillomandibular advancement surgery as a long-term permanent solution.Dr. Edward Zebovitz, a member of Airway and Sleep Group, performed this maxillofacial surgery on his patient and increased the size of her airway to twice its original size. His patient found immediate relief of her airway capacity within hours after completion of surgery and stated, “I feel I can breathe now.”#maxillofacial#airwayimprovement #maxillaryadvancement #BSSO#SeattleAirway #airwayandsleepgroup #AmericanSleepMedicineTysons

Temporomandibular joint conditions are linked to malocclusions and airway concerns. TMJ imaging is a key diagnostic tool for patients with pain or malocclusions.Magnetic resonance imaging, or an MRI, is an imaging technique that takes detailed snapshots of tissues inside our bodies. An MRI uses magnetic fields, radio waves and a computer to generate the images, but it is not the same as radiation. The MRI looks at the TM joint soft tissue and disk, as well as hard tissue. Based on the disk anatomy, the doctor can assess if you are at risk for a TMJ condition.To determine whether an MRI is the next step, we look at joint history, orthodontic history, pain history, and trauma history.For joint history we look for:Locking jointsClicking joints (especially if younger than 18)Loud grinding noisesFor orthodontic history we look for:An overbiteMalocclusionsExtractionsHeadgearTreatment with a function applianceOrthodontic treatment lasting longer than 2 yearsFor pain history we look for:Pain greater than 5/10Sharp or stabbing painHeadachesPain before 18yrs oldFor tor trauma history we look for:– Car accidents– Concussions (and participation in contact sports)– Tonsil/ Adenoid removalFor more information or to schedule an appointment, please visit the websites below:https://sunrise-orthodontics.com/https://airwayandsleepgroup.com/

If you have concerns that your child might be experiencing complications with their sleep and airway function, when they come in for a consultation there is an examination protocol that we follow to further inspect these concerns.Typical examination protocol already includes looking at the face, eyes, nose, lips, tongue, teeth and gums, and the oropharyngeal area. We follow the typical examination protocol while looking for specific signs that point to an airway issue. Common signs indicating airway complications are:Abnormal facial growth pattern (where the bones of the face are positioned), these patterns can be detected as early as two years old, with implementation of access to treatment by 4 years oldAllergic shiners (shadowy pigmentation under eye, like a bruise)Shape and depth of the noseObesityDeviated Septum/ swollen tissueGummy smileTied lipTooth crowding/ malocclusionsTooth erosion and wearThese signs can be a part of something bigger, such as breathing and airway issues in your child. Facial growth patterns tell us the positioning of their facial bones and whether it affects the tongue position/posture, and ultimately the airway. Head positioning can also indicate airway concerns. For example, forward head posture shows that the patient is searching for an airway.  Allergic shiners can tell us if they are having problems breathing out of their nose. We can also tell if the child is having problems breathing from their nose if their mouth is open while breathing throughout the day and night. Chapped lips will be an indicator of mouth breathing as well. A short upper lip and tied lips that sometimes produce a gummy smile which in the long run can impact the smile and tooth development.Malocclusions, erosion and wear have previously been independent of airways issues, but modern findings suggest that these can be symptoms of a bigger problem such as ability to breathe. These concerns can be noticed as early as 4 years old when bone growth and development becomes more noticeable.Airway examinations are important in pediatric patients in order to catch and treat complications early and prevent more serious or invasive treatments post permanent dentition and mature bone development.For more information and to schedule an appointment visit the links below:https://sunrise-orthodontics.com/https://airwayandsleepgroup.com/

Airway development is one of the most crucial aspects to a child’s overall health. Early intervention is the best approach to deficient craniofacial growth that affects sleep, tooth alignment and the space allotted for the tongue. Airway improvement has shown to improve the quality of sleep and treat obstructive sleep apnea.  And obstructive sleep apnea has been known to be one of the root causes for behavioral problems and learning issues like ADHD. An early airway diagnosis and intervention for children ages zero to 5 identifies and addresses issues before they have the chance to impact a child’s growth and development.A study by Pub Med had a series of six consecutive cephalograms taken between birth and 5 years of age, as well as one adult cephalogram. This study determined the maxillary growth and maturation during infancy and early childhood in 30 subjects (15 male and 15 female). The study concluded that the maxilla undergoes its greatest postnatal growth change during infancy and early childhood, when relative anteroposterior growth and maturation are emphasized.Overall linear growth changes that occurred between 0.5 and 5 years of age (a span of 4.5 years) were generally greater than the changes in maxillary growth that occurred between 5 and 16 years (a span of 11 years). The size and shape changes that occurred were greatest between 0.4 and 1 years. And yearly velocities decelerated regularly thereafter.Children should have their airway evaluated between the ages of zero to 5 as the best approach to deficient craniofacial growth is early intervention. Let Airway and Sleep Group provide a diagnosis of your child’s airway to give them the best start in life.Resources:https://www.researchgate.net/publication/233410246_Maxillary_growth_and_maturation_during_infancy_and_early_childhood

Dental arch crowding is one of the most common forms of malocclusions. Most orthodontic treatment plans require a year or more of treatment and are not guaranteed to last. Corticotomy Facilitated Orthodontics is a means for rapid tooth movement that significantly accelerates orthodontic treatment.A corticotomy is an aggressive and invasive surgical procedure that shortens orthodontic treatment time by bone remodeling. A bone graft is placed and facilitates tooth movement to areas where bone was previously absent. There is immediate tooth movement and it is twice as fast as traditional orthodontic treatment.You can benefit from a corticotomy if you suffer from dental arch crowding and need more space for your teeth and tongue. If you do not want to suffer through a year or more of orthodontic treatment, and you want stable, long lasting results, a corticotomy might be the right treatment plan for you.Please visit our websites below for more information:https://sunrise-orthodontics.com/https://airwayandsleepgroup.com/

According to the Perio-Implant Advisory, modern science is making disruptive advancements in medicine and dentistry. In dentistry specifically, Surgically Facilitated Orthodontic Therapy (SFOT) is an advanced procedure that pinpoints the underlying problems of insufficient alveolar bone and compromised arch forms to optimally enhance functional and esthetic concerns. SFOT major advantage to patients is that it can significantly decrease the amount of treatment time by more than 50%. Combined with clear aligner therapy, SFOT can increase case acceptance.The Perio-Implant Advisory states Surgically Facilitated Orthodontic Therapy (SFOT) can address the underlying problems of insufficient alveolar bone and compromised arch forms to optimally enhance functional and esthetic concerns. In the past, these issues were frequently ignored, inappropriately treated to lifelong iatrogenic consequences, camouflaged through extraction orthodontics and compensated restorations, or overtreated through orthognathic surgery when it wasn’t a true skeletal problem.The benefits of SFOT include:Engineers new tissue to provide a more robust and expanded arch form for the teeth to reside instead of resorting to extractions of teeth to fit the existing compromised archEnables ideal tooth position for optimal occlusionEnables ideal tooth position for optimal restorative dentistry (virtually planned)Implant site development/planning through augmentation and tooth movementEnhances esthetics through optimizing dental relationships and arch formsMaximizes orthodontic possibilitiesAirway and Sleep Group recognizes that everyone’s mouth shape and bite are unique to the individual and that not every treatment is applicable to every patient. Our dedication to airway improvement, orthodontic aesthetics and the latest advancements in modern dentistry play a role in every patient we treat. We are not limited to traditional orthodontic treatments to achieve the correct mouth shape or aesthetics for each patient we treat. If you want to investigate your treatment options, schedule a consultation with us by calling or texting 571-244-7329.

Childhood obstructive sleep apnea syndrome (OSAS) is an important risk factor for childhood developmental disorders, metabolic disorders and inflammation. 1.2 to 5.8% of the general pediatric population have OSAS. OSAS can have different levels of severity that could give rise to long term effects on children including alterations in behavior and neurocognitive deficits. These deficits affect attention, learning and memory as well as executive and motor functions.A review by the Department of Health, Life and Environmental Science, University of L’Aquila and the Academy of Orofacial Myofunctional Therapy showed rapid maxillary expansion (RME) as an effective treatment for obstructive sleep apnea syndrome (OSAS). The review studied OSAS in children less than 18 years-old who did and did not have their tonsils removed. Rapid Maxillary Expansion decreased the Apnea Hypopnea Index (AHI) by 66.1%.The Apnea Hypopnea Index (AHI) is the sum of the number of apneas (pauses in breathing) plus the number of hypopneas (periods of shallow breathing) that occur, on average, each hour. The AHI is calculated by dividing the number of events by the number of hours of sleep.Causes of Obstructive Sleep Apnea SyndromeObstructive sleep apnea syndrome (OSAS) is when a protracted partial upper airway obstruction (hypopnea) and/or an intermittent complete obstruction (apnea) occurs. Having this disorder could cause a number of disruptions to sleep. Some of these disruptions include a cessation in breathing, decrease in oxygen saturation, an increase the number of arousals, as well as severe impairments in cognitive function.Obesity is considered to be a major cause of OSAS in adults. Whereas the abnormal growth of the tonsils is also thought to be the prime cause of childhood OSAS. Abnormal tonsil growth may decrease airflow. In literature it is seen that abnormal growth of the tonsils leads to problems related to mouth breathing, snoring, chronic sinusitis, nasal congestion, hyponasal speech. Abnormal growth of the tonsils can also cause emotional disorders and poor neurological development.Rapid Maxillary Expansion Really WorksOver the period of 3 years, a decrease of 66.1% of AHI was detected in all of the 102 children with OSAS that underwent RME treatment. The review included those with or without having their tonsils removed. A larger AHI reduction was observed in children with small tonsils (97.7%) or no tonsils (82.4%) rather than large tonsils (56.4%). This data highlighted the importance of tonsillectomy and adenoidectomy combined with RME treatment.In all the studies considered, a general improvement of the daytime and nighttime symptoms of OSAS after RME therapy demonstrated that rapid maxillary expansion was an effective treatment for obstructive sleep apnea syndrome.

When your child shows visible signs of difficulty swallowing it may be caused by issues in craniofacial development. When the face and teeth are not correctly positioned, it impedes the child to have a proper swallow.Craniofacial Orthopedics Involves The Guidance Of Facial Growth And Development, Jaw Positioning, And Airway Modification. When Your Jaw Does Not Grow In An Optimal Proportion With The Rest Of The Face, The Imbalance Affects The Proper Alignment Of The Lower Teeth With The Upper Teeth And Can Negatively Affect The Way You Sleep, Smile, Chew, Speak And Feel About Your Smile. And A Bad Bite Can Lead To Bigger Problems Later In Life.Early Intervention With Craniofacial Orthopedics Leads To Improved Treatment Outcomes In Facial Harmony, Airway Openness And Coordination Of The Bite By Changing The Shape, Size And Relationship Of The Bones In The Jaw And Face. Dr. Calkins Has Extensive Knowledge Of Craniofacial Growth—Essential To Successful Treatment.Craniofacial Orthopedics Treatment Occurs In Two Phases. In Phase One, Treatment Begins Before All The Adult Teeth Have Erupted. During This Phase, Dr. Calkins Utilizes Treatments Designs To Correct Your Child’s Jaw Growth In Order To Align The Jaw Bone Properly. Once This Is Done, Phase Two Can Begin.Phase Two Usually Involves Orthodontics To Straighten The Teeth.Dr. Calkins Is One Of A Limited Number Of Dentist Who Are Experience In The Use Of MRI Imaging. Unlike X-Rays, An MRI Is Radiation Free And Provides Images Of The Bones And Surrounding Soft Tissue For A More Precise Diagnosis Concerning Proportional Growth Of Bones And Muscles.Craniofacial Orthopedics Can Also Assist In Pediatric Sleep Apnea Management.Learn more by visiting airwayandsleepgroup.com or by calling 703-646-9950 to schedule a consultation.

Sleep apnea can be the result of a person’s mouth not being ideally shaped to allow for space for their tongue leading to poor sleep quality. The solution for certain individuals may include the DOME procedure in which expanders are surgically placed in the mouth to widen the palate and roof of the mouth making room for the tongue.The study: Distraction Osteogenesis Maxillary Expansion (DOME) for Adult Obstructive Sleep Apnea Patients with High Arched Palate, written by Otolaryngology specialists Stanley Liu, Christian Guilleminault, Leh Kiong Huon, Audrey Yoon states:A narrow maxilla with high arched palate characterizes a phenotype of obstructive sleep apnea (OSA) patients that is associated with increased nasal resistance and posterior tongue displacement. Current maxillary expansion techniques for adults are designed to correct dentofacial deformity. We describe distraction osteogenesis maxillary expansion (DOME) tailored to adult patients with OSA with narrow nasal floor and high arched palate without soft tissue redundancy. DOME is performed with placement of maxillary expanders secured by mini-implants along the midpalatal suture. This minimizes the maxillary osteotomies necessary to re-create sutural separation for reliable expansion at the nasal floor and palatal vault. We report the safety and efficacy profile of the first 20 patients at Stanford who underwent DOME.Read the study here: https://www.researchgate.net/publication/318214932_Distraction_Osteogenesis_Maxillary_Expansion_DOME_for_Adult_Obstructive_Sleep_Apnea_Patients_with_High_Arched_Palate

Airway and Sleep Group is excited to offer VPro from Propel Orthodontics. VPro, along with Dr. Liliana Calkins’ expertise, is used during orthodontic treatment to reduce your overall treatment time and relieve any orthodontic discomfort. The device operates at a high frequency, delivering gentle vibrations to give you the best orthodontic treatment yet. And get this, it’s just 5 minutes a day!Good vibes, better treatmentHigh frequency vibration, like the vibration delivered from the VPro, improves orthodontic treatment both physically and biologically. This unique vibration profile can lead to many benefits, allowing us to give you the absolute BEST treatment possible including:•Reduced Treatment Time by up to 64%•Accelerated Tooth Movement•Reduced Discomfort•Improved Predictability•Optimal Aligner Seating•Assists in Retainer WearThe VPro Fastrack AppThe VPro Fastrack App can enhance your orthodontic experience on all levels. Enjoy the user-friendly patient application, optimized to keep your treatment on track. With All of the features you need. None that you don’t.•Track VPro usage•and daily aligner wear time•Share progress photos with us from home•Locate device with the click of a button•Receive tray change reminders, customized to your aligner schedule The app is Available on the Apple App Store and Google Play*App not compatible with the VPro+

Faster, more predictable treatment with MOPsWe are proud to offer the Propel® Excellerator® Series, the first and only product line cleared by the FDA for use in MOPs. While patient results may vary, adding MOPs to your orthodontic journey will allow you to reach your ideal smile up to 2.3x faster than orthodontics alone.What is MOPs?Micro-osteoperforation is a technique that stimulates bone remodeling, allowing the teeth to move faster and more predictably into their ideal position. This innovative technology gives our team a way to help patients finish braces or clear aligner treatment more effectively and efficiently.Simple In-Office TreatmentWe can complete a MOPs application in a matter of minutes during a regularly scheduled appointment. It is performed in 3 easy steps, allowing you to get back to your busy schedule in no time!Step 1: Evaluate the treatment areaStep 2: Rinse with Chlorhexidine and apply an anestheticStep 3: Create the MOPs or “dental dimples” in areas requiring stimulationIs it Right for Me?Whether you’re getting ready to start your orthodontic journey or are already in active treatment, MOPs may help you reach your smile goals quicker. The MOPs technique works with your own biology by stimulating the bone surrounding the teeth. In most cases, you will be able to finish treatment with exceptional results in less time and fewer treatment visits.Want to Finish Treatment in Half the Time? Contact Airway and Sleep Group for a consultation.

Spark aligners offer a personalized treatment plan that is custom to your smile goals and needs without brackets or wires. The aligners are more clear than other aligner products, stain less and are removable for a more sleek appearance and discreet treatment option. Spark is an efficient and comfortable treatment option that can help you reach your goals faster.Spark treats crowding, cross-bites, open bites, overbites, and spacing. If you have an active periodontal disease, Spark should be delayed or avoided until the symptoms are gone.Spark aligners work by getting a 3D scan of your teeth and coming up with a 3D future plan for your smile with your doctor. Then, you will receive custom aligners that will gradually move your teeth over the course of treatment.For more information visit our websites below in order to schedule an appointment:https://sunrise-orthodontics.com/https://airwayandsleepgroup.com/

Early orthodontic treatment can help prevent more severe dental problems later in life, especially when the problems are found early on, like around the time your child is beginning to lose their baby teeth. Interceptive orthodontics preserves space for unerupted teeth by addressing the structure of the jaw and teeth while the child’s baby teeth are still in its mouth.By age 7, your child’s mouth has grown enough so that your pediatric dentist or orthodontist can identify how it will develop as the permanent teeth begin to emerge. He or she can also develop a treatment plan that can help guide that development on a good course.Some orthodontic conditions are much easier to correct if they are detected early. Here are the ways an orthodontist can help with early intervention:A better prognosis of how your child’s teeth will developGuidance of the jaw growth to accommodate emerging teeth or preserve space for unerupted teethCorrection of bite problems, like a cross, deep or open biteCorrection of habits that can be detrimental to optimal development, like thumb sucking or tongue pushingInterceptive orthodontics can offer these long-term benefits:Lowered risk of future damage and/or more-invasive dental treatmentsIncreased function of the teeth, lips and faceImprovement of your child’s appearance and self-esteemYour child’s pediatric dentist is well trained in identifying potential bite problems in young children, and if they deem it necessary, can refer you to an orthodontist for assessment and treatment—like the orthodontists at Airway & Sleep Group. We are glad to examine your child and offer our recommendations.

Young children (ages 6-10) with severely protruded upper front teeth, commonly called "buck teeth," are at increased risk for dental trauma and may benefit from an orthodontic correction, according to a study published recently in the American Journal of Orthodontics & Dentofacial Orthopedics*. The study found that approximately 1 in 3 children who received orthodontic treatment for severely protruding teeth were less likely to experience dental trauma (such as a chipped, broken or knocked out permanent tooth)."Active children who play organized sports or love the playground and who have severely protruding teeth may benefit from early intervention by an orthodontist," says Morris N. Poole, DDS, president of the American Association of Orthodontists (AAO). "Youngsters with protruding teeth don't have adequate lip coverage to protect their teeth from a blow or a fall. The result of losing or damaging a front tooth in childhood becomes a lifelong problem. We only get one set of permanent teeth, and the corrective measures to restore or replace a broken or lost tooth can be expensive, and likely will need to be repeated over the course of a lifetime."According to the study, protruding teeth occur in about 15 percent of children ages 12 - 15 in the U.S. and is one of the most common problems treated by orthodontists. Early intervention (before adolescence) is warranted in some cases, say the study's authors. The AAO recommends that all children get a check-up with an orthodontist no later than age 7. If a check-up reveals a child will need orthodontic treatment at some point, the orthodontist will be able to recommend the most appropriate treatment at the most appropriate time.

Get ahead of potential bite and alignment problems, like Temporomandibular Joint Disorders by getting orthodontic treatment early for your children. Make future treatments more effective and efficient by getting an early diagnosis. This early diagnosis and treatment is also called interceptive orthodontics. When your child is seen early, while their bones and jaw are developing, orthodontists can assess future problems and recommend courses of action to prevent or mitigate them.Early interceptive orthodontics can be broken into two phases: the first phase during childhood and the second phase when your child hits their teenage years. Some recommended orthodontic treatments include oral appliances. One such appliance is a palatal expander. This appliance gradually widens the upper jaw to create more space in a child’s mouth so that the upper and lower jaws will fit together better and teeth will not be crowded. Oral appliances can also be used to help create or improve facial symmetry or bite, and correct potential issues that could affect your child’s speech.Particular issues you’ll want to get an early diagnosis on are temporomandibular joint disorders, commonly called TMJ. These disorders creates pain and discomfort, along with compromised movement of the jaw joint and its surrounding muscles. Symptoms can include pain and tenderness at the jawbone or pain in the ears, difficult or painful chewing, and a clicking or locking of the jaw joint itself.At Airway & Sleep Group, we are glad to provide a consultation of your child’s current dental health and inform you of potential interceptive orthodontic treatments.

Do you or your partner experience loud snoring? Or do you stop breathing, gasp or choke during sleep, experience excessive restlessness at night, or feel overly sleepy during the day? You may have sleep apnea.While you, as the snorer, may feel as if your snoring isn’t affecting your sleep, consider your partner. They may feel differently. Relationships can suffer is partners are irritated about being kept awake at night or are sleeping in separate rooms. More than 41% of women who say they need a good night’s sleep have it instead interrupted by a snoring partner. This can foster resentment and decrease intimacy in a relationship.Effects obstructive sleep apnea (OSA)Snoring and obstructive sleep apnea (OSA) can have serious health ramifications as well. The sufferer can move out of deep sleep into light sleep when their breathing pauses, thus lessening the quality of sleep. OSA can also trigger the release of stress hormones which change how your body uses energy. This can make you feel tired and sleepy during the day.Lack of quality sleep can cause weight gain, memory loss, and skin and brain aging. Combined with sleep apnea, the risks can be higher for heart attack, stroke, congestive heart failure, atrial fibrillation, diabetes, high blood pressure, certain cancers, and even sudden death. Treating either condition can decrease these risks.Often, snoring is dismissed as a natural part of aging. And while it’s true that snoring can increase with age and weight gain, it is not ordinary, and can and often should be treated. Especially when loud snoring is associated with sleep apnea.Treatments for Loud Snoring with Sleep ApneaTreatment for snoring range from alteration of your lifestyle all the way to surgery. Most commonly, doctors recommend a CPAP, a device that fits over the mouth or nose and blows air with continuous pressure into the airway to keep the airway from collapsing and allow normal breathing. Some individuals can experience difficulty using a CPAP machine. In this case, there may be other options. You should speak to your doctor or a sleep provider about therapies.Taking the appropriate steps to get tested prior to getting any treatment prevents an inaccurate self-diagnosis, inadequate treatment and/or premature dismissal of the problem. Contact the specialists at Airway & Sleep Group to find out more.

The detrimental side effects of sleep apnea drive people and their spouses to search for ways to get a good night’s sleep. But what if it comes down to wearing a CPAP machine? Though CPAP machines help prevent the brief breathing interruptions that are the hallmark of sleep apnea, some people find the discomfort and difficulty falling asleep wearing a mask too much to bear. Some people stop using CPAP machines due to the side effects.The Pros of using a CPAP machine•improves your ability to sleep without waking up•lowers your risk of having a heart attack, stroke, or other cardiovascular event•helps lower your blood pressure•reduces daytime sleepiness•may reduce blood glucose and cholesterol levelsBut what about those side effects? Not to mention without insurance coverage, breathing machines can cost between $500 and $3,000, depending on whether you’re purchasing a CPAP, APAP, or BiPAP device. Here are some of the reasons CPAP machines won’t work for some people:Cons of using a CPAP machine•discomfort and difficulty falling asleep, especially in the beginning•a feeling of claustrophobia or anxiety•nasal congestion•dry mouth•nosebleeds•skin irritation or sores where the mask touches the face•a feeling of being bloated with airOther options for sleep apneaPhysiologically, Sleep apnea is caused by your tongue blocking your airway as it relaxes. The latest and most tested treatment to improve airflow for sleep apnea is an orthodontic one. Rapid Maxillary Expansion uses orthodontic devices to widen and increase the size of the arch in your mouth so your tongue will have a space to rest naturally and comfortably. It not only treats sleep apnea, but improves the aesthetics of your face and smile. To learn more visit airwayandsleepgroup.com or call 703-646-9950 to schedule a consultation. A good night’s sleep is only a call away.Resources: https://www.healthline.com/health/what-is-a-cpap-machine#bottom-line

Maxillary transverse deficiency is a highly prevalent malocclusion present in all age groups, from primary to permanent dentition. If not treated on time, it can aggravate and evolve to a more complex malocclusion, hindering facial growth and development. Aside from the occlusal consequences, the deficiency can bring about serious respiratory problems as well, due to the consequent nasal constriction usually associated. In growing patients, this condition can be easily handled with a conventional rapid palatal expansion. However, mature patients are frequently subjected to a more invasive procedure, the surgically-assisted rapid palatal expansion (SARPE). More recently, researches have demonstrated that it is possible to expand the maxilla in grown patients without performing osteotomies, but using microimplants anchorage instead. This novel technique is called microimplant-assisted rapid palatal expansion (MARPE).The study, made to demonstrate and discuss a MARPE technique developed by Dr. Won Moon and colleagues at University of California – Los Angeles (UCLA) concluded that the demonstrated technique could be an interesting alternative to SARPE in the majority of non-growing patients with maxillary transverse deficiency. The present patient showed important occlusal and respiratory benefits following the procedure, without requiring any surgical intervention.Read the study here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5398849/Airway and Sleep Group utilizes the principles of rapid palatal expansion to improve airway and combat sleep apnea by creating ample room for the tongue through craniofacial orthopedics. Call 571-244-7329 for more information.

Are you from the premolar extraction generation? These are patients that had teeth removed before orthodontic treatment and are now in their late 50’s. They are finding that they can’t breathe due to lack of tongue space and have sleep apnea. Retracting (pulling back) the teeth make a smaller “container” for the tongue.The tongue is then forced backward and can block the throat, making the person a mouth breather; in this case, the tongue sits on top of the bottom teeth, allowing them to re-crowd even years after the braces come off.  What can you do if your dentist or orthodontist says you should have teeth removed to make space?Get a second opinion.  Your dentist or orthodontist is absolutely recommending the best treatment he/she knows to provide. That doesn’t always mean it’s the best treatment option available! Airway & Sleep Group corrects the shape and functionality of your mouth, tongue, jaw and bite with craniofacial orthopedics and by selecting the state-of-the-art orthodontic treatment best suited to achieve the perfect smile for you. You will not only have the most aesthetically pleasing smile to suit your face, but will enjoy quality sleep and improve your overall health.Craniofacial orthopedics and orthodontics are effective solutions for modifying your airway and treating sleep apnea by changing the shape, size and relationship of the bones in the jaw and face and creating enough space in your mouth for your tongue to relax naturally during sleep. To read 5 Good Reasons NOT To Have Teeth Removed for Braces visit: https://drandreastevens.com/blog/5-good-reasons-not-to-have-teeth-removed-for-braces-kanataottawa-dentist/If your dentist or orthodontist says your child should have teeth removed to make space, know that there are other options available. Learn more here: https://airwayandsleepgroup.com/home-3/

In a survey conducted by Dr Karin Badt on the effects of extraction orthodontics found that premolar extraction orthodontics has an adverse effect on health and appearance in a high percentage of those who have had the treatment. The procedure of premolar extraction is purported to cause structural changes in the facial form and found health issues consequent to these structural changes, specifically, temporomandibular disorder, inadequate tongue space, obstructive sleep apnea, forward head posture, neck/posture issues, atypical swallowing, pronunciation/speech difficulties, somatic tinnitus and frequent headaches. A survey disseminated randomly on the internet addressed to people who have had orthodontic treatment with extractions tested the hypothesis that adverse aesthetic consequences result from premolar extractions. They found that:81% of respondents reported at least 1 negative aesthetic consequence subsequent to extraction orthodontics.73.7% percent of respondents reported inability to put tongue completely on the roof of the mouth without the tip of the tongue lapping on or beyond the front teeth. 20.4% percent reported difficulty pronouncing the letters S, V, B and D.90% of respondents reported that 2 or more aspects of their day-to-day lives have been somewhat or very much impacted by their reported symptoms92% of the 72 who offered comments in the survey referred to severely impaired health, diminished physical attractiveness, and/or psychological difficulties resulting from these impairments. A number noted “depression,” “anxiety,” “loss of self-esteem” and “loss of confidence”.Dr. Liliana Calkins of Airway and Sleep Group, provides Dental Airway and Sleep Medicine in Orthodontics using DOME and Rapid maxillary expansion techniques. These treatments are scientifically proven methods to improve airway as well as create the natural smile that fits your face beautifully. Dr. Liliana Calkins is one of the few orthodontists in the country who possesses the extremely rare combination of professional expertise and artistic talent to achieve functional and cosmetic excellence by creating your natural facial balance through complete anatomical, functional and aesthetic integration.If your orthodontists recommends removing molars as part of your orthodontic treatment plan, consider calling Dr. Liliana Calkins or Airway and Sleep Group instead! Call 703-646-9950 to schedule your complimentary consultation and receive sound advice to create the aesthetically pleasing smile you’ve always wanted while avoiding the negative effects of premolar extraction.

There are a number of reasons why orthodontic treatment can be beneficial, including providing room for crowded and erupting teeth.When permanent teeth are crowded together, problems like these can occur:Difficulty in cleaningLong-term wear issuesBreakageImpaired or painful chewingPeriodontal diseaseUnsightlinessSome of the causes of crowded teeth include:Too many teeth for the size of the jawTeeth that are too large in size for the jawA cleft lip or palateIrregularly-shaped teethIrregularly-positioned teethExtra teethJaw fractureIn most cases, orthodontic treatment for crowded and erupting teeth is optional. However, there are instances where orthodontic treatment is required before dental work can be started. It can prepare teeth for dental restorations that may not have been possible prior to treatment because they were too close together or in crooked positions.While erupting teeth occur mostly in younger children, around the age of 6-7, crowded teeth can create problems in people of any age. And with today’s orthodontic technology, there is often a solution for everyone.To prepare room for crowded and erupting teeth, an orthodontist will perform an examination. Then, he or she will prescribe a treatment plan that can head off potential problems from the start.Orthodontic treatment can correct the alignment of the teeth and bite—with significant long-term benefits. To best prepare for a lifetime of healthy teeth, visit the orthodontists at Airway & Sleep Group.

Orofacial Myofunctional Disorders (OMD) interrupt normal movement patterns, and can effect proper chewing and swallowing. But there is hope with Myofunctional Therapy.Many individuals with OMDs have early delays when it comes to eating and swallowing. They end up with picky eating patterns as a result of their lack of oral coordination that is necessary in the first three years of life. Speech patterns can also be impacted since many OMDs are typically associated with the tongue, lip and jaw movement.Since the early 1900s, orthodontists have documented their concerns about OMDs. Without addressing the issues, an individual could experience:Long-term mouth-breathing patterns that can compromise healthy breathing overallDetrimental oral habits that can inhibit or impede healthy growth and developmentAtypical chewing and swallowing patternsImproper tooth development or alignmentImproper jaw growth and facial structure developmentImpact to any long-term orthodontic treatment stability, with possible malocclusion relapseNegative impact on the temporomandibular joint (TMJ)Distortion of speechNegative social relationships because of open mouth, or noisy chewing and swallowingSleep disordered breathing patterns due to improper tongue positionAn individual can also experience issues like chronic face, neck and back pain; tooth grinding and clenching; headaches, TMJD or TMD (temporomandibular joint dysfunction); tinnitus; and vertigo. It's important to address what is contributing to the OMD before any treatment can begin. Once the cause or bad habit is determined, Myofunctional Therapy can initiate proper chewing and swallowing and help teach new and healthy patterns of behavior.If you’d are experiencing and OMD issue, please contact the specialists at Airway & Sleep Group.

Migraines, or a migraine headache, is a moderate to severe pain you feel at the top or side of your head which some people experience upon waking.Even though you feel that pain in the upper parts of your head, the source may actually be coming from the bottom of your skull. Often, the temporomandibular joint (TMJ) or the muscles surrounding it are responsible. This is the hinge and the connecting tissue that connect your jawbone to your skull and what allows you to yawn, chew and talk.When you tighten or clench your teeth, like when you chew gum for an extended period of time, this puts pressure on the jaw muscles. The pain created then travels to other places in the skull, causing headaches or more severely, migraines. While you are sleeping, you may be grinding or clenching your teeth without even knowing it, with the result of experiencing migraines upon waking.Sometimes you go to bed with a headache, but since most pain medications last between 4 and 8 hours, the pain returns prior to awakening. Some of the causes for waking with a migraine can include:DehydrationSleep apnea or insomniaTeeth grinding or clenchingSnoringDepressionAnxietyHormonesMedicationsCaffeine withdrawalThere is a difference between a migraine and a headache. With a migraine you experience:A headache lasting more than 4 hoursDistracting, pulsing or throbbing painDizziness or flashing lightsNauseaMigraines that occur more than 15 times a month are called chronic migraines. If you regularly experience migraines upon waking, keep a record of what is happening, and make an appointment with your doctor or one of the physicians at Airway & Sleep Group. We’ll look into treatment and pain relief options to get you sleeping and waking without pain.

Does your head ache when you awaken in the morning? Even though there are a variety of reasons this might be happening, you might be experiencing sleep apnea.One out of 13 people report that they experience early morning headaches. This may be the result of your body’s actual physiology. In the early morning, your body’s internal pain reduction levels may be lowered, or your body could be producing more adrenalin during this time, and this could lead to migraine headaches. More often, morning headache is associated with sleep-related breathing disorders like sleep apnea. People with sleep disorders are 2 to 8 times more likely to have a morning headache than those without a sleep disorder.Some of the more common causes of morning headache can include:Insomnia. You could be sleeping too little due to tossing and turning or lying awake during the night.Snoring. As a symptom of sleep apnea, snoring is a risk for chronic headaches.Tooth Grinding. When you clench your jaw or grind your teeth in your sleep, the tightened muscles can lead to headaches.Improper Sleep Position. If you’re using the wrong pillow, your head could be in the wrong position, thereby straining neck and scalp muscles.Cold Room. If your room is too cold, your muscles can tighten and cause pain.As sleep specialists, Airway & Sleep Group looks at the symptoms and the underlying causes for morning headache with sleep apnea. We can provide an examination and talk to you about treatments that can help alleviate or even cure your morning headache. Contact us for an initial consultation.

Typically, headaches caused by sleep apnea are called morning headaches. They are present on awakening and tend to improve over a few hours. They can look like tension headaches or migraines. In one study, 20% of people diagnosed with sleep apnea had morning headaches. According to the American Migraine Foundation, people living with this condition are between two to eight times more likely to experience sleep disorders.A study published in the US National Library of Medicine’s National Institutes of Health showed that insufficient sleep, disturbed sleep, oversleeping and inconsistent sleep cycles, are often reported as triggers for a migraine attack. Of 12,810 eligible respondents with migraine and data on sleep, 91.3% with episodic migraine (who have <15 headache days/month) and 8.7% with chronic migraine (who have  ≥15 headache days/month), 37.0% were at “high risk” for sleep apnea. Among respondents to the Medical Outcomes Study Sleep Measures, persons with chronic migraine were more likely to report poor sleep quality than those with episodic migraine.Morning headache sufferers can then prevent morning migraines by correcting their sleep apnea to achieve quality sleep. Though there are a number of lifestyle changes that can help, like losing weight, avoiding alcohol or quitting smoking, there is one proven methodology to correct the physiology associated with sleep apnea.Airway and Sleep Group use Rapid maxillary expansion, or the DOME,  Distraction Osteogenesis Maxillary Expansion technique which changes the shape of your mouth by widening a high-arch palate with associated nasal obstruction to improve the symptoms of Obstructive Sleep Apnea. DOME and Rapid maxillary expansionhave been proven to improve quality of sleep for obstructive sleep apnea sufferers by enhancing the airway.Make the choice to wake up feeling rested and refreshed without a morning headache and learn more by visiting www.airwayandsleepgroup.com.

The need for diagnosing and treating Sleep Disordered Breathing, including Obstructive Sleep Apnea, is critical due to the volume of potential patients affected, the associated health risks (diabetes, high blood pressure, heart disease, stroke, depression) and the potential for reduced quality of life (poor concentration, fatigue, increased risk of accidents).10Diagnosis and treatment of OSA should not have to wait until patients’ symptoms are bad enough to drive them into their doctor’s office. Dentistry has, as part of its treatment structure, a yearly recall of patients. This presents an opportunity for sleep disorder dentists to partner with sleep physicians to improve patient quality of life and lower healthcare costs by working together to diagnose and treat OSA appropriately. Pulse oximetry sleep tests are useful to dentists for managing mandibular advancement splint (MAS) appliances but not for diagnosing or confirming resolution of OSA. Only a sleep physician who is board certified in sleep medicine can diagnose or confirm resolution of OSA.11 MAS is reimbursable, and overnight pulse oximetry sleep tests can be included as part of the cost-of-care delivery. Oximetry sleep tests are easy and inexpensive for dental sleep practitioners to employ using a pulse oximeter such as Nonin Medical’s WristOx2 Model 3150. Training is minimal, and patients appreciate the fact that their oxygen saturation levels are being monitored for verification of MAS effectiveness before they return to their physician for a final polysomnography. Performing these tests lets the physician know that the dental practitioner is serious about OSA treatment and knowledgeable about how to make treatment effective.To read more about the study by Ronald S. Prehn, DDS visit the Blog at https://airwayandsleepgroup.com/2021/06/01/using-overnight-pulse-oximetry-to-manage-oral-appliance-therapy-oat-during-treatment-for-obstructive-sleep-apnea-osa/

A study published in the Science Translational Medicine suggests that cholesterol, a common culprit in heart disease, plays a special role in raising risk for people with sleep apnea.Dr. Klar Yaggi, a heart and sleep medicine physician at Yale School of Medicine explains why there are other reasons why sleep apnea could be bad for heart health. "Sleep apnea causes these very transient awakenings, most of the time without the patients realizing they are being woken up. Each of those awakenings is like a jolt of adrenaline," Yaggi says. Over time, those episodes can cause clots to form in blood vessels and lead to heart attacks.Dr. Atul Malhotra, a heart and sleep medicine physician at University of California, San Diego School of Medicine explored the science as to why sleep apnea can lead to cardiovascular risk. He concludes that it is the inflammation caused by sleep apnea that can cause heart attacks.Though statins lower cholesterol by lowering harmful inflammation in blood vessels that can lead to cardiovascular diseases, taking statins won't stop people from choking in their sleep. Malhotra says "If you give somebody a statin to prevent sleep apnea complications, they'll still have fragmented sleep, poor quality of life, and risk for motor vehicle accidents.”And though a CPAP machine and shedding excess weight can be effective treatment for relieving sleep apnea there is another alternative. Sleep apnea occurs when there is a physical blockage in the upper airway preventing air from entering the lungs. Tooth removal and a high-arch palate in the mouth can limit the space for the tongue to relax naturally in the mouth.Airway and Sleep group employs techniques like rapid maxillary expansion which is capable of increasing the maxillary arch and widening the mouth to allow the space for the tongue to rest comfortably in the mouth. Rapid maxillary expansion, or the DOME,  Distraction Osteogenesis Maxillary Expansion technique widens a high-arch palate with associated nasal obstruction while improving symptoms of OSA and has proven to improve quality of sleep for obstructive sleep apnea sufferers.Studies have shown significant improvement in patients with narrow maxilla and nasal floor with decreases in AHI (or Apnea-Hypopnea Index) scores after being treated with DOME or Rapid Maxillary Expansion. Patients also see an increase in REM sleep.If you have high cholesterol and have symptoms of sleep apnea, contact Airway and Sleep Group at 703-646-9950 for a diagnostic consultation.Resource: https://www.npr.org/sections/health-shots/2016/01/06/462152276/cholesterol-provide-a-clue-about-heart-risks-from-sleep-apnea#:~:text=iStockphoto-,Cholesterol%20may%20play%20a%20special%20role%20in%20raising%20the%20risk,in%20people%20with%20sleep%20apnea.&text=Soon%20after%20many%20people%20fall,airway%20constricts%20and%20chokes%20them.

Rapid maxillary expansion (RME) was found to be an effective expander involving the teeth and their sockets. and significantly augments the upper part of the throat behind the nose. and minimize the upper space behind the palate. Rapid maxillary expansion (RME) is a procedure used for midpalatal suture opening by means of fixed orthodontic appliances, during growth. The aim is to increase the width extending across the  arch attached to the jawbone as the result of dental and skeletal expansion. Bonded RME is an efficient expander involving the teeth and their sockets in growing patients and associated with an expansion of the space in the upper part of the throat behind the nose. The effects of RME on the region of the upper part of the pharynx, connecting with the nasal cavity above the soft palate, exhibited a mushroom-like pattern where the upper part expanded, the middle part significantly narrowed, and the lower part mildly but insignificantly narrowed. This form of interceptive orthodontics improves the nasal airway and gives ample room for the tongue. This study shows volumteric changes in the size of airway using Cone Beam Computerised Tomography (CBCT).Orthodontists like Dr. Liliana Calkins of Airway and Sleep Group use Rapid Maxillary Expansion to treat obstructive sleep apnea in patients and avoid the removal of teeth in orthodontic treatments which can negatively affect airway. Call Airway and Sleep Group for a diagnostic consultation at 703-646-9950.

Teeth do not become crooked by chance. Modern research reveals most orthodontic problems are the result of incorrect jaw development. The most up-to-date evidence reveals hereditary factors or big teeth in small jaws are not responsible for crowded teeth or incorrect jaw development either. Moreover, braces and extracting teeth in teenage years does not solve the underlying causes of crooked teeth and incorrect facial development. So what is proven treatment for crooked teeth, improved airway and oral health?A Myobrace® Treatment is a preventive pre-orthodontic treatment that focuses on addressing the underlying causes of crooked teeth, often without the need for braces. Myobrace® treatment is also used as a way to improve oral health, facial development and aligning the jaws and teeth without extracting any teeth by unlocking natural growth and development and improving airway. Treatment is best suited to children aged 3 to 15 and involves using a series of removable intra-oral appliances that are worn for 1-2 hours each day plus overnight while sleeping.What Myobrace® treatment does:Corrects poor oral habitsDevelops & aligns the jawsStraightens the teethOptimises facial developmentImproves overall healthPromotes healthy eating habitsHow does it do this? By helping the child:Breathe through the noseCorrect tongue resting positionSwallow correctlyKeep the lips togetherYou shouldn’t wait until all permanent teeth have come through to begin treatment with braces. This can unfortunately lead to irreversible damage affecting not only the teeth, but also the child’s overall health and development.Poor myofunctional habits (poor oral habits) can be seen as early as three years of age before all permanent teeth are present. This means treatment of the causes can begin much earlier than originally thought.Myobrace® is designed to deal with incorrect myofunctional habits by teaching children to breathe through their nose, rest the tongue correctly in the roof of the mouth, swallow correctly and continue widening the jaws so they grow to their full and proper size. This results in sufficient room for the teeth, allowing them to come in naturally straight and often without the need for braces.How it WorksThe Myobrace®System consists of a series of intra-oral appliances that are worn for one hour each day plus overnight while sleeping. The appliances assist in correcting poor oral habits and expand the arch-form while exerting light forces to align the teeth and jaws. Separate appliances are used depending on the child’s age and type of orthodontic problem. Myofunctional therapy exercises are to be performed twice daily in conjunction with wearing the Myobrace® appliance and consist of a series of breathing, tongue, swallowing, lip and cheek exercises.Schedule an evaluation to determine if you or your child is suitable for Myobrace treatment. Call Dr. Liliana Calkins of Airway & Sleep Group at 703-646-9950

You only get one set of permanent teeth, so it only makes sense to make sure that you do all that you can to preserve them. This can mean avoiding tooth extraction whenever possible by the use of orthodontic treatment.Dentists, and even orthodontists, learned that the best treatment for overcrowded teeth was to pull one or more, or extract them, to make room for the other teeth. However, for every action, there is a reaction. Even though tooth extraction can minimize crowding, there can be negative results with teeth shifting out of position and creating improper tooth alignment, which can and will affect the bite. It is unfortunate, but the negative results aren’t always discussed.Orthodontic treatment reduces the need for tooth extraction. Your orthodontist may recommend a self-ligation braces bracket system called Damon System braces. These types of braces deliver faster treatment, greater comfort and consistent results.Damon braces are “tie-less” and use a slide mechanism that eliminates the need for elastic or metal ties that require tightening. This allows the teeth to move freely. The system’s high-tech, shape-memory wires move teeth with fewer adjustments and aligns teeth usually without tooth extraction or rapid palatal expanders.If you’d like to know more about the Damon system, reach out to the orthodontists at the Airway & Sleep Group. Visit https://airwayandsleepgroup.com/

Your smile is objectively one of the most important and unique features of your face, would you like it if you could have orthodontic appliances specifically tailored to your dental and facial anatomy? Now, it is possible with Insignia. Unlike other orthodontic treatment options, Insignia is designed specifically for you.Insignia digital bracket system offers a digital design and custom appliance treatment for you to receive your desired smile outcome with efficiency and consistency. There are four steps to the digital bracket system: Scanning, design, building, and bonding.The patient receives a CBCT which produces 3D images of the teeth, soft tissues, nerve pathways, and bone in one scan. With the scans, case specialists provide a design that you can review and edit using Insignias Approver software. This way you can see and approve the desired future outcome beforehand. After the design is approved, it is time to build the custom brackets, wires, and placement guides. Once the custom brackets are fabricated, they are ready for bonding. The brackets are accurately placed with indirect bonding jigs.Insignia is some of the most advanced technology, tailored to your specific smile. It is fast, comfortable, and predictable. Be sure to look at the websites below for more information regarding this treatment.Websites:https://sunrise-orthodontics.com/https://airwayandsleepgroup.com/https://ormco.com/products/digital-orthodontics/insignia/insignia-advantage/

A study by Stanley Yung-Chuan Liu, Christian Guilleminault, Leh-Kiong Huon, Audrey Yoon found that Objective Distraction osteogenesis maxillary expansion (DOME) is a reliable method to expand the nasal floor and hard palatal vault in adults with obstructive sleep apnea (OSA). DOME results in a reduction in the apnea-hypopnea index (AHI) and subjective report of improved nasal breathing.A narrow maxilla with high arched palate characterizes a phenotype of obstructive sleep apnea (OSA) patients that is associated with increased nasal resistance and posterior tongue displacement. Current maxillary expansion techniques for adults are designed to correct dentofacial deformity. We describe distraction osteogenesis maxillary expansion (DOME) tailored to adult patients with OSA with narrow nasal floor and high arched palate without soft tissue redundancy. DOME is performed with placement of maxillary expanders secured by mini-implants along the midpalatal suture. This minimizes the maxillary osteotomies necessary to re-create sutural separation for reliable expansion at the nasal floor and palatal vault. We report the safety and efficacy profile of the first 20 patients at Stanford who underwent DOME.Airway and Sleep group employs the DOME technique for improving airway and combatting the effects of obstructive sleep apnea. Schedule a consultation to develop a strategic plan for airway improvement by calling 703-646-9950.

The combination of clear aligners and HFV or MOPs can resolve a variety of issues associated with previous botched orthodontic treatments by achieving maxillary growth and palatal expansion. These treatments have shown to be proven effective in treating temporomandibular disorders that may occur after improper orthodontic treatment.Case Studies of Dr. Ben Miraglia showed that expansive orthopedic and orthodontic techniques can solve a variety of issues that came about after improper orthodontic treatments. The combination of palatal expansion, clear aligners and HFV or MOPs resolved issues like• temporomandibular disorders.• headaches and jaw pain. • intermittent jaw locking• improper arch width• narrow deficient smile• and crowded malocclusionAirway and Sleep Group employs the latest technologies and orthodontic treatments that will help meet patient demands for a shorter orthodontic experience without sacrificing the quality care. Micro-osteoperforation (MOPs) deliver results quickly and with fewer office visits, accelerating the rate of orthodontic tooth movement by up to 62%. MOPs can even improve patient outcomes with greater clinical predictability.With a small perforation near the difficult tooth movement, MOPs stimulate the maximum biological response1 while remaining microinvasive and palatable to the patient. High-frequency vibration (HFV) with VPro is another advancement in orthodontic treatment. Patients only need to use the VPro device for just five minutes per day. This therapy has also been shown to reduce treatment time by up to 64%.These two therapies combined with aligner therapy and palatal expansion reduce treatment discomfort, increase case predictability, optimize aligner seating, and reduce the need for additional refinement aligners. Patient comfort is key to a good treatment experience and often helps with compliance and engagement in the treatment. Five minutes of “soft pulsation” per day has been shown to reduce orthodontic discomfort by releasing the pain receptors that reduce inflammatory pressure. If you or your loved one experience feelings of discomfort after recently completing orthodontic treatment,  contact Airway and Sleep Group to schedule a comprehensive diagnostic consultation by calling 703-646-9950.

In partnership with DB Orthodontics, MSE Creator Professor Won Moon presented The Moon Principles by Won: Evolution of Micro-Implants Supported Midfacial Skeletal Expander (MSE) with Retrospective Overview, the Latest Development, and Prospective Advanced Applications.In this lecture, Professor Moon demonstrated how the MSE is set apart from many traditional expanders. He detailed the evolution of expanders, discussed the challenges associated with traditional methods, and how the MSE overcame the challenges orthodontists face to treat imperfect positioning of the teeth when the jaws are closed. What is the MSE?The MSE is a unique micro-implant assisted rapid palatal expander (MARPE). The MSE gives parallel expansion in both the anterior and posterior regions, in comparison to the v shaped anterior expansion created with traditional MARPE.MSE’s success lies in its bi-cortical engagement. The protocol for securing the MSI involves inserting four mini-implants into the palatal bone and the nasal cavity; creating effective parallel expansion, and creating more of a mid-facial expansion as well as a maxillary expansion. The MSE also creates relatively parallel expansion by expanding the inferior as well as the superior aspects of midfacial structure because of the bicortical engagements. This, in turn, maximizes airway enlargement.Professor Moon also explained how opening the patients’ airways has improved the breathing and quality of sleep of many of his patients.Combined with a face mask, the MSE becomes a powerful tool when treating class III patients with imperfect positioning of the teeth when the jaws are closed. The MSE can create a significantly greater amount of forward movement of the maxilla; beyond the scope of traditional face mask approaches.It promotes posterior force loading instead of middle or anterior loading. Traditionally, typically expanders are positioned more anteriorly, and the MSE is positioned in a more distal area – expansion is created into the nasal bone area and back into the zygomatic arch.Professor Moon presented many clinical cases showing how the MSE has been used in the treatment of young, older and mature patients; even extending to patients in their 50’s. Airway and Sleep Group hails the research provided by Dr. Moon and promotes the development of a healthy airway using the same principles of craniofacial orthopedics. Call 703-646-9950 to schedule a consultation.

Now that you have completed your orthodontic treatment, and your smile is perfect, you might wonder why your tongue still does not fit your mouth? Why do you keep snoring? Why did you develop tinnitus or temporomandibular joint pain during or after your orthodontic treatment?Please consider that this might be the result of a “complimentary” consultation, in which you did not receive a comprehensive diagnosis, treatment plan or referrals for interdisciplinary care from your treating orthodontist. Airway and Sleep Group is focused on the realm of airway and sleep medicine in orthodontics. It is hard to see its profession missing the crucial steps of thorough diagnosis, a protocol that focuses not only on your teeth, but the impact of the adequate function of the craniofacial-respiratory system on your health. Consultations with Dr. Liliana Calkins are not “complementary”, they however,  complement your health, and will more than satisfy your needs if quality of care is your paramount objective.The lure of a “complimentary” consultation, can actually be against you as a patient for the long-term results. Dr. Calkins has read plenty of reports from her patients, who did not receive a diagnosis, treatment plan or radiology report read by a radiologist. All these parameters matter for your health. Airway and Sleep Group patients arrive for care wearing appliances for Temporomandibular joint disorder that are not monitored, that are causing posterior open bite. Airway and Sleep Group’s outstanding specialty in Orthodontics needs honors the services rendered to their patients for the betterment of their health at a comprehensive level.When you come to Airway and Sleep Group you can expect your treatment to correct the shape and functionality of your mouth, tongue, jaw and bite by selecting the state-of-the-art orthodontic treatment best suited to achieve the perfect smile for you. We instruct patients on orofacial myofunctional therapy and treating temporomandibular dysfunction as well.Call 703-646-9950 to speak with Dr. Calkins for a consultation. Our specialists will keep your best interests in comprehensive oral health care, with quality of airway and sleep dental medicine in mind. 

Many people have malocclusions and are unaware of the cause. A malocclusion is the imperfect positioning of the teeth when the jaws are closed. An insufficient alveolar bone is a common find among patients with malocclusions. Cumulative alveolar bone loss results in a weakening of the supporting structures of the teeth and predisposes the patient to tooth mobility and loss. It is one of the hallmarks of periodontitis.These problems have previously been insufficiently treated. With Surgically Facilitated Orthodontic Treatment patients can now be treated properly and efficiently.Malocclusions with insufficient alveolar bone have traditionally been treated orthodontically by removal of permanent teeth which has a number of negative side effects. Removing teeth doesn’t address the constricted arch form that can negatively affect function, esthetics, and the critically important airway. Surgically facilitated orthodontic therapy solves the real, underlying problem of insufficient alveolar bone and expands the traditional “orthodontic walls.”SFOT is a modern advancement in dentistry that results in faster tooth movement by more than 50%. SFOT detects underlying issues of the alveolar bone and arch issues and enhances myofunctional improvement. The treatment aids in ideal tooth position, minimizes number of surgeries, engineers’ new tissue and expands arch form. It can aid in improving esthetic concerns as well.https://www.sciencedirect.com/science/article/abs/pii/S0889540613010524https://sunrise-orthodontics.com/https://airwayandsleepgroup.com/

At an early age in a child’s development, incorrect muscle function in the craniofacial (head and face) region can create problems like an anterior open bite, an open-mouth resting posture, or inadequate swallowing patterns. The solution: Myofunctional Therapy to encourage adequate facial and dental growth.What does a Myofunctional Therapy Session Include?In each Myofunctional Therapy session, the patient learns three to four exercises that target specific structural issues. Session one is comparatively easy, with exercises becoming more challenging with each visit. The good news is that these exercises are proven effective with no more than five minutes work, twice a day, with the exception of one timed exercise that can be done at any time. The time investment is small, considering the benefits.A tongue that is resting down and forward is related to a narrow palate, and lack of lip seal. So instead of the tongue being in its correct position (at the top of the mouth), it tends to rest low and pushes forward when swallowing. This is known as tongue thrust swallowing pattern.As a result, if this issue is allowed to continue, it will cause a loss of muscle tone in the intrinsic muscles of the tongue, which in turn, can lead to a range of problems from digestive issues to teeth movement. In addition, when the tongue rests low, the lips are usually parted, an issue that can lead to serious health concerns like sleep apnea and ADHD, as well as change the shape of the face.Your tongue is a muscle that can create a surprisingly strong force. It typically goes through repetitive movements about 1000 times a day! The force exerted by improper movement of the tongue contributed to deformation of the surrounding structures like the jaw. That’s why it is so important to correct any tongue malfunction or habitual misuse early through Myofunctional Therapy for encouragement of adequate facial and dental growth.Correcting MalocclusionMyofunctional Therapy may be required as part of the correction of a malocclusion, a condition in which the upper teeth and lower teeth do not meet in an optimal way. It provides a stable environment for the bite after completion of orthodontic treatment to encourage adequate facial and dental growth. To be treated successfully, an orthodontist must be aware of the neuromuscular forces association with a malocclusion. More seriously, a malocclusion can affect respiration.Get Treatment with Airway and Sleep GroupDr. Liliana Calkins, of Airway & Sleep Group, is trained to diagnose and treat abnormal activities in the tongue’s pattern movements, the muscles involved in chewing, and the muscles around the mouth and in the cervical neck area. To schedule an appointment, contact Airway & Sleep Group.

Too many items like flossers are designed for single use, and end up in our area landfills, or worse, littering our lives. It is amazing how much waste is generated each year. In 2018 alone, more than 292.4 million tons of materials and products were discarded, reported an Environmental Protection Agency study. Broken down by materials, paper/paperboard topped the list at 23.1%, followed by food, plastics, yard trimmings, metals, wood, textiles, and glass.A 2021 story in the Washington Post claimed that one third of all the food in the U.S. gets wasted, and that fixing that problem could help fight climate change. “About $408 billion worth of food, grown on 18 percent of U.S. farmland with 4 trillion tons of water, never make sit to someone’s stomach.” And that “the carbon footprint of U.S. food waste is greater than that of the airline industry—accounting for about 8 percent of all greenhouse emissions.”“When food rots in a landfill, it produces huge amounts of methane—a greenhouse gas at least 28 times as potent as carbon dioxide,” the author said. “But in compost bins, microbes convert that organic matter into nutrient-rich soil, keeping the carbon out of the atmosphere and producing valuable fertilizer.”How do We Change to Be More Responsible to our Planet?One of the best, and easiest, ways to reduce waste is to look for alternatives to single-use products. Grab cups or glasses for water instead of buying bottled water, take a reusable grocery bag to the store, or use washable cloths for cleaning.Think of the “three Rs” when making your choices: Reduce, Reuse or Recycle. How can you reduce the amount of waste you produce? Choose items with minimal packaging or lessen the quantity of food you discard by purchasing less or making better food choices, and composting what you can. Opt for glass plates and cloth napkins over disposables. Recycle perfectly-good items back into the community by donating them to charities with stores. This not only keeps items out of landfills, it helps to raise money for community-based causes. Support this reuse by shopping at thrift stores—you’ll get a great product and a bargain.Becoming more responsible to our planet is a matter of making better and informed choices. Start by making little changes, like recycling, or bringing reusable bags to the grocery store. Don’t purchase large amounts of food at each visit. Make a meal plan instead. Package your food or lunch in reusable containers. Instead of tossing out damaged items, fix them instead. And stop littering. These are all small changes that can make a big impact.Related: 9 Simple Ways to Reduce Waste in Your HomeAs a medical practitioner, Dr. Liliana Calkins is dedicated to the health and well-being of her patients. She’s also aware of how much she, and we all, can do to help create a healthier environment overall and be more responsible to our planet.Dr. Liliana Calkins, DDS is a board-certified orthodontist and a sleep medicine specialist with the Airway and Sleep Group.

You can’t go anywhere nowadays without seeing or hearing something about how we need to work together to protect our environment. Even in our practice at Airway and Sleep Group, we try to do what we can. One way is by promoting and using biodegradable, sustainable products.There are plenty of eco-friendly items available. Like bamboo toothbrushes. According to the website ibannboo.com, “A plastic bottle can take up to a thousand years to decompose. A biodegradable toothbrush helps reduce more than 4.9 billon plastic toothbrushes that are thrown away every year and end up in our oceans and landfills.” This site claims to sell more than 10 million bamboo toothbrushes throughout the world each year! It’s part of their mission to reduce plastic waste.“Bamboo is completely biodegradable, making it a perfect alternative for daily-used plastic products,” it continues. The handle is composed of 100% sustainable bamboo and can be placed in a home compost or commercial composting bin, although the bristles, made from nylon and charcoal cannot, and must be removed. But they are the best option available to date. If the bristles were to be 100% biodegradable, they would need to be made from animal hair, which would not be suitable for cleaning teeth, and would potential harm animals.Natural toothpaste is another way to support environmental concerns. Many natural toothpastes are chemical free--without glycerin, fluoride, alcohol and SLS (a surfactant known as sodium lauryl sulphate, the ingredient used as a foaming agent), and come in recyclable containers. Essential oils like peppermint, spearmint and orange give it an appealing flavor.Instead of plastic floss containers, invest in a refillable metal one, and fill it with biodegradable dental floss. Other sustainable dental-related items can include tablet toothpaste, charcoal whitening, water flossers, and chemical-free mouthwashes.Care for Biodegradable, Sustainable ProductsYou may have to take a little extra care of your biodegradable, sustainable products. Because they are made of natural materials, it is important to keep them dry and clean. Store your toothbrush upright in and open-air container, and store dry ingredients in a cool and humidity-free environment.Chemicals to Avoid in Tooth ProductsRead the labels on dental-related items you purchase and try to avoid these chemicals, if possible:SLS – can cause canker sores and irritation. Toxic to aquatic life when rinsed down the drain.Sodium Chlorite – can be toxic to kidneys. Used as a bleaching agent in paper manufacturing.Sodium Hydroxide – also known as caustic soda or lye. Can cause mouth and abdominal pain, diarrhea and vomiting.Trisodium Phosphate – a harsh cleaning solution. Can cause algae overgrowth in water systems.Titanium Dioxide – a chemical used to whiten paint, and used in some toothpastes. A potential carcinogen, especially if inhaled.Alcohol – Some mouthwashes contain up to 25% alcohol! Can be dangerous to children and can lead to dry mouth.Green DentistryThe Eco-Dentistry Association® provides education and standards for dentists who choose to be green dental practitioners. Its educational programs, research and member resources help dental professionals reduce the impact on our environment and offer alternatives to patients concerned with a wellness lifestyle.Dr. Liliana Calkins is a specialist in Orthodontics & Craniofacial Orthopedics. To learn more about biodegradable, sustainable and chemical-free dental products, contact her at Sunrise Orthodontics or Airway and Sleep Group.

More than 18 million American adults have obstructive sleep apnea (OSA), which can cause breathing cessation during sleep or abrupt awakenings accompanied by shortness of breath. According to Wikipedia, OSA is the most common type of sleep apnea, characterized by repeated episodes of complete or partial obstructions of the upper airway during sleep. It can cause breathing to stop and start repeatedly during sleep. OSA occurs in all age groups and in both sexes. In children, its occurrence can run between 2% to as high as 10 or 20% in habitually-snoring children.Symptoms of Sleep ApneaSome of the symptoms of OSA include poor sleep; fatigue during the day; or heavy snoring, choking, gasping or breathing cessation during the night.If you suspect you might have sleep apnea, visit your doctor. Bring along a record of your sleep or fatigue period and an updated list of medications you are taking—including any over-the-counter medications.Diagnosis One of the most common diagnostic tools for OSA is a sleep study, which may require an overnight stay at a sleep center. Here, technicians monitor a variety of functions during sleep including sleep state, eye movement, muscle activity, heart rate, respiratory effort, airflow, and blood oxygen levels to determine severity. They will look for signs of breathing cessation during sleep or abrupt awakenings accompanied by shortness of breath. You may be able to start treatment following your first night in the sleep center.Sleep Apnea TreatmentA highly-effective treatment recommended by doctors for many patients is a continuous positive airway pressure device, or CPAP. The device consists of a mask that fits snugly over the nose and/or mouth that gently blows air into the airway to help keep it open during sleep. Other training methods can include:Dental appliance that reposition the lower jaw and tongueUpper airway surgery to remove excess tissueNasal expiratory positive airway pressure with a disposable valve covering the nostrilsTreatment using hypoglossal nerve stimulationLifestyle changes can also make an impact on obstructive sleep apnea. These can include:Lose weight. Where a CPAP can only treat OSA, weight loss can cure it in an overweight person.Avoid alcohol. Alcohol can cause frequent nighttime awakenings and makes upper airway breathing muscles relax.Quit smoking. Smoking worsens swelling in the upper airway, making apnea and snoring worse.Sleep on your side. Some patients with mild sleep apnea have fewer breathing problems when sleeping on their side rather than their back.At Airway & Sleep Group, we work with patients on treatments for sleep apnea regularly. Contact us at 703-646-9950 for your initial consultation.

There is now an app to help kids (ideally from 4 to 18 years old) achieve the best postural habits for optimum face and airway development resulting in long-term health.The GOPex program, Good Oral Posture exercises is a regimen that can help guide children to acquire the habits that will foster excellent facial and jaw development and in turn allowing them to achieve their full genetic potential with large attractive jaws, healthy airway and a full (including Wisdom teeth) set of 32 straight and stable adult teeth.Human biology explains that pressure stimulates bone cells to grow. We know that astronauts that travel into space lose precious bone cells due to the lack of pressure from gravity. In the same way, when our muscles do not have good tone and are not exercised properly they will not exert the weight that bones need to maintain their optimal shape.By understanding this principle Forwardontics developed GOPex to help our muscles through changing modern habits. A series of simple exercises can be incorporated into daily activities to train the muscles to hold the posture with the adequate tonicity to apply weight to the cells and in turn allow the maximum growth of the facial structures.GOPex app works by allowing users to send videos performing postural exercises: chewing, counting or reading. Each video users send will be reviewed by the GOPex app which will provide 90 days of guidance and feedback for improvement.Incredible results will be observed in 30 days, but the goal is to make good posture a lifetime habit. GOPex utilizes brain plasticity to re-set children’s resting posture for growing healthier and preventing chronic disease.Application will be active for 90 days, but long-term subscription membership can be requested for continuing maintenance.Airway and Sleep Group understands that airway development exercises can teach children (and adults) to breath in a way that will help them develop proper nasal respiration, which allows the air to enter the body in the healthiest most efficient way.Take advantage of Airway and Sleep Group one-on-one expertise in orofacial myology to create a healthier more attractive you. Better muscle tone and improving the quality of your rest will be noticeable in many aspects of your health, both on your looks as well as in the way you feel. Call us at 571-244-7329.To learn more about the GOPex app go to http://www.forwardontics.com/store.html

There are over ninety diagnosable sleep disorders in children. These sleep disorders can affect kids’ brains, hearts, blood pressure, craniofacial and somatic growth, alteration in appetites.Ninety-five percent of children with obstructive sleep apnea (OSA) are never diagnosed. Children will struggle to function and stay awake, they have significant learning, behavior, speech and mood problems. Usually these children will be more likely diagnosed with ADHD.Craniofacial orthopedics and orthodontics are effective solutions for treating obstructive sleep apnea (OSA) by changing the shape, size and relationship of the bones in the jaw and face and creating enough space in your mouth for your tongue to relax naturally during sleep.Parents are invited to have a craniofacial growth evaluation early in the life of children, parents might notice sign and symptoms like snoring, noisy breathing, night waking and think this is normal. We invite them to know, these symptoms are NOT normal, they are unfortunately common and need to be evaluated and treated.For more information visit www.airwayandsleepgroup.com.#craniofacialgrowth#Healtyairwayforkids#pediatricairwaynewYork#pediatric sleep medicine#airwayandsleepmedicine in orthodontics

Excerpt taken from: Persistent Central Apnea and Long-Term Outcome After Posterior Fossa Decompressive Surgery for Arnold Chiari Type 1 Malformation in a Pediatric PatientArnold Chiari malformation (ACM) is the most common cause of central sleep apnea (CSA) in otherwise healthy children. Although there are several case reports and series reported on this topic, there are limited descriptions of the long-term course of these children after the surgical interventions. Posterior fossa decompression surgery to relieve pressure of the herniating cerebellum on the brainstem is generally thought to significantly improve CSA in most cases, however, there are very limited data on the natural course of CSA in children following decompression surgery. There may be a subset of children in whom it may take much longer for CSA to resolve, and in some it may not resolve completely. Hence, these children need to be followed closely with sleep studies to document resolution of CSA.In the case report referenced, Dr. Abigail Strang and Dr. Umakanth Katwa describe a 10-year-old male with severe CSA who was subsequently diagnosed with type 1 ACM and underwent posterior fossa decompressive surgery. However after surgery, although there was improvement in his CSA, he still had a significant degree of residual CSA which required bilevel positive pressure therapy and took more than 7.5 years to resolve. This case report illustrates the need for close follow-up in these children and for providers to understand the natural course so they can accurately counsel families about expectations after surgical treatments.Read the study here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6457512/Visit www.airwayandsleepgroup.com.

Once you’ve found a reliable dentist’s office and signed your family up for it, won’t your dental problems vanish? Given the high-stress lifestyle that many of us lead, you may wish to put oral health out of your mind. However, your body’s painful response to that stress might force dentistry back in your head where it can’t be ignored.We notice how our patients’ day-to-day lives affect their mouths. And, in truth, your daily habits affect your oral health just as much as your diet. That’s why we offer cosmetic, restorative, and TMJ dental treatments as well. And with flexible scheduling, affordable options, and patient-focused care, Reston residents can choose their plan of care. Our services will put your mind at ease while also informing you of the effects that your lifestyle has on your oral health.Below, we discuss how stress and anxiety affect TMJ/TMD and then detail our treatment options:What are Stress, Anxiety, and TMJ/TMD?First, we define stress as the body’s response to the events and situations of daily life. While each of us can handle stress in small amounts, it can become overwhelming in response to any novel, threatening, and/or chaotic events. Its symptoms include trouble sleeping, headaches, muscle tension, and teeth-grinding (bruxism).Second, anxiety refers to worry and fear over events (or the outcome of events). Again, we all experience varying levels of anxiety in our lives, but large quantities can cause panic attacks that paralyze sufferers. Its symptoms include fear, tension, and trouble sleeping or concentrating.Finally, “TMJ” is short for temporomandibular joint and “TMD” for temporomandibular disorder. The TMJ connects your jaw to your skull; thus, a TMJ disorder refers to the misalignment and pain of this joint. This condition is considered a type of TMD, and its symptoms include headaches, facial pain around the cheeks or jaw, and difficulty chewing.How They Are LinkedAs we’ve discussed before, oral health involves more than just teeth. A healthy mouth includes properly-functioning jaw muscles and joints as well. Thus, dentists and anyone else interested in dental wellness should be aware of the symptoms and causes of TMJ/TMD.You may have noticed that stress, anxiety, and TMJ/TMD share some symptoms (including tension and headaches). Furthermore, cause-and-effect links may be drawn between these conditions. For instance, the muscle tension and bruxism of stress may bring about tension, jaw pain, and difficult chewing – which indicate TMJ/TMD.To make matters worse, realizing that one suffers from TMJ/TMD may cause further stress and anxiety. If left untreated, you may struggle to open and close your mouth, which you will definitely feel anxious over. Thus, these ailments both bring about and reinforce one another.SolutionsOn your own, treating these conditions may be tricky. But Airway and Sleep Group offers TMJ/TMD services for this very reason. During a standard check-up appointment, we can investigate whether you suffer from TMJ/TMD and, if so, provide relief from its discomfort.To do so, we will adjust your daily habits to prevent symptoms from worsening. These steps may include simple steps such as practicing good posture and avoiding gum-chewing

Waking up in pain is the worst! You should feel refreshed after sleep, however when you have temporomandibular joint disorder (TMJD), you can wake up feeling anything but rejuvenated. TMJD, often known as TMJ, is unique to each person, and the symptoms and causes are specific to the individual. One of the first ways to start addressing your disorder is to evaluate your sleep since some of the worst strain can happen overnight. Best Positions for Sleep The position you sleep in can influence a number of TMJ issues by straining the face, jaw and shoulder muscles. The type of pain can depend on how well your neck and head are supported, and if you are creating tension in your jaw by grinding or clenching your teeth in your sleep. However, if you suffer from sleep disordered breathing, you might need to sleep on your side, making sure your head and neck have enough support. The worst position for TMJ is to sleep on your stomach, followed by sleeping on your side. Both can take your posture out of alignment. The best sleep position for TMJ is on your back. This helps by: Supporting your head, neck and shoulders Properly aligning the body Eliminating pressure on the jaw Reducing chances of grinding or clenching your teeth What is TMJ? TMJ refers to the temporomandibular joint (TMJ) that is the hinge that connects your jaw to your skull in front of each ear. It enables you to move your jaw up and down, side to side, and backwards and forward so you can talk, chew, yawn or swallow. Problems with the muscles and joints in this area are called TMJ disorders. If you suddenly experience pain in your jaw, you might be alarmed, but chances are it’s not serious. Sore muscles and sudden jaw pain can be the result of a dental issue or strain. But are these symptoms of TMJ disorders? Temporomandibular joint (TMJ) disorders occur when there are one or more problems within the joint that connects your jaw to your skull. The shock-absorbing disk that aids the jaw movement can become worn or slip out of alignment, or the muscles supporting the TMJ could be strained by grinding and clenching of your teeth while you sleep, for example. Both can cause sore muscles and jaw pain in a chronic fashion rather than a sudden onset. Symptoms of TMJ disorders can include: Jaw tenderness Pain when opening or closing the mouth Pain or difficulty chewing Joint locking when the mouth is in a closed or open position Earache Clicking or popping when the jaw moves Issues and habits that can cause pain and may lead to a TMJ disorder include: Clenching or grinding teeth Nail, cheek or lip biting Teeth misalignment or damage Jaw infection or injury Cartilage or tissue damage Sleep disordered breathingIt is not easy to find the specific cause of TMJ disorders since multiple factors may be involved. If you are exhibiting symptoms, make an appointment with Dr. Calkins, to gain more information visit the website: www.airwayandsleepgroup.com, we will start with an evaluation of your TMJ with the highest technology available and in conjunction with Magnetic Resonance Imaging. Dr. Calkins can evaluate the cause of your sore muscles and jaw pain, discover whether these are symptoms of TMJ, and prescribe remedies that can help. 

Faster, more predictable treatment with MOPsWe are proud to offer the Propel® Excellerator® Series, the first and only product line cleared by the FDA for use In MOPs. While patient results may vary, adding MOPs to your orthodontic journey will allow you to reach your ideal smile up to 2.3x faster than orthodontics alone.What is MOPs?Micro-osteoperforation is a technique that stimulates bone remodeling, allowing the teeth to move faster and more predictably into their ideal position. This innovative technology gives our team a way to help patients finish braces or clear aligner treatment more effectively and efficiently.Simple In-Office TreatmentWe can complete a MOPs application in a matter of minutes during a regularly scheduled appointment. It is performed in 3 easy steps, allowing you to get back to your busy schedule in no time!Step 1: Evaluate the treatment areaStep 2: Rinse with Chlorhexidine and apply an anestheticStep 3: Create the MOPs or “dental dimples” in areas requiring stimulationIs it Right for Me?Whether you’re getting ready to start your orthodontic journey or are already in active treatment, MOPs may help you reach your smile goals quicker. The MOPs technique works with your own biology by stimulating the bone surrounding the teeth. In most cases, you will be able to finish treatment with exceptional results in less time and fewer treatment visits.Visit www.airwayandsleepgroup.com for more information.

Many people have malocclusions and are unaware of the cause. A malocclusion is the imperfect positioning of the teeth when the jaws are closed. An insufficient alveolar bone is a common find among patients with malocclusions. Cumulative alveolar bone loss results in a weakening of the supporting structures of the teeth and predisposes the patient to tooth mobility and loss. It is one of the hallmarks of periodontitis.These problems have previously been insufficiently treated. With Surgically Facilitated Orthodontic Treatment patients can now be treated properly and efficiently.Malocclusions with insufficient alveolar bone have traditionally been treated orthodontically by removal of permanent teeth which has a number of negative side effects. Removing teeth doesn’t address the constricted arch form that can negatively affect function, esthetics, and the critically important airway. Surgically facilitated orthodontic therapy solves the real, underlying problem of insufficient alveolar bone and expands the traditional “orthodontic walls.”SFOT is a modern advancement in dentistry that results in faster tooth movement by more than 50%. SFOT detects underlying issues of the alveolar bone and arch issues and enhances myofunctional improvement. The treatment aids in ideal tooth position, minimizes number of surgeries, engineers’ new tissue and expands arch form. It can aid in improving esthetic concerns as well.https://www.sciencedirect.com/science/article/abs/pii/S0889540613010524https://sunrise-orthodontics.com/https://airwayandsleepgroup.com/

If the tongue and lips are not functioning correctly, crowded teeth and underdeveloped jaws are the result. These are called incorrect myofunctional habits. If function and jaw shape are correct, there is plenty of room for the teeth. Hereditary factors or big teeth in small jaws are not responsible for crowded teeth or incorrect jaw development. The real culprits are mouth breathing, tongue thrusting, reverse swallowing and thumb sucking, which are known as incorrect myofunctional habits. The tongue, the major culprit in Obstructive Sleep Apnea (OSA), will block the airway by moving backwards toward the throat during sleep, when there is not enough room for it in the mouth. By orthopedically creating space for the tongue and training it to swallow properly, the airway’s total volume greatly increases.Another thing to watch out for is if you’re swallowing the wrong way, with lots of movement in the bottom lip. Incorrect swallowing is when the tongue pushes forward and the lips push back when swallowing. When this happens your front teeth will be pushed backwards and this also causes your teeth to be crowded. A child swallows twice per minute and if they have an incorrect (reverse) swallowing pattern, the facial muscles will push backwards against the direction of growth, preventing the face from developing to its genetic potential.The tip of your tongue should rest gently behind your top front teeth. The border of your tongue should be gently in contact with the roof of your mouth, right where the teeth and gums meet. Your teeth should be slightly apart with your jaw very relaxed.To be able to relax the tongue and jaw, try the Jaw joint stretch: Press the tip of your tongue onto the roof of your mouth, directly behind your top front teeth without touching them. Next, use your tongue to apply gentle pressure. Slowly open your mouth as wide as you can, then slowly close it shut. Stop at the point where you feel discomfort.Airway and Sleep Group’s Orofacial Myofunctional Therapy corrects the oral posture of the muscles of the face and can be used to correct behavior patterns caused by not resting the tongue in the roof of the mouth. Call 703-646-9950 to set up a consultation.

Myobrace® is a preventive pre-orthodontic treatment with the goal of targeting the causes of crooked teeth so that children can naturally grow and develop naturally, hopefully without the need for braces. It is designed for children ages 3-15, and is best utilized before children have all their permanent teeth.Four Stages of Myobrace TreatmentThere are only four stages of treatment that are usually completed in 18 months, on average. They include:Habit Correction – teaching the patient to breathe through the nose and not the mouth, training the tongue to rest in a correct position, swallowing, and keeping the lips together when not speaking or eating. This enables the jaw to grow to the proper size and the teeth to come in straight.Arch Development – In some patients, the upper jaw requires enlargement to allow sufficient space for the teeth and tongue. The Myobrace System is used to help develop the jaw.Dental Alignment – When permanent teeth erupt, the Myobrace for Teens is utilized to help align teeth into their natural position. Depending upon the child’s own requirements, final treatment may involve braces, but generally for a much shorter time than without the Myobrace treatment.Retention – No fixed retainer is required, as is often the case with braces, to maintain good oral habits and alignment. Myobrace treatment enables more stable orthodontic results and improved overall health.Our specialists at Airway and Sleep Group are experts at treating Orofacial Myofunctional Disorders (OMDs). These are disorders of the muscles and functions of the face and mouth that can affect facial skeletal growth and development, speech, TMJ, orthodontic treatment stability, facial esthetics, chewing and swallowing.If you’d like to learn more about Myobrace Treatment, Orofacial Myofunctional Therapy or Sleep Apnea Treatment, please contact Airway and Sleep Group at 703-646-9950. Or visit www.airwayandsleepgroup.com

Obsessive-Compulsive Disorder is a common psychiatric disorder characterized by the presence of recurrent intrusive thoughts or images (obsessions) that are irrational and/or excessive. They can also manifest as behavioral rituals (compulsions) that help reduce anxiety. Together, these symptoms can cause distress and can significantly decrease quality of life and impact the individual’s everyday life. OCD can be seen in children as young as 4 or 5. Disruption to the sleep-wake cycle can be a result of OCD.Sleep problems have been found to be more common in girls and younger children with more severe forms of OCD. Sleep plays an important role in early growth and development. The disruption of sleep cycles at an early age, negatively affects the child’s growth pattern.Symptoms of OCD in children:Recurrent and persistent thoughts, urges, or imagesRepetitive behaviors they feel the urge to perform because of an obsession or specific rules they must follow rigidlyThe acts performed reduce their anxiety or destressSymptoms affecting sleep:Specific nighttime routines or compulsive ritualsl before bedDelaying bedtimeDisruptive sleepBehavioral problemsTiredness during the dayTreatment is best completed at an early age. Dr. Calkins as craniofacial orthopedist and orthodontist,  can examine the patient as early as 2 or 3 years old. Sleep disorders could be related to a poor function of the respiratory system. The craniofacial-respiratory system assessment and treatment can start as early as 2 years old.  For more information about treatment and scheduling a visit, click the links below:https://sunrise-orthodontics.com/https://airwayandsleepgroup.com/

Is your child living with a tongue-tie? The term for this is restricted lingual frenulum. This occurs when the tissue connecting the tongue to the floor of the mouth is thick and restrictive, resulting in limited range of motion as well as many other potentially harmful consequences. A restricted lingual frenulum can impact the development of the face, speech, jaw, and tooth alignment and more.Early effects of tongue ties in infants and children can include:Difficulty latching while nursingProblems bonding with the motherFeeding too frequentlyProblems eating, chewing, and swallowing foodIssues with speech developmentSleep concernsCraniofacial alteration in growth of maxilla and mandible.Early detection of a tongue tie is important to minimalize the negative effects on growth. Tongue restriction heavily influences jaw growth and development and class II malocclusions. The lower jaw is not able to develop because the restriction of the tongue stops growth of the mandible.The treatment for a tongue tie is a frenectomy or frenotomy, with orofacial myology (muscle training), prior and after the tongue release. These procedures are minimally invasive and is performed to cut the lingual frenulum or completely remove it. It is best performed early in children and babies to prevent growth and development problems that may occur. According to reports, the frenotomy is best performed in the first week of the child’s life.For more information, visit www.airwayandsleepgroup.com

Last year, many dental practitioners were forced to temporarily close in order to limit the spread of COVID-19. Now as the state enacts Forward Virginia, also known as Virginia’s phased-approach for reopening businesses, dental practitioners are making sure their policies and procedures align with the current state restrictions. Our team at Airway and Sleep Group and dentists around the world are using more protective procedures and equipment while finding better alternatives to ensuring our community receives dental care, especially for emergencies.While continuing oral and orthodontic care during lockdowns and social distancing guidelines is a challenge many dentists face, Airway and Sleep Group remains current on the guidelines and will adjust our procedures as necessary to ensure we keep our team and our patients safe. Our family-friendly dental practice is offering additional screenings prior to a patient’s appointment time, no patient appointment overlaps, an office layout that adheres to social distancing guidelines, and much more. Read our previous blog to learn more about our COVID-19 Best Practices.Here’s also what some dental practitioners are doing to bring dental care to their communities while making sure everyone remains safe:Mobile DentistriesDental practitioners are finding innovative ways to make dental care more accessible to their communities by going “mobile”, or becoming mobile dental clinics that provide standard procedures. Dental tools and other medical equipment used during a mobile visit are all HIPAA compliant.While the purpose of a mobile dentist is to physically bring dental professionals to their patients, it also comes with its many advantages as well, such as increased privacy and comfort for patients.Not to mention, it offers more flexibility for those who aren’t able to physically visit the dentist, like residents who live in assisted living, retirement communities, and rehabilitation centers.TelemedicineSimilar to mobile dentists, the purpose of telemedicine is to improve accessibility. Telemedicine allows dentists to meet with their patients in real-time without risking infection.The benefits of telemedicine include eliminating the commute to the practice, helping people save on transportation costs, and minimizing time spent away from work, school, and other daily activities.Telemedicine appointments are available at Airway and Sleep Group to enable patients to acquire advice and treatment without physical face-to-face interaction. And if a physical face-to-face appointment is necessary, Airway and Sleep Group organizes each physical meeting using a limited time at the office per patient.Choose A Family-Friendly Dental Practice in Reston, VAAs we continue to provide safe dental care procedures, we ask that our patients adhere to the CDC guidelines to ensure we are all doing everything we can to limit the spread of the virus. Come visit our professional orthodontic practice for your next routine checkup!Contact us today at www.AirwayandSleepGroup.com to discuss your oral health concerns and questions.

Cone Beam Computed Tomography in Orthodontic DiagnosisAdvanced digital technology has become essential in successful orthodontic diagnosis, evaluation and treatment plans to help orthodontic professionals to discover what cannot be detected in a clinical exam. Cone beam computed tomography (CBCT) is an important tool for orthodontic diagnosis. It provides medical professionals a three-dimensional, volumetric view of the craniofacial complex with much more reliable information than conventional two-dimensional radiology or X-rays.CBCT is used to help diagnose patients with anomalies like cleft palates, abnormalities of the temporomandibular joint, or airway evaluation in obstructive sleep apnea cases, among others. Most often, CBCT is used to identify and localize transposed or impacted teeth. Using the data, orthodontists can also assess the best location for a temporary skeletal anchorage device.Some of the other benefits of CBCT:Images accessed from three planes and reorientedHighly-localized imagesElimination of distortion and overlappingSingle-scan study casts construction enabledDetection of root absorptionOrthodontist Liliana Calkins DDS of Airway and Sleep Group uses these advanced digital technology aids for craniofacial-respiratory evaluation. This enables her to use the technology in an orthodontic or orthodontic/surgery combination to treat growth and development issues with expansion of the airway.Dr. Calkins focus is to understand and treat the causes and pathology of prevalent malocclusions,”  She says “We evaluate our patients to discern the underlying causes and treat them using an integral health approach to create a beautiful, natural, healthy face, functional occlusion and viable airway.”As digital technology advances, so do the treatment options at Airway and Sleep Group, leading to better diagnosis, treatment plans and outcomes.

Dr. Liliana Calkins, member and founder, of the Virginia Interdisciplinary Airway and Sleep Group; knows the importance of early intervention in treating pediatric Sleep Disordered Breathing (SDB). She is participating in a first-of-its-kind program at Tufts University to help dentists understand the basics of normal sleep maturation, respiratory physiology, and craniofacial development throughout childhood. Excited to learn the new treatment options for SDB in pediatric patients, she will become familiar with various sleep disorders in children and adolescents and review cutting-edge research and techniques in evaluation and treatment. Early intervention is Dr. Calkins’ highest recommendations to all our families, since the growth and development of the craniofacial- respiratory complex occurs early in life, from 0-5 years-old.The Program will be presented by a team of multidisciplinary instructors representing medical, surgical, and dental backgrounds including: Dr. Umakanth Katwa MD, Paediatric Pulmonary and Sleep Medicine; Bobby A. Ghaheri, MD; David Hatcher, DDS; Rebecca Thorsen, MS, CCC-SLP, COM®; Fabi Moy, M.A., CCC/SLP/COM©; and Orfeu Buxton, PhD., Audrey Yoon, DMD.The burgeoning field of treating Obstructive Sleep Apnea (OSA) is of the utmost importance to Dr. Calkins as Sleep Disordered Breathing (SDB) is increasingly recognized as a chronic disorder of dysfunctional breathing during sleep in children and can range from habitual snoring to OSA. The spectrum of SDB can result in adverse neurocognitive consequences from sleep fragmentation and intermittent hypoxemia, as well as adverse craniofacial maldevelopment, abnormal breathing patterns, learning difficulties, ADD and ADHD, poor academic performances, bed wetting, excessive sleepiness, and behavioral, mood, and anxiety disorders.Despite these alarming facts, research has shown that children are not screened to the best of doctor’s abilities for SDB in their routine physical and dental check-ups. This makes it difficult to initiate the early intervention strategies necessary to improve children’s overall quality of life and learning whilst preventing the development of significant and lasting morbidity.Dr. Calkins is excited to share her expertise from this Mini-Residency to recognize and treat Sleep Disordered Breathing effectively using this latest scientific research. Contact Airway and Sleep Group to receive a comprehensive evaluation for Sleep Disordered Breathing.

Combined with braces, accelerated orthodontics work to improve your smile in record time. While not everyone is a perfect candidate for the treatment, it is something worth talking to your orthodontist about.One of the major deterrents of the use of orthodontics is time. Many people, mainly adults, are afraid of getting treatment because they, understandably, do not want to wear braces for a few years. For the longest time, there was no catalyst to reduce the amount of time treatment was needed. Accelerated orthodontics provides a solution. All accelerated orthodontic treatments and devices work to shorten the amount of time one needs to wear braces. Propel VPro+ is similar to the other accelerated orthodontic lines in that it cuts the time down; however, it is unique in the sheer amount of time that saved through the routine use of it for a short period.In conjunction with your other orthodontics, accelerated treatments and devices will straighten your teeth in no time. Propel VPro+ devices are FDA approved medical devices that are unparalleled in its expedience and user-friendliness. Propel VPro+ can help give users the improved self-confidence that comes with straight teeth in a sliver of the time.Propel VPro+ Propel VPro+ is largely regarded as faster than other methods of accelerated treatments and can cut treatment time by up to 50%.Propel’s VPro Series is the first and only High Frequency Vibration (HFV) product line to support both active treatment and retention in just 5 minutes per day. It is designed for at-home or on-the-go use. Its features include a convenient 5-minute wear time, gradual and comfortable ramp up to full vibration frequency, and intuitive light notifications for easy operation. The VPro+ is Propel’s latest addition, featuring a sleeker design, waterproof Vibration Device, wireless charging, compact travel case and mobile app.Learn how it worksOsteoclast activity is the controller of bone resorption which is believed to be the controller of the rate at which teeth move. Through micro-osteoperforations (MOPs), Propel VPro devices stimulates cells into osteoclast which in turn results in the movement of the teeth into the desirable positions. This is a substantial reason why the device is seen as better than others.Airway and Sleep Group is a certified provider of Propel devices like VPro. Schedule a complimentary consultation with Dr. Liliana Calkins at Airway and Sleep Group to determine if accelerated orthodontics is a perfect fit for you. .

It is not only unattractive when someone’s mouth is hanging open loosely, when lips are apart in a resting pattern, it is a bad habit that can lead to more serious issues. Learning to keep the lips sealed is a behavior that can be altered through Myofunctional Therapy.A lips-apart resting posture is often the result of a nasal airway obstruction. However, once that obstruction is corrected, the lips-apart pattern can remain a persistent habit that must be further addressed.When nasal breathing is impeded, the body naturally accommodates by relying on mouth breathing—which changes the natural resting position of the jaw, tongue and lips. This change in position can influence growth patterns of the jaw and maxilla, often resulting in the development of significant malocclusion.Furthermore, long-term mouth breathing compromises the natural breathing process which relies on the nasal airway to cleanse and purify incoming air for the pulmonary system.It is often difficult to isolate one particular source cause for what is known as an Orofacial Myofunctional Disorder (OMD). In most cases, it results from a combination of factors including among them:A restricted airwayThumb sucking; nail or cuticle biting; teeth clenching or grinding; or tongue, lip or cheek sucking habitsLong-term use of sippy cups or pacifiersDevelopmental delaysNeurological problemsHeredityThrough Myofunctional Therapy, patients are learning to keep their lips sealed through a series of exercise that retrain adaptive patterns or muscle function or bad habits. This helps to create and maintain a healthy orofacial environment.The benefits of Oral Myofunctional Therapy may include:Correction/improvement of tongue and lip posturesAssistance in stabilization of teeth during and after orthodontic treatment or jaw surgeryIdentification of the need for speech treatmentThe orthodontists at Airway and Sleep Group are glad to share their knowledge and expertise on Myofunctional Therapy with you. Contact them at 703-646-9950 for an appointment.

More than 18 million American adults have obstructive sleep apnea (OSA), which can cause breathing cessation during sleep or abrupt awakenings accompanied by shortness of breath.According to Wikipedia, OSA is the most common type of sleep apnea, characterized by repeated episodes of complete or partial obstructions of the upper airway during sleep. It can cause breathing to stop and start repeatedly during sleep. OSA occurs in all age groups and in both sexes. In children, its occurrence can run between 2% to as high as 10 or 20% in habitually-snoring children.Symptoms of Sleep ApneaSome of the symptoms of OSA include poor sleep; fatigue during the day; or heavy snoring, choking, gasping or breathing cessation during the night.If you suspect you might have sleep apnea, visit your doctor. Bring along a record of your sleep or fatigue period and an updated list of medications you are taking—including any over-the-counter medications.DiagnosisOne of the most common diagnostic tools for OSA is a sleep study, which may require an overnight stay at a sleep center. Here, technicians monitor a variety of functions during sleep including sleep state, eye movement, muscle activity, heart rate, respiratory effort, airflow, and blood oxygen levels to determine severity. They will look for signs of breathing cessation during sleep or abrupt awakenings accompanied by shortness of breath. You may be able to start treatment following your first night in the sleep center.Sleep Apnea TreatmentA highly-effective treatment recommended by doctors for many patients is a continuous positive airway pressure device, or CPAP. The device consists of a mask that fits snugly over the nose and/or mouth that gently blows air into the airway to help keep it open during sleep.Other alternatives to CPAP can include:Dental appliance that reposition the lower jaw and tongueUpper airway surgery to remove excess tissueNasal expiratory positive airway pressure with a disposable valve covering the nostrilsTreatment using hypoglossal nerve stimulationLifestyle changes can also make an impact on obstructive sleep apnea. These can include:Lose weight. Where a CPAP can only treat OSA, weight loss can cure it in an overweight person.Avoid alcohol. Alcohol can cause frequent nighttime awakenings and makes upper airway breathing muscles relax.Quit smoking. Smoking worsens swelling in the upper airway, making apnea and snoring worse.Sleep on your side. Some patients with mild sleep apnea have fewer breathing problems when sleeping on their side rather than their back.At Airway and Sleep Group, we work with patients on treatments for sleep apnea regularly. Contact us for your initial consultation or visit www.airwayandsleepgroup.com for more information.

A perfect smile isn’t always enough. Other considerations in the facial structure are required in order to be able to develop naturally, breathe properly and avoid sleep apnea. Let’s explore the Myobrace® treatment, a state-of-the-art technology designed to improve natural growth and function.What is Myobrace Treatment?Myobrace® is a preventive pre-orthodontic treatment with the goal of targeting the causes of crooked teeth so that children can naturally grow and develop naturally, hopefully without the need for braces. It is designed for children ages 3-15, and is best utilized before children have all their permanent teeth.The treatment helps to straighten teeth, develop and align the jaws, and improve facial development. It does this by helping children breathe through their nose, rest their tongue at the top of their mouth, swallow correctly, and keep their lips closed.The removable appliance that somewhat resembles a mouth guard or Invisalign tray, is worn for 1-2 hours a day and overnight, and children are asked to participate in Myobrace activities including breathing, tongue, swallowing, lip and cheek exercises that are performed twice a day to help them develop proper oral habits. With full compliance, excellent results can be achieved.Related Video: Myobrace – Straight Teeth the Natural Wayhttps://www.youtube.com/watch?v=ZPQEFU8OwWc Four Stages of Myobrace TreatmentThere are only four stages of treatment that are usually completed in 18 months, on average. They include:Habit Correction – teaching the patient to breathe through the nose and not the mouth, training the tongue to rest in a correct position, swallowing, and keeping the lips together when not speaking or eating. This enables the jaw to grow to the proper size and the teeth to come in straight.Arch Development – In some patients, the upper jaw requires enlargement to allow sufficient space for the teeth and tongue. The Myobrace System is used to help develop the jaw.Dental Alignment – When permanent teeth erupt, the Myobrace for Teens is utilized to help align teeth into their natural position. Depending upon the child’s own requirements, final treatment may involve braces, but generally for a much shorter time than without the Myobrace treatment.Retention – No fixed retainer is required, as is often the case with braces, to maintain good oral habits and alignment. Myobrace treatment enables more stable orthodontic results and improved overall health.Health Benefits“A perfect smile is not enough for function,” explains Liliana Calkins, DDS, of Airway and Sleep Group. “We receive patients that have finished orthodontic treatment with other providers who can’t breathe properly or continue to have problems with sleep apnea.”The Myobrace pre-orthodontic treatment addresses issues related to airway dysfunction, such as sleep apnea, and breathing and jaw disorders including TMJ and teeth grinding.Our specialists at Airway and Sleep Group are experts at treating Orofacial Myofunctional Disorders (OMDs). These are disorders of the muscles and functions of the face and mouth that can affect facial skeletal growth and development, speech, TMJ, orthodontic treatment stability, facial esthetics, chewing and swallowing.We find that many OMDs originate with the habitual patterns of oral breathing, or insufficient nasal breathing. Even the act of swallowing and speech can be effected, since it relies on the balance between the muscles of the face, mouth, tongue and throat. The entire system must work in harmony. Orofacial Myofunctional Therapy can also reduce the symptoms of snoring and sleep apnea by resolving airway obstruction.If you’d like to learn more about Myobrace Treatment, Orofacial Myofu

Sleep Bruxism (SB) is a sleep related movement disorder characterized by maladaptive and repetitive grinding or clenching of the teeth. The central nervous system influences SB, affecting oral motor activity, the sleep-wake cycle. It can also be influenced by genetic and psychosocial factors. There is not much evidence related to sleep bruxism in children.Diagnosing SB comes from the patient’s history and a physical exam. Here is some examples of patient history that relate to Sleep Bruxism to be aware of if you are bringing your child in for an exam:Grinding or clenchingMorning facial pain/discomfortHeadacheTooth sensitivityPresence of a fracture or tooth reconstructionDental wearIncreased size or growth of the jaw muscle (masseter)Joint sounds from TMJDiagnostic criteria for severe sleep bruxism include:Tooth noise during sleep occurring at least 3-5 nights a week for 6 monthsDental wearExhaustion of the jaw-muscles in the morningIncreased size or growth of the jaw-musclesPrevalence of SB in children varies. Bruxism is traditionally higher in children and decreases with age, but it is still important to combat SB early so that it does not develop into a more serious sleep disorder or inhibit important growth and development patterns in children.For more information on sleep bruxism and treatment visit the websites below:https://sunrise-orthodontics.com/https://airwayandsleepgroup.com/

Did you know that solely breathing through your mouth during the day and/or at night can have significant impacts on your oral and general health? We are meant to be nose-breathers. Nose breathing gives you the ideal exchange of oxygen and carbon dioxide Breathing through our noses increases oxygen in the blood by 10-18%! Mouth breathing disrupts the exchange and decreases oxygen absorption. This can lead to over breathing because you need to breathe more frequently in order to replenish the oxygen that is being lost. Breathing through the nose also filters air and removes 98-99% of allergens, bacteria and viruses from the air. When breathing through the mouth, the air is not filtered and more harmful.What is Long Face Syndrome?Mouth Breathing can also cause the development of a long face, otherwise known as “Long Face Syndrome”.Signs of Long Face Syndrome include:A long faceVacant stareOpen mouth (mouth breathing)Tongue rests at the bottom of the mouthDark circles under the eyesShortened upper lipFlaccid lipsChildren that suffer from Long Face Syndrome get 10-18% less oxygen to the brain. When the tongue position is down and forward it creates malocclusions and teeth crowding. The tongue positions and mouth breathing influences changes in facial structure and growth over time.Other symptoms of mouth breathing:Bed wettingSnoringAttention or behavioral issuesThe Importance of InterventionIntervening early is crucial, because the adult facial skeleton is already 60% mature at age 4, and 90% by age 12. Recognizing symptoms of mouth breathing at an early age, also let the child receive benefits from nasal breathing.Nasal breathing improves blood-oxygen level, filtration and restorative sleep which is key for child growth and development. When children do not have the benefit of restoration sleep it can result in problems in school, behavioral issues, poor brain development, and irritability.If you are concerned with your child’s breathing, facial development, or sleep and believe it may be linked to mouth breathing or other malocclusions visit the sites below for more information or to schedule an appointment:https://airwayandsleepgroup.com/https://sunrise-orthodontics.com/

What is the Mallampati Score?Health professionals use the Mallampati score in anesthesia to predict the ease of intubation. However, it can also be an indicator for determining whether or not your child suffers from Obstructive Sleep Apnea. The physical exam to determine a patient’s Mallampati score is simple. The patient should be sitting upright with their head in a neutral position, facing forward. Then, ask the patient to open their mouth and extend their tongue. The examiner will look to see what structures can clearly be visualized in the back of the throat. The degree to which the soft palate, or back of the throat is made visible, determines the Class number of their score. The higher the class number, the less you can see of the back of the throat. The higher their score, the more likely they will have sleep apnea, although it is not 100% predictive.Obstructive sleep apnea (OSA) symptomsObstructive sleep apnea (OSA) symptoms in children can include the following:Abnormal breathing during sleepFrequent awakenings or restlessnessFrequent nightmaresEnuresisDifficulty awakeningExcessive daytime sleepinessHyperactivity/behavior problemsDaytime mouth breathingPoor or irregular sleep patterns OSA DiagnosisHowever, to truly determine whether or not your child has obstructive sleep apnea, you’d have to have an overnight polysomnographic evaluation in the sleep laboratory. The evaluation would determine abnormalities in oxygen desaturation, observe patient’s sleep state, include an electrooculogram and electrocardiogram, measure the airflow at nose and mouth, and observe the chest and abdominal wall motion among other data collections.In the pediatric age range, abnormalities include oxygen desaturation under 92%, more than one obstructive apnea per hour, and elevations of End-tidal carbon dioxide (ET CO2) measurements of more than 50 mm Hg for more than 9% of sleep time or a peak level of greater than 53 mm Hg.If you suspect that your child may suffer from sleep apnea, contact Airway and Sleep Group for a consultation for a definitive diagnosis. We are here to help!

The Effects of Obstructive Sleep Apnea Syndrome can be greatly diminished using Rapid Maxillary ExpansionChildhood obstructive sleep apnea syndrome (OSAS) is an important risk factor for childhood developmental disorders, metabolic disorders and inflammation. 1.2 to 5.8% of the general pediatric population have OSAS. OSAS can have different levels of severity that could give rise to long term effects on children including alterations in behavior and neurocognitive deficits. These deficits affect attention, learning and memory as well as executive and motor functions.A review by the Department of Health, Life and Environmental Science, University of L’Aquila and the Academy of Orofacial Myofunctional Therapy showed rapid maxillary expansion (RME) as an effective treatment for obstructive sleep apnea syndrome (OSAS). The review studied OSAS in children less than 18 years-old who did and did not have their tonsils removed. Rapid Maxillary Expansion decreased the Apnea Hypopnea Index (AHI) by 66.1%.The Apnea Hypopnea Index (AHI) is the sum of the number of apneas (pauses in breathing) plus the number of hypopneas (periods of shallow breathing) that occur, on average, each hour. The AHI is calculated by dividing the number of events by the number of hours of sleep.Causes of Obstructive Sleep Apnea SyndromeObstructive sleep apnea syndrome (OSAS) is when a protracted partial upper airway obstruction (hypopnea) and/or an intermittent complete obstruction (apnea) occurs. Having this disorder could cause a number of disruptions to sleep. Some of these disruptions include a cessation in breathing, decrease in oxygen saturation, an increase the number of arousals, as well as severe impairments in cognitive function.Obesity is considered to be a major cause of OSAS in adults. Whereas the abnormal growth of the tonsils is also thought to be the prime cause of childhood OSAS. Abnormal tonsil growth may decrease airflow. In literature it is seen that abnormal growth of the tonsils leads to problems related to mouth breathing, snoring, chronic sinusitis, nasal congestion, hyponasal speech. Abnormal growth of the tonsils can also cause emotional disorders and poor neurological development.Rapid Maxillary Expansion Really WorksOver the period of 3 years, a decrease of 66.1% of AHI was detected in all of the 102 children with OSAS that underwent RME treatment. The review included those with or without having their tonsils removed. A larger AHI reduction was observed in children with small tonsils (97.7%) or no tonsils (82.4%) rather than large tonsils (56.4%). This data highlighted the importance of tonsillectomy and adenoidectomy combined with RME treatment.In all the studies considered, a general improvement of the daytime and nighttime symptoms of OSAS after RME therapy demonstrated that rapid maxillary expansion was an effective treatment for obstructive sleep apnea syndrome.

Obstructive sleep apnea in children is characterized by disordered breathing during sleep which consists of prolonged partial upper airway obstruction or  complete obstruction, disrupting normal breathing  patterns. The prevalence of pediatric OSA is rising due to the increase in childhood obesity.These are the risk factors and symptoms associated with Pediatric OSA as previously mentioned:Risk Factors for Pediatric OSA:– Physical airway obstruction– Craniofacial abnormalities and malocclusions– Obesity– Premature birthSigns and Symptoms for Pediatric Patients:– Hyperactivity– Difficulty with school– Depressed mood– Inattentiveness– Snoring, gasping, chokings sounds during sleep– Bruxism (Grinding of the teeth)Pediatric Obstructive sleep apnea can negatively impact craniofacial growth and development as well as overall growth and development. Research has shown that early treatment is imperative in order to combat the destructive effects of pediatric OSA. Treatments for Pediatric OSA can either be dental or surgical or a combination.Treatment options for pediatric OSA that have been studied for the past two decades include; Rapid maxillary expansion, oral appliances and distraction osteogenesis.Rapid Maxillary Expansion (RME) is for children with narrow, high maxillary arches. RME expands the arch by connecting a device to the maxillary teeth and surrounding tissue and applying orthopaedic force. RME significantly reduces the problems associated with OSA and has long lasting results.The next option is mandibular advancement with oral appliances. In children, mandibular advancement is a type of orthodontic therapy that helps improve and expand upper airway space and may be permanent if used early enough.Distraction osteogenesis is a surgical treatment option that treats abnormalities in the oral and facial skeleton. This is a more invasive treatment option for children with more serious developmental and growth concerns. Distraction osteogenesis has been proven to improve upper airway obstruction and other functional problems.Please visit our websites below for more information or to schedule an appointment:https://sunrise-orthodontics.com/https://airwayandsleepgroup.com/

Advanced digital technology has become essential in successful orthodontic diagnosis, evaluation and treatment plans to help orthodontic professionals to discover what cannot be detected in a clinical exam. The iTero 5D intraoral digital imaging system is the first hybrid dental imaging system that simultaneously records three-dimensional, intraoral color and near-infrared imaging technology (NIRI) images of both the enamel and dentin of teeth. As it offers a comprehensive view of the oral anatomy, it is useful in a patient’s comprehensive preventive and restorative oral care. In addition, using the iTero TimeLapse technology, orthodontists can show comparisons over time, such as the simulated outcomes of Invisalign® treatments.Other benefits of the iTero imaging system:3D digital impressionsAids in locating and monitoring interproximal cavities/cariesBuilt-in intraoral cameraSimulation capabilityReal-time time lapseChairside scan evaluationNo harmful radiationOrthodontist Liliana Calkins DDS of Airway and Sleep Group uses these advanced digital technology aids for craniofacial-respiratory evaluation. This enables her to use the technology in an orthodontic or orthodontic/surgery combination to treat growth and development issues with expansion of the airway.Dr. Calkins said, “My focus is to understand and treat the causes and pathology of prevalent malocclusions. We evaluate our patients to discern the underlying causes and treat them using an integral health approach to create a beautiful, natural, healthy face, functional occlusion and viable airway.”As digital technology advances, so does Airway and Sleep Group’s treatment options, leading to better diagnosis, treatment plans and outcomes. Visit www.airwayandsleppgroup.com to schedule a consultation.

According to Ravi Agarwal, DDS, an Oral and Maxillofacial Surgeon, patients often turn to corrective jaw surgery to correct irregularities in their jaw and teeth to improve chewing, speaking, and appearance. However, an additional condition that many people don’t realize corrective jaw surgery can improve airway to combat the effects of obstructive sleep apnea.Obstructive sleep apnea, or when people repeatedly stop breathing while asleep, can occur when jaw bones aren’t properly working in tandem with muscles around the face and neck to support the tongue and airway. This can cause symptoms such as: excessive fatigue, loud snoring, morning headache, and sleepiness.Corrective jaw surgery can be a solution for patients with these problems. The surgery can realign the jaws and teeth, open up the airway, and relieve patients of their symptoms—so much so that some patients say their entire family sleeps better upon their snoring being corrected.The Mayoclinic reports that Maxillomandibular advancement surgery (MMA) can be an effective treatment for obstructive sleep apnea (OSA). “In MMA, the bones of the upper and lower jaw are repositioned to relieve airway obstruction. The procedure also suspends the attached pharyngeal airway muscles in an anterior position and simultaneously increases pharyngeal soft tissue tension.”Though the use of a CPAP machine is a non-surgical option for those hoping to improve their airway and aid in obstructive sleep apnea during sleep, young, and middle-aged adult patients (early 50s) may prefer maxillomandibular advancement surgery as a long-term permanent solution.Dr. Edward Zebovitz, a member of Airway and Sleep Group, performed this maxillofacial surgery on his patient and increased the size of her airway to twice its original size. His patient found immediate relief of her airway capacity within hours after completion of surgery and stated, “I feel I can breathe now.”#maxillofacial#airwayimprovement #maxillaryadvancement #BSSO#SeattleAirway #airwayandsleepgroup #AmericanSleepMedicineTysons

Temporomandibular joint conditions are linked to malocclusions and airway concerns. TMJ imaging is a key diagnostic tool for patients with pain or malocclusions.Magnetic resonance imaging, or an MRI, is an imaging technique that takes detailed snapshots of tissues inside our bodies. An MRI uses magnetic fields, radio waves and a computer to generate the images, but it is not the same as radiation. The MRI looks at the TM joint soft tissue and disk, as well as hard tissue. Based on the disk anatomy, the doctor can assess if you are at risk for a TMJ condition.To determine whether an MRI is the next step, we look at joint history, orthodontic history, pain history, and trauma history.For joint history we look for:Locking jointsClicking joints (especially if younger than 18)Loud grinding noisesFor orthodontic history we look for:An overbiteMalocclusionsExtractionsHeadgearTreatment with a function applianceOrthodontic treatment lasting longer than 2 yearsFor pain history we look for:Pain greater than 5/10Sharp or stabbing painHeadachesPain before 18yrs oldFor tor trauma history we look for:– Car accidents– Concussions (and participation in contact sports)– Tonsil/ Adenoid removalFor more information or to schedule an appointment, please visit the websites below:https://sunrise-orthodontics.com/https://airwayandsleepgroup.com/

Spark aligners offer a personalized treatment plan that is custom to your smile goals and needs without brackets or wires. The aligners are more clear than other aligner products, stain less and are removable for a more sleek appearance and discreet treatment option. Spark is an efficient and comfortable treatment option that can help you reach your goals faster.Spark treats crowding, cross-bites, open bites, overbites, and spacing. If you have an active periodontal disease, Spark should be delayed or avoided until the symptoms are gone.Spark aligners work by getting a 3D scan of your teeth and coming up with a 3D future plan for your smile with your doctor. Then, you will receive custom aligners that will gradually move your teeth over the course of treatment.For more information visit our websites below in order to schedule an appointment:https://sunrise-orthodontics.com/http://airwayandsleepgroup.com/

If you have concerns that your child might be experiencing complications with their sleep and airway function, when they come in for a consultation there is an examination protocol that Airway and Sleep Group follows to further inspect these concerns.Typical examination protocol already includes looking at the face, eyes, nose, lips, tongue, teeth and gums, and the oropharyngeal area. We follow the typical examination protocol while looking for specific signs that point to an airway issue. Common signs indicating airway complications are:Abnormal facial growth pattern (where the bones of the face are positioned), these patterns can be detected as early as two years old, with implementation of access to treatment by 4 years oldalso Allergic shiners (shadowy pigmentation under eye, like a bruise)Shape and depth of the noseObesityDeviated Septum/ swollen tissueGummy smileTied lipTooth crowding/ malocclusionsTooth erosion and wearThese signs can be a part of something bigger, such as breathing and airway issues in your child. Facial growth patterns tell us the positioning of their facial bones and whether it affects the tongue position/posture, and ultimately the airway. Head positioning can also indicate airway concerns. For example, forward head posture shows that the patient is searching for an airway.  Allergic shiners can tell us if they are having problems breathing out of their nose. We can also tell if the child is having problems breathing from their nose if their mouth is open while breathing throughout the day and night. Chapped lips will be an indicator of mouth breathing as well. A short upper lip and tied lips that sometimes produce a gummy smile which in the long run can impact the smile and tooth development.Malocclusions, erosion and wear have previously been independent of airways issues, but modern findings suggest that these can be symptoms of a bigger problem such as ability to breathe. These concerns can be noticed as early as 4 years old when bone growth and development becomes more noticeable.Airway examinations are important in pediatric patients in order to catch and treat complications early and prevent more serious or invasive treatments post permanent dentition and mature bone development.For more information or to schedule an appointment visit www.airwayandsleepgroup.com.

Airway development is one of the most crucial aspects to a child’s overall health. Early intervention is the best approach to deficient craniofacial growth that affects sleep, tooth alignment and the space allotted for the tongue. Airway improvement has shown to improve the quality of sleep and treat obstructive sleep apnea.  And obstructive sleep apnea has been known to be one of the root causes for behavioral problems and learning issues like ADHD. An early airway diagnosis and intervention for children ages zero to 5 identifies and addresses issues before they have the chance to impact a child’s growth and development.A study by Pub Med had a series of six consecutive cephalograms taken between birth and 5 years of age, as well as one adult cephalogram. This study determined the maxillary growth and maturation during infancy and early childhood in 30 subjects (15 male and 15 female). The study concluded that the maxilla undergoes its greatest postnatal growth change during infancy and early childhood, when relative anteroposterior growth and maturation are emphasized.Overall linear growth changes that occurred between 0.5 and 5 years of age (a span of 4.5 years) were generally greater than the changes in maxillary growth that occurred between 5 and 16 years (a span of 11 years). The size and shape changes that occurred were greatest between 0.4 and 1 years. And yearly velocities decelerated regularly thereafter.Children should have their airway evaluated between the ages of zero to 5 as the best approach to deficient craniofacial growth is early intervention. Let Airway and Sleep Group provide a diagnosis of your child’s airway to give them the best start in life.Resources:https://www.researchgate.net/publication/233410246_Maxillary_growth_and_maturation_during_infancy_and_early_childhood

Dental arch crowding is one of the most common forms of malocclusions. Most orthodontic treatment plans require a year or more of treatment and are not guaranteed to last. Corticotomy Facilitated Orthodontics is a means for rapid tooth movement that significantly accelerates orthodontic treatment.A corticotomy is an aggressive and invasive surgical procedure that shortens orthodontic treatment time by bone remodeling. A bone graft is placed and facilitates tooth movement to areas where bone was previously absent. There is immediate tooth movement and it is twice as much and twice as fast as traditional orthodontic treatment.You can benefit from a corticotomy if you suffer from dental arch crowding and need more space for your teeth and tongue. If you do not want to suffer through a year or more of orthodontic treatment, and you want stable, long lasting results, a corticotomy might be the right treatment plan for you.Please visit our websites below for more information:https://sunrise-orthodontics.com/https://airwayandsleepgroup.com/

According to the Perio-Implant Advisory, modern science is making disruptive advancements in medicine and dentistry. In dentistry specifically, Surgically Facilitated Orthodontic Therapy (SFOT) is an advanced procedure that pinpoints the underlying problems of insufficient alveolar bone and compromised arch forms to optimally enhance functional and esthetic concerns. SFOT major advantage to patients is that it can significantly decrease the amount of treatment time by more than 50%. Combined with clear aligner therapy, SFOT can increase case acceptance.The Perio-Implant Advisory states Surgically Facilitated Orthodontic Therapy (SFOT) can address the underlying problems of insufficient alveolar bone and compromised arch forms to optimally enhance functional and esthetic concerns. In the past, these issues were frequently ignored, inappropriately treated to lifelong iatrogenic consequences, camouflaged through extraction orthodontics and compensated restorations, or overtreated through orthognathic surgery when it wasn’t a true skeletal problem.The benefits of SFOT include:Engineers new tissue to provide a more robust and expanded arch form for the teeth to reside instead of resorting to extractions of teeth to fit the existing compromised archEnables ideal tooth position for optimal occlusionEnables ideal tooth position for optimal restorative dentistry (virtually planned)Implant site development/planning through augmentation and tooth movementEnhances esthetics through optimizing dental relationships and arch formsMaximizes orthodontic possibilitiesAirway and Sleep Group recognizes that everyone’s mouth shape and bite are unique to the individual and that not every treatment is applicable to every patient. Our dedication to airway improvement, orthodontic aesthetics and the latest advancements in modern dentistry play a role in every patient we treat. We are not limited to traditional orthodontic treatments to achieve the correct mouth shape or aesthetics for each patient we treat. If you want to investigate your treatment options, schedule a consultation with us by calling 703-646-9950.

The Effects of Obstructive Sleep Apnea Syndrome can be greatly diminished using Rapid Maxillary ExpansionChildhood obstructive sleep apnea syndrome (OSAS) is an important risk factor for childhood developmental disorders, metabolic disorders and inflammation. 1.2 to 5.8% of the general pediatric population have OSAS. OSAS can have different levels of severity that could give rise to long term effects on children including alterations in behavior and neurocognitive deficits. These deficits affect attention, learning and memory as well as executive and motor functions.A review by the Department of Health, Life and Environmental Science, University of L’Aquila and the Academy of Orofacial Myofunctional Therapy showed rapid maxillary expansion (RME) as an effective treatment for obstructive sleep apnea syndrome (OSAS). The review studied OSAS in children less than 18 years-old who did and did not have their tonsils removed. Rapid Maxillary Expansion decreased the Apnea Hypopnea Index (AHI) by 66.1%.The Apnea Hypopnea Index (AHI) is the sum of the number of apneas (pauses in breathing) plus the number of hypopneas (periods of shallow breathing) that occur, on average, each hour. The AHI is calculated by dividing the number of events by the number of hours of sleep.Causes of Obstructive Sleep Apnea SyndromeObstructive sleep apnea syndrome (OSAS) is when a protracted partial upper airway obstruction (hypopnea) and/or an intermittent complete obstruction (apnea) occurs. Having this disorder could cause a number of disruptions to sleep. Some of these disruptions include a cessation in breathing, decrease in oxygen saturation, an increase the number of arousals, as well as severe impairments in cognitive function.Obesity is considered to be a major cause of OSAS in adults. Whereas the abnormal growth of the tonsils is also thought to be the prime cause of childhood OSAS. Abnormal tonsil growth may decrease airflow. In literature it is seen that abnormal growth of the tonsils leads to problems related to mouth breathing, snoring, chronic sinusitis, nasal congestion, hyponasal speech. Abnormal growth of the tonsils can also cause emotional disorders and poor neurological development.Rapid Maxillary Expansion Really WorksOver the period of 3 years, a decrease of 66.1% of AHI was detected in all of the 102 children with OSAS that underwent RME treatment. The review included those with or without having their tonsils removed. A larger AHI reduction was observed in children with small tonsils (97.7%) or no tonsils (82.4%) rather than large tonsils (56.4%). This data highlighted the importance of tonsillectomy and adenoidectomy combined with RME treatment.In all the studies considered, a general improvement of the daytime and nighttime symptoms of OSAS after RME therapy demonstrated that rapid maxillary expansion was an effective treatment for obstructive sleep apnea syndrome.

As everyone knows, poor sleep quality and waking up repeatedly during the night can cause one to feel fatigue during the day. But did you know that waking up during the night can be caused by heavy snoring, choking, gasping or breathing cessation? Sleep-disordered breathing can cause you wake up often during the night and is characterized by recurrent episodes of upper airway collapse during sleep.Obstructive sleep apneaObstructive sleep apnea (OSA) is the most common type of sleep-disordered breathing. The following symptoms are often present for years before the patient is referred for evaluation. Some signs of OSA during the night are:• Snoring, usually loud, habitual, and bothersome to others• Witnessed apneas, which often interrupt the snoring and end with a snort• Gasping and choking sensations that arouse the patient from sleep, though in a very low proportion relative to the number of apneas they experience• Nocturia• Insomnia; restless sleep, with patients often experiencing frequent arousals and tossing or turning during the nightIf you have OSA, you may feel upon waking as though you are as tired as you were when you went to bed. You may have a headache upon waking memory and intellectual impairment, personality and mood changes, Gastroesophageal reflux or Hypertension. To know for sure whether you have obstructive sleep apnea, an overnight sleep study, or polysomnography, is necessary. The study would record sleep stages, heart rhythm, leg movements, airflow at the nose and mouth, breathing effort and breathing patterns.Treatment OptionsSome steps you can take to help manage or prevent OSA is to manage your sleep position: avoid sleeping on your back, or sleeping upright. You should also avoid smoking, alcohol and sleep deprivation.People with moderate to severe apnea should be treated with nasal continuous positive airway pressure (CPAP), however there are other ways to improve airflow using craniofacial orthopedics—like Rapid Maxillary Expansion.Airway and Sleep Group specializes in craniofacial orthopedics and use the latest treatment options to modify your airway by changing the shape, size and relationship of the bones in the jaw and face. Their airway improvement techniques help to create enough space in your mouth for the tongue to treat obstructive sleep apnea.

When your child shows visible signs of difficulty swallowing it may be caused by issues in craniofacial development. When the face and teeth are not correctly positioned, it impedes the child to have a proper swallow.Craniofacial Orthopedics Involves The Guidance Of Facial Growth And Development, Jaw Positioning, And Airway Modification. When Your Jaw Does Not Grow In An Optimal Proportion With The Rest Of The Face, The Imbalance Affects The Proper Alignment Of The Lower Teeth With The Upper Teeth And Can Negatively Affect The Way You Sleep, Smile, Chew, Speak And Feel About Your Smile. And A Bad Bite Can Lead To Bigger Problems Later In Life.Early Intervention With Craniofacial Orthopedics Leads To Improved Treatment Outcomes In Facial Harmony, Airway Openness And Coordination Of The Bite By Changing The Shape, Size And Relationship Of The Bones In The Jaw And Face. Dr. Calkins Has Extensive Knowledge Of Craniofacial Growth—Essential To Successful Treatment.Craniofacial Orthopedics Treatment Occurs In Two Phases. In Phase One, Treatment Begins Before All The Adult Teeth Have Erupted. During This Phase, Dr. Calkins Utilizes Treatments Designs To Correct Your Child’s Jaw Growth In Order To Align The Jaw Bone Properly. Once This Is Done, Phase Two Can Begin.Phase Two Usually Involves Orthodontics To Straighten The Teeth.Dr. Calkins Is One Of A Limited Number Of Dentist Who Are Experience In The Use Of MRI Imaging. Unlike X-Rays, An MRI Is Radiation Free And Provides Images Of The Bones And Surrounding Soft Tissue For A More Precise Diagnosis Concerning Proportional Growth Of Bones And Muscles.Craniofacial Orthopedics Can Also Assist In Pediatric Sleep Apnea Management.Learn more by visiting airwayandsleepgroup.com or by calling 703-646-9950 to schedule a consultation.

Sleep apnea can be the result of a person’s mouth not being ideally shaped to allow for space for their tongue leading to poor sleep quality. The solution for certain individuals may include the DOME procedure in which expanders are surgically placed in the mouth to widen the palate and roof of the mouth making room for the tongue.The study: Distraction Osteogenesis Maxillary Expansion OR (DOME) for Adult Obstructive Sleep Apnea Patients with High Arched Palate, written by Otolaryngology specialists Stanley Liu, Christian Guilleminault, Leh Kiong Huon, Audrey Yoon states:A narrow maxilla with high arched palate characterizes a phenotype of obstructive sleep apnea patients that is associated with increased nasal resistance and posterior tongue displacement. Current maxillary expansion techniques for adults are designed to correct dentofacial deformity. The study describes DOME tailored to adult patients with Obstructive Sleep Apnea with narrow nasal floor and high arched palate without soft tissue redundancy. DOME is performed with placement of maxillary expanders secured by mini-implants along the midpalatal suture. This minimizes the maxillary osteotomies necessary to re-create sutural separation for reliable expansion at the nasal floor and palatal vault. The study reports the safety and efficacy profile of the first 20 patients at Stanford who underwent DOME.For more information about how DOME can treat sleep apnea visit AirwayandSleepGroup.com or call 703-646-9950 to schedule a consultation.

The VPro Fastrack App can enhance your orthodontic experience on all levels. Enjoy the user-friendly patient application, optimized to keep your treatment on track. With All of the features you need. None that you don’t.•Track VPro usage•and daily aligner wear time•Share progress photos with us from home•Locate device with the click of a button•and Receive tray change reminders, customized to your aligner schedule