What is sleep apnoea and how can an orthodontist help?

At Bachmayer Orthodontic Clinic, we assess airway concerns in children, teens and adults and collaborate closely with GPs, sleep physicians and ENT specialists. This guide explains what sleep apnoea is, the warning signs to look for, how diagnosis works and which treatments may be recommended or coordinated through orthodontic care.

What sleep apnoea is and how it affects children and adults

Obstructive sleep apnoea (OSA) occurs when the airway narrows or collapses repeatedly during sleep. Breathing pauses or becomes shallow, oxygen levels can drop and the brain briefly wakes the body to reopen the airway. These disruptions fragment sleep and reduce overall sleep quality.

A less common form, central sleep apnoea, relates to the brain's signals that control breathing. Most orthodontic airway assessments relate to obstructive sleep apnoea.

In adults

OSA may contribute to:

• Loud snoring
• Morning headaches
• Daytime fatigue or sleepiness
• Reduced concentration and memory
• Irritability or mood changes
• Long-term cardiovascular health risks

In children and teens

Sleep apnoea can look different in younger patients. Signs may include:

• Mouth breathing or chronic nasal congestion
• Hyperactivity or behavioural changes
• Difficulty concentrating at school
• Teeth grinding during sleep
• Bedwetting
• Restless sleep or unusual sleeping positions
• Slower growth or delayed milestones

Because sleep quality influences learning, mood and development, early recognition and professional guidance are important.

Signs to look for in kids and teens

Children do not always present with loud snoring, so parents may notice more subtle patterns.

Watch for:

• Frequent snoring, gasping or noisy breathing during sleep
• Restless sleep, sweating or unusual sleep positions
• Persistent mouth breathing or open-mouth posture
• Daytime tiredness, irritability or hyperactivity
• Difficulty concentrating or behavioural changes
• Teeth grinding or bedwetting

If several of these symptoms appear regularly, discussing them with your GP and arranging an orthodontic airway assessment can help identify next steps.

How an orthodontist can help

Specialist orthodontists evaluate structures that influence breathing during sleep, including:

• Jaw growth and facial structure
• Dental arch width
• Bite relationships
• Tongue posture and oral habits

Orthodontists do not diagnose sleep apnoea independently. Instead, we assess risk factors and coordinate care with medical professionals who conduct formal diagnostic testing.

Our role may include:

• Identifying structural contributors such as narrow upper jaws or retrusive lower jaws
• Recommending early orthodontic interventions for growing children
• Providing mandibular advancement splints for suitable adult patients
• Referring patients to ENT specialists, myofunctional therapists or sleep physicians

This team-based approach ensures that airway concerns are addressed safely and effectively.

How diagnosis works and who we work with

Diagnosing obstructive sleep apnoea typically involves several steps.

1. Initial assessment

We review symptoms, medical history and sleep habits and perform an orthodontic examination.

2. Imaging and records

Digital scans, radiographs and clinical photographs may be taken to evaluate jaw relationships and airway space.

3. Sleep study referral

A GP or sleep physician arranges a sleep study, either in a sleep laboratory or using home monitoring equipment, to confirm the diagnosis and determine severity.

4. Team treatment planning

We collaborate with:

• General practitioners
• Sleep physicians
• ENT surgeons
• Oral and maxillofacial surgeons

This coordinated approach ensures each patient receives comprehensive care tailored to their needs.

Treatment options we provide or coordinate

Sleep apnoea management is highly individualised. Treatment depends on age, growth stage, jaw structure and OSA severity.

Mandibular advancement splints

These custom oral appliances gently position the lower jaw forward during sleep to help keep the airway open. They are often recommended for adults with mild to moderate OSA or for snoring management.

Maxillary expansion in children

Children with narrow upper jaws may benefit from orthodontic expansion. Expanding the upper jaw can improve nasal airflow and create more room for the tongue.

Growth-guidance appliances

Devices such as Twin Block or Herbst appliances can encourage forward lower jaw growth in selected growing patients.

Myofunctional therapy

Orofacial myofunctional therapy focuses on improving tongue posture, breathing patterns and swallowing function. We often collaborate with trained therapists as part of a comprehensive treatment plan.

CPAP therapy and ENT collaboration

Continuous Positive Airway Pressure (CPAP) therapy remains the gold-standard treatment for moderate to severe sleep apnoea. If enlarged tonsils, adenoids or nasal obstruction are present, referral to an ENT specialist may be recommended.

Orthognathic surgery coordination

For adults with significant skeletal discrepancies and persistent OSA, jaw surgery may be considered to enlarge the airway. This involves coordinated care with an oral and maxillofacial surgeon and orthodontic treatment before and after surgery.

Benefits and limits of orthodontic appliances

Mandibular advancement splints can significantly reduce snoring and OSA severity for many suitable adult patients. They are portable, discreet and often easier to tolerate than CPAP for some individuals.

Possible side effects may include:

• Temporary jaw discomfort
• Tooth pressure or bite changes

Regular follow-up appointments help monitor these effects and maintain proper appliance fit.

For children, orthodontic expansion and growth-guidance appliances may support healthier airway development. However, they are typically part of a broader treatment strategy rather than a complete standalone solution.

When surgery is considered and Medicare considerations

Jaw surgery may be recommended when significant skeletal discrepancies contribute to airway obstruction and conservative treatments have not provided sufficient improvement.

Orthognathic surgery involves coordinated planning between orthodontists, sleep physicians and oral and maxillofacial surgeons.

In Australia, Medicare funding for orthognathic procedures can be complex and depends on clinical indications and item numbers. Private health insurance policies also vary.

Patients considering surgery should discuss potential rebates and eligibility directly with their surgeon and insurer.

What the treatment journey looks like

Every patient's pathway is unique, but a typical care process may include:

Step 1 – Orthodontic consultation A comprehensive examination and discussion of symptoms.

Step 2 – Records and referrals Imaging and referral for a sleep study through your GP or sleep physician.

Step 3 – Team treatment planning Collaboration between medical and dental specialists to develop a personalised plan.

Step 4 – Treatment start Possible treatments include oral appliances, orthodontic expansion for children, CPAP therapy or surgical planning.

Step 5 – Ongoing reviews Regular monitoring ensures appliances remain effective and comfortable.

Treatment timelines vary. Oral appliances may be fitted within weeks, while orthodontic growth-guidance or surgical pathways may take longer depending on complexity.

FAQs

What is sleep apnoea and how does it affect different ages?

Sleep apnoea involves repeated breathing interruptions during sleep. Adults often experience snoring and fatigue, while children may show mouth breathing, behavioural changes or learning difficulties.

What are common signs in kids and teens?

Frequent snoring, gasping, mouth breathing, restless sleep, teeth grinding, bedwetting and daytime behavioural changes.

How can an orthodontist help?

Orthodontists evaluate jaw and airway structure, coordinate sleep studies with medical providers and offer treatments such as oral appliances or orthodontic expansion in appropriate cases.

What treatments are available?

Custom mandibular advancement splints, orthodontic expansion for children, growth-guidance appliances, referrals for myofunctional therapy and coordination with CPAP therapy or surgery.

What are the benefits and limits of appliances?

They can reduce snoring and OSA severity for many suitable patients but are typically part of a broader treatment approach.

When is surgery considered?

Surgery may be recommended when structural jaw discrepancies significantly affect airway size and other treatments are not sufficient.

How long does treatment take?

Oral appliances may be fitted within weeks, while orthodontic and surgical pathways can take several months depending on the treatment plan.

Next steps

If you are concerned about snoring, mouth breathing or disrupted sleep, professional guidance can help clarify the cause and available treatments.

At Bachmayer Orthodontic Clinic, our team in Norwest and Tallawong works closely with medical specialists to assess airway health and create coordinated treatment plans.

You can book a consultation with our orthodontic team or start with a free virtual assessment to receive initial guidance from home.