Figure 25a Figure 25b Figure 26 patients has become both practical and clinically defensible. In addition, use of the F.A.I.R.E.S.T. tool is a quick and reliable method of monitoring treatment progress in airway-compro-mised children when improvement of nasal and oropharyngeal airway func-tion is a treatment goal. When orthodontic/orthopedic intervention does not achieve improvement in mouth breathing and sleep experi-ence, the practitioner must review the initial diagnosis and address other conditions such as allergies, enlarged tonsils and adenoids, ankyloglossia, and orthopedic disorders such as a posteriorly positioned maxilla and/or mandible relative to the cranial base. The result of early, appropriately targeted intervention extends well beyond straight teeth. It encompasses correction of years of pathologic facial growth and development, improve-ment in systemic health through the restoration of nasal airway patency, enhanced quality of life, improved facial esthetics, and ultimately an orthodontic outcome that is truly life changing for the child and family. These cases reaffirm that early orthodontic intervention addressing maxillary transverse deficiency must be understood not merely as dental treatment, but as a meaningful contri-bution to the long-term health and development of the growing child. 2. Wahl, Norman. "Orthodontics in 3 millen-nia. Chapter 2: Entering the modern era." Am J Orthod Dentofac Orthop , 127.4 (2005): 510–515. • 3. Proffit, William R., Henry W. Fields Jr, and David M. Sarver. Contemporary Orthodontics . Elsevier Health Sciences, 2006. 4. Chung, Chun-Hsi, and Blanca Font. "Skele-tal and dental changes in the sagittal, verti-cal, and transverse dimensions after rapid palatal expansion." Am J Orthod Dentofac Orthop , 126.5 (2004): 569–575. 5. Tamimi, Dania. S pecialty Imaging: Temporo-mandibular Joint and Sleep-Disordered Breath-ing E-Book. Elsevier Health Sciences, 2023. 6. Cammaroto, G., L.M. Stringa, G. Iannella, G. Meccariello, H. Zhang, A.Y. Bahgat, C. Calvo-Henriquez, C. Chiesa-Estomba, J.R. Lechien, M.R. Barillari, B. Galletti, F. Galletti, F. Freni, C. Galletti, and C. Vicini. “Manipulation of Lateral Pharyngeal Wall Muscles in Sleep Surgery: A Review of the Literature.” Int J Environ Res Public Health , 2020 Jul 23; 17(15): 5315. 7. Proffit. • • “Obstructive sleep apnea and endothelial function in school-aged nonobese children: effect of adenotonsillectomy.” Circulation, 2007; 116: 2307. Bruun, S.N., C. Hansen, and L. Sonnesen. "Sleepiness in children with severe maloc-clusion compared with in children with neutral occlusion." Am J Orthod Dentofac Orthop, 165.5 (2024): 593–601. E.A. Bogue. “Bogue Index.” Internet J. Orth-odent, 7: 242 (May) 1921. Oh, J.S., S. Zaghi, C. Peterson, C.S. Law, D. Silva, and A.J. Yoon. “Determinants of Sleep-Disordered Breathing During the Mixed Dentition: Development of a Func-tional Airway Evaluation Screening Tool (FAIREST-6).” Pediatr Dent, 2021 Jul 15; 43(4): 262–272. Kim, K.A., S.J. Kim, and A. Yoon. “Craniofa-cial anatomical determinants of pediatric sleep-disordered breathing: A comprehen-sive review.” J Prosthodont, 2024; 1–9. Ozbek, M.M., K. Miyamato, A.A. Lowe, and J.A. Fleetham. “Natural head posture, upper airway morphology and obstructive sleep apnea severity in adults.” Eur J Orthodon-tics, 1988 April 20(2): 133–143. Beebe, D.W., M.D. Ris, M.E. Kramer, E. Long, and R. Amin. “The association between sleep disordered breathing, academic grades, and cognitive and behav-ioral functioning among overweight subjects during middle to late childhood.” Sleep, 2010; 33: 1447. Guilleminault, C., J.H. Lee, and A. Chan. “Pediatric obstructive sleep apnea syndrome.” Arch Pediatr Adolesc Med, 2005; 159: 775. This journal contains articles eligible for PACE and CERP Continuing Education Credits. Scan the QR code to the left to complete the CE quiz and purchase your CE credits. AGD Credits will be uploaded to your member portal automatically. • • Additional References • • Sheeba, Annie J., and Satvinder Singh Bakshi. “Adenoid Facies.” Anesthesiology, August 2018, Vol. 129, 334. Guilleminault, C., J.H. Lee, and A. Chan. “Pediatric obstructive sleep apnea syndrome.” Arch Pediatr Adolesc Med, 2005; 159(8): 775. Marcus, C.L., M.G. Greene, and J.L. Carroll. “Blood pressure in children with obstruc-tive sleep apnea.” Am J Respir Crit Care Med, 1998; 157: 1098. Ross, R.D., S.R. Daniels, J.M. Loggie, R.A. Meyer, and E.T. Ballard. “Sleep apnea-asso-ciated hypertension and reversible left ventricular hypertrophy.” J Pediatr, 1987; 111: 253. Gozal, D., L. Kheirandish-Gozal, L.D. Serpero, O.S. Capdevila, and E. Dayyat. • • • • References 1. Wahl, Norman. "Orthodontics in 3 millen-nia. Chapter 1: Antiquity to the mid-19th century." Am J Orthod Dentofac Orthop , 127.2 (2005): 255–259. • orthodontics.com Summer 2026 33
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