Clear Aligner Orthodontic Treatment Helps in Treatment of Malocclusion, Temporomandibular Joint Dysfunction and Sleep Apnea

“It’s not just about straight teeth anymore. It’s about overall health and longevity.”
By: M. Johnson Hagood, DDS and Debbie Bush

According to the American Sleep Apnea Association, Obstructive Sleep Apnea (OSA) affects an estimated 22,000,000 children and adults in the U.S. This is the condition of having your tongue, throat and soft palate slacken too much when you are asleep, blocking the flow of air through your windpipe. In response, your body will wake up and you may feel yourself gasping for air before falling back to sleep. Reduced oxygen flow and interrupted sleep has been associated with numerous health problems, including elevated blood pressure, diabetes, and lowered daytime alertness and increased sleepiness leading to accidents. If you snore or have a dry throat in the morning, OSA could be happening. If you brux (grind your teeth), it too is associated, due to malocclusion resulting from the crowding of teeth on jaws that are too small. You’ll soon read below why clear aligner orthodontics may bring you important health benefits by increasing the volume of your oral cavity.

mouth breathing diagram
mouth breathing kid
mouth breathing adult

Clear aligners are an appropriate and effective treatment for changing the shape of the arch, changing the width of the arch, and moving teeth into proper position on the arch. This will increase oral cavity volume and allow for proper placement of the tongue.

Dr. Johnson Hagood has studied airway-driven expansion orthodontics intensively for a number of years. Clear aligner orthodontic treatment is a minimally invasive and effective orthodontic technology for not only improving the appearance of smiles but also increasing oral cavity volume. It can be used to reshape and widen arches in children and adults (without surgery or “headgear”), so the tongue is optimally placed for breathing. Because almost all children and adults living today in the U.S. have dental crowding and non-ideal arch shape and width, there is large potential for clear aligner treatment (C.A.T.) to soon become the standard of care.

Southern Illinois University professor emeritus and physical anthropologist, Robert Corruccini, Ph.D., authored the book How Anthropology Informs the Orthodontic Diagnosis of Malcocclusion’s Causes. Corruccini explains that underdevelopment of the jaw has made modern man more susceptible to dental crowding and breathing problems while sleeping. He and other anthropologists have made the stunning discovery that no crowding or other dental malocclusions can be found in human skulls before 400 years ago. All humans had straight teeth and room for all 32 teeth including 3rd molars (wisdom teeth). Corruccini further explains what changed for human jaw development 400 years ago. It was the advent of industrialized society bringing about a soft diet. The combination of a soft diet and a lack of long-term breast feeding is responsible for the lack of full development of our upper and lower jaws resulting in a lack of room for our teeth and tongues. This lack of development diminishes the airway thus contributing to Sleep Disordered Breathing/OSA. Jaw size depends on rigorous chewing of hard foods and proper swallowing during breast feeding. Studies indicate breast feeding provides functional stress on the jaw and facial muscles to help the jaw grow forward, and post industrialized children are not eating the hard foods and doing the hard chewing that would make the jaws advance forward in growth to be long enough to hold all the teeth, including third molars (wisdom teeth). Orthodontic treatment that moves teeth towards the back of the jaw after teeth are extracted to un-crowd remaining teeth can further impact the airway anatomy. Prehistoric skeletal populations and nonwestern populations that are not industrialized have larger jaws. Historically, when affluent populations that have a lot of canned and processed foods have a lot of malocclusion. Agrarian populations of today, who eat more homegrown unprocessed foods, have less malocclusion. Extensive measurement studies show dental arches narrowing significantly in one generation, from pre-industrial to industrial society, and this cannot be attributed to genetics, but rather diet and chewing function.

University of Michigan professor emeritus and orthodontist, James McNamara, DDS, compiled extensive data on dental arches to determine that healthy, uncrowded maxillary arches have a transverse width (between the first molars, at the gum line) in the range of 35 mm to 40 mm. Lesser measurements will result in teeth crowding, the most common form of malocclusion (poor bite).

palate mold

During your comprehensive oral health exam, Dr. Hagood will examine the shape of your jaws and occlusion. He will photograph how your tongue lies when you are reclined, and he will measure the width of your maxillary (upper) arch. These observations and your health history will guide his evaluation of whether you will benefit from clear aligner orthodontic therapy for health as well as cosmetic reasons.

There are four major health benefits to this therapy:

  1. By aligning your teeth, you are improving the way your teeth come together to even out occlusal forces. This spares teeth, jaw muscles, and jaw joints from harmful stresses that do damage to the teeth and joints, as well as produce muscle and temporomandibular joint (TMD) tenderness and aching pain.
  2. By aligning your teeth, you change the morphology of the arch form and width, increasing the oral cavity volume for proper tongue placement. This helps the tongue from blocking your airway while you sleep at night. Thus, aligning teeth with clear aligner orthodontics is becoming an accepted treatment for helping prevent and minimize obstructive sleep apnea (OSA) and nighttime snoring.
  3. By aligning your teeth, prior to restoration with porcelain veneers or crowns, or replacement of teeth with implants or conventional bridgework, you are not only providing maximum space for these restorations but also tipping tooth roots into healthier, more upright position to support optimal occlusion and the longevity of your restorations.
  4. By aligning your teeth, the changing morphology of the dental arch will allow for crowded teeth to become uncrowded and gaps to be closed. This improves more than your smile’s appearance. The proper spacing of the teeth will make your oral care at home–brushing and flossing, easier and more thorough. Alignment will make it less likely for food to become trapped between teeth.


If you are concerned about the shape of your dental arches or dental crowding, and desire a beautiful smile, you now know additional reasons to considered clear aligner orthodontic treatment. If you snore or have been told you have episodes of not breathing during the night, you now know dental crowding plays a factor. If you brux (grind your teeth) and have excessive dental wear and/or sore TMJ muscles, malocclusion is playing a role and can be treated. When you align your teeth with clear aligners, your treatment plan will improve oral cavity volume, arch width, teeth alignment for optimal occlusion, tongue placement, space for dental restorations, space for oral hygiene, and the esthetics of your smile. Dr. Johnson Hagood is one of a few dentists in the U.S. today who takes such a comprehensive approach to evaluating your oral health and smile. His treatment plans are comprehensive to get at the root cause of problems and solve them through phases of treatment that are best for you.

Look Better. Feel Better. Breathe Better.