RDH: In recent years, speculation has been rife about a causative relationship between extractions for orthodontics and sleep-disordered breathing, says a registered dental hygienist.

It has been suggested that removing teeth, typically first or second premolars, will narrow the arch and therefore decrease the size of the airway, leading to or causing SDB or OSA. This theory has led some dental professionals to avidly oppose dental extractions for orthodontics, and instead push to “expand, expand, expand.” They urge their patients to seek third, fourth, and 10th opinions until they reach an “airway focused” practitioner who will agree to proceed without extractions. Ultimately, what does the scientific evidence say about this hot button topic?

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