This is absolutely fascinating. As someone who had an adenoidectomy at four years old for paediatric sleep apnoea and orthodontic treatment as young as seven years old with multiple fixed and removable expansion appliances I think often about this. Why did I have so many problems and some of my friends and family didn’t? Thankfully my Mother is an Anesthesiologist so she is well educated on the issues that arise from poor sleep and a difficult airway due to apnoea. I developed tongue thrusting, mouth breathing and although I slept, I was waking up multiple times a night with a blocked airway due to sleep apnoea. I was a breastfed child with aligned baby teeth, but when my adult teeth were looking to come in it was a whole different story.

Not only did the adenoid surgery apparently fix my issue overnight, but the orthodontics I had for ten years (I still wear an appliance at night to place my tongue properly which I choose to wear to maintain the proper positioning habit) fixed my problem completely to the degree of changing the shape of my face.

To see that there was a correlation all along to skull and mandible development through environmental and genetic factors made me think about the progression. My Mom had four premolar teeth (two on top, two on the bottom) removed to accommodate a mildly narrowed palette, but I had a much more significant problem.

Thank you for such an interesting article. It’s given me a lot of clarity about my orthodontic issues over the years.