Sleep-disordered breathing and orthodontics:   An American Association of Orthodontists white paper update. By: Dr. Nishita Ondhia

A white paper in research is an authoritative, in-depth, and evidence-based report that analyses a specific problem and presents a proposed solution or perspective.  It is intended to act as an educational, non-sales-pitch document and is often used to establish thought leadership

In March of 2026, the American Journal of Orthodontics and Dentofacial Orthopedics issued a a white paper, “Sleep-disordered breathing and orthodontics: An American Association of Orthodontists white paper update” with the following highlights (with my comments in blue):

• Orthodontists can play a role in screening for sleep-disordered breathing (SDB) conditions

• • The AAPD, American Association of Pediatric Dentists issues an alert in 2025 stating that paediatric  airway health is an essential part of oral health in children
  • All dentists, not just orthodontists, should be screwing for airway health, inclusive of SDB
  • Orthodontists can play a role in screening for SDB, however, in my experience this is   not the norm in current orthodontic offices
• Current evidence does not support that any orthodontic intervention can prevent the development of SDB

• • Agreed
  • Early orthodontic intervention is used only when indicated in patients who are screened, have a diagnosis of signs and symptoms of SDB and have been diagnosed with inadequate airway anatomy
  • Treating SDB is a multifocal approach and treating the anatomy is only one aspect in betting airway health

• Current evidence does not support that orthodontic procedures affect the etiology or increase the likelihood of SDB

• • Agreed
  • SDB is multifactorial
  • Early interventional orthodontics is used to better the anatomy only, this, in turn, will help the other treatments needed to better airway health

• Current evidence does not support that craniofacial imaging provides reliable screening or diagnostic value for SDB

• • Agreed
  • In Ontario, we do not use crainiofacial imaging to screen for or diagnose SDB
  • dentists cannot diagnose SDB, we are not physicians

The white paper states we need to work with our medical colleagues.  Agreed, collaboration is the KEY!!

The paper also only talks about Orthodontists and their role.  In fact, I would say Othodonctics and its role.

Orthodontists are board certified.  They are experts.

Primary care dentists, who are trained in Early Interventional Orthodontics with a special interest in Airway Health and proper oral function are also trained and are experts.

The use of Early Interventional Orthodontics in helping better the anatomy of the airway is an important part of airway health; it can be performed by trained dental professionals regardless of a board certification in orthodontics.

By: Dr. Nishita Ondhia