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According to "Dr. Wo" Wm. Randol Womack, DDS, Board Certified Orthodontist Editorial Director, Orthotown Magazine

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A Bedtime Story
by Wm. Randol Womack, DDS, Board Certified Orthodontist
Editorial Director, Orthotown Magazine

I think most orthodontists would agree that the practice of orthodontics is a rapidly changing environment. After a failed two-year retirement, I went back into practice in 1999. Many of the technical advances in orthodontics have occurred since that time: Self-ligation, digital imaging, TADs, the new lingual appliances, diode lasers, Internet marketing, social media marketing, orthodontic apps, Facebook and text communication with patients, cone beam scans for diagnosis and treatment planning and devices to accelerate treatment, just to name a few.

But one aspect of technology the orthodontist should be aware of in treating the “total patient” is screening for and treating sleep-disordered breathing (SDB). Most articles that I see today are directed toward adult SDB. There are patients who are obviously overweight or bordering on obesity or, even worse, actually classified as obese.

Here are some facts from the Center for Disease Control Web site:
  • Childhood obesity has more than tripled in the past 30 years.
  • The percentage of children aged six to 11 years in the United States who were obese increased from seven percent in 1980 to nearly 20 percent in 2008. Similarly, the percentage of adolescents aged 12 to 19 years who were obese increased from five percent to 18 percent over the same period.
  • In 2008, more than one-third of children and adolescents were overweight or obese.
Childhood obesity has both immediate and longterm effects on health and wellbeing.

Immediate health effects:
  • Obese youth are more likely to have risk factors for cardiovascular disease, such as high cholesterol or high blood pressure. In a population-based sample of five- to 17-year-olds, 70 percent of obese youth had at least one risk factor for cardiovascular disease.
  • Obese adolescents are more likely to have prediabetes, a condition in which blood glucose levels indicate a high risk for development of diabetes.
  • Children and adolescents who are obese are at greater risk for bone and joint problems, sleep apnea and social and psychological problems such as stigmatization and poor self-esteem.


Long term health effects:
  • Children and adolescents who are obese are likely to be obese as adults and are therefore more at risk for adult health problems such as heart disease, type II diabetes, stroke, several types of cancer and osteoarthritis. One study showed that children who became obese as early as age two were more likely to be obese as adults.
The orthodontist is in an excellent position to begin recognizing those patients in his or her practice where the possibility of SDB could exist. Learning about SDB and the consequences on the health of patients should become the next area of “technology” to be incorporated into the orthodontic practice. Incorporating screening into the initial informationgathering process for new patients is simple and can easily be handled by educated treatment coordinators. After all, the orthodontist is, in a sense, a practitioner in pediatric health care. A recent article in Sleep Magazine stated that one-quarter of all children experience problems with sleep. These numbers increase in relation to the age of the child to a staggering estimate of 40 percent of adolescents who experience significant sleep disturbance. Orthodontists might not consider this a priority considering the demands on provider time for services, but I am convinced that this topic will become more visible in meetings and articles in the future.

I encourage you to keep this growing concern in mind as you see patients. Consider how you might be instrumental in bringing awareness to parents and patients about the consequences of sleep disturbance on their physical, emotional, cognitive and psychosocial health and wellbeing. Become informed and involved in this important aspect of providing the very best total patient care for each patient. And you can look forward to more emphasis on SDB in future issues of Orthotown Magazine.
Orthotown Magazine
September 2025
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