Integrative Dental Of Denver

771 Southpark Drive Suite #100, Littleton, CO, 80120


Reversing Previous Treatment and Re-Opening Extraction Spaces

We Do Not Believe in Extracting Permanent Teeth for Orthodontic Purposes

When permanent teeth are extracted and the remaining teeth are straightened by retracting them back into the mouth, problems can develop.  In some cases, the process of retraction can cause narrower jaws, a smaller airway, dysfunctional jaw joints, a long face, the appearance of a large nose, a weak chin and other esthetic complications. 

We do not extract permanent teeth for orthodontic purposes.  We have found many techniques that can be employed to make enough room in the mouth for all of the permanent teeth.  

Health Concerns of Headgear and Other Retractive Mechanics:

Although it is less common than it once was, kids are still prescribed headgear as part of  their orthodontic treatment. Most headgear pulls the maxilla (top jaw) backwards, which decreases the size of the oral cavity, leaves less room for the tongue and can lead to shrinking of  the airway. 

Although headgear tends to be the most invasive form of jaw retraction, there are other appliances that create a “headgear effect”.  The “headgear effect” happens when jaws are pulled back which can: elongate the face, weaken the profile and cause potential airway problems. 

From a health perspective, pulling the maxilla backwards may not only shrink the airway, but may also pull the temporomandibular joints (TMJ) out of position which can cause cracking, popping, jaw pain and other TMJ symptoms.

Reversing Previous Treatment & Reopening Extraction Spaces to Alleviate Sleep Apnea

According to a 2015 study, as many as 1 in 4 people in The United States live with undiagnosed sleep apnea. Many sleep apnea sufferers have narrow and restricted airways. Many also had permanent teeth extracted for orthodontic purposes when they were teenagers. 

Retractive orthodontic techniques can, in some cases, lead to these conditions:  

  • Narrow dental arches
  • Retracted (pulled posterior) jaws
  • Increased risk of TMD problems.
  • A tongue that feels like it is too big to fit in the mouth properly
  • A small restricted airway

Patients who have had extraction/retraction orthodontic treatments have also reported:

  • Poor sleep & daytime fatigue
  • Waking up choking in the middle of the night 
  • TMD symptoms such as neck pain, jaw pain, headaches, and other pain 
  • Dissatisfaction with their appearance: sunken in face, weak profile, premature facial aging
  • Hypertension, diabetes, and other chronic systemic illnesses

The good news is that many adults who have had teeth extracted for orthodontic purposes and now suffer from sleep apnea can have their extraction spaces re-opened! 


As our collective knowledge of airway and sleep apnea grows, more and more adults are discovering the health benefits of an uncompromised airway.

Orthodontic treatment that includes reopening extraction spaces can help to reduce symptoms related to sleep apnea and TMJ disorders. 

Certain orthodontic appliances advance and expand the maxilla and mandible (upper and lower jaws).  These appliances allow us to re-create the space needed for so that we can replace the permanent teeth that were extracted. 

This treatment can be a double win for patients. It improves appearance by widening the smile and improves health by opening the airway and allowing for proper position of the temporomandibular joint. 

These studies  show how orthodontic appliances have been used to reduce the severity of sleep apnea in ADULTS.

For more information about reversing previous treatment and reopening extraction spaces or to set an appointment to discuss your situation, contact us at 303.797.0832.

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