Orthotown May 2020 - 32
office visit
a growing child. We had been looking at
airways on CBCT, were aware of apnea in
children and treating it with expansion, but
it was not until this case that I made it my
mission to try to educate the whole dental/
medical community on it.
Although the boy's mom was one of my
dearest friends, he had not yet been seen
in our practice because he "looked OK."
During a sleepover at our house, my son
mentioned that it was hard to sleep around
him because he always snores loudly. I then
reached out to his mom, who is a physician.
She had already taken him to an ENT who
had done an endoscopy and prescribed a daily
corticosteroid spray. She agreed to let me
take a CBCT, which showed a constricted
airway. We placed a rapid palatal expander
despite the fact that he had no crowding. The
results in his behavior and athletic ability
were so pronounced that she agreed to come
speak to the local pediatric dentists to raise
32
awareness. He was able to stop using the
corticosteroid spray. Because he didn't have
the typical dolichofacial presentation and
his dental arches were only slightly narrow,
the pediatric dentist and I didn't realize he
had a problem, and his mom didn't think
to tell me because she didn't think I could
do anything about it. Thanks to my son,
he went from not being able to run a lap
around the track to winning the national
water polo championships!
You just got back from Colombia
after giving a talk on pediatric
sleep apnea. What are some of the
differences you've noticed about
treatment in Latin America and
treatment here?
I was blown away by the extreme
awareness of aesthetics across all social
classes and by the total transformations
that were possible. Dr. Castellanos, who
led the conference, takes a very comprehensive approach to his patients' orthodontic
treatment, making sure to include any
cosmetic dentistry as well as cosmetic soft
tissue procedures as part of his plan. The
previous Miss Colombia winners are his
former patients and he brings this "wow"
smile concept to everyone in his practice.
Even within our patient population in
Marin County, in which many people are
into a holistic/outdoorsy/natural philosophy, there is so much we can do for them
aesthetically with minimal invasiveness.
I'm always surprised by how much patients
appreciate those finishing touches that are
so rejuvenating, even those who had said
that they didn't care how they looked. Even
more important is to set our young patients
up for success by treating them for their
future aesthetics and not to their present.
The aging process is predictable, and so
the techniques for delaying it can also be
MAY 2020 // orthotown.com
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Orthotown May 2020
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