We would like to take the opportunity to reintroduce a previous post. Childhood apnea is now being recognized as a significant health issue, particularly in children with a skeletal discrepancy where the lower jaw is well behind the upper jaw and rotated downward, in a clockwise direction, as seen in the pre-surgical x-ray below. A physician prescribed sleep-study is key. This can affect how and when orthodontics is performed. In many adult patients, orthodontic treatment combined with corrective jaw surgery, has worked very well for a number of our patients. In the growing patient however, certain bite-relationships (where the upper teeth are out in front of the lower teeth, known as a Class II malocclusion) may need to be seen in a different light. If there are sleep issues when young, conventional orthodontic treatment, in particular circumstances, not all, may not be appropriate. It may be necessary to await completion of growth so that corrective jaw surgery can be undertaken to help prevent the serious health effects of apnea in the future. Attached are links to two informative articles. The xrays show the changes in the airway of a patient who underwent the procedure discussed today.