You’ve spotted the signs—wear, scalloping, fragmentation, maybe even a low AHI—but what does that really mean? When the data doesn’t match the symptoms, how do you move forward? And how do you integrate airway into full mouth rehab without compromising function, stability, or predictability? In this episode, Jaz is joined by Dr. Aston Parmar to explore the real-world application of airway dentistry. They discuss how to help patients own their problem, why sleep testing matters, and how airway influences diagnosis, treatment planning, and long-term outcomes. https://youtu.be/-zVV1FAT0NI Watch PDP263 on YouTube Protrusive Dental Pearl Nasal Breathing and Simple Screening Nasal airflow can be a major limiting factor in sleep quality. Simple test: flare nostrils → if breathing improves, nasal resistance may be present. Nasal dilators can be a cheap, low-risk intervention for selected patients. Not all patients need mandibular advancement — sometimes the issue is nasal. Second pearl: test snoring improvement by advancing the mandible. If forward positioning reduces snoring sound → mandibular advancement may help. Key Takeaways Patients must own their problem before accepting treatment Airway dentistry is about risk reduction, not cure Apnea-Hypopnea Index (AHI) has limitations—context and patterns matter more than raw scores Upper Airway Resistance Syndrome (UARS) is common but underdiagnosed Sleep fragmentation can exist even with low AHI scores Myofunctional therapy improves compliance and outcomes Multi-night sleep testing provides more accurate insights Collaboration with ENT specialists improves diagnostic accuracy Airway is the bookend of full mouth rehab (start and end) Dentistry should be airway-sympathetic, not just tooth-focused Mandibular advancement devices are effective but require careful titration Morning occlusal guides help reduce bite changes from appliances Not all patients need the same pathway—risk stratification is key Predictability in dentistry depends on understanding the whole system The environment (airway, function, biology) matters more than the teeth Highlights of this episode: 00:00 – Introduction to Upper Airway Resistance Syndrome 02:08 – Pearl: Nasal Breathing and Simple Screening 07:43 – Recap: Myofunctional Therapy and Indications 08:30 – Role of Myofunctional Therapy in Treatment Planning 09:40 – Patient Communication and Case Acceptance 23:20 – Sleep-Disordered Breathing Spectrum 23:50 – Apnea vs Hypopnea and Apnea-Hypopnea Index (AHI) Limitations 30:00 – Upper Airway Resistance Syndrome (UARS) 35:43 – Management of UARS 37:00 – Mandibular Advancement Devices (MAD) 39:00 – Maxillary Expansion and Surgical Options 41:00 – Treatment Pathway and ENT Involvement 44:00 – Risk Assessment in Full Mouth Rehab 59:30 – Airway-Sympathetic Dentistry 01:02:00 – Treatment Philosophy and Case Selection 01:07:00 – Airway as Bookends of Treatment 01:09:00 – Managing Side Effects of MAD 01:12:00 – Career Insight and Final Reflections Want to learn more? Watch part 1 of this episode: PDP262 – Implementing Sleep, Airway and Myo to Restorative Dentistry Part 1 Also, check out Stop Blaming Bruxism with Dr. Sandra Hulac – PDP142 🦷Master Airway Dentistry in Practice Join Dr. Aston Parmar’s course on 8th May in Cardiff Learn how to screen, test, and manage airway patients Understand real-world workflows and patient communication Build confidence in integrating airway into your practice 👉 Book via: www.dentalsleep.co.uk 🦷 Ergonomics Day – Dentistry Without Back Pain! Join us Saturday, 13th June, Heathrow with Dr. Anikó Ball, world-leading ergonomics expert! Learn proper posture, positioning, and techniques to prevent back problems while practicing dentistry. 💺 Hands-on workshop with a mobile dental chair 📸 Live camera demo on a big screen 💻 Can’t attend in person? Join online with live stream & replay 🎟 Early bird tickets even include a full event video! 👉 Grab your spot now! #PDPMainEpisodes #CareerDevelopment #OrthoRestorative This episode is eligible for 1.25 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcome C AGD Subject Code: 730 – Oral Medicine, Oral Diagnosis, Oral Pathology Aim To provide dentists with a practical understanding of airway-focused dentistry, including sleep assessment, risk-based treatment planning, and the integration of airway considerations into full mouth rehabilitation. Dentists will be able to: Recognize the limitations of AHI and the importance of sleep fragmentation in diagnosis. Understand the role of myofunctional therapy in improving airway function and treatment outcomes. Apply a risk-based approach when integrating airway considerations into restorative and occlusal treatment planning.
