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Good morning.

Welcome back to More Than Teeth, where we connect the dots between dentistry, airway health, and whole-body wellness. I’m Dr. Michael Bennett, and today, we’re diving into one of my favorite topics: how to measure the effects of oral appliance therapy before you ever send a lab prescription. This is about precision, patient comfort, and setting the stage for a truly customized, airway-first treatment plan.

In Today’s Edition

We’ll walk through a step-by-step airway evaluation protocol that lets you:

1. Capture a baseline CBCT before fabrication of your sleep device.

2. Use a trimmed bite registration to maximize tongue space and avoid airway encroachment.

3. Add nasal valve support and breathing exercises to recruit the body’s own airway-opening reflexes.

4. Re-scan, adjust, and integrate an airway-team approach for long-term patient success.

And yes, we’ll even talk about what to do when that first scan doesn’t give you the “wow” you were hoping for.

5-minute read👇

Clinical Corner

🥼Use the clinical corner as your secret weapon to impress your colleagues and patients!

Key Takeaways🔑

• Measure before you make – A pre-device CBCT with bite registration in place helps you avoid costly re-fabrications and improves case predictability.

• Tongue space is non-negotiable – Trimming the bite reg to free the anterior space is central to oropharyngeal patency.

• Nasal patency boosts throat patency – Opening the nose triggers reflexive airway dilation downstream.

• Use the weakest link rule – The airway’s performance is determined by its narrowest section.

• Think team, not solo – Address inflammation, weight, allergies, exercise, and sleep hygiene with referrals and patient education.

The Clinical Walkthrough

Step 1 – Start With Measurement
Take a baseline CBCT of your patient before appliance fabrication. This gives you a reference point for airway size, shape, and minimum cross-sectional area. Another option is to use Eccovision pharyngometry for airway comparisons. Perhaps, we’ll discuss this in a future newsletter.

Step 2 – Trim for Tongue Freedom
Your bite registration should:

• Avoid any anterior contact that could block forward tongue posture.

• Leave space between the upper and lower anterior teeth for tongue protrusion.

• Allow the patient to comfortably suction their tongue to the palate during closure.

Remember—we are treating oropharyngeal obstruction caused by the tongue and velopharyngeal collapse of the soft palate and uvula. More space = better function.

Step 3 – Recruit the Nose–Brain–Airway Connection
Fit nasal valve supports (e.g., Intake™, Mute® turbines) to most patients, because almost everyone has some degree of nasal valve narrowing. Improved nasal airflow triggers an autonomic response that helps dilate the oropharyngeal airway.

Use the 3-Blow Method to optimize the nasopharyngeal airway space:

1. Gently inhale through the nose.

2. Controlled exhale through the mouth.

3. Repeat with increasing depth and awareness, encouraging diaphragmatic activation.

When the brain senses better nasal airflow, it “joins the fight” to open the throat.

Step 4 – Check, Don’t Guess
Take a second CBCT with the patient in the trimmed bite registration, nasal valve supports in place, and tongue suctioned to the palate. Compare the minimum volume first, because the airway is only as strong as its narrowest point.

Step 5 – If the Scan Isn’t Better…

• Increase the vertical and protrusion by 1 mm.

• Have the patient perform:

  • Tongue circling around pursed lips (2 minutes)

  • Tongue suction holds (2 minutes)
    These myofunctional drills improve tongue tone and can make an immediate difference.

• Repeat the CBCT and re-evaluate.

Evidence Spotlight: CBCT as a Predictor for OAT Success

A recent pilot study introduced the Oral Appliance Effect Index (OAEI), a CBCT-based model designed to predict whether an oral appliance will improve airway patency in the upright-awake position. Using cephalometric parameters from CBCT scans, the model accurately identified airway enhancement potential in about 70% of cases.

Adding details on muscle anatomy to the analysis improved prediction accuracy even further, suggesting that CBCT can be more than just a before-and-after measurement tool—it can help guide starting positions, device design, and patient selection before fabrication.

This approach supports a precision-medicine workflow: identify likely responders, fine-tune bite registration, and shorten the path to effective therapy.

Read the full article here

Practice Implications: Sample Dialogue

For parents:
"We’re not just looking at teeth—we’re looking at the pathway your child’s air takes when they breathe at night. By making space for the tongue and opening the nose, we can improve sleep, growth, and health for a lifetime."

For teens:
"This isn’t about braces—it’s about making sure your tongue and airway have room to do their job so you sleep better and feel sharper in school."

For adults:
"Your sleep appliance will work best if we start with a position that already improves your airway on scan. We can test that before we make it, so you’re not wearing something that’s just a guess."

Coach Cathy’s Take

“What you say matters. What you see changes lives—but what you do every day between dental visits is what cements the change. Your airway isn’t just about bones and muscles; it’s about the whole system.

Start simple. Think vegetables first. Before you grab anything else, reach for something fresh: carrot sticks, cucumber slices, bell pepper strips. Keep a vegetable tray in the fridge so you don’t have to think about prep when you’re hungry. A chopped salad in a covered bowl? That’s your fast food. Roasted vegetables in the oven while you’re doing other things? That’s dinner and tomorrow’s lunch handled.

Why? Because starting meals with fiber-rich, low-glycemic vegetables helps blunt blood glucose spikes. Stable blood sugar means steadier energy, less inflammation, and better tissue healing, which matters when we’re remodeling your airway or getting you to sleep better.

And here’s a free, powerful habit: go for a walk after you eat. Even 10 minutes around the block helps lower blood glucose and supports digestion. Bonus—it helps you wind down in the evening so your sleep comes more easily.

These aren’t just “good health tips.” They’re airway tips. The less inflammation in your body, the easier it is to breathe deeply, sleep soundly, and wake up refreshed.”

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Miscellaneous

😅P.S. … A Word from Dr. Bennett & Cathy

As a husband-wife team—one dentist, one certified health coach—we’ve spent decades studying the links between the mouth, metabolism, and healing. Whether we're talking to patients in the chair or family around the dinner table, the message is the same:

So many of today’s chronic conditions—diabetes, autoimmune disorders, even anxiety—can be traced back to inflammation, disrupted sleep, and poor recovery. And often, the earliest signs show up right in the oral cavity.

We’ve seen how changing what people eat, how they sleep, and how they breathe can change everything—from mood and migraines to blood pressure and brain fog. Our hope is that every dental practice, parent, and provider joins this movement of upstream healing. Because it’s not just about avoiding disease—it’s about building strong, vibrant, deeply rested lives.

For our 10 beautiful grandchildren, and for yours, too.

— Dr. Michael & Cathy Bennett
More Than Teeth | A Mission for Generational Health