An orthodontic airway plate (OAP) is a customized nonsurgical device, something like an orthodontic retainer, that can be worn in an infant’s mouth to help correct defects in the baby’s airway and jaw. OAP treatment is an effective, noninvasive option for many babies born with airway disorders and/or feeding difficulty and for whom surgery was once the only treatment option. OAP treatment requires a team with experts in Neonatology, Nursing, Genetics, Pediatric ENT, Gastroenterology, Pulmonary, Sleep Medicine, Critical Care, Pediatric Plastic Surgery, Speech Language Pathology, and Craniofacial and Airway Orthodontics (a subspecialty of orthodontics that focuses on the treatment of patients with congenital abnormalities such as cleft lip and palate or obstructive sleep apnea). Craniofacial and Airway Orthodontists have the training and experience to custom-fabricate and adjust the OAP as needed in close collaboration with the entire team. Stanford Medicine Children’s Health is currently offering the OAP treatment using HyeRan Choo, DDS, DMD, MS’s OAP design and implementation protocol named COAP (Choo OAP) to help babies COPE with feeding and breathing difficulties.
The upper part of the orthodontic airway plate (OAP) is fitted into a baby’s mouth, something like an upper-arch retainer or a complete denture. A stiff plastic “tail” attached to that upper plate extends about an inch down into the throat. The tail keeps the baby’s tongue from falling backward and obstructing the airway. The plate not only holds the tongue in a safe position, keeping the airway open, but also positions the tongue farther forward, which stimulates the lower jaw to rapidly grow forward. As the jaw grows forward, the airway naturally enlarges too, and the facial form moves into balance.
The forward tongue position stimulated by the OAP helps the baby suck the nipple of a bottle or breast, strengthening the tongue and helping the newborn learn to suck and swallow effectively on its own.
It typically takes only a couple of days for a baby to get used to wearing an OAP. After that, it is neither uncomfortable nor bothersome. The OAP is removed from the mouth for cleaning just once a day. Otherwise, the baby wears it at all times until the end of treatment, which typically lasts six to eight months. The treating orthodontist will check the fit of the OAP on a regular basis to make sure the upper arch growth is not restricted and the cleft palate is getting smaller.
Parents learn how to put the OAP in and take it out of the baby’s mouth while the baby is still in the hospital. Watching the orthodontist do it may be, at first, a little daunting. But with a little practice, it is not at all difficult. It takes parents about a week to get good at handling the OAP.