Airway Orthodontics in Shelby Township, MI
Every new patient at Fredal Orthodontics gets an airway screening at the free consultation. It includes a CBCT scan (a 3D X-ray). If Dr. Thomas Fredal Jr. sees a concern, he refers the patient to an ENT (an ear, nose and throat doctor).
*For new patients only. Patients transferring from another orthodontist: $250 consultation fee, credited toward treatment if they start here.
What Is Airway Orthodontics?
Airway orthodontics looks at breathing as well as the teeth and bite. Every new patient at Fredal Orthodontics receives an airway and breathing screening as part of the initial consultation, regardless of age. Each evaluation at the consultation looks at facial growth, how the teeth develop and any airway concerns.
How Fredal Orthodontics Assesses the Airway
An i-CAT CBCT scan is part of the diagnostic records. It lets Dr. Fredal check the upper airway in 3D, including the narrowest point of the airway (the minimum cross-sectional area) and its overall shape.
The nasal airway, tongue posture and mouth-breathing patterns are checked too. When visible, large tonsils and adenoids (soft tissue at the back of the throat and nose) are noted. So are features of the face or jaws that may narrow the airway.
The patient’s history matters as well. Dr. Fredal asks about mouth breathing as a habit, snoring, restless or broken sleep, and other sleep concerns.
Treatment by Age: Children, Teens, Adults
Patients of every age get the airway screening. Dr. Fredal bases each treatment choice on the patient’s orthodontic and skeletal diagnosis.
Children (From Age 7)
Dr. Fredal follows the American Association of Orthodontists’ advice that every child have an orthodontic check by age 7. Each check includes a 3D i-CAT CBCT scan. It lets him see jaw growth, the teeth coming in, and the airway.
When early treatment is needed, he uses growth-guided steps such as palatal expansion while a child is still growing. A palatal expander is an appliance that widens the upper jaw. He also offers the Invisalign Palatal Expander, which is removable and 3D-printed.
Teens and Adults
Teens and adults also get the airway screening, with a 3D CBCT scan, at the consultation. Dr. Fredal offers MARPE, an expander held in place with mini-screws. He routinely treats adult skeletal cases with MARPE.
Expansion and Surgery Options at Fredal Orthodontics
| Treatment | At Fredal Orthodontics | Price |
|---|---|---|
| RPE (Rapid Palatal Expander) | Parents turn the screw at home once a day. A typical case has 28 to 42 days of active turning. | Expander only: $2,980 |
| Invisalign Palatal Expander | Removable and 3D-printed. | Exact cost given in writing at your visit |
| MARPE | An outside provider places the mini-screws. | Braces with MARPE from $10,080, as a package. $2,000 down with in-house financing. |
| Orthognathic surgery (jaw surgery) coordination | Planned with an oral surgeon, using Virtual Surgical Planning (VSP: planning the surgery on a 3D computer model). | The fee covers the orthodontic part. The surgeon and the hospital or surgery center bill on their own. |
Who Fredal Orthodontics Coordinates With
If the screening finds concerning symptoms or structural findings, Dr. Fredal refers the patient.
ENT: Dr. Fredal refers patients to an ENT, typically Dr. Thottam.
Sleep medicine: When sleep apnea is suspected or present, Dr. Fredal plans treatment with the right medical providers. Fredal Orthodontics does not provide sleep appliances.
Myofunctional therapy: For tongue posture, oral habits or functional concerns, he may refer to a local myofunctional therapist. The therapist guides retraining of the tongue and mouth muscles. This therapy is not offered in the office.
Oral surgery: For orthognathic surgery, Dr. Fredal works with an oral and maxillofacial surgeon.
What Airway Orthodontics Does Not Do
The airway screening is not meant to diagnose obstructive sleep apnea (OSA). In OSA, breathing stops and starts again and again during sleep.
The screening helps Dr. Fredal decide when a patient needs a referral for further evaluation.
Airway Treatment Cost at Fredal Orthodontics
The airway screening is part of the free new-patient consultation at Fredal Orthodontics. The 3D CBCT scan has no charge. Patients transferring from another orthodontist pay a $250 consultation fee, credited toward treatment if they start here.
A second-opinion visit is free. So is a visit about MARPE or other skeletal expansion. A return visit before treatment starts is free too. If a patient missed a visit as a no-show, the return visit costs $100.
Prices are in the table above. Fees do not change with how long treatment takes. In-house financing has 0% interest and no credit check, and a down payment is required. Monthly payments start as low as $179. Payment amounts vary with the treatment cost, down payment and financing terms.
Why Fredal Orthodontics for Airway Orthodontics
Fredal Orthodontics is a private practice with one doctor. Dr. Fredal plans and oversees every patient’s treatment himself. The doctor who reads the airway findings is the one who plans the treatment.
The Airway Is on Every Scan
The i-CAT CBCT scan that shows the airway is merged with an iTero digital scan. Dr. Fredal uses this fully digital workflow to diagnose and plan in 3D, for both Invisalign and braces.
Expansion When It Is Clinically Appropriate
Dr. Fredal offers maxillary expansion, which widens the upper jaw, when it is clinically appropriate. When he decides whether to expand, he weighs facial balance, how the jaws line up, growth, the bite and the airway.
Personal Care From an Orthodontic Specialist
Dr. Fredal leads every consultation himself and reviews all of your records with you. He has treated more than 2,000 orthodontic cases throughout his orthodontic training and clinical practice.
Airway Orthodontics FAQs
How can you tell if your child has an airway problem?
Start with the airway screening at the consultation. Dr. Fredal asks about your child’s history: mouth breathing as a habit, snoring, restless or broken sleep and other sleep concerns. He also checks the upper airway in 3D on the i-CAT CBCT scan. If he finds a concern, he refers your child to an ENT for a closer look.
Is the airway screening only for children?
No. Every new patient at Fredal Orthodontics gets the airway screening at the consultation, whatever their age. Dr. Fredal checks the upper airway in 3D on the i-CAT CBCT scan for children, teens and adults. For adults with skeletal cases, he routinely uses MARPE, an expander held in place with mini-screws.
Does Fredal Orthodontics diagnose sleep apnea?
No. The airway screening is not meant to diagnose obstructive sleep apnea. If Dr. Fredal finds a concern, he refers the patient to an ENT, typically Dr. Thottam. When sleep apnea is suspected or present, he plans treatment with the right medical providers.
Is the CBCT scan free?
Yes. Fredal Orthodontics takes a 3D CBCT scan at every new-patient consultation and does not charge for it. Dr. Fredal uses the same scan to check the upper airway. Patients transferring from another orthodontist pay a $250 consultation fee, credited toward treatment if they start here.
Does insurance cover airway treatment?
Orthodontic treatment is typically covered under any orthodontic dental benefits you have. Fredal Orthodontics is in network with Delta Dental and files claims for you. You get your benefits check in writing. For jaw surgery, medical insurance may pay for part of the surgery in many cases, if certain medical criteria are met.
How long does airway treatment take?
A typical expander case has 28 to 42 days of active turning, once a day at home. Many comprehensive orthodontic cases are completed in approximately 12 to 18 months. Treatment time varies with how complex the case is, the tooth movements needed, growth and how well the patient follows the plan. Dr. Fredal gives each patient a time estimate after the diagnostic evaluation.
Mouth Breathing Treatment and Other Next Steps
Breathing in children: mouth breathing and the palatal expander.
Expanders held by mini-screws: MARPE and the TADs (temporary anchorage devices, the small screws that hold it in place).
Jaw surgery: how it is coordinated with your surgeon.
The age 7 check: care for children.
Ready to book? Schedule a visit.
Concerned About Breathing or Sleep?
The free consultation includes an i-CAT FLX V17 CBCT scan, an iTero digital scan and photos. Dr. Fredal goes over all of the records with you. He tells you what he recommends and gives you the exact cost in writing, for a child, a teen or an adult.
*For new patients only. Patients transferring from another orthodontist: $250 consultation fee, credited toward treatment if they start here.