After reading the excellent article on the correction of a posterior crossbite in the July 2011 issue (Liu R, Xiaoqing M, Wamalwa P, Zou SJ. Nonsurgical treatment of an adult patient with bilateral posterior crossbite. Am J Orthod Dentofacial Orthop 2011;140:106-14), I wonder about the possible effect on reduction of intraoral volume that this treatment plan created.

One of my concerns is that the tooth movement has an effect on the space the tongue normally occupies. When we reduce the intraoral volume, we might force the tongue back into the airway and cause a breathing obstruction. Clearly, the authors recognized that, since the mandibular retainer used is trying to prevent relapse from the tongue reclaiming its original territory. The reference to the article by Schwenzer et al on tongue reduction points to a remedy for this issue.

I wonder whether this patient’s future health might be compromised because of the need to produce an ideal occlusion.