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The Braces-to-UARS Pipeline: When Orthodontics Narrow Your Airway

I was 12 when I got braces. Four premolar extractions. "It'll give you a beautiful smile," they said.

Age 13: chronic exhaustion began. Brain fog. Napping after school. Couldn't focus like I used to.

I thought it was puberty. Hormones. Growing pains.

It wasn't. It was my airway.

Fast forward to my UARS diagnosis at 25: CBCT scan showed a "tiny straw-like airway." And when I looked at the timing—age 12 braces, age 13 exhaustion—it wasn't a coincidence.

I'm writing this in the depths of December. Short, dark days. The kind that make chronic illness feel heavier. But there's something about this time of year—the stillness, the permission to rest—that makes space for hard truths. This is one of them.

The Connection No One Told Me

When you remove teeth (especially premolars) to "make space" for orthodontic alignment, you're not just straightening teeth. You're potentially narrowing the palate.

Here's why that matters:

Your palate is the roof of your mouth AND the floor of your nasal cavity.

When extractions narrow the palate:

  • Tongue has less space → changes resting position
  • Nasal cavity narrows → harder to breathe through nose
  • Airway space reduces → breathing resistance increases

For some people, this is fine. For others—especially those with already narrow airways or anatomical predispositions—this tips the scales into UARS territory.

My Timeline

Age 12: Orthodontic extractions and braces
Age 13: Exhaustion, brain fog, constant need to nap
Age 13-25: Years of doctors dismissing me. "Depression." "Anxiety." "Just tired." "Fibromyalgia."
Age 25: UARS diagnosis. CBCT scan confirms tiny airway.

Looking back, the timing was not a coincidence.

You're Not Alone

I'm not the only one. When I joined UARS communities (Reddit r/UARS, Facebook groups), the pattern was everywhere:

"I got braces with extractions as a kid. I've been exhausted ever since."

Particularly common in:

  • Young women
  • Slim, "healthy-looking" people
  • Those with naturally narrow jaws or palates

Why don't doctors connect these dots? Most don't think to ask about childhood orthodontics. Why don't orthodontists warn about this? Historically, airway impact wasn't considered in traditional orthodontics.

But now we know better. Airway-focused orthodontics is a growing field. Too late for many of us, but it's changing.

What Can Be Done?

If you already had extractions and suspect UARS:

The damage isn't necessarily permanent. Options include:

  • Palate expansion (MSE, EASE, DOME - research carefully, results vary)
  • Jaw surgery (what I chose - double jaw surgery to enlarge airway)
  • CPAP/BiPAP (manages symptoms, doesn't fix root cause)
  • Myofunctional therapy (tongue posture retraining)

There's no one-size-fits-all. What worked for me (DJS) might not be right for you. And even then, it didn't "cure" me (see my other post about that).

If you're a parent considering braces:

Ask your orthodontist:

  • "Will extractions affect my child's airway space?"
  • "Have you considered palate expansion instead?"
  • "Do you screen for airway issues before orthodontic treatment?"

Look for "airway-focused orthodontists" or "myofunctional therapy" practitioners who consider breathing, not just aesthetics.

The Winter Paradox

It's the week before Christmas as I write this. The darkest time of year. For those of us with chronic illness, winter is... complicated.

The hard parts:

  • Less sunlight = worse symptoms (for many of us)
  • Holiday pressure to be "festive" when you're barely functional
  • Family gatherings highlighting how much you've lost
  • Cold weather making everything harder

But also:

  • Permission to rest (it's winter, everyone slows down)
  • Dark evenings making early bedtimes feel less isolating
  • The quiet between Christmas and New Year—a liminal space for reflection
  • Less expectation to be "productive"

I'm learning to lean into the stillness instead of fighting it. To let winter be what it is: a season for hibernation, for turning inward, for surviving more than thriving.

If you're chronically ill with limited support during the holidays, I see you. You're not failing for resting. You're not dramatic for finding this season hard.

We're just trying to make it through. And that's enough.

If This Sounds Familiar

If you had childhood braces with extractions and you've struggled with exhaustion, brain fog, sleep issues ever since—look into UARS.

You're not crazy. You're not making it up. There's a real physical connection between narrowing your palate and breathing resistance during sleep.

This isn't about blaming orthodontists. They were working with the knowledge they had. But NOW we know better. And we can advocate for airway-focused care.

You deserve answers. Keep pushing.

If you're newly diagnosed or suspect UARS, start here: What is UARS?

For more on why treatment doesn't always work: The CPTSD-UARS Connection

Note: I'm not a doctor or orthodontist. This is my personal experience and research. Consult healthcare providers for your situation.