Why See Dr. Maruko

 

Dr. Maruko practices exclusively in airway orthodontics—a specialized approach for patients whose health concerns extend beyond traditional orthodontic needs. By limiting the number of patients she sees, Dr. Maruko provides highly individualized care and attention.

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Orthodontists are trained to create beautiful smiles by moving teeth and reshaping the jaw structure in all three dimensions—horizontal, vertical, and front-to-back. In addition to her orthodontic expertise, Dr. Maruko has extensive training in sleep and airway health. This allows her to plan treatments that not only enhance smiles but also contribute to better breathing, overall wellness, and long-term health.

 

 

Do You Extract Teeth?

 

Dr. Maruko’s goal is always to preserve natural teeth and create the space they need. While some orthodontists work strictly within the limits of the existing jaw size—sometimes requiring extractions—Dr. Maruko uses expansion orthodontics to widen the jaw, creating room for the teeth and tongue while improving nasal breathing.

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She aims to avoid extractions whenever possible. However, in rare cases where a tooth is severely damaged or positioned poorly, removal may be the healthiest option. If a patient prefers a treatment plan centered around extractions, Dr. Maruko may refer them to another orthodontist.

 

 

Are X-Rays Required?

 

Yes. X-rays are essential in orthodontics for identifying eruption problems, evaluating root and bone health, and analyzing the position of the jaws and teeth. Healthy bone is crucial for successful orthodontic treatment, so Dr. Maruko does not provide care without appropriate X-rays.

 

 

What About Cone Beam CT?

 

Dr. Maruko uses a Cone Beam CT (CBCT) machine with a large field of view, allowing her to take one comprehensive 3D image instead of multiple smaller X-rays. From this single scan, she can assess the airway, jaw joints, teeth, and bone structure.

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While this is highly effective for orthodontic diagnosis and treatment planning, it is not used for detecting soft tissue issues. Your general dentist may still request smaller, focused X-rays to check for cavities or gum health.

 

 

Do You Treat Adults with Sleep Apnea?

 

Yes. Sleep and airway orthodontics can play an important role in reducing obstructions that contribute to sleep apnea. Every treatment begins with thorough diagnostics. Depending on the individual, therapy may range from minor tooth alignment and tongue space improvement to comprehensive orthodontics combined with jaw surgery.

 

 

How Can I Tell if My Child Needs Early Airway Orthodontics?

 

Signs that your child may benefit from early airway-focused orthodontic evaluation include:

 

• Difficulty breathing during sleep

• Snoring or restless sleep

• Sleeping with the head tilted back

• Crowded or tightly spaced teeth

• Bedwetting or ADHD-like symptoms

 

Children with airway problems sometimes appear inattentive or hyperactive because they are simply exhausted from poor sleep. Addressing airway issues early can greatly improve quality of life and development.

 

 

What Is the Right Age to Start Airway Orthodontics?

 

Every child is different. The American Association of Orthodontists recommends an initial visit by age seven, but Dr. Maruko often prefers earlier evaluations if airway or space issues are suspected.

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For children under five, starting with myofunctional therapy may be sufficient to promote healthy growth and nasal breathing. In more severe cases—such as children with significant breathing issues—a sleep physician may recommend CPAP therapy, and tonsils or adenoids should also be evaluated.

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Dr. Maruko works with children as young as four who have begun myofunctional therapy and show readiness for orthodontic care.

 

 

Why Work with a Myofunctional Therapist?

 

Myofunctional therapists are a key part of the airway care team. They focus on improving muscle function and posture related to breathing, swallowing, and speech, and some are trained to assist with TMJ issues. However, they are not orthodontists and cannot determine the optimal timing for orthodontic treatment. Working collaboratively ensures that structure and function improve together for the best long-term results.

 

 

Do You Use a Specific Appliance?

 

Dr. Maruko believes in using the right tool for the right patient, rather than relying on a single appliance type. Orthodontic tooth movement is guided by biology and physics—each appliance simply applies pressure to move teeth through bone. Because every appliance has its own advantages and limitations, Dr. Maruko customizes her approach to select what best meets each patient’s unique needs.