Premolar Extractions for Obstructive Sleep Apnea in Children With Overjet

Inclusion Criteria: * 10-15 years old * registered orthodontic patients * able to undergo routine orthodontic care and are registered to obtain an orthodontic appliance in the future. * do not have a high care need * no known hypercapnia or hypoventilation * no known allergies or nose blockages * diagnosed as Class II Division I (=6mm of overjet) and bilateral Class II half cusp or unilateral Class II full cusp. Exclusion Criteria: * known hypercapnia or hypoventilation * patients with hypertrophic tonsils and adenoids * patients with allergies or nose blockages that interfere with breathing * patients who are not registered as orthodontic patients at research sites deemed acceptable to undergo routine orthodontic care