Airway Orthodontics is a proactive and preventive approach to orthodontic care that looks at more than just the alignment of teeth. It considers how the jaws, palate, tongue posture, and nasal passages affect a person’s ability to breathe.
There are three types of sleep apnea: Obstructive Sleep Apnea (OSA), Central Sleep Apnea (CSA), and Complex (or Mixed) Sleep Apnea. Because each type has a different underlying cause and requires a tailored treatment approach, it is essential to involve a Sleep Medicine Specialist for an accurate diagnosis.
- Obstructive Sleep Apnea is the most common type and occurs when there is a physical blockage of the airway, often due to the collapse of soft tissues such as the tongue, soft palate, tonsils, or adenoids during sleep.
- Central Sleep Apnea results from the brain failing to send proper signals to the muscles that control breathing. In this case, there is no physical obstruction—breathing simply stops temporarily due to neurological factors.
- Complex (or Mixed) Sleep Apnea is a combination of both obstructive and central components.
Proper diagnosis is key to effective treatment. While Central Sleep Apnea often requires neurologic or cardiologic management, Obstructive Sleep Apnea is the type that ENT specialists and orthodontists can play a significant role in treating—particularly by addressing anatomical factors like enlarged tonsils, adenoids, or a narrow palate. When the upper jaw is too narrow or underdeveloped, it can crowd the teeth, impact bite alignment, and reduce the size of the nasal and oral airways. Many times this also presents with a crossbite in the posterior. Similarly, enlarged tonsils and adenoids can obstruct airflow, particularly at night, leading to apnea, mouth breathing, snoring, poor sleep quality, and developmental concerns.
Children with untreated airway issues may experience:
- Chronic fatigue and poor focus
- Bedwetting beyond the typical age
- Delayed growth and development
- Frequent ear infections or sore throats
By identifying and treating these issues early, we can often prevent the need for more invasive procedures later in life and greatly improve a child’s well-being.
Collaboration with ENTs and Medical Providers
Because airway issues often involve more than just the teeth and jaws, collaboration is key. At Lowe Orthodontics, we regularly work with ENTs (Ear, Nose, and Throat specialists), pediatricians, sleep doctors and other medical professionals to ensure our patients receive comprehensive care.
If we observe signs of airway obstruction, such as mouth breathing, nasal congestion, or enlarged tonsils, we may refer patients for an ENT evaluation or Apnea evaluation. ENTs can assess whether enlarged tonsils or adenoids are contributing to the problem and determine if removal (a tonsillectomy and/or adenoidectomy) is appropriate.
When these tissues are chronically enlarged, they can physically block the upper airway—especially during sleep—and contribute to improper oral and facial development. Removing these obstructions often results in dramatic improvements in breathing, sleep quality, and even behavior in young patients. Research has shown that removing enlarged tonsils and adenoids is one of the most effective treatments resolving airway issues.
Palatal Expanders: Creating Space and Supporting Growth
One of the most effective orthodontic tools we use in Airway Orthodontics is the palatal expander. This device gently widens the upper jaw over time, helping to correct narrow arches, improve bite alignment, and most importantly—expand the nasal airway.
The roof of the mouth (palate) forms the floor of the nasal cavity. When we widen the palate, we’re not just making room for teeth—we’re also creating more space for air to flow through the nose. This can lead to improved nasal breathing, reduced mouth breathing, and better overall oxygenation—especially during sleep.
Palatal expansion is most effective when performed in younger children, while the bones are still developing and the mid-palatal suture has not yet fused. Early intervention allows us to guide facial and jaw development in a way that promotes both healthy alignment and optimal airway function.