Orthodontists want to meet your child while they are young- think 5 years old.  We want to meet them while they are still growing and developing.  While orthodontic issues like crowding, overbite and crossbite are not 100% proof that your child may have an airway problem, they are key indicators that they may have an airway disturbance or may develop one in the future.  When you add in snoring, daytime sleepiness, mouth breathing or chronic ear infections, orthodontic concerns become more necessary to treat.  Time is not on your child’s side.

Orthodontics, and specifically early intervention, focuses on the structure of your child’s airway which happens to overlap with their dental structures.  A wide palate, for example, means that your child will have plenty of room for their teeth to be well aligned while also opening up the nasal passages to breathe better.  Correcting an overjet (where the upper teeth protrude) means that the lower jaw is in a better place (forward) to make breathing easier.  And their bite will be better, too.  Orthodontics and airway work together.  The scientific evidence for this statement is indisputable.

A key ingredient for orthodontists to help with airway disturbances is early evaluation and intervention.  If your child can tolerate having their teeth cleaned at their dentist, xrays made to check for cavities, etc, they can easily tolerate an expander.  Your child’s experience at the orthodontist will be very different from their dental visits since orthodontists do not ever need to give injections for their treatments.  With modern appliance design and manufacture (most devices are now 3D printed which means most kids can avoid the gooey impressions and painful separators),  expanders are minimally invasive, especially when compared to having tonsils or adenoids removed.

An ENT may diagnose your child with enlarged tonsils and adenoids.  These things definitely impact our airway.  The ENT may even recommend removing these soft tissue structures.  Removing them does not necessarily solve the structure problem, so orthodontic intervention may also be necessary.

There have been a few scientific studies that show in cases where orthodontics is indicated AND tonsils and adenoids need to be removed, the order of the intervention should lean towards the less invasive treatment- orthodontics.  In many cases that were studied at the Stanford University sleep lab, under the care of an MD, patients who received palatal expanders did not require surgical intervention to remove their tonsils and adenoids.  In fact, their sleep disturbances were cured well into their adult years.

Diagnosing and treating sleep disturbances is definitely a multi-factorial equation.  It takes a team of concerned providers to get your child the best care.  No one provider has all of the answers.  So, before you go down the road of surgery or pharmaceuticals or breathing masks, make sure you consult an orthodontist who is knowledgeable about airway and how orthodontic intervention can help.  To know how to choose the right orthodontist, check out our blog titled “Choosing an Airway-Friendly Orthodontist”-  Five things you should know.