What does airway orthodontics mean?

Airway orthodontics considers breathing and sleep concerns alongside the development of the teeth, bite and jaws. At SmileMaker, the starting point is an orthodontic evaluation and a conversation about your child’s health history.

Our role is to identify orthodontic concerns, explain possible next steps and recommend medical evaluation when needed. An orthodontic examination or questionnaire alone cannot confirm or rule out sleep apnea. A pediatrician, ENT or sleep specialist can assess the medical concerns and determine whether sleep testing is appropriate.

Concerns worth bringing up

Tell us about patterns you have noticed, including:

• Frequent snoring
• Regular mouth breathing during the day or night
• Gasping, labored breathing or pauses in breathing during sleep
• Restless sleep or frequent waking
• Unusual daytime sleepiness

These signs can have different causes. They do not tell us by themselves whether your child has sleep apnea or needs orthodontic treatment.

Contact your child’s pediatrician about recurring snoring or breathing pauses. You do not need to wait for an orthodontic appointment to raise a breathing concern.

An evaluation that fits your child’s stage of development

Children ages 7–10

During these years, children often have a mix of baby and permanent teeth. We can assess how the bite is developing and whether an orthodontic concern needs attention now or monitoring over time. Tell us about breathing and sleep concerns, too. An early evaluation does not automatically mean an expander, braces or another appliance is needed.

Children and teens ages 11–15

As more permanent teeth come in, we evaluate the bite, jaw relationships and stage of development. Children of the same age can have different orthodontic needs. Whether this is a first visit or a follow-up, bring any new breathing concerns, medical recommendations or sleep-study reports so we can consider them when discussing orthodontic options and timing.

The American Association of Orthodontists recommends a first orthodontic checkup no later than age seven. Older children can still benefit from an evaluation. Read more about children’s orthodontic care and growth monitoring.

What your orthodontic consultation covers

Your free initial consultation is an opportunity to discuss your child’s orthodontic needs and bring up breathing or sleep concerns. We will:

1. Listen to your concerns. Discuss what you have noticed, relevant health history and any recommendations from your child’s dentist or medical providers.
2. Evaluate the teeth, bite and jaws. Assess orthodontic findings and explain whether observation, further records or treatment should be considered.
3. Consider existing medical information. Review a diagnosed sleep condition or an existing sleep-study report when relevant to orthodontic planning.
4. Discuss next steps. Explain our findings, possible orthodontic options and whether referral to a pediatrician, ENT or sleep specialist is appropriate.

If you have a sleep-study report or referral, let our team know before the visit so we can explain how to provide it. Bring your questions about the purpose of any proposed treatment, alternatives, limitations and follow-up.

Coordinating with your child’s medical care

Breathing problems during sleep can involve several factors, including the nose, tonsils and adenoids. A medical evaluation helps determine the cause and appropriate care. An overnight sleep study may be recommended to evaluate suspected sleep apnea.

If your child already has a sleep-apnea diagnosis, we consider the medical team’s findings when assessing orthodontic care. Continue the care and follow-up recommended by that team. Orthodontic changes do not establish whether a sleep disorder has resolved; your child’s medical provider guides that assessment.

Orthodontic options depend on the findings

The recommendation may be observation, treatment for a specific bite or jaw concern, medical evaluation, or a combination of these steps.

Palatal expansion may be considered when an assessment identifies a narrow upper jaw and an appropriate orthodontic reason for treatment. The type of treatment and timing depend on your child’s development and individual findings.

For selected children with diagnosed sleep apnea, expansion may have a role within a coordinated treatment plan. Evidence about its sleep-related benefits remains limited, and we cannot promise that orthodontic treatment will resolve sleep apnea.

If expansion is recommended, Dr. Burton will explain its goals, risks, alternatives and how it fits into the full orthodontic plan. For information about miniscrew-assisted expansion specifically, visit our MARPE palatal expansion page.

Questions parents ask

Does mouth breathing or snoring mean my child needs an expander?

It depends on your child’s overall evaluation. Some children with a narrow upper jaw may benefit from expansion, while others need a different next step. We’ll look at the teeth, bite and jaws, discuss what you’ve noticed, and recommend medical evaluation when appropriate. Mouth breathing or snoring alone doesn’t tell us whether an expander is the right choice.

Do we need a sleep study before an orthodontic consultation?

You’re welcome to start with a consultation and share what you’ve noticed, whether or not your child has had sleep testing. If a sleep study has already been completed, its findings may help inform orthodontic planning. A medical provider can advise you on whether sleep testing is appropriate.

Is airway orthodontics the same as MARPE?

The conversation is broader than one treatment. We start by understanding your child’s orthodontic needs and any breathing or sleep concerns. MARPE is one specific approach to upper-jaw expansion, and it may be discussed when an individual assessment supports it.

Will a scan tell us whether my child has sleep apnea?

Imaging can help answer specific questions about the teeth and jaws when it’s appropriate for orthodontic care. We’ll explain the purpose of any imaging we recommend. For sleep apnea concerns, a medical provider guides the evaluation and any sleep testing. An orthodontic scan cannot diagnose or rule out sleep apnea.

Can adults discuss these concerns, too?

Adults are welcome to bring these questions, too. Share any breathing or sleep concerns and existing medical diagnosis at your orthodontic consultation so we can consider them alongside your teeth, bite and jaws. Recommendations are tailored to your individual findings. Explore our adult orthodontic care for more information.

Talk with SmileMaker about your child’s next step

Request a free initial orthodontic consultation and tell our team you would like to discuss breathing or sleep concerns. Choose the office that works best for your family:

• East Nashville: 1077 E. Trinity Ln., Suite 101, Nashville, TN 37216
• Hendersonville: 711 E. Main St., Suite 110, Hendersonville, TN 37075

Request a free orthodontic consultation or call 615.865.6551.

Submitting a request does not reserve an appointment time. Our team will contact you about scheduling.