Airway-Focused Approach

Breathing Is Part of the Complete Picture

A child’s teeth and jaws do not develop in isolation. Growth, oral posture, tongue function, nasal breathing, sleep quality, and the way the upper and lower jaws relate to one another may all be relevant when planning orthodontic care.

At Braces Plus, an airway-focused approach means paying attention to these connections rather than looking only at whether the teeth are straight. Dr. Eimar evaluates each child’s orthodontic development while also listening for breathing and sleep-related concerns that may warrant further attention.

Orthodontists do not independently diagnose sleep apnea or every condition affecting breathing. When signs suggest that medical evaluation may be appropriate, Braces Plus can collaborate with or refer families to a physician, sleep specialist, ear, nose and throat specialist, myofunctional therapist, or another qualified healthcare professional.

This is Complete Picture Care: understanding what falls within orthodontics, recognizing when another perspective is needed, and helping families find the most appropriate next step.

What We Consider During an Airway-Focused Assessment

• How the upper and lower jaws are growing

• Dental arch width, tooth eruption, and available space

• The relationship between the teeth, bite, and jaws

• Tongue position, lip posture, and oral function

• Nasal breathing compared with habitual mouth breathing

• Snoring, restless sleep, or witnessed breathing pauses

• Morning tiredness, headaches, or difficulty waking

• Daytime attention, behaviour, and school-related concerns

• Relevant medical, dental, and sleep history

• Whether monitoring, orthodontic care, or professional referral may be appropriate

Children with sleep-disordered breathing may show signs during both the night and the day. Recognized concerns include snoring, mouth breathing, breathing that starts and stops, frequent waking, bedwetting, morning symptoms, daytime tiredness, hyperactivity, and difficulty paying attention at school. These signs do not confirm a diagnosis, but they may indicate that further medical assessment should be considered.

Your Experience at Braces Plus

Your child’s visit begins with a conversation about their growth, sleep, breathing, oral habits, dental development, and any concerns your family has noticed.

Dr. Eimar will assess the teeth, bite, jaw relationships, dental arches, and oral function. When clinically appropriate, diagnostic records or three-dimensional imaging may provide additional information for orthodontic planning. He will then explain what he sees in clear, parent-friendly language.

The appropriate next step may be:

Continued Growth Monitoring
Your child’s orthodontic development may simply need to be observed over time.

Orthodontic Treatment
A dental or jaw-development concern may benefit from treatment at an appropriate stage of growth.

Collaborative Evaluation
Breathing or sleep-related signs may warrant assessment by a physician, sleep specialist, ear, nose and throat specialist, or another qualified provider.

Coordinated Support
Where appropriate, orthodontic care may form one part of a broader plan involving medical assessment, myofunctional therapy, or other professional care.

An airway-focused approach does not mean assuming that orthodontic treatment will resolve every breathing or sleep concern. It means recognizing relevant signs, planning orthodontic care thoughtfully, and working within a collaborative healthcare model.

Signs Worth Discussing

Parents often notice changes at home that may not be visible during a daytime orthodontic appointment. Sharing these observations can help Dr. Eimar better understand the complete picture.

Habitual Mouth Breathing

Frequently breathing through the mouth instead of the nose, including while resting or sleeping, may be worth discussing with a healthcare professional.

Loud or Frequent Snoring

Regular snoring can be a sign of restricted airflow during sleep, particularly when accompanied by restlessness, gasping, or breathing pauses.

Breathing Pauses or Gasping

Witnessed periods in which breathing stops and restarts, or episodes of gasping, snorting, or choking during sleep, should be brought to the attention of a medical provider.

Restless or Disrupted Sleep

Frequent waking, unusual sleeping positions, excessive movement, sweating, nightmares, or sleep that does not appear restful may warrant further discussion.

Difficulty Waking or Daytime Tiredness

A child may struggle to wake in the morning, appear unusually tired, or have reduced energy despite spending enough time in bed.

Attention or Behavioural Changes

Some children with disrupted sleep may show hyperactivity, irritability, difficulty concentrating, or challenges with school performance rather than obvious daytime sleepiness.

Bedwetting

Persistent or newly occurring bedwetting may sometimes appear alongside paediatric sleep-disordered breathing and should be discussed with the child’s healthcare provider.

Morning Dry Mouth or Headaches

Waking with a dry mouth, sore throat, or headache may be another reason to discuss sleep and breathing patterns.

These signs can have many possible explanations and do not necessarily mean a child has sleep apnea or requires orthodontic treatment. A medical provider and, when indicated, a sleep study are needed to diagnose paediatric sleep apnea and determine its severity.