Airway
A careful assessment of jaw development, bite, and breathing-related concerns.
At Miso Orthodontic Studio, Dr. Richard Song evaluates the teeth and jaws in the context of facial development and function. Assessment of airway and sleep-related concerns is part of every comprehensive consultation, helping us understand how jaw structure, oral function, and breathing fit together.
Jaw structure and palatal width are part of a broader picture that includes the nose, tonsils, adenoids, tongue, and surrounding soft tissues. An orthodontic examination can identify structural findings that deserve closer attention.
We bring these findings together to identify anatomical constraints and develop a treatment plan that addresses your bite, jaw relationships, and functional needs.
Traditional orthodontic treatment centers on tooth alignment, the bite, and jaw relationships. Airway-focused orthodontics builds on this foundation by explicitly incorporating breathing patterns, sleep history, and airway anatomy into treatment planning. At Miso, we consider how the teeth and jaws relate to the entire face and how their development may contribute to airway and sleep-related concerns.
Persistent mouth breathing and airway obstruction during growth are associated with differences in resting lip posture and facial development. Features may include lips that remain apart, greater lower-face height, and a lower jaw that sits farther back. Recognizing concerns early helps us plan care while growth is still occurring.12
Jaw relationships established during growth can remain visible in the adult profile, including chin projection, lower-face proportions, and resting lip posture. An adult evaluation considers these established features alongside current breathing and sleep concerns.
What we evaluate
We review mouth breathing, snoring, sleep quality, and concerns raised by you or your child’s healthcare providers.
We assess how the upper and lower jaws relate to each other and to the cranial base, as well as their position within the overall face. We also evaluate facial proportions, palatal width, the bite, and growth stage.
We examine tongue mobility, resting lip posture, and habits that may affect dental development or function.
We consider your medical and dental history, airway questionnaire, clinical examination, photographs, and imaging together. A CBCT scan provides a three-dimensional view of the jaws and surrounding structures, helping us identify anatomical constraints in the context of the complete evaluation.
Persistent mouth breathing, habitual snoring, restless sleep, or breathing pauses during sleep. Difficulty focusing, irritability, or hyperactivity may also warrant a closer look at sleep quality.1
Habitual snoring, witnessed breathing pauses or gasping, and persistent daytime sleepiness or unrefreshing sleep.3
In children, disrupted sleep can present as hyperactivity or inattention rather than obvious sleepiness. These behaviors can resemble ADHD and may sometimes be mistaken for it, making sleep history an important part of a comprehensive assessment.13
A narrow palate, crowding, or a noticeable imbalance between the jaws is also a reason to schedule an orthodontic evaluation.
Treatment is tailored to your jaw structure, bite, and stage of growth. Our approach addresses the specific anatomical findings identified during your comprehensive evaluation.
For children with a narrow upper jaw, palatal expansion widens the upper arch, creates space for the teeth, and improves how the upper and lower teeth fit together. Expansion can also have a role in the treatment of children with sleep apnea and a narrow upper jaw.4
Miniscrew-assisted rapid palatal expansion uses small temporary anchors in the palate to help widen a narrow upper jaw. It addresses the underlying width of the jaw and creates more room within the upper arch.
Growth modification uses a child’s remaining growth to help improve a significant imbalance between the upper and lower jaws. When the lower jaw is underdeveloped or sits too far back, an appliance can guide it into a more forward position to improve the bite and jaw relationship.
Learn more: Adult MARPEOrthodontics for children
A facemask may be considered for a growing child with an underdeveloped upper jaw. It applies forward traction as part of a plan to improve jaw relationships and the bite.
Orthodontics and corrective jaw surgery can address substantial differences in jaw size or position, improving how the jaws and teeth fit together. Advancing both jaws can also be part of treatment for obstructive sleep apnea.5
TADs are small temporary anchors used as a supporting tool for selected orthodontic tooth movements or expansion appliances.
When your findings call for additional expertise, we coordinate care and referrals with an ENT, sleep physician, primary care doctor, or oral and maxillofacial surgeon. Together, we address the dental, skeletal, and medical factors relevant to your airway and sleep-related concerns.
Treatment can address a narrow upper jaw or an imbalance between the jaws, improving the bite and the skeletal framework around the airway. Your evaluation helps us identify which approach fits your anatomy and goals.
Palatal expansion widens a narrow upper jaw and the base of the nasal cavity. Many patients report easier nasal breathing after expansion. We consider your breathing and sleep concerns alongside your jaw structure when planning treatment.
The American Association of Orthodontists recommends an orthodontic check-up by age 7, or earlier when a concern is recognized. Mouth breathing, snoring, restless sleep, or noticeable differences in jaw development are reasons to seek an earlier assessment.6
Yes. Adults with a narrow upper jaw or an imbalance between the jaws can benefit from an evaluation of their bite, facial proportions, and airway anatomy. Options include skeletal expansion in conjunction with clear aligners or braces, or in some cases, combined orthodontic and surgical treatment.
We review your medical and dental history and airway questionnaire, examine your teeth, bite, and jaw relationships, and assess your photographs and CBCT scan together. Dr. Song explains the findings and the treatment options that address your needs.
Miso Orthodontic Studio is opening soon in downtown Jersey City. Join the founding waitlist to be notified when complimentary consultations become available.
