Airway & Facial Development
Throughout my career, I found myself asking the same question: why do some people naturally develop healthy, well-balanced smiles, while others experience crowding, tooth wear or bite problems?
That curiosity led me to explore airway health, oral function and sleep-disordered breathing in much greater depth. The more I learned, the more I realised how closely breathing, facial development and oral health are connected.
Today, that understanding influences the way I assess many of my patients. In many children, concerns such as mouth breathing or sleep-disordered breathing can influence the way the face, jaws and teeth develop over time. Rather than focusing only on the visible dental problem, I also consider whether underlying functional factors may be contributing to the bigger picture.
Growing Healthy Smiles
Every child deserves the opportunity to grow, sleep and breathe well.
Healthy smiles begin long before the adult teeth appear. A child’s breathing, sleep and oral development influence far more than the way their teeth look. They help shape jaw growth, facial development and long-term oral health.
When we think about healthy smiles, it’s easy to focus on the teeth alone. However, the foundations for a healthy smile are established much earlier. Healthy breathing, good oral function and balanced jaw development all help create the space and support that adult teeth need to erupt naturally. In some children, sleep-disordered breathing may affect these developmental processes, which is why early assessment can sometimes be beneficial.
By understanding these foundations, we can sometimes identify opportunities to support healthy development while a child is still growing through gentle, non-invasive approaches where appropriate.
Could an Assessment Be Helpful?
Every child develops differently, and many children with these signs are perfectly healthy. However, if you recognise several of them, it may be worth considering an assessment.
An assessment may be helpful if your child:
✓ Regularly breathes through their mouth
✓ Snores or sleeps with their mouth open
✓ Has prolonged dummy use or thumb-sucking habits
✓ Seems restless during sleep
✓ Wakes frequently during the night
✓ Often appears tired despite a full night’s sleep
✓ Regularly has dark circles under their eyes
✓ Has difficulty concentrating or focusing
✓ Grinds their teeth at night
✓ Has crowded teeth or narrow dental arches
✓ Has difficulty keeping their lips together comfortably
✓ Has speech development concerns, such as a lisp
✓ Struggles with bedwetting beyond the age of five
Having one or more of these signs does not necessarily mean something is wrong, but they can sometimes indicate that further assessment would be beneficial.
In many children, small changes made while they are still growing can have a meaningful impact on their oral development. In others, reassurance and monitoring may be all that’s needed. My role is to help you understand the difference.
Airway & Facial Development – FAQ’s
Your child’s first appointment is designed to be relaxed, informative and unhurried. The aim is to build a clear picture of their growth and development, rather than simply looking at their teeth.
We will discuss:
- Breathing habits
- Sleep quality
- Medical history
- Oral habits, such as thumb sucking or dummy use
- Speech development
- Facial growth and jaw development
The clinical assessment may include photographs, digital scans, measurements and an evaluation of how your child breathes, rests their tongue and bites together.
If I feel treatment is appropriate, I will explain all available options and whether I believe intervention is likely to benefit your child. Sometimes reassurance and simple monitoring are all that is needed.
Treatment always depends on the individual patient, including their age, symptoms, medical history and the factors contributing to their breathing concerns. Not every patient requires treatment, and recommendations are made only where I believe they are likely to provide a genuine benefit.
Depending on the individual situation, treatment may include:
- Medical assessment or referral where appropriate
- Management of nasal obstruction
- Guidance to encourage healthy oral habits
- Myofunctional therapy
- Elastodontic appliances
- Orthodontic treatment
- Oral appliance therapy
- Lifestyle advice and modifications
- Monitoring growth and development over time
- Working alongside other healthcare professionals where appropriate
There is no single “right” age. In some cases, children can benefit from an assessment from around the age of two, particularly where prolonged dummy use, thumb sucking or mouth breathing may already be influencing jaw and facial development.
As children grow, assessments can also help identify other factors affecting breathing, sleep and oral development. Every child is different, and the purpose of the assessment is to determine whether treatment is likely to be beneficial or whether monitoring and reassurance are the most appropriate approach.
Breathing influences much more than oxygen intake. Consistently breathing through the nose helps support healthy facial growth, jaw development and sleep quality. Mouth breathing, particularly during childhood, may sometimes be associated with changes in facial development and the way the teeth come together. While not every child who mouth breathes will develop problems, it is one of the factors I consider during an assessment.
Mouth breathing can also reduce the natural protective effects of saliva, particularly during sleep. A dry mouth may increase the risk of tooth decay, gum inflammation and enamel wear over time, which is another reason breathing habits are an important part of assessing long-term oral health.
The tongue plays an important role in the normal development of the jaws and dental arches. When resting gently against the roof of the mouth, it provides natural support for healthy growth. Low tongue posture can sometimes be associated with narrower dental arches, crowding or altered oral function. This is one of several factors assessed as part of a comprehensive evaluation.
Not necessarily. Some children will still benefit from orthodontic treatment later, while others may reduce the complexity of future treatment by addressing functional factors during growth. In some cases, supporting healthy jaw development early may mean that braces are no longer needed, although this cannot be guaranteed.
The aim is not to replace braces, but to support healthy development wherever possible and to recommend the most appropriate treatment for each individual child.
Yes. If I feel another professional could provide additional support, I may recommend working alongside specialists such as orthodontists, myofunctional therapists, speech and language therapists, ENT specialists or sleep physicians. A collaborative approach often provides the best outcome for the child.
That’s always a possibility, and often reassuring news. The purpose of the assessment is to understand your child’s development and determine whether any support would be beneficial. If everything appears to be developing well, I will simply explain my findings and, where appropriate, recommend monitoring as your child grows.
Although this page focuses on children, many adults recognise similar symptoms in themselves.
Common signs may include:
- Snoring
- Daytime tiredness or fatigue
- Waking feeling unrefreshed
- Morning headaches
- Teeth grinding or clenching
- Dry mouth on waking
- Frequent waking during the night
- Difficulty concentrating
- Reduced energy levels
Some adults may also have a history of orthodontic relapse, excessive tooth wear or recurrent cracked teeth, which can sometimes be associated with increased airway-related forces and grinding habits.
If sleep-disordered breathing is suspected, I may recommend further assessment or referral where appropriate.
In children, early intervention may help support healthy jaw development, oral function and healthy facial growth. In adults, treatment often focuses on improving breathing, protecting the teeth and supporting long-term oral health.