The Dangers of Children with Airway Problems

Snoring, sleep disordered breathing and sleep apnea in children is associated with impaired attention, neurocognitive deficits and poor academic performance that is measurable in third grade children[1].

Children should not snore when sleeping, at any age. Snoring even 1-2 nights per week indicates a potential sleep apnea disorder. Other signs are bedwetting (consistent), restless sleep (they move and thrash throughout the night), ADD/ADHD-like behavior and resistance going to sleep – to name a few more common symptoms.

Some signs and symptoms that are warning are obviously enlarged tonsils (if you can see them they are probably too large, despite what the pediatrician may say), front teeth that don’t close (open bite), retruded jaws. Dentists trained on TMJ and sleep disorders can evaluate children quickly by a history and clinical examination. Additional testing can provide a diagnosis.

In the study mentioned, snoring “always” was significantly associated with poor academic performance in math, science and spelling. This relationship was also seen in children who snored, but who didn’t have hypoxia (low oxygen at night).

When evaluating children (up to age 16) the adult criteria cannot be used. Children suffer negative effects in jaw growth, cognitive performance and TMJ problems that often arise because of a distortion in jaw growth. The effects of a sleep disorder in children affect growth of the mouth and face, which worsens the airway. Normal measurements of oxygen, apnea (stopping breathing), must be far more sensitive for children due to the effects on growth. These changes are notable clinically and on cephalometric images[2].

Fortunately, today we have better clinical evaluations based on research, non-radiographic soundwave analysis of the airway and 3D airway imaging of tonsils/adenoids that make restrictions easy to see.

If identified early enough, removal of enlarged tonsils and adenoids can reverse the effects caused by your child not being able to breathe well; in one study 77% of open bites and about 60% of crossbites self-corrected after removing airway blockages from tonsils and adenoids[3]

If your grade schooler or middle school child snores, has headaches, TMJ noises or sleeps poorly it would be beneficial to have them evaluated at our office for a potential sleep disorder. We will work with a physician to get a proper diagnosis and course of treatment using our knowledge of dental-facial growth, anatomy and make sure the airway is clear.


[1] Am. J Respir Crit Care Med. 2003, Aug 15:168(4)

[2] Craniofacial differences according to AHI scores of children with OSA: cephalometric study of 39 patients

[3] Int J Pediatr Otorhinolaryn. 1991 Sep;22(2). Influence of tonsillar obstruction and tonsillectomy on facial growth and dental arch morphology

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