Airway Orthodontics

For our practice, Orthodontics is a lot more than just straight teeth and a beautiful smile, we are focused on the overall long-term health of our patients. When a child presents with a crowded or crooked smile, this is a sign that the jaw is not growing properly. Certain oral habits and jaw deformities can lead to Obstructive Sleep Apnea (OSA) and Sleep Disordered Breathing (SDB). Airway Orthodontics refers to orthodontic treatment methods used to expand a patient’s airway in order to treat OSA and SDB.

A Life-Changing Orthodontic Experience

“I can’t thank the team at Stone Oak Orthodontics enough! As an adult, orthodontic procedures can seem intimidating, so I had always delayed treatment simply due to feeling confused and overwhelmed. Dr. Caesar completely changed all of that for me!

Not only did he go above and beyond in answering every question I had (and I had A LOT), but he spoke to me in a way that was educational, empathetic, and honest. For the first time ever, I felt a sense of comfort and confidence as I began my treatment.

Admittedly, I have a pretty low pain tolerance so you can imagine how surprised I was when I was told we were done….while still holding my breath in anticipation for the “hard part” to begin. As my smile improved, so did my quality of life. I could literally breathe easy for the first time within weeks of Dr. Caesar placing my MARPE.

I’ve never felt compelled to leave reviews but from the staff that went above and beyond to accommodate my schedule when making appointments, to the personal check-ins throughout the process; I am truly thankful to everyone at Stone Oak Orthodontics for making the procedure I was initially so anxious about feel like a life-changing experience!”

– Sarah Felix, Stone Oak Ortho Patient​

What is Obstructive Sleep Apnea (OSA) and Sleep Disordered Breathing (SDB)?

Obstructive Sleep Apnea occurs when the airway closes off sufficiently during sleep that breathing stops. This triggers release of cortisol (the “fight or flight” or “survival” stress hormone) that increases heart rate and activates muscles to force breathing. Although the person doesn’t actually wake, they are driven from deep restorative sleep to “catch their breath”. Once they begin to relax to the deeper levels of sleep, it happens all over again.

This is hard on the body – like running a race all night long. You wake up exhausted and unrested, but more importantly, prolonged levels of increased cortisol negatively affects the immune system, normal hormone production, insulin function, gastric acid production, learning and memory retrieval, and a host of other organs and body functions.

Recognizing Dental Signs of Airway Obstruction

Nasal Airway Obstruction

  • Narrow Maxilla
  • Posterior Crossbite
  • High mandibular plane angle
  • Vertical Maxillary excess
  • High caries risk
  • Short Upper Lip

Pharyngeal Airway Obstruction

  • Bruxism/Tooth Wear
  • Open Bite
  • Anterior Spaces
  • Scalloped Tongue
  • Abfraction Lesions


The most common and significant are:

  • Obstructive tissues (enlarged tonsils, adenoids, turbinate bones (in the nose), deviated septum)
  • Lack of room for the tongue (narrow jaws, recessive upper and lower jaws, tongue-tied)


  • Growth-oriented Orthodontics (jaw expansion, advancement of upper and/or lower jaws to create room for the tongue and open the airway) rather than pulling teeth.
  • Reduction of obstructive tissues (Remove Tonsils/Adenoids, allergy correction or naturopathic) Research has shown that the best results occur when both are done!

When to Assess and Treat?

As soon as you are aware of the problem! Although 7-8 years of age is an important age for orthodontic correction, we can make a big difference in 3- to 6-year-olds with some simple and timely care. Contact our office today for a free consultation.


Click here to read a research article on Airway Orthodontics.