I thought since the last two local dental meetings addressed sleep apnea it may be a good time to discuss airway deficiency and facial growth. Not everyone with decreased nasal airway has a growth problem, but those children who have a problem related to airway cannot be treated to a stable orthodontic result UNLESS they can breathe through their nose. If they can’t breathe through their nose they become a mouth breather. This means a low and forward tongue posture. The swallow becomes abnormal and does not help the upper jaw develop. The posterior teeth are apart and passively erupt causing a more divergent growth and open bite pattern. As the mandible drops down a Class II relationship is more likely.
What do we do? Catch this early. By the time kids are teenagers the growth effects are difficult to correct. Ask parents about snoring, apnea. Look for the venous pooling under the eyes and the tongue posture. Refer for airway evaluation. There are many studies relating ADD and airway deficiency and with the increasing awareness of sleep apnea most physicians are aware of the devastating effects of decrease nasal respiration.