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Treating Child Sleep Related Breathing Disorders with Orthodontics

Treating Child Sleep Related Breathing Disorders with Orthodontic

Dr. Karen Conn of Bryn Mawr Orthodontics discusses the symptoms of sleep-related breathing disorders (SRBD), including sleep apnea, in children and how orthodontic treatment with a palatal expander can help

by Dr. Karen Conn, DMD, MS

Sleep related breathing disorders (SRBD) is a broad term that includes conditions that disrupt breathing during sleep.  One of the most common SRBD’s in children is Obstructive Sleep Apnea (OSA).  OSA is a condition in which the airway becomes blocked during sleep, which can lead to snoring, gasping, and choking.  When left untreated, OSA can cause a number of health problems, including excessive daytime sleepiness, difficulty concentrating, and learning problems.  Untreated OSA raises your risk for serious health problems, including heart disease, stroke, high blood pressure, and diabetes.

In order to properly treat SRBD, it is important to accurately determine the underlying cause of the problem.  This may involve a multidisciplinary approach, including an evaluation by an orthodontist, a pediatrician, and/or an ear, nose, and throat (ENT) specialist.

Symptoms of SRBD

The symptoms of SRBD can vary depending on the type of disorder.  Some common symptoms found in children with SRBD include:

  • Snoring
  • Gasping or choking during sleep
  • Restless sleep
  • Frequent waking during the night
  • Bed wetting
  • Night terrors
  • Daytime sleepiness
  • Difficulty concentrating
  • Learning problems
  • ADHD-like behaviors
  • Teeth grinding
  • Mouth breathing
  • Tongue tie

Multidisciplinary Approach to SRBD

The first step is to do a thorough review of the medical history and symptoms and a comprehensive clinical evaluation.  Oftentimes, an orthodontist will work alongside a pediatrician to order a sleep study to diagnose sleep apnea.  

An experienced orthodontist with advanced 3D cone beam technology can thoroughly evaluate the airway structures to determine if there is a structural issue contributing to a child’s reduced airway.  In some cases, proper referral for evaluation of the adenoids and tonsils by a pediatric ENT is recommended.  Nasal obstruction can also be due to allergies or a deviated septum.

If the jaws are impeding the airway or encroaching on the tongue space, treatment to help improve the tongue position is recommended.  Orthodontically, treatment with a rapid palatal expander (RPE) is recommended in these situations.  Oftentimes, myofunctional therapy is also recommended in conjunction with orthodontic treatment; a myofunctional therapist is a specialist who helps to train the tongue to improve the tongue’s rest posture and any habits.  Sometimes a tongue tie contributes to the position of the tongue and should be treated by a pediatric dentist.  

Orthodontic treatment can often play a significant role in improving the health of children who are suffering from SRBD when orthodontic problems are accurately diagnosed as the root of the cause.

How a Rapid Palatal Expander Can Help Children with SRBD

A rapid palatal expander (RPE) can be a safe and effective way to help treat SRBD in children.  An expander is an orthodontic appliance that is used to widen the upper jaw.  An expander can be used to treat a variety of orthodontic conditions, including crossbites, crowding, and in many cases SRBD.  Expanders can help to widen the upper jaw, which can help to open up the airway, allow more room for the tongue, and improve breathing during sleep.  Studies have shown that maxillary expansion can also help shrink enlarged adenoids and tonsils.  An expander is a non-surgical option that can help to improve breathing during sleep and reduce the risk of health problems associated with SRBD.


If you are concerned that your child may have a SRBD, including obstructive sleep apnea, please schedule an appointment with an orthodontist to discuss your child's symptoms and options for treatment.  Early intervention is important for improving the health and well-being of children with SRBD.

Karen Conn, DMD, MS is a Board-certified orthodontist and co-owner of Bryn Mawr Orthodontics (Bryn Mawr, PA), where she specializes in Invisalign and braces for children, teens and adults.  She has been recognized as a Philadelphia Magazine Top Dentist, Main Line Today Top Dentist, Suburban Family Top Orthodontist, and is among the nation’s top 1% of Invisalign providers.  Dr. Conn received her undergraduate and doctorate degrees from the University of Pennsylvania.  She completed her residency in Orthodontics and Dentofacial Orthopedics at Temple University, where she also earned a master's degree in Oral Biology, and published a research thesis on the association between dentofacial genetics and sleep apnea.

Bryn Mawr Orthodontics serves its neighbors in Bryn Mawr, Gladwyne, Villanova, Ardmore, Haverford, Wynnewood, Narberth, Radnor, Penn Valley, Bala Cynwyd, Merion, Wayne, and the entire Main Line.

To learn more about Bryn Mawr Orthodontics contact the office today (484-383-0055) or schedule a free consultation online.

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