When most people think about orthodontics, they picture braces, aligners and, eventually, a straighter smile. But modern orthodontics is increasingly looking beyond the teeth themselves.
One fascinating area of research is the relationship between the development of the jaws, the bite and sleep-disordered breathing – a group of conditions that includes habitual snoring and obstructive sleep apnea.
Why would an orthodontist care about how a child sleeps?
The answer begins with anatomy. The jaws, teeth, tongue and surrounding facial structures all occupy the same relatively small space around the upper airway. As a child grows, the way these structures develop can influence the shape and dimensions of that space.
A 2025 study of 246 children and adolescents receiving orthodontic treatment found that 6.5% screened as being at high risk for sleep-disordered breathing. The researchers also found differences in certain skeletal jaw relationships between children at higher and lower risk. Importantly, the study did not show that orthodontic treatment itself causes sleep problems—or that every child with a particular bite has a breathing disorder. Instead, it highlights why the orthodontic examination can sometimes be one piece of a much larger health picture. (PubMed)
The clues parents may notice
Some of the most important clues have nothing to do with crooked teeth.
A child who regularly snores, sleeps with an open mouth, seems unusually restless at night, wakes with headaches, or is excessively tired or inattentive during the day may deserve a conversation with their pediatrician. In children, sleep-disordered breathing can sometimes look like behavioral or concentration problems rather than simply “being tired.”
Orthodontists aren’t sleep physicians, and an orthodontic examination cannot diagnose sleep apnea. But orthodontists may notice facial growth patterns, jaw relationships or dental characteristics that warrant additional questions.
That makes communication between families, orthodontists, pediatricians, dentists and sleep specialists particularly valuable.
Orthodontics is becoming more interdisciplinary
The connection between orthodontics and sleep is an example of a broader change in the field. Orthodontic treatment is no longer viewed solely as cosmetic dentistry. Properly aligned teeth can make chewing and cleaning easier, while assessment of facial growth can provide useful information about a child’s developing anatomy.
Research is even exploring orthodontic appliances specifically designed to address pediatric obstructive sleep apnea. A 2025 multicenter clinical study of a removable appliance designed to provide slow maxillary expansion reported improvements in sleep-related symptoms and apnea-hypopnea index among children with diagnosed obstructive sleep apnea. However, this was a relatively small, non-randomized study, so the findings should be viewed as promising rather than proof that orthodontic treatment is a universal solution for pediatric sleep apnea. (PubMed)
What should parents do?
The message isn’t that every child who needs braces needs a sleep evaluation.
Rather, it’s that an orthodontic consultation can be an opportunity to look at the whole picture of facial growth and development. If a child snores frequently or shows other signs of disrupted breathing during sleep, parents should mention it to their pediatrician rather than assuming that it is simply a phase.
And when orthodontists, dentists and physicians work together, a visit that begins with “Do these teeth need braces?” can sometimes lead to a much more important question:
“How well is this child breathing and sleeping?”
A straighter smile may be the most visible result of orthodontic care—but healthy growth, function and overall well-being are increasingly part of the conversation.
Call our office today for your FREE consultation at 201-891-7400. You can also visit our website at smilesbylorino.com for more information.
Robert Lorino, DMD, MS
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