Pediatric Airway Health

Does your child struggle to sleep through the night, chronically snore, or have prolonged bedwetting?

These may be signs of an underlying sleep-related breathing issue that’s impacting your child’s development. Too often, parents are told to “wait and see,” while their child continues to struggle. We're here to offer real answers—and lasting solutions.

A healthy mouth provides enough space for the tongue to rest comfortably—but when that space is limited, the tongue can fall back and block the airway. Airway-focused orthodontics creates room for the tongue and expands the nasal airway, promoting proper nasal breathing. Since nasal breathing is essential for quiet, restorative sleep, these improvements can have a lasting impact on your child’s health and well-being.

Our goal is simple - quality sleep for your child.

That means proper nasal breathing day and night.

Airway-focused orthodontics emphasizes the critical role of proper craniofacial development and nasal breathing in a child’s overall health. This approach integrates dental care with the early identification and management of airway obstruction or narrowing, orofacial myofunctional disorders, and related developmental concerns.

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What are the signs?

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    Mouth breathing

    Mouth breathing—day or night—can impair optimal oxygen delivery to the brain, affecting both short-term function and long-term development. Mouth breathing can also lead to poor sleep and energy, increases risk for cavities, can worsen asthma and allergy symptoms. Long-term it can negatively affect jaw and facial growth.

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    Behavior

    Daytime symptoms linked to poor sleep include: morning tiredness, irritability or mood swings, difficulty concentrating or hyperactivity, or sleepiness during the day. ADHD-like symptoms can sometimes be caused—or significantly worsened—by sleep-disordered breathing (SDB), especially in children.

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    Restless Sleep

    Signs of restless sleep in children include tossing and turning while asleep, waking up frequently, kicking or flailing, talking or crying, sweating, difficulty falling or staying asleep, sleeping in odd positions, or grinding teeth.

Early airway treatment can improve

sleep disordered breathing, focus, and healthier growth - helping children thrive at home, in school, and beyond.

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How is sleep disordered breathing diagnosed?

Our practice employs a comprehensive diagnostic process, evaluating the entire craniofacial complex, posture and cervical spine. We work collaboratively with physical therapists, ENTs, pediatricians, OTs, chiropractors, naturopaths, pediatric functional medicine providers and myofunctional therapists. We develop individualized, integrative treatment plans that may involve interceptive orthodontics, myofunctional therapy, or referral for medical intervention.

By addressing airway issues during critical growth periods, we aim to facilitate nasal breathing day and night, support optimal facial development, enhance sleep quality, and reduce long-term health risks associated with sleep-disordered breathing.

What we evaluate as part of our initial airway exam:

  • Ability to nasal breathe

  • Signs of sleep disordered breathing

  • Signs of allergies 

  • Tonsils and adenoids

  • Oral restrictions (i.e. tongue tie)

  • Craniofacial growth and development 

  • TMJ health 

★ ★ ★ ★ ★

“My son is 2.5 and was waking up sometimes 5x per night. FIVE pediatricians told me his sleep disturbances were behavioral, and I needed to let him cry (none asked additional questions or considered nutrient deficiency or airway obstruction or anything. "Let him cry" was literally the first path).

He had a lot of the "classic" signs of airway obstruction (sleeping arched, nighttime mouth breathing, ratty hair in the morning) which luckily I had seen in a mom's group on the internet. So, to summarize a months-long journey, we saw Dr Kramer, she referred us to ENT, they were able to help, and now he sleeps great.

During my initial call with her, during our consultation, and in following up on referrals, Dr Kramer was soooo incredible. I truly believe if I hadn't found her we still wouldn't be getting sleep. Even in follow up steps where I felt discouraged or dismissed, she was there (calling me first rather than the other way around!!!)to make sure that we felt supported and were receiving proper care.

I cannot say enough good things about this practice.”

C.C. | Fort Collins parent

★ ★ ★ ★ ★

Dr. Kramer is absolutely amazing! We have spent the last two years working with her after she was recommended to us by our family dentist, who is also a family member. We wanted to help our daughter improve her breathing, sleep, and overall aesthetics, and we could not be more grateful for the care she has provided. We are truly blown away by her dedication, attention to detail, and commitment to perfection. She genuinely cares about her patients and takes the time to get things right. We couldn’t recommend her more highly!

K.N. | Fort Collins parent

Pediatric Airway Treatment Options

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    01 | Under Age 3


    For children under 3, we support airway health through early evaluation of oral habits, tongue and lip function, proper jaw development, and signs of mouth breathing—offering referrals to experts on myofunctional exercises, breastfeeding/latch support, feeding support, tongue-tie release or ENT evaluation when needed. We promote the Weston A. Price diet and baby led weaning.

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    02 | Fixed Appliances


    Fixed expanders gently widen the upper jaw to create more space for the tongue and improve nasal airflow, supporting better breathing and overall airway health in growing children. Some children and teens benefit from fixed upper and lower expanders to help their jaws develop to their full, natural size—these effective devices are easy to manage, require gentle turning to widen, and work best when started before growth plates (palatal sutures) begin to fuse in adolescence.

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    03 | Candid Clear Aligners


    Candid aligners can support airway health in children by gently guiding jaw and dental development, helping create more space for the tongue and improving nasal breathing—key factors in promoting better sleep, focus, and overall growth.

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    04 | Nuvola Junior System


    Nuvola Junior is an innovative, metal‑free aligner system designed specifically for growing children, combining clear aligners and a 30‑minute‑a‑day functional “Freedom” appliance to gently guide jaw development, expand arches, and improve chewing, breathing, and swallowing with minimal disruption to their daily routine.

FAQs

  • Airway orthodontics is a specialized approach in orthodontic treatment that focuses on improving a patient’s breathing by optimizing the size, shape, and function of the upper airway. It looks beyond straightening teeth and considers the overall structure of the jaws and how it impacts airflow, especially during sleep.

  • Traditional orthodontics primarily focuses on teeth alignment and bite correction. Airway orthodontics incorporates these goals but also considers how jaw development and dental positioning affect nasal breathing, tongue posture, and the airway.

  • Both children and adults can benefit. It is particularly helpful for:

    • Children with narrow jaws, mouth breathing, or sleep issues

    • Adults with sleep apnea, snoring, or TMJ dysfunction

    • Anyone with breathing difficulties linked to facial structure

  • Common symptoms include:

    • Snoring or mouth breathing

    • Chronic nasal congestion

    • Restless sleep or sleep apnea

    • Fatigue, headaches, or difficulty concentrating

    • Crowded or misaligned teeth

    • Forward head posture

  • Factors can include:

    • Genetics

    • Prolonged thumb-sucking or pacifier use

    • Tongue-tie or improper tongue posture

    • Chronic allergies or enlarged tonsils/adenoids

    • Mouth breathing habits

  • Treatments vary by age and diagnosis and may include:

    • Upper and lower expansion to widen the jaws

    • Myofunctional therapy (exercises for tongue and facial muscles)

    • Braces or aligners

    • Oral appliances to reposition the jaw

    • Collaboration with ENT specialists, sleep physicians, myofunctional therapists or physical therapists

  • Early evaluation (age 5–7) is ideal, as children’s bones are still developing. However, airway-focused treatment can be beneficial at any age but it is the least invasive before the age of 10.

  • Yes. Narrow jaws, retruded chins, or misaligned bites can contribute to obstructive sleep apnea by reducing airway space. Airway orthodontics may help alleviate these structural causes.

  • It can. By promoting proper jaw growth and posture, it often results in improved facial balance and aesthetics, particularly when started in childhood.

  • Coverage depends on the treatment and your insurance company. Some aspects may fall under dental or orthodontic benefits.