Airway Focused Dentistry

What is Airway Focused Dentistry?  Isn’t dentistry about the teeth and gums?  Why would my dentist get involved in my airway?

These are the questions I asked myself as I observed patients through the years on whom standard dental treatments did not work.  They still got cavities, had crooked teeth even after braces, and had gum disease.  These were often patients who also had other medical problems: ADHD, ear infections, sinus infections, heart disease, obesity, stroke, diabetes, anxiety and depression.

I started paying more attention to the anatomy and habits of healthier patients and noticed some remarkable similarities.  Most healthy patients had broad and long dental jaws and breathed through their nose.  What I have learned by studying this is that broader and longer jaws also correlates with a better, larger airway.  When the airway is larger we breathe better.  Better breathing is nose breathing, not mouth breathing.  When the jaws are short and narrow the airway is compromised leading to mouth breathing and at night, when muscles relax, leads to obstructive sleep apnea (stopping breathing for a time).  Nose breathing filters the air, moistens the air, warms the air and adds nitric oxide.  When we breathe through the mouth none of these things occur, this air is an irritant to the throat and lungs leading to chronic inflammation.

How can a dentist help with an airway issue?  Dentistry is the only profession that can alter the craniofacial development through early intervention orthodontics.  By catching habits and developmental issues early we can affect the developmental outcomes so patients have healthier lives.  Here is a short list of some red flags that airway structure may be a problem:  babies who cannot breast feed, children who snore, mouth breathing, thumb sucking, continued bed wetting, speech problems, growth and development problems, ADHD, ear infections, sinus infections, asthma, anxiety and depression.  That is not to say that airway is the only issue that may cause these problems but there is strong research evidence that airway contributes to and sometimes is the main causative factor.

Dentistry and medicine are now in the process of rethinking how we improve breathing 24 hours a day to impact the quality and longevity of life.  Currently, dentists assist sleep apnea patients with nighttime only sleep appliances that open the airway as an alternative to CPAP machines.  This approach does help symptoms but is not curative.  The way to cure or prevent airway problems is to expand the airway and eliminate habits and obstructions that prevent nose breathing.  This requires early detection of potential problems, like tongue tie, deviated nasal septum, enlarged tonsils and adenoids, and narrow and short jaws. If these problems are detected at a later age the treatments may be curative or will at least improve the quality of life and longevity.  Identifying these problems is the responsibility of the pediatrician (tongue tie, ear infections, ADHD, growth and development) and dentist (tongue tie, enlarged tonsils, mouth breathing, narrow and short jaws).

I am currently developing an interdisciplinary group of dentists and physicians to identify and treat these issues in children and adults.  You will hear more about this topic from me in the future, or for more information you can contact our office 540-687-6363.


Dr. Robert A. Gallegos is a Fellow in the Academy of General Dentistry, he is on the faculty of Spear Education, a member the American Academy of Cosmetic Dentistry, the American Academy of Dental Sleep Medicine and the American Dental Association.  Dr. Gallegos practices dentistry in Middleburg, VA.

Dr. Gallegos