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The presentation of a child's face and his/her oral cavity can tell the dentist a lot about his/her airway.  There are various visible facial cues that characterize a child with a breathing dysfunction.  Orally, the growth of the upper arch/palate and the spacing (or lack thereof) tell us how the nasal cavity is developing. The way the teeth come together in the bite also gives us clues into their development.  Signs of wear and/or erosion from bruxing (tooth grinding) can be evident and suggests a link to a potential sleep disorder (Simmons, J. Prehn "Nocturnal bruxism is a protective mechanism against obstructive breathing during sleep." Abstract 2009 APSS Conference).  Additionally, as dental practitioners, we can evaluate and grade the tonsils in most patients which give us a clue into their airway space.  

In 2012, the  American Academy of Pediatrics developed their guidelines to screen pediatric patients for  the "snoring child." Considerations are how loud the snoring is and if it is habitual (more than 3 nights per week).  If a child is audibly snoring regularly, a consideration should be made to have a sleep study done and/or to have the child evaluated by a pediatric ENT and follow up with an airway focused dentist or orthodontist to manage the arch growth discrepancy.  This will not self-correct.

Parents and health practitioners alike can be paying closer attention to sleep disordered breathing in young children.  Research is showing us that there is a strong correlation between snoring, mouth breathing, and apnea with behavioral and social-emotional issues in children.  A study that demonstrates this was out of the United Kingdom by the Avon Longitudinal Study of Parents and Children. This study linking behavioral issues to sleep disordered breathing followed 11,000 children for a period of 6 years and was published in Pediatrics.   It is important to consider this and rule out sleep disordered breathing  if a child is diagnosed with ADD/ADHD. Other associations to poor sleep quality in children are bed-wetting, a history of ear infections, sinus infections, sore throats, or allergies.