Snoring, Mouth Breathing, and Sleep Apnea: Orthodontic Considerations

Snoring and mouth breathing are common findings that may be associated with sleep-disordered breathing (SDB) or obstructive sleep apnea (OSA). These conditions may affect behavior, physical growth, and cognitive performance in children and may contribute to long-term health risks in adults. Orthodontic evaluations may identify craniofacial or dental features associated with airway restriction. Medical diagnosis of OSA is established by a physician, typically through a sleep study (polysomnography).

Pediatric OSA

In children, untreated OSA has been associated with restless sleep, hyperactivity, learning difficulties, and altered growth patterns. Factors that may contribute to airway restriction include enlarged adenoids or tonsils, nasal obstruction, chronic sinus inflammation, a narrow maxilla, or a retruded mandible.

Orthodontic treatment may be considered to address craniofacial growth patterns or dental arch constriction that are associated with airway anatomy. Palatal expansion may be used to address maxillary constriction, and orthopedic guidance of jaw growth may be considered in selected growing patients. Myofunctional therapy may complement orthodontic care by addressing tongue posture, lip competence, and orofacial muscle coordination. These approaches do not diagnose or treat OSA and are coordinated as part of a broader, multidisciplinary care pathway when indicated.

Adult OSA

In adults, untreated OSA is associated with increased risk of hypertension, cardiovascular disease, type 2 diabetes, and cognitive impairment. Diagnosis and primary management are directed by a sleep physician. Continuous positive airway pressure therapy remains the primary treatment for many individuals. When CPAP is not tolerated, a sleep physician may prescribe an oral appliance.

Orthodontic treatment may be used to align the teeth and jaws to support dental stability or improve compatibility with medically prescribed oral appliances. Orthodontic care does not diagnose or treat OSA and is provided in coordination with the treating physician.

Oral appliances for OSA are provided under the direction of a sleep physician. Collaboration with speech-language pathologists and orofacial myofunctional therapists may be considered to support airway function as part of coordinated care.

If concerns such as persistent snoring, mouth breathing, or sleep-related symptoms are present, a clinical evaluation and appropriate medical referral may be indicated.