When Sleep Suffers, Everything Suffers.
Airway dentistry and sleep disordered breathing treatment for children and adults in San Jose and the Bay Area. We address the airway, jaw, and breathing function together.
Sleep disordered breathing (SDB) is an umbrella term for conditions in which normal breathing is consistently disrupted during sleep. It ranges from habitual snoring and upper airway resistance to full obstructive sleep apnea. It affects both children and adults, often in ways that go unnoticed for years.
When the airway is narrowed, obstructed, or structurally underdeveloped, the body cannot breathe freely during sleep. This forces the jaw and surrounding muscles into compensatory strain, which often drives TMJ dysfunction, teeth grinding, restless sleep, and chronic fatigue.
At Phelps & Cohen, we evaluate and treat SDB as part of our broader airway health practice. We look at how jaw development, oral posture, nasal breathing, and craniofacial structure are contributing to the problem. We treat accordingly, in collaboration with sleep physicians and ENT specialists.
Many patients with sleep disordered breathing don't realize they have it. They've simply adapted to feeling tired, tense, or unwell. If these symptoms feel familiar, a sleep-focused evaluation is worth having.
In children especially, SDB often presents not as obvious sleepiness but as behavioral changes, poor focus, or chronic mouth breathing, symptoms that are frequently misattributed to other causes.
Both age groups benefit from early evaluation. The signs, causes, and treatment approaches are meaningfully different.
In growing patients, SDB is often tied to underdeveloped dental arches, restricted nasal passages, or enlarged adenoids and tonsils. When caught early, orthodontic expansion, myofunctional therapy, and airway collaboration can redirect facial growth and resolve obstruction before patterns become permanent.
In adults, SDB is frequently connected to jaw position, tongue posture, nasal airway resistance, and weight, or a combination of these. Oral appliance therapy, myofunctional retraining, and targeted airway collaboration can significantly reduce obstruction and improve sleep quality without surgery.
Airway is the foundation. When a child can't breathe freely at night, every system is working against itself: facial development, behavior, cognitive performance. Addressing the airway early changes the entire trajectory.
Dr. Eric Phelps, Phelps & Cohen Orthodontics
We don't guess about airway. Before recommending any treatment, we conduct a thorough evaluation using advanced diagnostic tools that give us objective data about your airway dimensions, nasal breathing capacity, and sleep function.
This allows us to differentiate between structural, muscular, and behavioral contributors, and design a treatment plan that addresses the actual source of obstruction.
Provides detailed three-dimensional imaging of the airway, jaw, sinuses, and craniofacial structures, revealing anatomical contributors to obstruction not visible on conventional X-rays.
Acoustic measurement of the upper airway's size and collapsibility. Identifies the specific location of airway narrowing and predicts how well an oral appliance may reduce obstruction.
Objectively measures nasal airway resistance and identifies whether nasal obstruction is contributing to mouth breathing and nighttime airway collapse.
For patients with suspected obstructive sleep apnea, we coordinate with sleep physicians for a formal polysomnography or home sleep test. Those findings are integrated directly into the treatment plan.
Evaluates how jaw function is contributing to airway position during sleep, particularly the relationship between jaw posture and upper airway collapse.
Treatment is phased and individualized. Here's how we typically approach SDB. Every patient's path is different.
Using CBCT, pharyngometry, and rhinometry, we map where the airway is compromised and why. Is it the nasal passages? The soft palate? Tongue posture during sleep? Underdeveloped dental arches? Each has a different solution, and knowing the answer before starting treatment is what makes the difference between short-term relief and lasting correction.
For children, this often means palatal expansion to widen the dental arch and open the nasal airway, or referral to an ENT for adenotonsillectomy if tissues are contributing to obstruction. For adults, it may involve a custom oral appliance that repositions the jaw and tongue to maintain airway patency during sleep, myofunctional therapy, or coordination with a sleep physician for CPAP alternatives.
Myofunctional therapy is often a cornerstone of lasting SDB treatment. Poor tongue posture, lip incompetence, and habitual mouth breathing all contribute to airway instability. Without addressing them, structural changes alone rarely hold. We work with myofunctional therapists to retrain the muscles that protect the airway during rest and sleep.
We follow up with repeat diagnostics to confirm that airway dimensions have improved and symptoms have resolved. For patients treated through a sleep physician, we coordinate to verify that AHI (apnea-hypopnea index) has reached therapeutic levels. Treatment isn't finished until we can demonstrate measurable improvement.
Most people think of orthodontics as being about teeth. At Phelps & Cohen, we think about it as being about breathing. The development of the jaws and dental arches has a direct, measurable effect on airway volume.
When the upper jaw is narrow and underdeveloped, the nasal floor sits higher, reducing nasal airway space. When the lower jaw is set back, the tongue is set back with it, directly narrowing the upper airway during sleep. This is why orthodontic treatment, done with airway in mind, is one of the most powerful tools available for SDB.
Sleep disordered breathing rarely has a single cause or a single solution. Effective treatment requires coordination across disciplines, and that's exactly how we practice.
We work with a trusted network of specialists to ensure that every dimension of your airway health is evaluated and addressed, not just the part that falls within orthodontics.
If you or your child are showing signs of sleep disordered breathing, our airway health specialists in San Jose are here to help. A comprehensive airway evaluation is where answers begin. We'll tell you exactly what's happening and what your options are.
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