Pediatric Airway Care: Making It Feasible for Dental Practices

By Jon W. Caulfield, DDS

As awareness of pediatric obstructive sleep apnea (OSA) grows, more families are turning to their dental professionals for help identifying and managing sleep-related breathing issues in children. Yet, many dentists still see airway-centric pediatric care as a niche specialty rather than an integral part of routine dentistry.

Dr. Jon Caulfield of Epic Dentistry in Littleton, Colorado, argues that it’s time to change that perception. “By addressing sleep-breathing dysfunctions early, dentists can prevent or improve many orthodontic and health problems before they become difficult to treat,” he explains. His practice focuses on airway, sleep, and TMJ care for both children and adults, integrating these concerns directly into everyday patient visits.

Recognizing Clinical Red Flags for OSA

Every pediatric dental exam offers an opportunity to screen for warning signs of obstructive sleep apnea.At Epic Dentistry, Dr. Caulfield’s team watches for:

• Lack of spacing or accelerated wear in primary or mixed dentition

• Narrow upper jaws

• Tethered oral tissues

• Enlarged tonsils

• Mouth breathing

• Incorrect tongue posture

These clinical cues, combined with discussions about sleep quality and behavior, often reveal children who may need further evaluation. Screening tools and diagnostic sleep tests can then confirm OSA and its severity.

Adjunctive Therapies That Support Pediatric Airway Health

Dr. Caulfield emphasizes that no single treatment resolves pediatric OSA—it requires a multidisciplinary approach. His practice uses several evidence-based adjunctive therapies:

• Myofunctional Therapy: Dental hygienists trained in myofunctional therapy provide in-person and remote support to retrain oral function and muscle balance.

• Laser Therapy: Using a Deka CO₂ laser, Dr. Caulfield performs airway interventions such as tonsillar and soft tissue releases to open breathing pathways.

• Habit Correction: Lip seal exercises, tongue posture training, and thumb-sucking cessation strategies help restore proper oral habits.

• Nasal Hygiene and Sleep Habits: Daily nasal care, including non-steroidal sprays and rinses, improves airflow. Parents learn routines that optimize nasal breathing before bed.

• Breathing Re-education: Following methods inspired by Patrick McKeown’s Buteyko breathing approach, this therapy helps children and families adapt to healthy CO₂ levels and improve airway stability.

Building Strong Medical–Dental Partnerships

Comprehensive care for pediatric OSA requires collaboration between dental and medical professionals. Dr. Caulfield routinely partners with ENTs, pediatricians, chiropractors, craniosacral therapists, and myofunctional practitioners to ensure children receive full-spectrum care.

“Building these connections must be proactive,” he advises. Dentists should reach out directly to local providers—by visiting their offices or emailing them—to share care philosophies and develop mutual referral systems.

Making OSA Care Work in a Busy Practice

When Epic Dentistry began offering airway and sleep services, Dr. Caulfield started small—dedicating just a half-day each week to airway cases. If the schedule wasn’t full, the team used that time for training, refining systems, and improving workflows.

He also leveraged support from Vivos, an oral appliance company focused on the root causes of airway dysfunction. Their pediatric curriculum and after-hours education on medical billing and implementation helped his team integrate OSA treatment smoothly.

“The fundamental shift involves asking different questions,” he says. “It’s a more medically oriented exam that looks beyond teeth to the patient’s overall health.”

A Healthier Future for Children—and Dentistry

Integrating pediatric OSA care into dental practice is not only feasible—it’s essential. With proper training, collaboration, and structured scheduling, dental professionals can dramatically improve long-term outcomes for young patients while expanding their practice’s expertise and impact.

As Dr. Caulfield concludes, “Dentists can be the central providers who bring the village together for comprehensive, successful care.”