Expansion2022 / Retrospective cohort study
Yoon et al. · Sleep Medicine
In 60 children with enlarged tonsils, the expansion group showed average adenoid- and tonsil-volume reductions of 16.8% and 38.5%. The study supports exploring expansion in selected patients with a narrow palate. Its retrospective imaging findings do not establish a guaranteed response or replace ENT and sleep assessment.
Expansion2022 / Randomized trial
Gokce et al. · International Journal of Pediatric Otorhinolaryngology
This trial compared three expansion appliance designs in patients with a narrow upper jaw, using acoustic rhinometry to assess the nasal airway. It is useful for understanding the structural effects of expansion. Comparing appliance types answers a different question from comparing treatment with observation or demonstrating resolution of sleep apnea.
Expansion2024 / Clinical guideline
American Thoracic Society · American Journal of Respiratory and Critical Care Medicine
The ATS conditionally supports orthodontic or dentofacial orthopedic treatment for selected children with persistent sleep apnea and relevant craniofacial findings. A constricted maxilla and an orthodontic indication matter to candidacy. The recommendation has very low evidence certainty and belongs within coordinated management of persistent pediatric sleep apnea.
Expansion2023 / Randomized trial
Gokce et al. · Sleep and Breathing
In 46 randomized patients with a narrow maxilla and obstructive sleep apnea, three expansion designs produced similar expansion but no statistically significant improvement in apnea-hypopnea index at three months. The finding highlights the need to measure sleep outcomes directly instead of treating a wider palate as proof of improved sleep apnea.
Pediatric sleep2026 / Professional policy
American Academy of Pediatric Dentistry
The AAPD encourages dental teams to screen for sleep apnea risk and coordinate medical referral. It supports collaborative assessment of selected dental and skeletal concerns while describing limits in the expansion literature. A questionnaire or dental examination alone cannot establish a child's diagnosis or disease severity.
Pediatric sleep2023 / Randomized trial
JAMA
In children with snoring and mild sleep-disordered breathing, adenotonsillectomy improved several secondary outcomes, including symptoms, quality of life, behavior, and blood pressure over 12 months. It did not significantly improve the primary attention or executive-function outcomes. Benefits therefore depend on the outcome being measured, alongside surgical risks and individual assessment.
Pediatric sleep2013 / Randomized trial
New England Journal of Medicine
The CHAT trial compared early adenotonsillectomy with watchful waiting in school-age children with obstructive sleep apnea. Surgery improved symptoms, behavior, quality of life, and sleep-study findings, but not the primary attention and executive-function measure. Some children also improved without surgery, reinforcing the importance of individualized decisions and follow-up.
Pediatric sleep2025 / Patient education
National Heart, Lung, and Blood Institute
This NIH guide explains childhood sleep apnea symptoms, common contributing factors, and the role of a sleep study in diagnosis. It describes several treatment pathways, including care for enlarged tonsils and adenoids. Snoring, mouth breathing, and daytime behavioral changes are reasons to seek assessment, not a diagnosis by themselves.
Oral functionUndated / Professional guidance
American Speech-Language-Hearing Association
ASHA describes assessment of oral resting posture, swallowing, speech, and related movement patterns within an interdisciplinary team. Nasal obstruction and other medical contributors may require evaluation alongside therapy. This practice resource helps explain functional care; it is not a clinical trial demonstrating that exercises alone cure sleep apnea.
Oral function2009 / Randomized trial
American Journal of Respiratory and Critical Care Medicine
This small randomized trial studied oropharyngeal exercises in 31 adults with moderate obstructive sleep apnea. The exercise group showed improvements in apnea severity and symptoms. These findings support further study of a complementary treatment, but cannot be generalized directly to children or used to replace individually prescribed sleep-apnea care.
Oral function2015 / Randomized trial
Sleep and Breathing
Among 27 children with residual obstructive sleep apnea after adenotonsillectomy, two months of oropharyngeal exercises improved apnea measures and oral-function findings compared with controls. The small sample and short follow-up limit certainty. The study concerns complementary care after surgery, rather than a universal alternative to medical or surgical treatment.
Oral function2017 / Randomized trial
Sleep and Breathing
This randomized study of 54 children examined myofunctional therapy for sleep-disordered breathing. Treatment improved tongue performance, oral breathing, lip tone, and resting tongue posture, with reported improvements in oxygen saturation and symptoms. Functional changes are encouraging, but do not establish lasting resolution of sleep apnea or equal effectiveness for every child.
Oral function2024 / Clinical report
American Academy of Pediatrics / Pediatrics
This infant-focused report recommends assessment of feeding function and breastfeeding support before considering frenotomy for symptomatic ankyloglossia. It states that releasing an infant's frenulum to prevent future obstructive sleep apnea is not evidence based. Its recommendations address infant feeding and should not be casually extrapolated to every older child's functional complaint.
Oral function2022 / Professional policy
American Academy of Pediatric Dentistry
The AAPD discusses how a restrictive frenulum may affect selected oral functions and emphasizes appropriate assessment and individualized decisions. It also identifies gaps in diagnostic standards and calls for stronger research. A visible frenulum or its appearance alone should not be presented as proof that a procedure is needed.
Jaw development2024 / Clinical best practice
American Academy of Pediatric Dentistry
This best-practice document covers examination, diagnostic records, oral habits, crossbites, crowding, and treatment priorities across stages of dental development. It supports matching treatment timing to a child's specific findings. Guidance about developing teeth and jaws does not establish that every child needs early expansion or that orthodontics alone treats sleep apnea.
Jaw development2009 / Case-control study
Arquivos de Neuro-Psiquiatria
Researchers compared craniofacial measurements in mouth-breathing and nasal-breathing children with measurements in adults with obstructive sleep apnea. Some patterns were similar between mouth-breathing children and affected adults. This observational association cannot show that mouth breathing caused the differences, diagnose apnea in a child, or reliably predict an individual's future disease.
Surgical care2015 / Prospective cohort study
Journal of Clinical Sleep Medicine
This two-center cohort followed selected adults after maxillomandibular advancement for moderate-to-severe obstructive sleep apnea. Improvements in apnea severity and other health measures persisted at long-term follow-up. The study supports surgery as an option for appropriately selected patients, but its small, nonrandomized sample does not guarantee equivalent results for every patient.
Surgical careUndated / Patient education
American Association of Oral and Maxillofacial Surgeons
This patient resource explains oral appliances, positive airway pressure, and surgical options, including repositioning the upper and lower jaws to enlarge the airway. It describes collaboration among medical and dental specialists. Choosing surgery depends on diagnosis, anatomy, treatment tolerance, and individual risks; this overview is not comparative trial evidence.
Oral function2015 / Clinical guideline
American Academy of Sleep Medicine / American Academy of Dental Sleep Medicine
This adult guideline describes physician-directed oral-appliance therapy delivered with a qualified dentist, including custom titratable devices for appropriate patients. It recommends monitoring dental effects and confirming response with follow-up sleep testing. These recommendations concern adult sleep appliances, not pediatric expansion, and do not imply that any mouthguard treats sleep apnea.
Jaw development2026 / Patient education
American Association of Orthodontists
The AAO recommends an orthodontic checkup when a problem is recognized and no later than age seven. Early assessment can identify selected bite or growth problems, while many children only need observation. A checkup is not a recommendation for immediate treatment, and the best timing depends on the individual findings.
Pediatric sleep2017 / Position paper
American Academy of Sleep Medicine / Journal of Clinical Sleep Medicine
This AASM position paper does not recommend home sleep apnea testing to diagnose obstructive sleep apnea in children, citing insufficient supporting evidence and pediatric measurement needs. It explains why adult testing pathways cannot simply be copied for children. Screening questions and online evaluations can guide referral but cannot replace diagnostic assessment.
Pediatric sleep2012 / Longitudinal cohort study
Pediatrics
In a large birth cohort, parent-reported snoring, mouth breathing, and witnessed apnea were associated with later behavioral difficulties after adjustment for measured confounders. The findings support taking sleep symptoms seriously. Because symptoms and behavior were observational reports, the study does not prove causation or show that an airway procedure treats ADHD.
Expansion2021 / Uncontrolled before-and-after study
Pirelli et al. · Sleep Medicine
In 19 children with sleep apnea and malocclusion, rapid maxillary expansion increased measured nasal width and upper-airway volumes. The study also included respiratory and sleep evaluations. These findings support a structural effect in selected children, but the small uncontrolled sample and short follow-up do not establish reliable cure rates or predict every child's response.
Expansion2020 / Systematic review and meta-analysis
Calvo-Henriquez et al. · International Journal of Pediatric Otorhinolaryngology
This review included 12 studies involving 301 children and found reduced nasal resistance and increased nasal airflow after maxillary expansion. The pooled resistance estimate came from nine uncontrolled studies, which limits causal certainty. Improved nasal measurements do not by themselves demonstrate resolution of sleep apnea or eliminate other causes of obstruction.
Expansion2022 / Prospective nonrandomized controlled trial
Brunetto et al. · Progress in Orthodontics
Selected adults with a narrow upper jaw and obstructive sleep apnea showed improved sleep measures and quality of life after MARPE compared with untreated controls. Only 14 treated participants entered the outcome analysis; unsuccessful expansion cases were excluded. This supports further investigation, with important limits from selection, sample size, and short follow-up.
Surgical care2020 / Retrospective cohort study
Yoon et al. · Sleep Medicine
This selected adult cohort reported improvements in nasal obstruction, sleepiness, and sleep-apnea severity after expansion combining a skeletal expander with osteotomies. Although 75 patients were eligible, paired apnea measurements were available for 43. The uncontrolled retrospective design and incomplete outcome data limit certainty; surgical selection and follow-up remain central to interpreting these results.
Jaw development2017 / Cross-sectional imaging study
Angelieri et al. · International Journal of Oral and Maxillofacial Surgery
Researchers examined scans from 78 adults aged 18–66. Most had a fused midpalatal suture, but 12% did not; age and sex did not significantly predict maturation stage within this sample. The findings favor individual assessment over a universal age cutoff, but imaging classification alone does not establish treatment success or a need for surgery.
Jaw development2024 / Randomized trial
Radwan et al. · Orthodontics & Craniofacial Research
Forty growing children with mandibular retrusion were randomized to Twin Block or fixed-appliance care for 12 months. Twin Block improved oropharyngeal volume and oxygen-desaturation measures. A sleep-disordered-breathing diagnosis was not required for enrollment, so these findings do not establish cure of diagnosed pediatric sleep apnea or prevention of future disease.
No matching resources. Try another term or reset the filters.
