Medically reviewed by Dr. Amin P. Samadian, DDS, MBA, Diplomate of the American Board of Dental Sleep Medicine and Fellow of the American Academy of Craniofacial Pain. Last reviewed November 7, 2026.
A child's jaws, nose and airway grow together, and the way a child breathes shapes how they grow. A child who breathes through the mouth tends to rest the tongue low, and the upper jaw then has less to guide it outward. Childhood is the window when this is easiest to influence. At the San Francisco Center for TMJ and Sleep Apnea, Dr. Amin Samadian looks at the teeth, the jaws and the breathing together. Call 415-570-2841 to book an evaluation for your child.
What parents usually notice first
- Breathing through the mouth during the day or while asleep
- Snoring, noisy breathing or restless sleep
- Grinding teeth at night
- Waking tired, dark circles under the eyes, or trouble concentrating
- Crowded teeth or a narrow, high palate
- A crossbite, or a jaw that shifts to one side
- Lips apart at rest, or a tongue that pushes forward when swallowing
None of these alone means something is wrong. Several together are a good reason for a visit.
How the airway and the jaws are connected
The roof of the mouth is also the floor of the nose. When the tongue rests up against the palate, it gently guides the upper jaw to grow wide. When a child breathes through the mouth, often because of allergies, congestion or large tonsils and adenoids, the tongue drops and the palate can grow narrow and high. A narrow upper jaw leaves less room for the teeth and a smaller nasal passage, which makes nose breathing harder still. Breaking that cycle early is the point of airway-focused care.
What we do
A full evaluation
We look at the teeth, jaw growth, palate width, tongue posture and tongue tie, and how your child breathes and sleeps. When needed, a 3D scan shows the jaws and airway. If sleep-disordered breathing is suspected, we talk with you about pediatric sleep testing.
Working with your child's doctors
If the nose or tonsils are part of the problem, we coordinate with your pediatrician and with ENTs we work with. Opening the nose and guiding the jaws work best together.
Expansion and ALF
While the palate seam is still open, a palatal expander or ALF appliance can widen the upper jaw gently, making room for the teeth and the tongue.
Myofunctional therapy
Myofunctional therapy retrains how the tongue rests, how the lips seal and how a child swallows, so that the new habits support the growth the appliances start.
Orthodontic coaching
We follow growth over time with orthodontic coaching, so each step happens at the right age instead of all at once later.
When to come in
An early visit gives the most options, because growth is easiest to guide while it is happening. Bring your child in if you notice the signs above, at any age.
Book an airway evaluation for your child
We are at 260 Stockton St, 4th Floor, San Francisco, CA 94108. Call 415-570-2841 or request an appointment online.
