Pediatric Airway Treatment Starts at Age One by Dr. Jonelle Anamelechi

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Pediatric Airway Treatment Starts at Age One 

Is dentistry ready to lead the way to a generation of better breathers, sleepers, eaters, and overall health?

by Dr. Jonelle Anamelechi

Dentistry stands at a pivotal crossroads. As our understanding of the airway, sleep-disordered breathing, and early oral development continues to expand, we must ask an important question: Is dentistry ready to lead the way toward a generation of healthier breathers, sleepers, eaters, and ultimately, healthier people, including in oral health? I believe the answer lies in how we embrace early dental visits and how intentionally we integrate pediatric airway health into everyday care.

For decades, dentistry has focused primarily on teeth—caries prevention, alignment, and aesthetics. While these remain essential, growing evidence indicates that the mouth is not an isolated system. It is central to breathing, feeding, speech, sleep, and neurodevelopment. We now know we are uniquely positioned to identify airway dysfunction early—often years before symptoms escalate into chronic disease.


The science behind the pediatric airway
Sleep-disordered breathing (SDB) in children exists on a spectrum from primary snoring to obstructive sleep apnea (OSA). Studies suggest that up to 10% of children snore regularly, while 1–5% meet criteria for pediatric OSA. The downstream effects include behavioral challenges, attention deficits, impaired growth, cardiovascular strain, and learning difficulties.

Many early risk factors are visible during routine dental visits: high-arched or narrow palates, mouth breathing, abnormal tongue posture, enlarged tonsils, lip incompetence, and restrictive oral frenula. These are not rare findings—they are daily observations in pediatric dental practices.

Yet too often, these signs are normalized or deferred until orthodontic age, long after critical growth windows have passed.


Why the age one visit matters more than ever
The American Academy of Pediatric Dentistry recommends establishing a dental home by age one or within six months of first tooth eruption. While this visit is commonly framed around caries prevention, its true power lies in early functional and airway assessment.

At the age one visit, clinicians can assess:
  • Nasal versus oral breathing
  • Feeding efficiency and fatigue
  • Tongue posture and mobility
  • Lip seal and muscle tone
  • Palatal width and shape
  • Parental reports of snoring, reflux, restless sleep, or frequent night waking
Research increasingly links early oral dysfunction—such as untreated oral restrictions or chronic mouth breathing—to altered craniofacial growth and long-term airway compromise. Early identification allows for monitoring, education, and referral during a period when growth is most adaptable.


Dentistry’s expanding role in whole-child health
Dentistry is no longer a siloed profession. We are part of an interdisciplinary ecosystem that includes pediatricians, ENTs, lactation consultants, speech-language pathologists, sleep physicians, and myofunctional therapists. What differentiates dentistry is access and frequency. Infants and young children may see a dentist more often than a medical provider during certain developmental windows—particularly when families establish a dental home early.

This positions dentists as frontline screeners for airway risk.

Recent literature supports the view that early maxillary development and nasal breathing are critical factors in airway health. The shape of the palate directly influences nasal airway volume, while chronic mouth breathing has been associated with altered facial growth patterns, increased risk of malocclusion, and reduced sleep quality.

Dentistry has the tools, training, and vantage point to intervene—but only if we expand our clinical lens.


From awareness to action: What readiness looks like
Being “ready” to lead requires more than awareness. It demands intentional changes in education, systems, and mindset.

First, education. Dental schools and residency programs must continue to integrate airway, sleep, and feeding science into their curricula. Continuing education should move beyond isolated lectures and toward practical, evidence-based protocols that dentists can implement immediately.

Second, screening systems. Simple airway screening questions—about snoring, mouth breathing, sleep quality, and feeding challenges—should be as routine as caries risk assessments. Documentation matters, not only for continuity of care but for reinforcing dentistry’s role in preventive health.

Third, collaboration. No dentist treats airway issues alone. Building trusted referral networks and shared care models is essential. When families experience coordinated, cohesive care, outcomes improve—and dentistry earns its seat at the health care table.

Finally, confidence. Dentists must feel empowered to initiate these conversations. Parents are often relieved when a clinician connects the dots between oral findings and their child’s sleep, behavior, or feeding struggles. This is a scope evolution for us as colleagues.


A vision for the future
Imagine a generation of children whose airway health is supported from infancy—who breathe through their noses, sleep soundly, eat efficiently, and grow with balanced facial development. Imagine fewer children requiring extensive orthodontic or surgical interventions later in life because risk factors were addressed early.

That future is possible—but only if dentistry steps fully into its role.

As a board-certified pediatric dentist and practice owner who cares for infants from birth, I have seen firsthand how early identification and intervention can change a child’s trajectory. The age one visit is not merely a milestone; it is a moment of opportunity.

So, is dentistry ready to lead the way toward better breathers, sleepers, eaters, and toward better overall health? The evidence says yes. The access says yes. The need says yes.

Now, the responsibility is ours.
Author Bio
Dr. Jonelle Anamelechi Jonelle Anamelechi DDS, MSPH, FACD, is a board-certified pediatric dentist, multi-practice owner, and airway-focused clinician who helps children feed better, speak more clearly, breathe more freely, and smile brighter from birth. She advocates for early dental intervention and interdisciplinary care as a foundation for healthier breathing, sleep, and development.
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