You have the Oura ring, the smart blackout masks, and the mattress that cools to the perfect temperature to facilitate REM. You’ve tried sleepy-time teas, the legs-up-the-wall pose, and impeccable sleep hygiene—but you’re still waking up tired. Here’s the thing: Poor sleep is far more than feeling tired the next day—it disrupts every major system in the body. “It throws off hormone balance, raises inflammation, and stresses the heart. For women, it can worsen anxiety, affect fertility, and even accelerate signs of aging,” says Radhika Kapoor, a board-certified pediatric dentist. Studies show that chronic sleep deprivation increases the risk of cardiovascular disease, diabetes, and depression, with women often experiencing more severe consequences due to hormonal fluctuations and caregiving stress, she adds. For some patients, however, hope has been found in an unlikely place: the dentist’s office.
Airway dentistry is a rapidly growing field that bridges the gap between sleep medicine and dentistry. It focuses on minimizing the disordered breathing that happens while we sleep, instead helping proper airway development to prioritize nasal breathing. The result can be improved sleep, better mood, and enhanced overall health.
“Sleep-disordered breathing is an umbrella term that includes conditions where airflow is restricted at night—ranging from loud snoring to complete pauses in breathing, or apnea,” says Kapoor, whose New Jersey practice is airway focused. The American Thoracic Society defines it as difficulty moving air through the upper airway during sleep, leading to oxygen drops and sleep fragmentation.
In adults, this can show up as mouth breathing, snoring, teeth grinding, restless sleep, waking up unrefreshed, daytime fatigue, brain fog, memory issues, and mood swings. “Many people chalk these symptoms up to stress or aging, when the real issue is the airway not functioning properly,” says Kapoor.
A matter of life and death
Some patients who have undergone therapy report life-changing results. Cristal Gehrke, a 43-year-old mom from League City, Texas, had been suffering from tachycardic episodes, migraine-like headaches, and fatigue for over a decade. She had never suspected or been diagnosed with sleep-disordered breathing because she didn’t fit the parameters for patients who typically have that issue. “It just seemed like I was a tired mom trying to do my best out there in the world,” she says.
While filling in a questionnaire at her dentist’s office, Gehrke’s responses indicated she might be a candidate for an at-home sleep test, and she reluctantly agreed to one. The results terrified her: Her heart rate was going up to 185 beats per minute, with such tachycardic episodes occurring several times through the night. She was essentially running a marathon when she should have been at rest.
Gehrke couldn’t commit to a CPAP machine because of sensory issues, so her dentist suggested a mandibular repositioning nighttime appliance (MRNA). She started wearing the custom-fitted oral appliance, a bulky, retainer-like device, over her upper teeth at bedtime. A lower one was introduced a few weeks later. Within six months, she was sleeping through the night and wasn’t as tired during the day. Her headaches had resolved, and she had just one tachycardic incident in all that time. “I was used to having a daytime tachycardiac episode once a week and going through a bottle of Advil every six to eight weeks for my headaches,” she says. A follow-up sleep study showed no sleep apnea incidents at all. She thinks her dentist could have saved her from having a heart attack down the line.
Dentists are stepping up
It’s no coincidence that Gehrke’s dentist, Kalli Hale, caught this issue before it became life-threatening. Hale, an airway dentist in Texas, started out in general dentistry before discovering that evidence for a lot of the medical symptoms her patients were dealing with could be found in their teeth. Certain symptoms set off her medical spidey sense. When she referred those patients for sleep studies, she was repeatedly shocked by their results. She saw patients on high blood pressure medication who had heart attacks and developed atrial fibrillation, but their medical practitioners had never recommended a sleep study. “That’s critical oxygen deprivation at night, which is completely changing the way that person is going to age and what their longevity looks like overall,” she says. Hale, a general dentist, was connecting the dots that primary care physicians should have. She dove into learning about dental sleep medicine and trained in obstructive sleep apnea.
Airway dentistry isn’t a recognized and board-certified specialty yet and is not a standard part of dental school or residency training, so dentists must actively seek out education around the subject themselves. “This usually takes the form of certifications, fellowships, or mini residency programs offered through accredited, evidence-based organizations,” says Kapoor. These programs provide additional education in areas such as sleep-disordered breathing, craniofacial development, oral myofunctional therapy, and integrative management with medical colleagues, representing a focused area of advanced continuing education.
“I quickly realized that traditional approaches often treated symptoms instead of causes,” says Kapoor. That experience—and her own personal health journey as both a patient and mother—pushed her to explore airway dentistry. Hale, too, convinced that airway dentistry could offer her pediatric and adult patients greater benefit, sold off her seven traditional dental offices. She currently runs The Airway Dentist, four airway-focused dental practices in the Houston area, with three more under construction around Texas.
Disordered sleep impacts children and adults
Pediatric patients are often a central focus: Airway dentistry supports healthy development of children’s airways, guides proper growth and tongue posture, and encourages nasal breathing. Mouth breathing has a lot of proven downstream effects in kids, like daytime fatigue, poor concentration, and behavioral problems. Improper facial development even changes children’s physical features, leading to long, narrow faces with recessed chins and narrowed cheekbones.
However, adults can really benefit too. Many of us might already be dealing with these issues as adults without ever being diagnosed with a narrowed airway. The reasons for this narrowing have been traced back to jaws getting smaller over generations, primarily because we’re all chewing less on a softer, Western-style diet. “For example, 100 years ago, we didn’t have foods that melted in your mouth. We breastfed longer. The muscles of the mouth of a baby worked a lot more a century ago than compared to today,” says Hale.
These structural changes have effects on our breathing and sleep that medical science is just recognizing. “There are a lot of medical issues we’re treating right now with medication that are an underlying sleep problem,” says Hale, who stresses the importance of normalizing sleep tests for this reason.
In adults, airway dentists recommend therapies that can expand, support, and stabilize the airway using different approaches that help maintain an open and healthy passage for breathing. “Patients who once thought fatigue or poor sleep was just part of getting older often discover that with the right therapy, their energy and focus improve,” says Kapoor. However, airway dentists who treat adults (not all do) say it’s more challenging—and expensive—than children, as the patients’ airways are not actively growing and developing the way children’s are. “Dentists might have to do some nonsurgical and even surgical procedures to help them get to a better width and growth in their jaws,” says Hale.
How airway dentistry changes lives
Gehrke is just one of the many patients who have benefited dramatically from their experience with an airway dentist. Hale reports statistically significant changes in sleep apnea and hypertension levels in her patients; she’s seen acid reflux and environmental allergies improve, and has been able to wean a lot of patients off their anxiety medications as well. Kapoor reports similar success with patients with sleep apnea and chronic migraines. “We’ve also seen improvements in TMJ pain, focus, and even digestive symptoms when breathing was corrected. These are life-changing shifts,” she says.
There’s even a bonus for those of us primarily propelled by vanity: A patient’s appearance is enhanced. “There are some beautiful improvements we see over time, with dark circles under the eyes getting better, the smile widening, and improvements in double chins,” says Hale.
What to expect from the treatment
Airway dentists start by screening patients with diagnostic tools like Cone Beam CT scans of the head and airway, which provide detailed 3D imaging of both the jaws, sinuses, and nasal passages, and recommend home sleep studies. “Depending on the case, treatment may include oral sleep appliances, collaboration with ENT and sleep physicians, or minimally invasive procedures such as laser treatment of tongue ties or soft palate remodeling,” says Kapoor.
The process is highly customized and multidisciplinary. In Hale’s experience, a majority of adults need expansion of the upper—and often lower—jaw but not everybody can afford it. For adults, while these therapies are categorized under medical insurance, airway dentists are out of network with insurance providers, and their allowable fees typically do not even cover the cost to make the appliances. The financial burden is most often on the patient.
While the FDA recently cleared an oral appliance, Vivos, to treat moderate and severe obstructive sleep apnea in adults, other treatment options currently need to be patient funded. Dentists are open to working with patients to get the best outcome within their budgetary constraints. “If, at the minimum, you’re getting mandibular advancement, you are going to be a healthier adult, and that’s what matters,” Hale says. “One of the greatest gifts that we can give an adult patient is proper sleep quality, and when systemic health issues improve, it’s just mind-boggling.”
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