The diagnosis and treatment of pediatric Airway Disorders like Sleep Apnea and TMD/Facial Pain impacts not only the child, but the family. On the following pages, you will learn the symptoms, diagnostic procedures and treatment available for your child. Dr. Robinson works with your pediatric team to deliver a clear and concise treatment plan for optimal outcome. We appreciate the opportunity to work with your family.



Many significant growth and developmental milestones occur during our first 18 months of life. In fact, 60% of child’s facial development is completed by age 6, and 90% by age 12.

As children grow, proper breathing is essential to their health, development, and educational success. Early detection and correction of airway problems can be integral to optimizing this fundamental and critical physiology. Airway evaluation is an important part of the process.

Using precision diagnostic technologies and methodologies, our physicians are able to detect and correct any growth and development issues that may be present before thy lead to any more serious comorbidities.



  • Functioning of muscles
  • Proper nutrition
  • Ability to breathe normally

Some of the most common facial development abnormalities seen in children are caused by a compromised airway or the inability to breathe properly through the nose. Children who can not breathe well through their nose tend to breathe more through their mouth. This sets up a chain of events which may severely impact not only the health of a child but also the way a child’s facial features develop and ultimately the way a child looks as an adult.

Are you looking for answers to these important questions?

  • Why is my child restless during sleep?
  • Why does my child suffer from bedwetting?
  • Why can’t my child stay asleep all night?
  • Why does my child snore?
  • Why does my child sleep with his or her mouth open?
  • Why does my child hold their head in front of the shoulders?
  • Why does my child get frequent ear infections?
  • Why does my child have asthma?
  • Why does my child have allergies?
  • Why does my child have frequent sore throats?
  • Why does my child have bad breath?
  • Why does my child have cavities so often?
  • Why does my child have crooked teeth?
  • Why does my child grind his or her teeth?


It’s easy to forget how strong the tongue can really be (Can exert from 40-80 kPa). The tongue often positions itself in the lower jaw to allow a child to breathe more readily through the mouth. This pressure changes the growth of the lower jaw so that it grows more vertically, making the child’s face grow longer. Since nasal breathing is severely compromised by this, the upper jaw and midface (nasal bones, cheek bones, and bones supporting the tissue of the face) fail to develop at a normal rate because the natural growth stimulant of air flow through the nose is absent. This results in a deficiency of growth of the upper jaw and midface, which added to the long facial growth from the lower jaw directly impacts the facial balance, beauty and function of a child and later as an adult.

A poorly formed maxilla (upper jaw) also affects the eye sockets that support and shape the eyeball, it supports the nasal airways, leading to deviated septum, asymmetrical noses, snoring and sleep apnea. An underdeveloped jaw can lead to forward head posture, which helps to pen the airways- however, throws off the alignment of the spine and body. This poor posture then leads to headaches, teeth grinding, neck/shoulder tension, fatigue.

Top Ten Signs of a Mouth Breather

  • Snoring
  • Bedwetting
  • Allergies/Sinus Problems
  • Frequent Colds
  • Swollen Tonsils and Adenoids
  • “Allergic Shiners”- dark circles under the eyes
  • Chapped Lips
  • Forward Head Posture
  • Teeth Grinding
  • Lack of Concentration

Why is Nasal Breathing Better?

  • Nasal breathing allows for warm, moist, purified air to the lungs
  • Mouth breathing causes cool, dry, dirty air to the lungs
  • The nose contains Nitric Oxide which kills deadly bacteria
  • Oxygen is absorbed more efficiently when you breathe through your nose
  • Nasal breathing reduces Hypertension and Stress
  • Each nasal breath lowers blood pressure
  • Nasal breathing leads to a better performance during exercise
  • Nasal breathing leads to 10-20 percent more oxygen uptake
  • Mouth breathing causes and exacerbates Asthma, High Blood Pressure, Heart Disease and other medical problems.
  • Mouth breathing will make you more susceptible to common cold and infections
  • Mouth breathing has been linked to ADHD and learning difficulties
  • Mouth breathing causes improper growth of the face
  • Mouth breathing can contribute to dental decay and periodontal disease


Enlarged adenoids and tonsils are by far the most common causes of airway compromise in children. Enlarged adenoids can block a child’s nasal passage completely, they can cause sleep disturbances such as sleep apnea where breathing is stopped altogether. The most current literature indicates that tonsils and adenoids serve to bolster the immune system during the first two years of life. After that, there seems to be no obvious function and a child can live normally without them.


Sleep disorders in children and adolescents are common; even infants may have sleep disorders. Studies have shown that poor sleep quality and/or quantity in children are associated with a host of problems, including academic, behavioral, developmental and social difficulties, weight abnormalities, and other health problems. Not only do pediatric sleep problems affect child health, but they can impact family dynamics and parental or sibling sleep. Children may suffer from problems with falling or staying asleep; from physiological problems such as obstructive sleep apnea, to abnormal or disruptive sleep behaviors such as sleepwalking and other parasomnias such as restless legs syndrome, and even daytime symptoms such as excessive sleepiness, and others. While adults may suffer from the same problems, the etiology, presentation, and associated findings in children may be very different than those seen in adult.


  1. Removes harmful factors influencing growth
  2. Excellent ages for growth guidance and restoring normal growth
  3. Assist in improving the psychological well-being of the child
  4. Saves some patients from future jaw surgery
  5. Can assist in building better bites and smiles – preventing crowded/crooked teeth

Blocked airways and poor tongue posture can trigger excess adrenaline. Many studies have shown compromised airways and improper breathing as a contributing factor to ADHD in children. Many serious sleep issues can be attributed to poorly formed airways

Our team prides ourselves on precision diagnosis and treatment of airway issues. We check for proper development of the jaw and harmony of the face. We also screen for breathing and oral habits which may over time, result in abnormal dentofacial development. By working with the natural growth instead of against it, we can prevent problems from beginning, or becoming worse, and give your child a lifetime of healthy smiles and deep breathing!

If your child is tired all the time as a result of interrupted sleep related to the nasal blockage which typically worsens at night, give us a call to schedule a consultation. It’s never too late to start breathing right.


  • Mouth Breathing- Lips apart
  • Chapped Lips
  • Venous Pooling beneath the eyes- dark circles beneath the eyes
  • Changes in head posture – posturing the head forward and/or tipping the forehead backwards
  • Tongue-tie/lip-tie
  • Tongue-thrusting
  • Deviated septum
  • Tonsil and Adenoid Problems – Chronic sinus problems, throat problems
  • Snoring – Snoring is not a natural thing for children
  • Loud grinding of teeth during sleep
  • Bed wetting
  • Reflux in the Eustachian Tube
  • Frequent ear infections
  • Chronic sinus infections
  • Allergies
  • Clenching/grinding
  • Difficulty swallowing
  • Picky eating

Advanced Lightwire Functional Appliance

A.L.F. Appliance Ability to Resolve the Following Issues

  • Improper positioning of dental arches
  • Improper mandible development or mandible underdevelopment
  • Swallowing Dysfunction
  • Speech Impediments
  • Sleep Apnea and Sleep Disorders
  • Airway constriction and breathing problems
  • Biomodulation of nervous system
  • Improved sensory and nervous system regulation and response
  • Cranial Bone Realignment
  • Suboptimal posture and spinal alignment
  • TMJ Disorders
  • Misalignment of teeth and poor occlusion (aesthetic and functional)

The content found on this page is in part courtesy of Dr Robinson’s mentor Dr Saroush Zaghi.  Find more at his website, The Breathe Institute.


If jaw pain, facial pain, or sleep disorders plague you, let us help! The Pain And Sleep Therapy Center has a treatment that will provide relief. From laser therapy and physical therapy to airway pressure machines and orthotic appliances, we will find a way to help you live your best life.

For more information, please call 302-239-1757


No one tells a better story than our patients. Click below to see the people whose lives have been changed by the Pain and Sleep Therapy Center of Delaware Valley.