Signs to detect early maxilla, airway problems in a child.

Below is a simple list of signs a parent (or anyone) can look for at home to detect early maxilla and airway, and breathing problems in a child. The earlier they are detected and addressed the better.

Facial Signs (seen just by looking at the child’s face)

A. Mouth posture

• The child often keeps their mouth slightly open
• Lips rarely stay closed at rest
• Lower lip looks voluminous, loose or hangs down

B. Under-eye area

• Dark circles
• Puffy or swollen under the eyes
• Tired look even when not tired

C. Midface development

• Flat midface (cheeks not well supported)
• Longer, more narrow face
• Nose appears small or turned up
• Eyes look more “tired” or droopy

D. Dental clues

• Crowded baby teeth (baby teeth should not be crowded)
• Narrow smile (you see fewer teeth when they smile)
• Cross-bites (bites sideways)
• Gummy smile (maxilla tipped downward)

2. Tongue & Mouth

A. Tongue posture

Normal: tongue rests fully on the roof of the mouth
Possible problem: tongue sits low or between the teeth

B. Chewing & swallowing

• Swallows with movement of lips or cheeks, even tension around the eyes
• Doesn’t use the tongue correctly
• Struggles with harder foods

C. Speech issues

• Lisping
• Nasal voice
• Difficulty pronouncing certain sounds

(speech problems often come from poor tongue posture or a high, narrow palate).

3. Sleep Signs (extremely important)

These are some of the strongest indicators:

A. Snoring

Children should never snore. Even slight snoring indicates airway difficulty.

B. Restless sleep

• Tossing and turning
• Sleeping in strange positions
• Sweating at night
• Bedwetting (common in sleep-disordered breathing)

C. Open-mouth sleeping

If you check on them at night and see their mouth open, that’s a red flag.

D. Tired during the day

Even with a full night’s sleep.

4. Behaviour and Emotional Signs

Airway issues affect oxygen, and sleep, which affects behaviour.

Common signs:

• Hyperactivity
• Trouble focusing
• Irritability
• Difficulty waking up
• ADHD-like symptoms (often misdiagnosed as actual ADHD)
• Learning difficulties

5. The Step-by-Step Pathway (what a parent should do)

Step 1 Observe at home

Use the signs above to check for:

• mouth breathing
• narrow palate
• poor sleep
• low tongue posture

Step 2  ENT evaluation. Clear airway first.

Check for:

• enlarged tonsils/adenoids
• nasal blockage
• chronic allergies
• structural nasal issues

Step 3 Sleep lab evaluation

Step 4 Orthodontic or airway-focused orthodontic evaluation

Look for:

• narrow palate
• crossbites
• maxilla width
• space for tongue

They may recommend:

• palatal expansion
• early functional appliances
• habits correction (myofunctional therapy)

Step 5 Myofunctional therapy

This includes:

• nasal breathing
• tongue resting posture
• swallowing
• lip seal

This step is crucial for lasting results.

Step 6 Home habits

Improve:

• chewing strength (firmer foods) and chewing length (take time to chew food thoroughly)
• nasal breathing day & night
• posture (especially screen posture)
• sleep quality