Why Airway Orthodontics Is About Health, Not Just Straight Teeth — What Northridge Families Need to Know About a Different Kind of Orthodontist
Most people think orthodontics means one thing: straight teeth.
Ask anyone who has had traditional braces or Invisalign and the goal was clear — move these teeth into this alignment, create this smile, done.
That is one version of orthodontics. And in many cases it produces a beautiful result.
But there is another version — one that is growing in evidence, in clinical practice, and in public awareness — that asks a different question entirely: Why are the teeth crowded in the first place?
The answer to that question changes everything about how treatment should work. And it explains why airway-focused orthodontics is not just a cosmetic service. It is a healthcare service — one that addresses how a person breathes, sleeps, grows, and functions for the rest of their life.
The Real Reason Teeth Crowd
Teeth do not randomly decide to grow crooked. They grow into the space the jaw provides. When that space is adequate, teeth typically come in aligned. When the jaw is too narrow — when the dental arch is compressed — there is not enough room, and teeth crowd, rotate, and shift.
The modern human jaw is measurably narrower than it was even 200 years ago. Oral anthropologist Robert Corruccini documented this extensively, comparing pre-industrial and industrialized populations. Processed food, soft diets during childhood development, reduced breastfeeding, and chronic mouth breathing all interfere with the normal forces that drive jaw development.
Here is what most people don’t know: the upper jaw forms the floor of the nasal cavity. A narrow upper jaw is not just a dental architecture problem. It is a nasal breathing problem. When the palate is high and narrow instead of wide and flat, the nasal passages above it are compressed — reducing nasal airway volume and making mouth breathing more likely.
Mouth breathing, in turn, further disrupts jaw development. Nasal breathing generates the correct intraoral pressures and tongue resting postures that shape the jaw during growth. Chronic mouth breathing removes those forces, and the jaw develops more narrowly as a result. It is a self-reinforcing cycle — narrow jaw → mouth breathing → narrower jaw — that conventional orthodontics addresses at the symptom level (crowded teeth) without touching the cause.
The Extraction Problem
The traditional orthodontic response to a crowded jaw is to make the tooth inventory smaller. Extract two or four premolars. Now there is room for the remaining teeth to align.
This works, cosmetically. But consider what it does structurally. It takes a jaw that was already too narrow for its teeth and removes teeth — leaving the jaw the same width it was, and often producing a slightly narrower profile and a tongue that has even less space at rest.
The connection between extraction-based orthodontics and airway problems has been a subject of serious clinical debate. Stanford sleep researcher Christian Guilleminault, one of the founders of modern sleep medicine, was one of the most outspoken critics of extraction orthodontics on airway grounds. His research documented cases where extraction orthodontics in childhood was followed by adult sleep-disordered breathing.
At Smile By Dr. K, the philosophy is explicitly non-extraction. Not because extractions are never medically indicated — there are cases where they are appropriate. But because expanding toward the jaw’s natural potential is almost always the better first approach, and because a wider jaw means a wider airway.
BioX: Biological Expansion That Works With Growth
The tool Dr. Yoram Kohanzadeh uses for jaw development in children is called BioX — a biological expansion protocol that uses gentle, consistent force to guide the jaw toward its full growth potential.
Unlike rapid palate expanders that force bone separation quickly, BioX works with the body’s natural development timeline. The palate is widened gradually, the nasal floor widens with it, nasal breathing improves, and the tongue has more room to rest in the correct position — which itself promotes better forward jaw development over time.
BioX is appropriate for children as young as age 4–5 when early intervention is indicated. In severe cases, Dr. K begins evaluation at age 3. The treatment window matters enormously: the midpalatal suture fuses during puberty, and the expansion that requires a small appliance and a few months at age 6 requires surgery or a more aggressive procedure at age 25.
The research supports early expansion for airway. A 2016 meta-analysis by Machado-Júnior et al. showed significant reduction in apnea-hypopnea index (AHI) in children with OSA treated with rapid maxillary expansion. Multiple systematic reviews since then have confirmed that widening the palate improves nasal airflow and sleep-disordered breathing metrics in children with maxillary constriction.
For Teenagers and Adults: Invisalign and Braces With an Airway Philosophy
Teenagers and adults seeking straighter teeth still benefit from an airway-focused approach.
Dr. K offers both Invisalign and traditional braces — and the key distinction is that treatment is designed around arch expansion and jaw position first, with alignment achieved through that expansion, not through extraction or compression.
This means:
- Broader, more natural-looking smiles — wider arches produce the broad smile that looks healthy, rather than the slightly narrow smile that can result from extraction-based retraction
- Better tongue space — a wider upper arch allows the tongue to rest correctly on the palate, which is its natural resting position and the posture that maintains proper facial structure long-term
- Improved nasal breathing — palate width and nasal airway volume correlate directly; expansion interventions in adolescents regularly improve nasal breathing metrics
- Orthodontic treatment that does not worsen existing airway problems or create new ones
This is not cosmetic dentistry dressed up as health care. The structural relationship between jaw width, tongue space, nasal airway, and airway collapsibility during sleep is well-documented in the literature. Orthodontic decisions made in childhood and adolescence have lifelong consequences for breathing.
Sleep Apnea and Sleep-Disordered Breathing: Part of Every Evaluation
At Smile By Dr. K, every patient evaluation includes a structured review of sleep and breathing symptoms. Not because every patient needs treatment for sleep apnea — most do not, and OSA is a medical diagnosis made by physicians, not orthodontists — but because understanding breathing symptoms puts the orthodontic picture in context.
A child who snores, mouth breathes, and has crowded teeth is presenting a related constellation of findings, not three separate problems. Treatment should address that constellation — not just the cosmetic subset visible in the photograph.
Dr. K works with referring physicians, ENTs, pediatric sleep specialists, and myofunctional therapists as appropriate. He can refer for sleep studies. He coordinates care. The goal is not to capture all of a patient’s health into a dental practice — it is to make sure the jaw-and-airway piece of the puzzle is properly addressed as part of integrated care.
What Makes Dr. K Different
Dr. Yoram Kohanzadeh is the first and only certified airway orthodontist in Southern California. He has pursued specific post-graduate training in the relationship between craniofacial development, jaw function, nasal breathing, sleep-disordered breathing, and orthodontics.
His practice at Smile By Dr. K serves patients from Northridge, Chatsworth, Newbury Park, Thousand Oaks, and West LA. He sees patients of all ages — from toddlers with early signs of jaw underdevelopment to adults who are finally understanding why decades of chronic fatigue may have a structural cause.
The two locations make access easier for families across the San Fernando Valley and Conejo Valley.
Start With an Airway Evaluation
If you are considering braces or Invisalign — for yourself or your child — add one question to your orthodontist consultation: “Are you evaluating my airway and jaw width, or just my teeth alignment?”
At Smile By Dr. K, that question is always part of the answer.
👉 Take our free 60-second airway screening →
Or call us:
Northridge: (818) 341-5150
Newbury Park: (805) 498-7785
Serving families and adults in Northridge, Chatsworth, Newbury Park, Thousand Oaks, West LA, and the San Fernando Valley.
Dr. Yoram Kohanzadeh is the first and only certified airway orthodontist in Southern California. This post is educational and does not constitute medical advice.