The Experience Miracles Podcast

Mouth Breathing Matters: The Impact of Airway Health on Your Child’s Development

Jan 21, 2025

Pediatric Airway Dysfunction: How Breathing Problems Drive ADHD, Sleep Issues, and Nervous System Dysregulation

Episode 71 — Experience Miracles Podcast | Host: Dr. Tony Ebel, DC, CACCP — Pediatric Chiropractor & Founder of PX Docs | Published: January 21, 2024 | Duration: ~75 min Guest: Dr. Bahar Esmaili — Pediatric Airway Dentist & Vivos-Certified Practitioner

Key Takeaways

  • Breathing dysfunction and nervous system dysregulation are the same problem. Every one of Dr. Tony Ebel’s Perfect Storm patients breathes from their neck rather than their diaphragm — keeping the nervous system locked in chronic Sympathetic Dominance regardless of age, from infants to teenagers to adults.
  • The Apnea Hypopnea Index considers just one respiratory event per hour devastating for anyone under 18. By age six, Dr. Bahar Esmaili’s daughter Melody was averaging 10 events per hour — yet five board-certified specialists across seven years never once asked: “How does she breathe?”
  • Nasal breathing is non-negotiable for parasympathetic function. No diet, no supplements, and no amount of chiropractic care can move a child’s nervous system into vagal tone if they are not breathing properly through the nose. That is not negotiable.
  • Crooked teeth are not a dental problem. They are the visible end result of nervous system dysfunction and cranial distortion that began before the child’s first tooth ever erupted.
  • The correct treatment hierarchy matters: Neurologically-Focused Chiropractic Care — especially upper cervical and transition zone correction — must come first. Without that foundation, airway and dental work creates change that won’t stick.

Why Do So Many Children Have Breathing Dysfunction?

Breathing dysfunction in children is not a dental problem, a sleep problem, or an ENT problem. It is a nervous system problem that shows up in the mouth, the airway, the jaw, the posture, and ultimately the behavior of the child. Dr. Bahar Esmaili, a pediatric airway dentist trained and certified through the Vivos system, spent years navigating conventional medicine with her daughter Melody before uncovering this connection. Five board-certified specialists, two ENTs, two orthodontists, and a double board-certified pulmonologist all treated Melody’s symptoms. Not one asked the question that would have changed everything: how does she breathe?

The root of pediatric breathing dysfunction begins before birth. A hostile womb environment — maternal stress, sleep apnea during pregnancy, toxin exposure, or distortions in the mother’s spine and pelvis — can interfere with the epigenetic signals that guide proper cranial-facial development in the fetus. After birth, the Birth Trauma of forceps, vacuum extraction, or C-section further distorts the cranium and Upper Cervical Spine, compressing the brainstem and disrupting the neurological signals that govern airway muscle tone. The result is a child who cannot breathe properly through the nose, whose tongue cannot rest at the roof of the mouth, and whose nervous system is locked into chronic Sympathetic Dominance.

What parents see on the surface — snoring, mouth breathing, grinding teeth, ADHD-like behavior, poor sleep, and crooked teeth — are symptoms of a deeper pattern. The underlying problem is a neurologically disorganized airway that has been compensating since before the child drew their first breath.

Dr. Bahar’s Story: From Mainstream Dentist to Airway Pioneer [00:00 – 12:00]

Dr. Bahar Esmaili: There’s nothing funny or cute about a child that snores. Nothing. If a child has noisy breathing, if you can hear them breathe, if you can see them swallow and hear them breathe, those are subtle signs that this child’s body is dysfunctional — neurologically, structurally — and they cannot function.

I graduated from dental school in 2009, eager to help people. But the first question I asked was one nobody taught me to answer: how do we prevent these problems from happening in the first place? With student loan debt on my shoulders, I had to do what I was paid to do — fix one tooth at a time.

My daughter Melody was born in 2013. She never slept well. She was constantly sick. She snored. By age five, she’d ground her teeth down to almost nothing. Preschool was calling every day saying she had ADHD and needed medication.

Dr. Tony Ebel: That road was only going one direction, and it wasn’t the direction you wanted.

Dr. Bahar: At age three I went to an ENT and asked for a sleep test. They told me to put Flonase in her nose and come back when she’s eight. By five, the school was pushing medication. I saw an orthodontist — come back when she’s eight. At six, I demanded a home sleep test.

The Apnea Hypopnea Index measures the average number of times per hour your breathing stops or becomes restricted for at least 10 seconds. For anyone under 18, one event per hour is considered devastating. Melody’s average was 10 events per hour. The pulmonologist agreed she was severe. The recommendation: remove her tonsils and adenoids.

“There’s no other way to really say it other than amputation — we amputated body organs that were doing their job.”

The New England Journal of Medicine published a retrospective study showing that for hundreds of years, removing adenoids and tonsils produced the same outcomes as watchful waiting. Nobody followed it. We took them out. Her snoring somewhat improved. But she still didn’t sleep. She still wasn’t waking rested. She still had ADHD.

I had followed every prescription the standard of care offered. For another child, maybe it would have helped. For mine, it was a 100% failure.

Dr. Tony Ebel: Mainstream medicine only gives a certain number of answers because the diagnostics are so isolated. The treatment should be specialized — but diagnostics must be global, because the body doesn’t work in compartments. Why are we diagnosing it in compartments?

The Question Nobody Asked: “How Does Your Child Breathe?” [12:00 – 22:00]

Dr. Bahar: Here is what I want everyone to understand right out of the gate. Every year I took Melody to a pediatrician — I’m a doctor trained by the system myself. Five board-certified specialists. Two orthodontists. Two ENTs. A double board-certified pulmonologist and pediatric sleep specialist.

Not one asked the one important question about this child. You know what that is? How does she breathe?

Nobody was interested in whether she was breathing properly or why she wasn’t. If that question had been answered, I would not have lost the first seven years of her life — the most important years for brain development, facial development, and left-right brain integration.

“The problem is hidden in plain sight.”

In 2017, I started taking courses on sleep and airway. A speaker showed a picture of a child with ground-down teeth and enlarged tonsils and said: this is apnea. I’m sitting there thinking — that’s my child.

I found a book called Close Your Mouth by Patrick McKeown, trained in the Buteyko method. Dr. Buteyko proved nearly a century ago in the Soviet Union that asthma can be treated — even resolved — by restoring proper breathing. The information wasn’t new. I had just never been taught it.

Dr. Tony Ebel: This is the same path parents walk when they’re stuck with a provider who can’t think outside the system. The training, the debt, the threat of liability — it builds a current that pulls everyone toward the same downstream answers. The middle place in that journey — knowing what’s wrong but not knowing how to fix it — is where a lot of parents are right now. The whole purpose of this podcast is to get you to step three: knowing the root cause and knowing what to do about it.

The Root Connection Between Breathing, the Nervous System, and Childhood Health [22:00 – 38:00]

Dr. Tony Ebel: The teenagers in Boulder I treated had straight teeth, no cavities — and they were full of jaw tension, neck tension, headaches, anxiety, and ADHD. They couldn’t sleep. They couldn’t regulate their emotions. It’s all the same neuro-biomechanics. A colicky baby, a five-year-old with ADHD, a teenager with anxiety — the underlying pattern is identical.

Dr. Bahar: Kids never grow out of it. They always grow into something else.

This is what I want dentists to understand: we have 32 teeth in the mouth and 33 vertebrae in the spine. They are equivalent structures. Think of the upper and lower jaw as mom and dad, and the teeth as their children. The teeth do not decide where they come in — the body predetermined their position before the first tooth ever erupted.

If the cranium is distorted, if the temporal bones are off, if the occiput is sitting heavily on the atlas — then the jaws are off by different zip codes before any teeth arrive. Class 2 malocclusion, the most common reason parents seek orthodontics, is a jaw that is structurally backward. That is not a tooth problem. That is a nervous system problem.

“By creating an illusion of straight teeth, we’re basically taking away from the fact that the nervous system responsible for the crooked, malaligned tooth is still malaligned.”

Dr. Tony Ebel: When we study embryology, we know the first structure that develops is the notochord in the neural tube. Neurological tissue forms first. The skull and spine develop around it. The nervous system is boss — then the structure, then the teeth. Everything downstream reflects the health of what came upstream.

Dr. Bahar: The body’s airway is a hollow space confined within the mouth, neck, cranium, and pelvis. It must maintain patency — stay open — in every position, all day, while standing upright. That requires enormous neurological organization. When that organization breaks down, the whole cascade follows: Subluxation, Sympathetic Dominance, dysfunctional breathing, gut dysfunction, immune dysfunction, constipation, poor sleep, and behavioral challenges.

Dr. Tony Ebel: And here’s what’s critical to understand about what the brain actually needs most. Gut function is third. Breathing and proprioception — gravity, movement, spatial orientation — are first and second. The brain is more dependent on those two than on nutrition. Which is why if you’ve tried everything for your child’s gut, their immune system, their sensory challenges — and you’ve gotten some gains but hit a ceiling — you need to go to the brainstem, the mouth, and the airway. That’s where the problem started. Everything else is downstream compensation.

How Prenatal Environment and Birth Trauma Shape the Airway [38:00 – 43:00]

Dr. Bahar: The womb is where the problem begins — not birth onwards. During early fetal development, there is a gene called SHH that must activate for proper cranial-facial formation. For it to turn on, the fetal environment must be optimal. If mom has sleep apnea, preeclampsia, diabetes, or oxidative stress — if her nervous system is locked in fight-or-flight — that gene may not activate.

Dr. Tony Ebel: Mom’s nervous system is designed by God to shift into growth mode during pregnancy. A parasympathetic, nourishing state. But we’re stressing mothers out, scaring them, leaving them locked in sympathetic dominance. And that becomes the neurological environment in which the baby is developing. That’s epigenetics — genes don’t turn on and off on a predetermined schedule. The environment dictates it.

My undergraduate degree was in molecular biology and genetics. I know this study. So when we say we can prevent so much of the storm by taking care of mothers — I would go all the way back to preconception — that’s not a theory. That’s biology.

Dr. Bahar: Distortions in mom’s spine and pelvis will literally mold the child’s skull during development. Then comes the birth canal — or the surgical alternative. Then tongue ties, bottle feeding, primitive reflexes that never integrate. Imagine a piece of paper — one human cell — that environmental forces were supposed to fold into perfect origami. But those forces were wrong. Instead of origami, you get a crumpled punch.

That’s what Dr. Tony sees at six years old: grinding teeth, cross-bite, crowded jaw, and a child who can’t sleep.

“The body literally becomes mangled into this subluxated, dysautonomic state. And it shows up physically, digestively, immunologically, in the mouth, in their emotions, in their sleep.”

Constipation? Ninety percent of it is neurogenic, not nutritional. Immune dysregulation, ear infections, nasal congestion — all downstream from a nervous system that was never properly organized from the start.

Warning Signs Every Parent Should Know [43:00 – 53:00]

Dr. Bahar: Signs in the mouth are the tip of the iceberg. Everything Dr. Tony talks about with nervous system dysfunction — that’s what’s under the water. When the body falls apart, the mouth is often where you first see it.

Here is what parents should look for:

Audible breathing. If you can hear your child breathe at rest, that’s abnormal. If you can see them swallow and hear them breathe, that child’s body is dysfunctionally organized — neurologically and structurally.

Mouth always open. A child whose mouth is never closed is not breathing properly through the nose. Nasal breathing is not optional. If your child is not nose-breathing, the body cannot achieve vagal tone. Regardless of diet, supplements, or how many adjustments they’re getting. That is not negotiable.

Primitive swallowing. When a child swallows by using their facial muscles rather than their tongue, that is an infantile swallow pattern that should have resolved. Tongue tie is often a downstream symptom of this pattern, not the root cause.

Speech delays. When children cannot organize their tongue and jaw properly, speech development suffers. This connects directly to ADHD and autism-spectrum developmental challenges.

Snoring. There is nothing funny or cute about a child who snores. Nothing.

Structural signs. Flat feet, rounded shoulders, forward head posture, a face growing long and narrow, ears that flare outward — these are not subtle signs. They are as obvious as a nail in the forehead. That child is dysfunctionally breathing.

“I find myself writing all the time that the problem is hidden in plain sight.”

Dr. Tony Ebel: One hundred percent of my Perfect Storm patients breathe from their neck. Once you see it, you can’t unsee it. It doesn’t matter if the child is two or sixteen. The head is half a foot in front of the spine. The neck muscles are straining to move the ribcage. The diaphragm has effectively been sidelined.

A neck breather is a sympathetic breather. That pattern reduces vagal tone — both structurally and physiologically — and the gut, the HPA axis, the immune system, all become secondary sources of dysfunction as a result.

Here is a simple test from Dr. Bahar: roll your shoulders back, put your head over your spine where it belongs, and press your tongue completely to the roof of your mouth. Now try to breathe through your nose. If you can’t seal the tongue there, you are almost certainly not a true nose-breather. And if you hold your breath and cannot last 40 seconds before the urge to inhale — your body is not sensitive enough to CO2, which means you’ve adapted to chronic mouth-breathing.

The Treatment Hierarchy: Right Order, Right Results [53:00 – 1:05:00]

Dr. Bahar: If your child resonates with everything we’ve discussed — the snoring, the sleep, the ADHD, the crowded teeth, the history of birth intervention — here is the order.

Step one: get the child breathing properly. Breathing is a function of a hollow space in the body that must stay open. The muscles that keep that airway open are the cervical muscles — the most movable part of the spine. The position of the cervical spine directly affects airway muscle tone. The most critical junction in the entire body is where the skull meets the spine: the atlanto-occipital joint. Half of that structure is controlled by the mouth. The other half by the atlas and axis.

Before any airway appliance or tongue training, get that child evaluated by a chiropractor trained in SOT technique (Sacro-Occipital Technique). Without proper spinal and pelvic orientation, you cannot organize the 22 bones of the cranium and allow the tongue to function as it should.

Dr. Tony Ebel: This matters more than most people realize. Our Perfect Storm kiddos would make great progress in the first 60 to 90 days — sleeping better, breathing better, digesting better. Then they’d plateau. And I was told: must be nutritional. Go chase it with supplements. What it actually was: subluxation patterns stuck in the thoracic transition zones.

We were correctly focused on the upper cervical and the sacrum — the parasympathetic hotbeds. But the middle was a mess. The cervico-thoracic junction, the thoracolumbar junction, the lumbopelvic junction — when subluxations are stuck in those regions, respiration cannot travel through the spine in the sequential, symmetrical pattern it needs. Breath and oxygenation get locked in the middle, even when the upper cervical work is perfect.

Dr. Bahar: And the same is true in reverse. Cranial and myofunctional therapists who work on the palate and parietals without chiropractic can create change — because those structures are pliable, especially in younger children. But the change won’t stick. The mandible position will keep re-subluxating the spine. The two modalities absolutely must work together.

“Breath is the currency of nervous system and posture is how the body manifested.”

Dr. Bahar: Before age seven, far more structural change is possible. Before age two, the most. But regardless of a child’s age, start with the nervous system. Start with the spine.

Vivos: Non-Surgical, Non-Pharmaceutical Airway Restoration [1:05:00 – 1:13:00]

Dr. Bahar: Vivos is the only company that has patented and received FDA clearance for treating all breathing disorders — including obstructive sleep apnea from mild to severe — for both adults and children. The treatment uses removable appliances. No surgery. No pharmaceuticals. No permanent hardware.

Treatment runs approximately 12 months. Appliances are available from age two to age 85. Vivos is not palate expansion — it is airway development through tongue training and functional guided growth, in collaboration with chiropractic, physical therapy, and airway-trained dental care.

Diagnosis has also changed completely. Where Melody’s sleep evaluation required a $5,000 lab visit and still produced a traumatic experience, families can now test at home over multiple nights using nothing more than a ring on the finger and an app on their phone. The data captures HRV, respiratory events, and full sleep quality metrics in the child’s actual sleeping environment. Multi-night testing in the home gives a complete, real-world picture.

Dr. Tony Ebel: In-lab sleep studies tell you almost nothing useful because the child isn’t in their environment. Home testing is how you actually see what’s happening.

Dr. Bahar: Within three months of proper treatment — training her tongue, restoring nasal breathing, calming her nervous system — I had a brand new child. Melody went from 10 respiratory events per hour, years of grinding, constant illness, and an ADHD label to a completely different child. The answer was not complicated. It just required someone to ask the right question.

Breath Is the Currency of the Nervous System [1:10:00 – End]

Dr. Tony Ebel: Let me say this one more time with clarity. The number one place we need to go to get our kids better is the nervous system. And one of the surest signs of nervous system dysfunction is breathing dysfunction. They are literally tethered together.

When we have a chiropractic patient making great progress but unable to cross into the final phase of healing — what we call stability — it is almost always the mouth. Always the airway. Not the gut. Everyone thinks it’s the gut. It isn’t. It’s respiration. Get the right airway team involved, and everything else follows.

Dr. Bahar: The treatment philosophy is: fix it, leave it, let the body sustain itself. No CPAP machines for the rest of your life. No surgery. God didn’t design us to need machines to breathe. The body’s healing capacity, when the airway is properly restored and the nervous system is organized, is extraordinary.

“There are Melodys being born right as we are recording this. We want to get to them. We want a better world where everyone has a chance to breathe.”

Frequently Asked Questions

Is snoring in children a sign of a serious problem?

Yes. There is nothing funny or cute about a child who snores — it is an audible sign of airway obstruction and nervous system dysregulation. A snoring child cannot maintain a patent airway during sleep, which means the body is not getting adequate rest or parasympathetic recovery. Any child who snores regularly should be evaluated for breathing dysfunction and its neurological root causes, not reassured that they’ll grow out of it.

Can breathing problems cause ADHD and sleep issues in children?

Yes. Breathing dysfunction and nervous system dysregulation share the same root: a disorganized brainstem and upper cervical spine. When a child chronically mouth-breathes or breathes from the neck instead of the diaphragm, the nervous system stays stuck in Sympathetic Dominance. This produces the same cluster parents recognize as ADHD, poor sleep, anxiety, and emotional dysregulation. Dr. Bahar’s daughter Melody was labeled ADHD and treated by five specialists — all before anyone identified she simply wasn’t breathing properly.

Why do children develop crooked teeth?

Crooked teeth are a downstream symptom of structural and neurological dysfunction, not a genetic inevitability. When a child’s cranium, upper cervical spine, and jaw are distorted — from birth trauma, tongue tie, mouth breathing, or underdeveloped arches — the teeth come in wherever the disorganized environment places them. Straightening them with braces while leaving the underlying nervous system dysfunction intact creates the appearance of health without the function.

What is the correct treatment order for a child with airway dysfunction?

Dr. Bahar Esmaili’s recommended hierarchy: (1) Neurologically-Focused Chiropractic Care first — especially SOT technique for upper cervical and pelvic correction; (2) tongue training and myofunctional therapy; (3) airway appliance therapy such as Vivos. Without correcting spinal and cranial subluxations first, airway and dental work can create temporary change, but the mandible position will keep re-subluxating the spine and the gains will not hold.

What is the Vivos system and is it safe for children?

Vivos is the only company with FDA clearance for treating all breathing disorders, including mild to severe obstructive sleep apnea, in both children and adults. Treatment uses removable appliances worn for approximately 12 months — no surgery, no pharmaceuticals, no permanent hardware. Available from age two to age 85, the system trains the tongue and airway muscles while guiding natural jaw development. Hundreds of patients have successfully resolved sleep apnea through Vivos treatment and come off CPAP entirely.

How do I find a PX Docs chiropractor who understands airway and nervous system care?

The PX Docs Directory lists Neurologically-Focused Chiropractic Care providers trained in Dr. Tony Ebel’s clinical protocols, including full-spine transition zone care. These practitioners understand the connection between subluxation, Sympathetic Dominance, and airway dysfunction — and coordinate with airway dental specialists like Dr. Bahar Esmaili when a child is plateauing.

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