When most people think about what happens at a dental visit, they picture x-rays, a cleaning, and a check for cavities. Airway screening is rarely part of that picture. But the mouth, jaw, and throat are the gatekeepers of your breathing, and a trained eye looking at those structures during a routine dental exam can identify signs of airway compromise that would otherwise go undetected for years.
At Santa Teresa Smiles, Dr. Noha Oushy incorporates airway screening as a standard part of patient care. As a Breathe Institute affiliate, this practice follows the research and clinical frameworks developed by one of the leading airway-focused institutions in the country. The goal is simple: catch the signs early, before breathing dysfunction has time to affect sleep, development, cardiovascular health, and quality of life.
The Dental Office Is Uniquely Positioned to Screen for Airway Problems
Physicians are often the first providers people think of when it comes to breathing and sleep concerns. But dentists have something that most physicians do not: regular, close-up access to the structures most relevant to airway health. The tongue, the palate, the tonsils, the jaw, the bite, and the nasal passage openings are all visible or assessable during a standard dental exam.
This makes the dental visit one of the most practical and scalable settings for identifying patients who may be at risk for sleep-disordered breathing, mouth breathing, or upper airway resistance. Dental professionals are increasingly recognized as playing a key role in screening for sleep-disordered breathing in both children and adults, with the potential to identify at-risk patients and guide referrals before significant health consequences develop.
The question is not whether dentists should screen for airway issues. The question is whether they have the training and the framework to do it well.
What the Breathe Institute Brings to Airway Care
The Breathe Institute is a global network of airway-centered healthcare professionals, including dentists, ENTs, speech-language pathologists, and myofunctional therapists, united by a commitment to research-driven airway health. Since 2016, it has grown to include over 3,000 practitioners across disciplines who use validated tools and interdisciplinary collaboration to identify and address airway dysfunction.
One of the Breathe Institute’s most significant contributions to clinical practice is the development of the FAirEST screening tool. The Functional Airway Evaluation Screening Tool was developed through research at UCLA and identifies six clinical red flags that can be assessed during a routine dental examination: mouth breathing, mentalis strain, dental wear, tonsillar hypertrophy, ankyloglossia, and narrow palate. The FAirEST-6 is a concise and validated clinical assessment tool that aids in early identification of sleep-disordered breathing, giving dental providers a structured and evidence-based way to flag patients who need further evaluation.
At Santa Teresa Smiles, Dr. Noha Oushy uses this framework as part of a broader integrative evaluation that considers how breathing affects the entire body, not just the teeth.
What Airway Screening Actually Involves
Airway screening at Santa Teresa Smiles goes well beyond what most people associate with airway evaluation. It is not limited to a single test or referral to a sleep clinic. Our approach combines clinical observation of the structures inside and around your mouth with a home sleep study that captures how your airway is actually functioning while you sleep. These two pieces of information together give Dr. Noha Oushy a far more complete picture than either one alone.
The clinical screening portion looks for structural and functional signs that breathing may be compromised. It takes place alongside the rest of the dental examination and does not require additional appointments or equipment in most cases. The sleep study component allows us to evaluate oxygen levels, breathing patterns, and sleep quality in your own environment, which is where airway dysfunction most often reveals itself.
Tongue Position and Mobility
The resting position of the tongue and its range of motion reveal a great deal about how a patient breathes. A tongue that sits low in the mouth rather than resting against the palate is a common sign of mouth breathing. Restricted tongue mobility, often caused by a tongue tie, can limit nasal breathing and affect jaw development over time.
Palate Shape and Width
A high, narrow palate is one of the most visible structural signs of long-term mouth breathing. When nasal breathing is compromised, the tongue does not press against the palate as it should, and the palate narrows rather than widening with growth. This in turn can reduce the space available for nasal airflow, creating a self-reinforcing cycle.
Tonsil Size
Enlarged tonsils reduce the space available in the upper airway, particularly during sleep when muscle tone decreases. Tonsillar hypertrophy is one of the six FAirEST red flags and one of the most commonly identified findings in patients with sleep-disordered breathing.
Signs of Dental Wear and Jaw Function
Teeth grinding and clenching are often the body’s response to airway compromise during sleep. When the airway narrows, the jaw may move forward to reopen it, producing the grinding motion that shows up as wear on the teeth. Patients who present with significant unexplained wear are often worth screening for airway issues.
Mentalis Strain
When the lips cannot close comfortably at rest, the chin muscle, called the mentalis, visibly strains to bring them together. This is a functional sign that the patient is a habitual mouth breather and that nasal airflow may be insufficient for comfortable resting breathing.
Nasal Breathing Assessment
Simply observing whether a patient breathes through their nose or mouth at rest provides meaningful clinical information. A patient who consistently breathes through their mouth during a dental exam is showing a pattern worth noting and exploring further.
Home Sleep Study
When clinical findings suggest airway compromise, or when a patient reports symptoms such as snoring, waking unrefreshed, or daytime fatigue, Dr. Noha Oushy may recommend a home sleep study as the next step. This allows us to evaluate how the airway is functioning during actual sleep, measure oxygen saturation, and identify patterns of disrupted breathing that would not be visible during a daytime exam. The sleep study and the clinical screening inform each other, and together they guide a treatment approach that is grounded in a full picture of what is actually happening.
Why Mouth Breathing Matters More Than Most People Realize
Mouth breathing is often dismissed as a minor habit or a temporary response to congestion. From an integrative and biological dentistry standpoint, chronic mouth breathing is a significant health concern with downstream effects throughout the body.
Nasal breathing filters, humidifies, and warms air before it reaches the lungs. It also drives the production of nitric oxide, a compound that supports cardiovascular function, immune response, and oxygen delivery to tissues. When breathing shifts to the mouth, these functions are bypassed.
In children, chronic mouth breathing affects facial and jaw development, palate width, bite alignment, and behavior. In adults, it is associated with poor sleep quality, daytime fatigue, increased cardiovascular risk, and reduced athletic performance. Identifying and addressing mouth breathing early, before structural changes have fully set in, is one of the most meaningful interventions a dental provider can make.
Who Should Be Screened
Airway screening is appropriate for patients of all ages. The signs look different across age groups, but the underlying concern is the same: is this patient breathing in a way that supports their health?
In children, signs to watch for include open-mouth posture, dark circles under the eyes, behavioral issues, difficulty concentrating, bedwetting, and slow or unusual facial growth. Many of these are attributed to other causes for years before anyone thinks to evaluate the airway.
In adults, the presentation often includes snoring, morning headaches, dry mouth upon waking, unexplained daytime fatigue, acid reflux, and teeth grinding. These are common complaints that patients frequently mention to physicians or simply accept as part of their daily experience.
At Santa Teresa Smiles, Dr. Noha Oushy screens all patients as part of a comprehensive evaluation and follows up on findings with personalized guidance and referrals when appropriate.
What Happens After Screening
A positive screening finding is not a diagnosis. It is a signal that warrants further evaluation, and that evaluation is most effective when it involves the right team of providers.
Depending on what the screening reveals, Dr. Noha Oushy may coordinate care with ENTs, sleep medicine physicians, myofunctional therapists, or other specialists who can address the airway from their area of expertise. This interdisciplinary approach reflects the Breathe Institute model, which recognizes that airway health is not a problem any single provider can fully address alone.
In some cases, dental intervention plays a direct role in treatment. Oral appliances can support jaw position and airway patency during sleep. Palatal expansion can widen the nasal airway structurally. Tongue tie release, when indicated, can restore tongue function and nasal breathing patterns. These are not standalone solutions, but they can be meaningful pieces of a coordinated care plan.
Airway Health Is Whole-Body Health
Integrative and biological dentistry starts from the premise that the mouth is connected to everything. How you breathe affects how you sleep, how your heart functions, how your immune system performs, and how your body manages stress and inflammation. An airway problem is not just a nighttime inconvenience. It is a physiological burden that the body carries constantly.
At Santa Teresa Smiles, Dr. Noha Oushy brings the Breathe Institute framework into every comprehensive exam because identifying airway dysfunction early is one of the highest-value things a dental provider can do for a patient’s long-term health. It costs very little to look. And what it finds can change the direction of a patient’s care in ways that extend far beyond the dental chair.
If you have questions about airway screening or want to understand what an integrative dental evaluation looks like at Santa Teresa Smiles, we are here to help.
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