Whole-picture care for jaw, airway and sleep health

Every face carries a record of how it grew, and how it learned to breathe.

We assess the structural and developmental factors that may contribute to TMJ pain, sleep-disordered breathing, bruxism, tongue-tie related dysfunction and crooked teeth.

Sleep-Disordered BreathingMouth breathingCrooked teethBruxismTMJ pain

Book a Consultation The developmental journey →

Anatomical line study of the same head, showing the airway

The face The structure

If your child snores, breathes through their mouth, or sleeps restlessly, you are right to wonder why. These are not things to simply grow out of, and noticing them early matters. We help you understand what is happening, and guide healthy growth while it can still be shaped.

Our approach

Many treatments focus on the symptoms. We also look at the structure and function behind them.

Growth and airway-focused care is an evolving field. Our recommendations are based on current evidence, clinical assessment and multidisciplinary collaboration. Treatment is tailored to the individual, and outcomes vary between patients.

Development over time

The concerns we see rarely begin with the teeth. More often they trace back to how a person breathed, fed and grew. We read that developmental story, from infancy to adulthood, and work with the factors behind it.

Infancy 0–2 years

It begins with breathing and feeding

How an infant breathes, feeds and rests the tongue starts shaping the airway and the growing face, long before a single tooth is in question.

Anatomical line illustration of the same head showing the developing airway — ⇆ Drag to reveal the structure The infant airway and the growing skull that breathing and feeding first begin to shape.

Early childhood 3–11 years

Growth can be guided

The jaws and airway develop fastest now. Mouth breathing, tongue tie and narrow arches set patterns that, caught early, can still be redirected.

Anatomical line illustration of the same head showing the growing jaw and airway — ⇆ Drag to reveal the structure The jaws and airway developing fastest, while growth can still be gently guided.

Adolescence 12–17 years

Patterns become structure

As growth completes, habit and restriction harden into facial structure: crowded teeth, a set jaw position, a narrowed airway.

Anatomical line illustration of the same head showing the set jaw and narrowed airway — ⇆ Drag to reveal the structure The jaw, bite and airway as growth completes and patterns settle into structure.

Adulthood 18+ years

The record, and its resolution

In many adults, TMJ pain, bruxism and disrupted sleep reflect long-standing developmental and functional patterns. We trace them back and work with what we find, at any age.

Anatomical line illustration of the same head showing the jaw, airway and accumulated structure — ⇆ Drag to reveal the structure The long-standing patterns held in the adult jaw, airway and bite, which we trace back and work with.

What we do differently

DevelopmentalStructuralAirway-CentredWhole-Picture

Guiding healthy growth, breathing and sleep, at any age.

At Growth and Airway, we take a fundamentally different view of dental and craniofacial health. Conventional care tends to treat problems as they present: jaw pain managed with a night splint, crooked teeth corrected with braces, sleep apnoea managed with a CPAP machine. We ask what created those problems in the first place.

Often, the answer lies in the development of the jaws, the airway, and the soft tissues that govern how we breathe, swallow, and rest. TMJ pain, bruxism and teeth grinding, mouth breathing, tongue tie, and sleep-disordered breathing are frequently connected rather than separate, unrelated problems. They can share common structural and functional factors. When those factors are addressed, meaningful and lasting improvement is often possible.

We work across the full lifespan. For children, we aim to intervene early, guiding craniofacial growth while the face and jaws are still developing and helping prevent orthodontic and airway problems from becoming entrenched. For adults, we identify and address the structural and functional factors contributing to TMJ disorder, sleep apnoea, bruxism, and related conditions, rather than only managing symptoms over time.

Conditions we assess and treat at Growth and Airway

Eight connected concerns, one structural lens

Editorial line illustration of a child's nasal passage and airway

Paediatric Airway and Growth

Snoring, restless sleep, bed-wetting, behavioural and attention difficulties, and mouth breathing in children can all point to an underlying airway problem. Early assessment, while the face is still developing, can help guide these patterns and may reduce the likelihood or complexity of treatment later.

Editorial line illustration of a narrowed, obstructed airway

Sleep Apnoea and Sleep-Disordered Breathing

In some patients, obstructive sleep apnoea may be associated with craniofacial structure, narrow dental arches, nasal obstruction and oral breathing patterns. Working alongside the appropriate medical colleagues, we assess whether dental or structural treatment may form part of care, rather than relying on a device alone.

Editorial line illustration of nasal versus mouth breathing

Mouth Breathing, Tongue Tie and Lip Tie

Chronic mouth breathing and tethered oral tissues can interfere with normal jaw growth, facial development, posture and sleep quality. Early assessment in children can help address these patterns before they become established. In some adults, tongue restriction may also be one contributing factor in oral dysfunction, TMJ symptoms or sleep-related concerns.

Editorial line illustration of a narrow dental arch

Crooked Teeth and Narrow Dental Arches

Crowded or crooked teeth are most often a sign of insufficient arch space, which reflects jaws that have not developed to their full potential. Narrow jaws are closely associated with mouth breathing, tongue tie and a reduced airway. We address the developmental environment, not just the position of teeth.

Editorial line illustration of the temporomandibular jaw joint

TMJ Pain and Jaw Disorders

Temporomandibular joint pain, jaw clicking, facial tension and headaches are frequently associated with airway restriction, jaw development, or teeth clenching and grinding. We look for the structural and functional factors involved and aim to address them, rather than only managing discomfort over time.

Editorial line illustration of the jaw clenching muscle

Bruxism and Teeth Grinding

In some patients, teeth grinding and clenching at night can be associated with disturbed sleep and airway resistance. Where relevant, we assess airway and jaw function as part of a broader approach, rather than relying on a night guard alone.

Editorial line illustration of head and neck posture alignment

Poor Posture and Craniofacial Imbalance

Forward head posture and spinal alignment can be connected to jaw position and airway function. The relationship between the jaw, the airway and posture is increasingly recognised in the research literature. Our approach considers the whole body, not just the oral cavity.

Editorial line illustration of the tongue and facial muscles

Myofunctional Therapy

Retraining the muscles of the tongue, face and jaw corrects the functional habits that drive many structural problems, including mouth breathing, swallowing patterns and poor tongue posture. We use myofunctional therapy as an integral part of treatment for both children and adults.

Treatment pathways

Early Intervention and Children's Airway Health

Guiding healthy growth before problems take hold

We work with early-stage dentition onwards, guiding jaw development, expanding narrow dental arches, and treating tongue tie, lip tie and mouth breathing before they become lifelong patterns.

The earlier we act, the less intervention is needed. Children seen at Growth and Airway include those with mouth breathing, tongue tie, paediatric sleep disorders, crooked teeth and poor craniofacial development.

Tongue tieMouth breathingPaediatric sleep apnoeaCrooked teethJaw development

Children's care →

An adult, calm and at ease in soft natural light

Adult TMJ, Sleep Apnoea and Airway Treatment

A whole-picture approach to jaw pain, bruxism and disrupted sleep

TMJ pain, sleep apnoea, teeth grinding and clenching, and chronic headaches are not conditions you should simply have to adapt to. We look at the airway and structural factors involved and offer non-surgical treatment options.

Adult conditions treated at Growth and Airway include TMJ disorder, bruxism and teeth grinding, obstructive sleep apnoea, snoring, poor posture and airway-related headaches and facial pain.

TMJ painBruxismSleep apnoeaTeeth grindingSnoring

Adult treatment →

Your patient journey

From your first question to lasting change

Every patient at Growth and Airway follows a structured, unhurried pathway designed to understand the factors behind their symptoms before any treatment begins.

Comprehensive Airway Assessment

We begin with a thorough clinical evaluation of your airway, jaw function, facial structure and breathing patterns. For children, we assess craniofacial development and growth trajectory. Advanced diagnostics give us a complete picture before we draw any conclusions about what may be behind your symptoms.

Diagnosis and Assessment

We work to identify the structural and functional factors involved in your condition. Whether you are presenting with TMJ pain, bruxism, sleep apnoea, mouth breathing, or crooked teeth, we look at where the problem may have originated so that treatment is directed at those factors, not only the symptoms.

A Treatment Plan Built for You

Every plan is individual. We may use airway appliances, myofunctional therapy, airway-focused orthodontics, tongue tie assessment and release, or coordinated referrals to ENT surgeons and sleep specialists. Every recommendation comes with a clear rationale and a clearly stated goal.

Supported Progress and Review

We work alongside you throughout your care. Regular reviews and adjustments, combined with a collaborative relationship with specialist colleagues, mean that treatment evolves as you do. Results are built to last rather than to require indefinite management.

The founder

Dr Biju Krishnan

Founder · BDS FICD FCGDent FRSM · General Dentist with a Special Interest in Orthodontics

Growth and Airway was founded by Dr Biju Krishnan, a general dentist with more than thirty years in clinical practice and a special interest in airway-focused, developmental orthodontics. He qualified at the University of Dundee in 1993, founded and led CFast, co-founded the Society for Dentofacial Growth and Function, and as an FDI Speaker lectures nationally and internationally.

More about Dr Krishnan →

“The structure of the face is the story of how someone breathes.”

Growth and Airway Institute

Our philosophy

We treat the whole person, not the isolated complaint

Conventional dental care has traditionally focused on the teeth themselves. We also see the teeth as the most visible sign of a broader developmental picture, one that involves the jaws, the airway, the tongue, the posture, and the relationship between structure and function across the body.

Our practice brings together the disciplines needed to understand that picture accurately and act on it with care. We favour non-surgical, biologically respectful approaches that work with the body's own capacity for change. For patients with TMJ pain, sleep apnoea, bruxism, or chronic mouth breathing, the aim is meaningful, lasting improvement rather than indefinite symptom control.

Airway-first clinical thinking

Every decision we make considers how it serves breathing quality, sleep and long-term craniofacial function for both children and adults.

Interdisciplinary by design

We collaborate as a matter of course with ENT surgeons, myofunctional therapists, osteopaths, sleep physicians and paediatricians.

Grounded in current evidence

Our clinical protocols are drawn from peer-reviewed research in craniofacial development, sleep medicine, TMJ disorder and functional orthodontics.

Common questions

Understanding your condition is where good treatment begins

The questions below reflect what patients ask most often when they first come to us. If yours is not here, we will be glad to answer it at your consultation.

Why does my child breathe through their mouth and what should we do?

Mouth breathing in children is often a sign of nasal obstruction, tongue tie, a narrow palate, or enlarged tonsils and adenoids. Left unaddressed, it can affect facial development, disrupt sleep quality and contribute to behavioural and attention difficulties. Early assessment allows us to look for the cause and act while growth is still on our side.

How are crooked teeth connected to breathing and jaw development?

Crowded or crooked teeth are very often a sign of insufficient arch space, which can reflect jaws that have not developed to their full potential. Narrow jaws are commonly associated with mouth breathing, tongue tie and a reduced airway. Expanding the arch and guiding jaw development addresses the environment in which teeth sit, rather than simply repositioning teeth within a restricted and underdeveloped space.

What causes TMJ pain and jaw clicking?

TMJ pain, jaw clicking and facial tension are most commonly associated with a combination of jaw structure imbalance, airway restriction, and teeth clenching or grinding during sleep. The temporomandibular joint can work under significant strain when the airway is compromised or the jaw is poorly positioned at rest. We assess the contributing factors before recommending treatment rather than applying a generic approach to every patient.

Can sleep apnoea be treated without a CPAP machine?

For some patients, sleep apnoea has a structural component that can be addressed through airway orthodontics, oral appliance therapy, myofunctional therapy and in some cases tongue tie release. CPAP is effective but does not change the underlying structure. We work with sleep physicians to assess whether a structural approach is realistic and appropriate for each individual patient.

Is bruxism caused by stress or is there a structural reason?

Stress is often cited as the primary cause of teeth grinding, but research increasingly suggests a link between bruxism and disrupted breathing during sleep. When breathing is restricted, the jaw can move forward and the teeth clench, which may act as a reflex to help keep the airway open. Addressing the underlying airway and structural factors, rather than only fitting a night guard, can in some cases reduce grinding.

What is tongue tie and how does it affect adults as well as children?

Tongue tie is a restriction of the lingual frenulum that limits tongue movement and resting posture. In children, it affects feeding, speech, jaw growth and breathing. In some adults, tongue restriction may contribute to oral dysfunction, TMJ symptoms, posture-related strain or sleep-related concerns. Assessment of tongue tie is part of our comprehensive evaluation for patients of all ages, and the connection to adult symptoms is frequently overlooked in conventional dental and medical assessment.

In their words

“After years of jaw pain and disrupted sleep, we found a practice that asked why those problems existed rather than simply what to do about them. Within months, things had changed in ways I genuinely had not expected to be possible.”

Patient, adult TMJ pain and sleep apnoea treatment

30+Years in clinical practice

SDGFCo-founding member

Multidisciplinaryteam

Non-surgicalprotocols

Take the first step

Ready to understand what is really behind your symptoms?

Book a consultation and we will take the time to listen carefully, assess thoroughly, and explain your options clearly. There is no obligation and no rushed decision-making.

Book a Consultation Our Approach