Also quite frequently, little effort is made to integrate our great amount of knowledge on the impact of regular snoring, mouth breathing, and abnormal skeletal development4 with our knowledge of another health problem: snoring and SDB. The common view is that “crooked” teeth, malocclusion, cross-bite, tongue thrust, and overbite, for example, are in the domain of dentists, not pediatricians. But are they not also costly health problems? Orthodontic problems are present due to the abnormal skeletal development of the maxilla and mandible during these prepubertal years, and are most often seen in children who experience regular snoring and mouth breathing during sleep. A constricted maxilla will lead to nasal disuse and an elongated soft palate, a narrow mandible will lead to narrowing behind base of tongue, and both will further impact the skeletal growth and decrease the size of the upper airway (see bibliography in Gaultier and Guilleminault6–). The indication of the problem could be a clinical complaint, but it could also be the presence of a high and narrow hard palate, the development of enlarged tonsils related also to mouth breathing,7 overlapping teeth, a large overbite or overjet, the recommendation of braces and orthodontic treatment, with regular snoring. The evaluation of clinical symptoms of abnormal breathing in children must involve the evaluation of orthodontic problems. This health problem must be taken as seriously as school problems, chronic sleepwalking, or daytime tiredness, perhaps even more, as maxillary and mandibular growth problems signal abnormal development of the skeletal support of the upper airway. And this abnormal skeletal development happens before the enlargement of soft tissues that will further reduce the size of the airway, setting the field for the development of adult sleep apnea.