Establishment of nasal breathing should be the ultimate goal to secure adequate craniofacial and airway development in children.

As shown for many years and studied again by Chambi-Rocha et al. in this issue of the Journal, chronic mouth breathing during active craniofacial development of a child may result in anatomical changes that directly affect the airway. These changes may result in greater airway instability and collapsibility that potentially lead to other problems later in life, such as sleep-disordered breathing. Prior investigations of children with mouth breathing have shown a correlation with abnormal orofacial growth. There is also a continuous interaction between nasal breathing and appropriate sucking, swallowing, and mastication to optimize orofacial growth. This is especially important in children, in whom the naso-maxillary complex continuously grows from infancy, throughout the pre-pubertal period, and until the