Best Airway Orthodontist in Richmond, VA
Richmond Pediatric Dentistry and Orthodontics (RPDO) is the practice we recommend for families around Richmond who want an orthodontist to look at the jaw and palate side of breathing. Dr. Kevin Bibona and Dr. Payton Cook see orthodontic patients at offices in Henrico, Hanover and Chesterfield counties.
The practice offers palatal expanders for growing kids and MARPE-type expansion for teens and adults, and says an airway evaluation is part of its free first visit. Not sure yet? Take the 1-minute airway quiz.
Why RPDO is our pick in Richmond
Every practice in this guide passes three checks. Here is how RPDO did on each.
Families praise the care
The practice lists a 4.8 rating, and its review profile shows more than 1,500 Google reviews. The praise is about the team and how kids are treated. One parent wrote about the staff helping when “we had trouble turning” an expander. None of the reviews we found describe airway results, so we do not claim any. A few are further down this page.
What we checked
- 4.8 rating listed by the practice
- 1,500+ Google reviews in its profile
- Airway pages published on its own site
- Two orthodontists on the team: Dr. Bibona and Dr. Cook
The practice has real airway pages on its own site
RPDO publishes pages on airway orthodontics in Richmond, airway orthodontics in Midlothian and palatal expanders. You can read them before you ever pick up the phone.
Two specialty-trained orthodontists
Both orthodontists completed a university orthodontic program and are listed on the practice's site. We could not confirm board certification for either one, so we do not claim it. You can ask at your first visit.
Ready to see if your child is a fit? The first visit is free.
The orthodontists at RPDO
Dr. Kevin Bibona, DDS
Earned his Doctor of Dental Surgery and his certificate in orthodontics at VCU School of Dentistry, after Washington and Lee University. Past President of the Richmond Dental Society and a member of the American Association of Orthodontists. Sees patients at the Patterson Avenue, Short Pump and Midlothian offices. Read his full background.
Dr. Payton Cook, DDS
Earned her Doctor of Dental Surgery at VCU School of Dentistry and her certificate in orthodontics at the University of Texas Health Science Center at Houston, where she also completed her orthodontic residency. A Short Pump native and a member of the American Association of Orthodontists. Sees patients at the Short Pump, Mechanicsville and Midlothian offices. Read her full background.
Neither bio mentions airway-specific training, so ask each doctor how they approach it.
Meet the doctors. The first visit is free.
What an airway orthodontist does
An airway orthodontist looks at how the jaws and palate develop with breathing in mind.
For a child, that often means widening a narrow upper jaw with a palatal expander while the bones are still growing. For an older teen or adult, it can mean MARPE-type expansion. Sometimes the right answer is a referral to another doctor.
An orthodontist does not diagnose sleep apnea. That takes a sleep study ordered by a physician. RPDO says the same: its airway page states that airway orthodontics is not a diagnosis for sleep apnea and that an expander is not a treatment for it.
Why jaw and palate shape matter for breathing
A few things can narrow the airway or change how the face grows:
- A narrow upper jaw or a high palate
- An underdeveloped lower jaw, which can leave less room for the tongue
- Long-term mouth breathing in a growing child
- Poor tongue posture
- Enlarged tonsils or adenoids, which are a medical issue and need an ENT
The first two are where an orthodontist can help. The last one is why the orthodontist and your other doctors need to talk to each other.
Who else may be involved
Depending on your child, the team can include:
- Your pediatrician or family doctor
- An ENT, for tonsils, adenoids and allergies
- An allergist
- A sleep physician, if sleep apnea is suspected
- A myofunctional therapist, who RPDO refers out to
Signs you or your child may need an airway evaluation
Signs in children
Sleep and breathing
- Mouth breathing during sleep
- Loud snoring, or gasping
- Restless sleep, or sleeping in unusual positions
- Bedwetting past the usual age
- Morning headaches or a dry mouth
Behavior and school
- Trouble concentrating, or ADHD-like hyperactivity
- Tiredness even after enough sleep
- Irritability or mood swings
Teeth and face
- Crowded teeth
- A narrow upper jaw or high palate
- A recessed chin, or a long, narrow face
- Dark circles under the eyes
Signs in adults
Adults often notice loud snoring, morning headaches, daytime tiredness, jaw pain, and trouble concentrating at work. A partner may notice pauses in breathing.
Any one of these can have other causes. A pattern is what is worth bringing up with your child's orthodontist and pediatrician.
If you see pauses in breathing, gasping or choking at night, or anyone has trouble breathing, call your doctor first. Severe swelling, fever with swelling, or trouble swallowing or breathing means urgent medical care.
Quick check: is it worth asking about airway?
Answer yes or no for your child, or for yourself. This quiz cannot diagnose anything. An exam can.
Palatal expanders for kids, expansion for older teens and adults
Palatal expanders for children
A palatal expander gradually widens the upper jaw. A wider palate adds room for permanent teeth and can increase the space in the nasal airway. RPDO says the expander is usually active for a few weeks, then stays in place for 3 to 6 months. Its expander page calls ages around 7 through the early teens the most predictable window.
RPDO lists several types, including rapid palatal expanders, Haas expanders, quad helix and removable designs. Read how the practice explains it on its palatal expander page.
Expansion for older teens and adults
RPDO lists MARPE, which uses about four mini-screws, and MASPE, which it describes as its usual adult approach. These are meant for patients whose jaw has stopped growing the way a child's does. An exam and imaging decide whether it fits.
The practice does not publish a price for expanders. It says the cost is reviewed at the consultation.
How the practice decides what a patient needs
Here is how age and anatomy usually point the choice:
- A growing child with a narrow upper jaw is a candidate for a palatal expander.
- A teen or adult whose jaw has stopped growing may be a candidate for MARPE or MASPE, if the exam supports it.
- Braces or clear aligners come after expansion, to finish the bite.
The deciding step is the exam, not the symptom list. That is why a consultation comes before any plan.
When airway orthodontics is not the answer
Airway treatment does not fit everyone. Suspected sleep apnea needs a physician first, and RPDO says it has no on-site sleep testing. Enlarged tonsils or adenoids and allergies belong with an ENT or allergist.
The practice says it coordinates with those doctors when they should be involved. Ask who else should look at your child before treatment starts.
What happens at your first visit
RPDO says your first consultation is free and you do not need a referral. Here is how the practice describes the visit:
A welcome and tour, then a review of your health history and any past X-rays.
An exam with Dr. Bibona or Dr. Cook, with a bite and airway check and digital imaging when needed. The airway visit includes a talk about sleep and breathing history.
A treatment plan with a timeline and a written cost estimate. The practice says there is no pressure to decide that day.
Bring a short list of what you have noticed, and anything your dentist or pediatrician has said. More is on the practice's consultation page.
What patients say about RPDO
RPDO lists a 4.8 rating. Here are three comments from the practice's own site. You can read more on its testimonials page.
Dr. Bibona and staff have been AMAZING!
Dr. Cook was amazing! Everything was thoroughly explained with rationale for decisions.
We will be bringing the rest of the family here.
Join the families who already made the call.
Where to find RPDO around Richmond
RPDO has five offices across Richmond, Henrico, Hanover and Chesterfield. Four offer orthodontics. The hours below are what the practice lists for orthodontics.
Patterson Avenue (orthodontics only)
8503 Patterson Avenue, Richmond, VA 23229
Monday to Friday, 7:30 a.m. to 4:30 p.m.
Dr. Bibona
Serves Tuckahoe, Westhampton, Regency and the Near West End. Directions
Short Pump
12270 West Broad Street, Richmond, VA 23233
Monday to Thursday, 8:00 a.m. to 5:00 p.m., Friday until 1:00 p.m. (office hours)
Dr. Bibona and Dr. Cook
Serves Short Pump, Wyndham, Innsbrook, Glen Allen and Goochland. Directions
Mechanicsville
7521 Right Flank Road, Suite 110, Mechanicsville, VA 23116
Orthodontics Tuesdays, 7:30 a.m. to 4:30 p.m.
Dr. Cook
Serves Mechanicsville, Atlee, Studley and Hanover County. Directions
Midlothian
13901 Coalfield Commons Place, Suite 101, Midlothian, VA 23114
Orthodontics Tuesdays and Thursdays, 7:30 a.m. to 4:30 p.m.
Dr. Bibona and Dr. Cook
Serves Midlothian, Bon Air, Brandermill, Woodlake and Chesterfield County. Directions
Phone: (804) 740-7281. Call to confirm which office and which day fits the doctor you want to see.
Airway orthodontist questions in Richmond, VA
Does an airway orthodontist treat sleep apnea?
An orthodontist does not diagnose sleep apnea. That takes a sleep study ordered by a physician. RPDO says airway orthodontics is not a diagnosis for sleep apnea and an expander is not a treatment for it, and it has no on-site sleep testing. It works with your pediatrician, ENT, allergist or sleep physician when that makes sense.
Can a palatal expander help my child breathe through their nose?
Widening a narrow upper jaw also widens the floor of the nose, which can make nasal breathing easier for some children. It is not a cure for snoring and it does not fit every child. An exam decides.
At what age should my child see an orthodontist?
The American Association of Orthodontists recommends a first check around age 7. RPDO says expanders are most predictable from about age 7 through the early teens.
Am I too old for airway orthodontics?
There is no age limit on getting an evaluation. Adult jaws have finished growing, so treatment looks different. RPDO lists MARPE and MASPE for older patients, and an exam sorts out which one fits.
How long does a palatal expander stay in?
RPDO says the expander is usually active for a few weeks, then stays in for 3 to 6 months while the bone settles. Its airway page gives a shorter range, so ask your doctor for the plan that fits your child.
What does airway orthodontic treatment cost?
RPDO does not publish a price for expanders and says the cost is reviewed at the consultation. The practice lists braces at about $3,000 to $7,000 and says the fee quoted at your consultation is the full fee. Medical insurance may contribute when breathing or sleep problems are documented, so ask the office.
Will my insurance work?
RPDO says it accepts most dental insurance plans and checks your benefits. It does not accept DMO or DHMO plans. It also participates in Virginia Medicaid, and orthodontic coverage for patients under 21 is decided case by case. See its insurance page and financing page.
Do I need a referral to see an airway orthodontist?
RPDO says you do not need a referral and the first visit is free. If your child's dentist or pediatrician has raised a concern, bring their notes.
Which RPDO office should I go to?
Patterson Avenue is orthodontics only and open on weekdays. Short Pump, Mechanicsville and Midlothian have both pediatric dentistry and orthodontics, but orthodontics runs on set days at Mechanicsville (Tuesdays) and Midlothian (Tuesdays and Thursdays). Call (804) 740-7281 to book the right doctor and day.
Is this the same as the airway page on the RPDO site?
No. This page is a guide from Best Airway Orthodontists that explains what airway orthodontics is and what to ask. For the practice's own description, read its airway orthodontics page.
How is an airway orthodontist different from a regular orthodontist?
Every orthodontist straightens teeth. An airway-focused orthodontist also asks how the width of the palate and the position of the jaws affect breathing and sleep, and works with your other doctors when the answer is outside the mouth.
Still have a question? Ask it at your free first visit.
Start with a free consultation
If you have been wondering about snoring, mouth breathing or tired mornings, the first step is a conversation with someone who looks at the jaw and airway side of it.
Not in Richmond? You can find an airway orthodontist near you on the home page, or see all Virginia practices.
Meet the RPDO team
The RPDO team shares braces tips, office life and a lot of laughing on Facebook. These are some of their most-watched reels, so you know who you will meet.