Dr. Niki Boloorchi on Pediatric Dental Anesthesia, Tongue-Tie Procedures, and Creating a Holistic Approach to Dentistry

Dr. Niki Boloorchi, DDS, of Tooth & Tongue Dental, is not your average pediatric dentist. As a specialist in pediatric dental anesthesia and tongue-tie procedures, she has built a practice that prioritizes patient safety, holistic care, and conservative treatment approaches. Her deep understanding of airway development, sleep-disordered breathing, and oral function sets her apart in the field. In this conversation, Dr. Boloorchi shares insights into her approach, dispels common myths about tongue-tie procedures, and discusses how she collaborates with specialists to create the best outcomes for her young patients.

What led you to focus on pediatric dental anesthesia and tongue-tie procedures?

I started out as a dental anesthesiologist and primarily worked with children. Over time, I noticed that many of my young patients had airway development issues—high vaulted palates, open bites, and a tendency to mouth breathe. That realization led me down a path of extensive study into pediatric airway health. I trained with The Breathe Institute in LA and Dr. Baxter in Alabama, learning about the connections between oral development, breathing, and overall health. That’s when I decided to integrate airway-focused dentistry into my practice, which naturally led to a focus on tongue-tie procedures as well.

How are tongue ties connected to airway development and sleep issues?

It’s all related. If a child’s tongue can’t rest properly on the palate due to a tongue-tie, their palate doesn’t form correctly. This creates narrow nasal cavities, making it harder to breathe through the nose. As a result, kids often become mouth breathers, which can lead to enlarged tonsils, poor oxygenation, sleep issues, and even behavioral symptoms that mimic ADHD. Many children with sleep-disordered breathing grind their teeth at night because their bodies are subconsciously trying to reposition the tongue to open their airway. Addressing tongue ties early can help prevent a domino effect of airway and sleep issues.

Many parents are understandably nervous about anesthesia for their child. How do you ensure the process is safe and comfortable?

Safety is my number one concern. First, we conduct a thorough physical exam and medical history review before every procedure. If a child has any risk factors that might require an overnight stay, we refer them to a hospital setting. In our office, we have strict safety protocols—there are always two anesthesia providers in the room, and we have a fully stocked crash cart with backup supplies. California has also tightened regulations in recent years to prevent the tragic cases people have heard about in the news. The reality is, those unfortunate incidents typically occurred due to inadequate training, lack of proper emergency equipment, or leaving a child unattended post-procedure. Our office is designed for sedation safety, and we never compromise on that.

Your approach is often described as holistic. What does that mean in the context of your dental practice?

For me, a holistic approach means looking at the whole picture—not just the teeth. When treating tongue-tie in infants, I don’t just check for tightness and cut. I evaluate their feeding, breathing, sleep, and even physical development milestones like crawling and walking. I often refer infants to chiropractors or craniosacral therapists before considering surgery. For older children and adults, I emphasize airway health, proper tongue posture, and myofunctional therapy. I also offer homeopathic wound healing kits with options like ozonated oil, Arnica, and proteolytic enzymes, but I respect parents’ choices if they prefer traditional pain management.

There’s been some debate about tongue-tie procedures being overprescribed. What’s your take?

I agree that tongue-tie releases have become trendy, and not everyone who gets diagnosed actually needs the procedure. That’s why I take a conservative, functional approach—I don’t base my decision solely on how the tongue looks, but on how it functions. Some cases resolve with therapy alone, while others genuinely require a release. It’s frustrating to see some practitioners doing releases just to make money, but I always tell parents: If I wouldn’t do it for my own child, I won’t do it for yours.

How do you collaborate with referring partners, like IBCLCs and other dentists?

For dentistry referrals, I communicate closely with referring dentists, take detailed imaging under anesthesia, and send a full report back after treatment. For tongue-tie referrals, I share before-and-after photographs along with my personalized report.  Follow up appointments with parents at the 10-day mark help us assess whether the procedure has made a significant difference in pre-operative symptoms.  It takes a village to care for our little mouths, so I work with a close network of speech therapists, lactation consultants, feeding specialists, chiropractors, and bodyworkers to ensure patients have the best possible support before and after their procedure.

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What advancements in pediatric dental care are you most excited about?

I’m thrilled about integrating our CBCT and Invisalign for palatal expansion in older kids. It’s a non-invasive way to improve airway health, create more space for proper tongue position, and support better oxygenation and jaw development. We also continue to refine our anesthesia protocols and train regularly to ensure the safest and most comfortable experience for our patients.

What’s next for Tooth & Tongue Dental?

I hope to expand the office in the near future. Many traditional dental offices aren’t set up to accommodate kids with sensory sensitivities, and I want to create a space with lower stimulation, weighted blankets, and longer appointment times. It’s a work in progress, but I’m hopeful!

How can parents take the next step if they think their child might need specialized dental care or a tongue-tie evaluation?

The best first step is scheduling a consultation. We offer in-person exams to thoroughly evaluate function and airway health. For families traveling from afar, we can start with a Zoom call, but in-person visits are always more effective. Consultations are usually $250 and may be covered by dental insurance depending on your plan.

Call us at 925-949-8427 to schedule an appointment or visit our website