The temporomandibular joint (TMJ) and airway are two factors that should be addressed when diagnosing patents for orthodontic treatment. Temporal mandibular joint disorders (TMD) can be improved or corrected in conjunction with orthodontics. A narrow airway is an early sign to developing obstructive sleep apnea and can be remedied if diagnosed early prior to the start of treatment. These case reports describe patients with a history of upper bicuspid extractions that have TMD and a constricted airway. Treatment included functional appliances prior to traditional orthodontic treatment to improve patients' TMD symptoms and narrow airway.