The American Journal of Orthodontics and Dentofacial Orthopedics recommends orthodontists make screening for sleep-disordered breathing (SDB) a routine part of their clinical practice.
What Is Sleep Disordered Breathing?
Sleep disordered breathing includes a variety of conditions from snoring to upper airway resistance syndrome and obstructive sleep apnea (OSA). OSA is a breathing disorder characterized by prolonged, partial upper airway obstruction and or complete obstruction that disrupts normal ventilation during sleep. We often associate SDB with adults, but children and teenagers can also suffer from SDB and it is most often due to anatomical features.
The American Academy of Pediatric Dentistry recognizes that OSA occurs in the pediatric population. OSA in the pediatric population is between about 2% and 11%. The actual percentage is hard to determine because so many children are not screened for OSA. Parent questionnaires report about 6% of children snore constantly, 4% have had apneic events, and 11% have symptoms of SDB.
What Are Symptoms of Sleep Disordered Breathing in Children?
Symptoms of SDB in Children Include:
- Snoring
- Bedwetting
- Poor school performance due to misdiagnosed ADHD
- Aggressive or disruptive behavior
- Development delay
- Waking during the night
- Grinding their teeth
- Difficult time paying attention
- Falling asleep during school
Why Should Pediatric Sleep Disordered Breathing Be Treated?
In children, SDB is a risk factor for the following:
- Bedwetting
- Attention deficit hyperactivity disorder (ADHD)
- Obesity
Why Should It Be Screened by Orthodontists?
It has become common for the medical profession to work closely with orthodontists in providing care for SDB patients. Modern imaging at orthodontic practices allows for evaluating the shape and size of your child’s airway. Orthodontists have expertise and knowledge of the growth and development of oro-facial and dentofacial structures. They also understand the orthopedic, orthodontic and surgical correction of the jaws and other supporting tissues.
Historically, most children are not screened for SDB because symptoms are often similar to other conditions. Since the American Association of Orthodontics recommends a child see an orthodontist around age seven, orthodontists are often the first to diagnose children with SDB. Pediatric SDB risk is higher in the orthodontic population, and a subtype of SDB patients may only be seen at orthodontic offices.
How Is Sleep Disordered Breathing Treated By An Orthodontist?
During an orthodontic evaluation, an orthodontist can determine if your child has oro-facial or dentofacial structures that may be causing SDB. If not, he may recommend you talk to your child’s doctor or see a pediatric sleep medicine doctor. However, if the orthodontist can see the deformities that are causing the SDB, he can treat your child with oral appliance therapy.
Orthodontic appliances can be custom-fabricated for the patient to be worn during sleep. They reposition the lower jaw, tongue, soft palate and maintain an open and unobstructed airway. By pushing the jaw and tongue forward, it prevents the upper airway from collapsing during sleep.
Patients who use orthodontic appliances for SDB see a significant reduction in breathing pauses during sleep, an improvement of airflow, reduction in snoring and much higher compliance compared to CPAP.
What Should I Do If I Suspect Sleep Disordered Breathing?
If you suspect your child suffers from SDB, contact Joosse Family Orthodontics. Dr. Joosse can screen for SDB and provide advice on treatment and next steps. Call us at 757-229-4181 or visit us online to request your complimentary consultation today.
