Role of Orthodontics in Sleep/Breathing Disorders

Q: I was recently in to see my pediatrician for my child’s attention deficit disorder. They indicated that the ADD may be related to a Sleep disorder and the way the jaws were growing and asked me to see an orthodontist. I’m curious why?

A: If five or more of the following questions are answered “yes”, your child may have a Sleep / Breathing disorder.

1) Does your child listen when spoken to directly?

2) Does he have difficulty organizing tasks or is easily distracted by extraneous stimuli?

3) Does she fidget with her hands or feet, squirms in her seat or is he “on the go” or often acts as if “driven by a motor”?

4) Or does your child often interrupt or intrude on others e.g. butts into conversations or games?

5) Does your child tend to breathe through the mouth during the day &/or night?

6) Does she have a dry mouth on waking up in the morning or occasionally wet the bed?

7) Does he wake up feeling un-refreshed or has a teacher or other supervisor commented that your child appears sleepy during the day?

8) Is it hard to wake your child up in the morning or when your child does wake up do they complain of a headache?

9) Does your child snore more than half the time, always snore, or snore loudly?

10) Does she have “heavy” or loud breathing, has trouble breathing or have you ever seen your child stop breathing during the night?

Sleep Disturbed Breathing (SDB) in children is a general term describing a wide range of disorders from Snoring to Daytime sleepiness to Obstructive Sleep Apnea Syndrome (OSAS).

The key factor in SDB is the obstruction of the upper airway.

The recommended initial treatment for pediatric OSAS may consist of surgical removal of adenoids and tonsils AND additionally, there is an association between the airway and the structure of the face and jaws. Therefore, an Orthodontist plays a substantial role in the diagnosis and treatment of these children.

Small jaws=Small airway. Orthopedic Orthodontic treatment can:

1) Advance and increase the size of the lower jaw. This brings about a change in the surrounding bone/ soft tissue structures, especially when the lower jaw is recessed in kids with large overbites.

2) Increase the lower face height by facilitating downward and forward growth of the lower jaw, especially in kids with deep bites

3) Increase the width of the upper jaw, thereby increasing the oral & nasal cavity size, especially in kids with narrow jaws and crowded teeth.

All of these orthodontic interceptive measures help to increase the volume of the upper airway, reduce airway resistance and correct SDB. In our practice we subscribe to the idea that an ENT clears the contents and the Orthodontist enlarges the container. Both are important for a comprehensive solution of SDB. If you have any questions or concerns about your child please don’t hesitate to call/text us at Bhatia Orthodontics at 808-638-3078.

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