Children are not adults - pediatric obstructive sleep apnea and dentistry

Lead Author Affiliation

International Dental Studies Program

Introduction/Context/Diagnosis

Obstructive Sleep Apnea (OSA) most commonly affects children between the ages of 2 to 7 years, an especially critical time for growth and development. Unlike in adults, OSA presents itself differently in children (ADHD) but can still have adverse health effects as in adults. Additionally, the alarming increase in childhood obesity over the past few decades has been associated with an increase in the prevalence of OSA from a stable 1% to 4% to as high as 19% to 61%, increasing the importance of OSA screening in children by health care providers. Dentists can and should be the front line screeners for patients with potential OSA. Thus, the objectives of this presentation are:

  1. To introduce pre-doctoral dental students to dental sleep medicine with emphasis on Pediatric Obstructive Sleep Apnea.
  2. To stress the importance of screening pediatric patient population for increased risk for OSA and facilitate medical referral when indicated.
  3. To stress the importance of integrating dental sleep medicine in dental curricula.

Methods/Treatment Plan

A selective review of medical and dental peer-reviewed, predominantly recent literature was performed using Pubmed and Google Scholars. Search terms included “Sleep apnea”, “Snoring”, “Pediatric OSA”, “ADHD”, and “Sleep bruxism”, and “Rapid Maxillary Expansion”

Results/Outcome

The primary cause of OSA in children is enlargement of adenotonsillar tissue, which is clearly visible during the head and neck examination by dentists. Intake questionnaires such as BEARS appears to be user-friendly pediatric sleep screening tool. Bruxism, GERD, jaw clenching, and rhythmic mandibular thrusting have been associated with OSA in children. Oral appliances are the leading alternative to surgery and CPAP machines. The average number of educational hours is 3.92 for the schools with curriculum time in dental sleep medicine.

Significance/Conclusions

The involvement of dentists in the screening process for OSA can contribute significantly to children's health through early detection and management. Ultimately, the sleep physician is in charge of the disposition of the patient, and as dentists, we become a very viable, needed, successful part of the medical team. The number of curriculum hours still appears insufficient in most US dental schools and require evolution to develop any competency in screening for sleep-disordered breathing.

Location

University of the Pacific, Dugoni Dental School, San Francisco, CA

Format

Poster

Poster Session

IDS Student Presentations

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May 31st, 10:00 AM May 31st, 3:00 PM

Children are not adults - pediatric obstructive sleep apnea and dentistry

University of the Pacific, Dugoni Dental School, San Francisco, CA

Obstructive Sleep Apnea (OSA) most commonly affects children between the ages of 2 to 7 years, an especially critical time for growth and development. Unlike in adults, OSA presents itself differently in children (ADHD) but can still have adverse health effects as in adults. Additionally, the alarming increase in childhood obesity over the past few decades has been associated with an increase in the prevalence of OSA from a stable 1% to 4% to as high as 19% to 61%, increasing the importance of OSA screening in children by health care providers. Dentists can and should be the front line screeners for patients with potential OSA. Thus, the objectives of this presentation are:

  1. To introduce pre-doctoral dental students to dental sleep medicine with emphasis on Pediatric Obstructive Sleep Apnea.
  2. To stress the importance of screening pediatric patient population for increased risk for OSA and facilitate medical referral when indicated.
  3. To stress the importance of integrating dental sleep medicine in dental curricula.