Sleep disorders breathing and role of a dentist in Children

 

I am at TUFTS, Doing Pediatric dental sleep medicine. Isn’t a dentist’s job to drill and fill teeth? So What lead me here helping children sleep better?

In the last decade, I chose the path of prevention. My journey began with search to prevent crooked teeth and need for teeth removal and braces (clip). Through the process I learned crooked teeth which appeared to be a esthetic concern had deeper health effects.

Children with narrow upper jaw ( high arched palate) have predisposed risk to develop SDB ( sleep disordered breathing) . SDB has the following symptoms

Day Time symptoms

1.Increased day time sleepiness

  • Morning headaches
  • Lack of concentration
  • Fatigue
  • Waking up tired
  • Attention deficits
  • Irritability
  • Poor performance in school
  • Increase in blood pressure

Night time symptoms

  • Age inappropriate bedwetting
  • Frequent awakening (to empty bladder too)
  • Snoring
  • Mouth breathing
  • Bruxism ( nighttime teeth grinding)
  • Restless sleep
  • Abnormal position while sleeping
  • Frequent change in position
  • Recent onset parasomnia ( sleep tremors, nightmares, confusing arousals, sleepwalking)

The above increases the risk to develop obstructive sleep apnea in children. The condition in which the breathing stops during sleep. Having a wider forward growing face helps in the prevention risk of SDB and OSA.

How to identify and prevent early? 
It can be identified and prevented as soon as the child is born.
1. Ensuring the child is exclusively and extended breastfed at least till 2 years of age
2. The upper and lower jaws should be aligned straight. Lower jaws receding behind than upper isn’t healthy.
3. Gaps or spacing in milk teeth ( physiological space) is a good indicator that the jaws are growing wider and forward. Though it’s very rare to find its ideal. ( pic attached) Milk teeth that look well-aligned without gaps are a warning sign of improper jaw growth.
4. Nonrestricted mouth. Restrictions like tongue ties have a huge influence on narrow jaws. The tongue needs to be in its resting position on the palate this helps the jaw grow wider ( restrictions however prevent the entire tongue go up ). Restrictions also create soft tissue dysfunctions leading to downward and backward growth of jaws (chin retrusion)
5. Mouth is to eat nose is to breathe. Open mouth posture is a big alarm.
6. Night grinding isn’t normal. Many of my patients with severe sleep apnea diagnosed, walked in with bruxism as a symptom.

When risk identified early the disease can be prevented with simple lifestyle changes.

Speak to your airway focused preventive Pediatric dentist today to ensure a healthy future for your child

 

-Dr.SHIFA ARSHAD

Preventive Pediatric Dentist

Founder of WE LITTLE

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