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This post is presented by All Smiles Orthodontic Specialists
As discussed in previous posts, there are many important benefits to taking your child to an Orthodontist at an early age (ideally around the age of 7). One such benefit that many people are unaware of is that orthodontists are capable of providing an assessment of your child’s airway during the initial exam without the need for additional diagnostic records.
In our office, screening for airway issues, such as sleep-disordered breathing (SDB) and obstructive sleep apnea (OSA), occur seamlessly during the exam. Much like our screening for oral pathology, the parents of children who do not exhibit any relevant signs or symptoms may not even realize that we have performed our mental checklist during the exam. When we have found signs that are consistent with a breathing disorder, parents have been surprised yet thankful for the thorough examination.
What causes OSA/SDB?
The #1 cause of OSA in children is enlarged adenoids and tonsils which cause a physical obstruction or narrowing of the airway. Some studies have shown that removal of the adenoids and tonsils improve or eliminate OSA in 80% of the cases. However, obesity is also a significant risk factor, as children who are clinically obese are approximately 5 times more likely to suffer from OSA. More broadly, anything that restricts the upper airway can contribute to SDB / OSA, such as allergies, deviated nasal septum, small upper or lower jaw and large tongue to name a few.
Why do we screen for breathing disorders?
Because it’s important! SDB has been linked to bed wetting, behavioural problems, attention deficit disorders, poor academic performance and stunted growth. Studies have shown that these issues may improve when OSA/SDB is resolved.
Because it’s easy! As an orthodontist, I am in a perfect position to screen children for airway related issues. I am trained to recognize certain types of skeletal imbalances that are risk factors for breathing disorders. My exam involves looking in the mouth, which allows me to easily check for enlarged tonsils. An X-ray that I take for diagnosing orthodontic issues has been proven to be a valid screening tool for assessing the size of the adenoids. Also, a parent is usually at arm’s length to answer all of my sleep related questions. Does Johnny snore? How often does he snore? Does he ever stop breathing? Is he well rested in the morning?
What happens next?
If our screening suggests that your child is at sufficient risk for sleep-disordered breathing or obstructive sleep apnea, we will refer you to an Ear, Nose and Throat (ENT) specialist. It is the ENT who is capable of making the proper diagnosis and subsequent treatment recommendations. Treatment options could involve surgical removal of the tonsils and adenoids, diet, steroid inhalers, a CPAP machine or no treatment at all.
Orthodontically, for those patients who we have found to be at risk of airway disorders, we are more likely to recommend expanding the width of the upper jaw and advancing the lower jaw forward in hopes of enlarging the airway. We are also less likely to retract the teeth backwards for fear of impinging on the airway.
What can you do as a parent?
Watch and listen to your kids sleep. Snoring is not a harmless noise that should be dismissed. It is a sign that your child’s airway is obstructed, and this should not be taken lightly. Try to observe them during different periods of their sleep cycle as snoring and sleep-disturbed breathing tend to occur during deep sleep when the muscles surrounding the airway are relaxed. Also…take advantage of your orthodontists’ expertise in dental development and craniofacial growth as well as their willingness to offer free initial exams.
Dr. Joe Stanley
To schedule your child’s orthodontic evaluation, contact us today!
We serve Saint John, Rothesay, Fredericton and Oromocto.
Originally from Nova Scotia, Dr. Stanley first practiced Dentistry for 6 years in Yarmouth, Nova Scotia before making the move to New Brunswick. Dr.Stanley and his wife Jennifer, who is a West Saint John native, now reside in Quispamsis, NB. Dr. Stanley and Jennifer have four young children under the age of 7.
The Stanley’s enjoy being involved in many activities around the community. Aside from spending time with his family, Dr. Stanley can be found golfing, coaching minor hockey, playing hockey or cheering on his favorite hockey team. Go Bruins Go!
Most recently Dr. Stanley has expanded his services to the Fredericton/Oromocto area for 2 days per week. He is very excited for this new endeavor and looks forward to meeting you!
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