When it comes to identifying the causes of sleep apnea, medical professionals and scientists have pointed an accusatory finger at lots of things through the years.
Many of those risk factors – smoking, excessive weight, use of alcohol and sedatives – can be controlled. But what about improper jaw growth and facial development during childhood, which has been identified as the root cause of obstructive sleep apnea?
“That can be controlled, too,” says Buffalo Grove orthodontist Dr. Yan Razdolsky. “We’re using orthodontic treatment to guide dento-skeletal development in a way that allows for proper airway function.”
The treatment of dental problems may eventually cure a child of a sleep disorder, according to the Sleep & Behavior Medicine Institute in Chicago. Treating sleep disorders at an early age may also prevent the onset of some dental problems.
Symptoms of sleep disorders that frequently are associated with dental problems include:
- Mouth breathing while sleeping
- Episodes where breathing stops, or the person gasps for air
- Snoring
- Teeth grinding
- Multiple awakenings during the night
- Night terrors or bad dreams
- Sleep walking, talking or screaming
- Bed-wetting more than once a week
- Nocturnal asthma
- Difficulty waking up in the morning
- Headaches
- Excessive daytime weariness, fatigue, sleepiness or daydreaming
- Hyperactivity and learning problems
Children who exhibit these symptoms should be evaluated and treated before or after orthodontic treatment, according information provided by the Sleep & Behavior Medicine Institute. The institute routinely works with Dr. Razdolsky to treat sleep problems in children, adolescents and adults.
We have focused a great deal of attention 
this year on sleep apnea. In January, we wrote about how orthodontics can be used to treat sleep apnea. In April, Dr. Razdolsky spoke on this topic at his annual seminar for area dentists, dental hygienists and dental assistants.
“We need to keep educating dental professionals on our ability to diagnose and treat sleep apnea,” he says. “Patients tend to see their family dentist and orthodontist more frequently than their family doctor, so we are on the front line when it comes to being positioned to identify obstructive sleep apnea. This is important because OSA can cause many other health complications.”
Those complications include childhood obesity, juvenile diabetes, and behavior disorders such as attention deficit disorder and attention deficit/hyperactivity disorder.
An article published in Frontiers in Neurology in 2013 concluded that pediatric OSA in children who are not obese can becaused by an oral-facial growth disorder.
Improper dento-skeletal development can be a contributing factorto improper airway function and improper overall individual development, according to a March 2015 Dental Economics article. Having a deep overbite that forces the lower jaw into a retruded position also can affect a child’s airway. A narrow upper jaw can lead to less space for the tongue and less airway space. However, widening the upper palate with a palatal expander can reduce nasal obstruction, raise tongue posture and enlarge the pharyngeal airway.
A study found that this treatment could increase the nasal passage by more than 11 percent on average, which resulted in increased nasal permeability and helped establish a predominant nasal breathing pattern, as opposed to mouth breathing, according to an article published in the American Journal of Respiratory and Critical Care Medicine.
An improper airway affects the way a child grows because the muscles adapt to obstructions in an effort to clear the airway. Those muscle adaptations impact dento-skeletal development.
Identifying OSA and treating it through orthodontic methods in childhood has the potential to eliminate the problem. But it’s important to diagnose and treat the growing child. By age 9, the upper jaw width is practically complete, but jaws continue to grow in females until about age 15, and in males until about age 20. It’s also important to diagnose the airways using 3D imaging, and to have a sleep study performed at a qualified medical (not dental) sleep center. A multi-disciplinary approach to care leads to the best results.
We continue to educate the public on the importance of having children evaluated by an orthodontist by age 7 because research continues to identify conditions that, if they exist at this early age, are highly treatable.
