Treat Airway Issues as Early As Possible

The American Dental Association advises parents that pediatric airway problems be identified and treated by age 6. Children who don’t breathe properly struggle to grow into their best selves. Pediatric airway issues can lead to obstructive sleep apnea, which impacts their ability to learn and grow.

Children with pediatric airway issues are sometimes misdiagnosed as having ADD or other learning issue, when really what they are suffering from is sleep deprivation. A study published in the journal Pediatrics (“Inattention, hyperactivity, and symptoms of sleep-disordered breathing,” 2002) found that a large percentage of children with hyperactivity or inattentive behaviors had underlying sleep disorders.

It would be far better for children in this situation to have treatment of the obstructive airway that causes sleep apnea than through the strong medications.

The American Sleep Apnea Association says that 4% of children suffer from sleep apnea, and evidence is growing that untreated pediatric airway disorders resulting in sleep apnea leads to learning difficulties and behavioral problems. Research has indicated that pediatric sleep issues have an impact on the brain’s executive functions, including cognitive skills and self-control. 

How do you know if your child has an airway problem?

Chronic mouth breathing is one indicator of obstructed airways. When the oral cavity and teeth are constantly exposed to air, the tissues, gums, and teeth can dry out and become vulnerable to tooth decay and gum disease. Mouth breathing because of an obstructed airway can cause crooked teeth, facial deformities, and gum disease. A healthy child breathes through their nose without effort.

Does your child snore? Snoring can indicate an obstructed airway. Even a gentle snore that sounds adorable could indicate that your child’s airways are being blocked.  

What are the risks of pediatric airway obstructions?

When airways are blocked, there are partial and complete pauses in breathing that can last for at least ten seconds. Blood oxygen saturation levels decrease during the pause, which causes the brain to awaken the body enough to restore a normal pattern of breathing. The pattern occurs many times during the course of a night’s sleep, leading to disrupted sleep and chronic fatigue.

Children who suffer from pediatric airway obstructions leading to sleep apnea find it difficult to concentrate on schoolwork, experience intense mood changes and sometimes, display aggression and hyperactivity.

How is pediatric sleep apnea diagnosed?

A pediatrician or an ENT (Ear, Nose and Throat) doctor will examine your child’s head, neck, mouth, tongue, and adenoids to evaluate each structure and how they work together. The doctor may suggested a sleep study, also called a polysomnogram. If the doctor suspects that your child has obstructive sleep apnea and thinks the child does not need a sleep study, they may suggest oximetry, an overnight recording of oxygen levels that can be done at home. Oximetry is not as definitive as a polysomnogram, but it may be the right course for your child.

How does an orthodontist treat pediatric sleep apnea?

After your child has had a conclusive sleep study, the orthodontist will examine your child’s oral structures and determine if they would benefit from an oral appliance to expand the palate and nasal passage. The hard (or upper) palate may be too narrow for the child’s mouth, or the bottom jaw and tongue may need to be repositioned to keep the upper airway open. The orthodontist will discuss your child’s situation with the pediatrician and/or the ENT after the examination to determine the best approach for your child.

Oral appliances are effective for children whose facial bone growth is not yet complete. A palate expander may be used to expand the transversal diameter of the hard palate over a six-month to a one-year period of time. Orthodontic treatment can provide a simple solution to obstructive airway problems if diagnosed and treated early.

The oral appliance is less invasive than undergoing an adenotonsillectomy, which used to be done as routine surgery on all children. Today we know the adenoids and tonsils are an important part of the lymphatic system that bacteria and viruses that enter the body through the nose and mouth. They are only removed today if there is a medical reason, like obstructive airway issues or chronic infections.

Orthodontists treat obstructive sleep apnea because of their expertise and knowledge of the growth and development of oral-facial and dental-facial structures, as well as the knowledge of how orthodontic treatment is used to correct the positions of the teeth and jaws.

Development of the facial structures and airway structures in children does not always occur on the same time-table. The orthodontist’s knowledge of pediatric development provides an excellent and trusted source for parents who are concerned about their child’s health and well-being. The orthodontist does far more than provide your child with a beautiful smile. They play an important role in maintaining your child’s overall health.

Starting treatment of pediatric airway issues at an early age is now universally recognized as an important part of your child’s healthcare. Delaying treatment of an airway obstruction and hoping your child “grows out of it” is now recognized as a flawed decision that can lead to future health problems with sleep, breathing, development and oral health.

If you have any questions, please call the office at 631-427-8444.