Abstract
OSA pediatric subjects suffer from episodes of upper airway obstruction that can be partial or complete, with atypical sleep patterns and blood-gas level alteration. If poor treated and/or diagnosed, it can cause cardiovascular disease, learning difficulties, behavioural issues, and retardation of growth. In the literature, there are conflicting evidence about OSA assessment and treatment in pediatric age, so the aim of this paper is to highlight the multidisciplinary approach in the management of sleep disorders, stressing the role of the pediatric dentist in both diagnosing and treating the OSAS in children, according to the current evidence of the treatment options effectiveness of the syndrome itself. Conclusions. Scientific evidence shows that OSAS management requires a multidisciplinary approach in order to make an early diagnosis and a correct treatment plan. The orthodontic treatment approach includes orthopedic maxillary expansion and mandibular advancement using intraoral appliances. Hence, the orthodontist and the pediatric dentist play an important role not only in early diagnosis but also in the treatment of pediatric OSAS.
Highlights
Sleep-disordered breathing (SDB) in children consists in a wide spectrum of respiratory disorders, which are commonly characterized by upper airway increased resistance, with pulmonary ventilation temporary interruption and sleep quality alteration [1]
Despite the previously described tools and flowcharts, sleep-disordered breathing assessment and management are often complex in children due to the variety and controversy in evidence about diagnosis and treatment choices effectiveness in growing patients. e aim of this paper is to provide an update in Obstructive Sleep Apnea Syndrome (OSAS) diagnosis and therapy state-of-the-art and to stress the key role of the pediatric dentist in the diagnosis and treatment of OSAS in children
All the already diagnosed OSAS children should be referred to the pediatric dentist too, in order to have an evaluation of the dental-related factors, that are connected with the presence of apneic episodes done and so establish a cause-guided treatment
Summary
Sleep-disordered breathing (SDB) in children consists in a wide spectrum of respiratory disorders, which are commonly characterized by upper airway increased resistance, with pulmonary ventilation temporary interruption and sleep quality alteration [1]. OSA pediatric subjects suffer from episodes of upper airway obstruction that can be partial or complete, with atypical sleep patterns and blood-gas level alteration. (a) Simple snoring: less severe and most common condition (occurs in 3–15% of the pediatric population, especially between 3 and 6 years (13–35%)), characterized by upper airway partial obstruction clinically manifested by soft palate vibratory noises; often associated with OSA and UARS. Despite the previously described tools and flowcharts, sleep-disordered breathing assessment and management are often complex in children due to the variety and controversy in evidence about diagnosis and treatment choices effectiveness in growing patients. All the already diagnosed OSAS children should be referred to the pediatric dentist too, in order to have an evaluation of the dental-related factors, that are connected with the presence of apneic episodes done and so establish a cause-guided treatment.
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