Posts for: April, 2015
We all know how much better we feel after a good night’s sleep: refreshed, energized and ready to handle — even excel at — our day-to-day responsibilities. Yet millions of people, young and old, are robbed of a good night’s rest by sleep-related breathing disorders such as sleep apnea, in which the soft tissues in the back of the throat block the airway during sleep. This temporarily disrupts airflow, causing numerous “micro-arousals” (sleep interruptions) that we may not even be aware of. A lack of sleep can make us drowsy, irritable and unfocused. In children, these typical symptoms of sleep apnea can lead to mistaken diagnoses of Attention Deficit Hyperactivity Disorder (ADHD).
The relationship between sleep apnea and behavioral problems has been highlighted in several recent scientific journal articles, including a major study published several years ago in Pediatrics, the official journal of the American Academy of Pediatrics. The lead author, Dr. Karen Bonuck, said at the time: “We found that children with sleep-disordered breathing were from 40 to 100 percent more likely to develop neurobehavioral problems by age 7, compared with children without breathing problems. The biggest increase was in hyperactivity, but we saw significant increases across [other] behavioral measures.” Therefore, an accurate diagnosis of a child’s behavioral problems — leading to the right treatment — is crucial. While sleep apnea must be diagnosed by a physician, treatment for the condition is often provided by a dentist.
What can be done for children suffering from sleep apnea? The most common treatment is surgical removal of the tonsils or adenoids. This treatment can sometimes be performed by an oral and maxillofacial surgeon, a dentist who has received several years of post-graduate surgical training. There are several other procedures oral surgeons can perform to open the airway, depending on what anatomical structures are blocking it.
Sometimes a child with sleep apnea can benefit from a procedure to expand the palate (roof of the mouth) to enlarge the airway. This is not a surgical treatment but rather an orthodontic one. An orthodontist (a dentist who specializes in moving teeth) will fit the child with a palatal expander, a butterfly-shaped device that gradually separates the two bones that form the upper jaw and roof of the mouth. This is often done to prevent crowding of teeth and other bite problems, but has been shown in some cases to improve airflow.
There is another dental approach used to treat adults and older children, whose jaw growth is complete. It’s called oral appliance therapy, and it involves wearing a custom-made device during sleep that resembles a sports mouthguard or orthodontic retainer. An oral appliance can maintain an opened, unobstructed, upper airway during sleep in various ways, including: repositioning the lower jaw, tongue, soft palate and uvula; stabilizing the lower jaw and tongue; increasing the muscle tone of the tongue.
If your child has been diagnosed with sleep apnea, we can help you find the best treatment approach. For more information, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Sleep Disorders & Dentistry” and “Snoring & Sleep Apnea.”
When Cat Cora is not doing battle as the first female chef on the Food Network's hit series Iron Chef America, she is busy caring for the needs of her four active young sons. This includes monitoring the food they eat and their oral hygiene habits.
The busy chef, restaurateur, author, philanthropist and television personality recently revealed in an interview with Dear Doctor magazine that it all started when her four sons were little. She got rid of bottles and sippy cups as soon as possible to prevent tooth decay. She also started exposing her boys to a wide variety of spices and foods when they were infants — for example, by putting cinnamon in their baby cereal. Cat limits the amount of sugar in their diet by using fruit puree in baked goods and BBQ sauces, or the natural sugar substitute Stevia. Furthermore, Cat reports, “my kids have never had fast food.”
Cat is right on target with her approach to her children's oral health. In fact, we are often asked, when is the right time to schedule a child's first dental appointment? Our answer surprises some people — especially those expecting their first child.
The ideal time to take your child to the dentist is around age 1. Why so young? A baby's first visit to the dentist sets the stage for lifelong oral health. Besides, tooth decay can start very early. Baby Bottle Tooth Decay (BBTD), as the name suggests, impacts children who often go to sleep sipping a bottle filled with a liquid containing natural or added sugars, such as formula, fruit juice or a fruity drink mix. Another condition, Early Childhood Caries (ECC), is often found in children who continuously use sippy cups (again, filled with sugary liquids), children who breast feed at will throughout the night, children who use a sweetened pacifier, and children who regularly take sugar-based oral medicine to treat chronic illness.
To learn more about this topic, continue reading the Dear Doctor magazine article “Age One Dental Visit.” Or you can contact us today to schedule an appointment. And to read the entire interview with Cat Cora, please see the article “Cat Cora.”